PSY 275 Week 1 Defining Abnormality and the DSM Example

When Does Worry Become a Disorder? Defining Abnormality and Using the DSM With One Case

[Student Name]

University of Phoenix

PSY/275: Introduction to Abnormal Psychology

Week 1 Assignment

[Instructor Name]

[Date]

The person described is a composite written for a model paper; research findings come from the sources listed.

Almost everyone worries. At what point does worry become a mental disorder? Abnormal psychology studies patterns of thought, emotion and behavior that cause significant distress or impairment, and it begins by asking how such patterns are defined and recognized. This paper applies common definitions and the DSM to a composite case.

The Case

Dana is thirty-four and works as a teller at a bank in Mesa, Arizona. Over the past year, her worry has steadily grown. She worries for most of each day about making mistakes at work, about money and about her two children's safety, even when nothing specific is wrong. She feels tense, tires easily and lies awake going over the day. Twice this month she called in sick to avoid customers. Her partner says she seems on edge all the time, even on weekends. Dana knows her worry is excessive but cannot stop it, however hard she tries.

The Four Ds

Psychologists often use several criteria together rather than any one alone.

Deviance means behavior that departs from what is typical in a culture. Dana's level of worry is greater than most people experience, but deviance alone does not make behavior abnormal; unusual talent is also deviant.

Distress means personal suffering. Dana is clearly distressed: she describes constant tension and dread.

Dysfunction means interference with daily life. Her worry disrupts sleep and has caused missed work, a sign of dysfunction.

Danger refers to risk to oneself or others. Dana shows no sign of danger, and most people with mental disorders are not dangerous.

Taken together, distress and dysfunction suggest that Dana's worry has moved beyond ordinary concern.

What Makes Something a Disorder?

Wakefield (1992) proposed the harmful dysfunction analysis of mental disorder: a condition in which a mental mechanism no longer does the job it evolved to do, and in which that failure causes harm as judged by social values. The idea combines a factual part, a failed mechanism, with a value part, harm. Ordinary worry is a working alarm system that helps people prepare for real problems. Dana's worry seems to have lost its connection to real threats and continues regardless, while causing harm to her work and sleep. By this analysis, her pattern may qualify as a disorder in a way that normal worry does not.

Culture and Judgment

What counts as abnormal depends partly on culture. Hearing a deceased relative's voice may be considered normal in grieving within some cultures and a symptom elsewhere. Clinicians must ask whether behavior fits the person's cultural context. Dana's worry would be considered excessive across most cultural standards, but a clinician would still ask how she and her family understand it.

The DSM

The DSM, which the American Psychiatric Association issues and revises, lists criteria for mental disorders used by clinicians in the United States. Its current editions describe each disorder with symptoms, duration requirements and exclusions. A diagnosis allows clinicians to communicate, plan treatment, conduct research and bill insurance.

For persistent, excessive worry across many areas that is hard to control and accompanied by symptoms such as restlessness, fatigue and sleep problems, lasting at least six months, the DSM describes generalized anxiety disorder. Dana's history appears consistent with this, though only a full assessment could confirm it and rule out other causes, such as thyroid problems or substance use.

Benefits and Criticisms of Diagnosis

Diagnosis has clear benefits: it can validate a person's experience, guide treatment and connect people to services. It also has risks. Labels can lead to stigma, both from others and from people's views of themselves. Categories may not fit people whose symptoms fall between disorders, and critics argue that some diagnoses reflect cultural judgments as much as science. The DSM has been revised many times, which shows that classification changes as knowledge and values change.

Stigma and Help Seeking

Dana has not told her manager or her family doctor about her worry because she fears being seen as weak or unstable. Stigma, negative beliefs about people with mental disorders, is one of the main reasons people delay treatment. Accurate information, such as how common and treatable anxiety disorders are, can reduce stigma.

How Common Are Mental Disorders?

Kessler et al. (2005) interviewed more than nine thousand adults chosen to represent the national population for the National Comorbidity Survey Replication and estimated that roughly one in two people in the United States will develop a diagnosable condition during their lives, with anxiety disorders the most common class, and that most disorders begin in childhood, adolescence or early adulthood. Dana's experience is therefore far from rare.

Half of adults will meet criteria for a disorder at some point; Dana's struggle is common, not a sign that something is uniquely wrong with her.

Thinking About Causes

Engel (1977) argued that medicine's purely biological model could not account for illness and proposed a biopsychosocial model that considers biological, psychological and social factors together. For Dana, biological factors might include a family history of anxiety; psychological factors, a habit of interpreting uncertainty as danger; and social factors, financial strain and long shifts. The model guides assessment and treatment toward all three areas rather than one.

How a Clinician Would Assess Dana

A clinician would conduct a clinical interview covering her symptoms, their duration and their effects, her history and her cultural background. A standardized anxiety questionnaire would measure severity. A medical check would rule out physical causes. The clinician would also screen for depression, which often occurs with anxiety. Assessment results would then guide treatment, such as cognitive behavioral therapy.

Conclusion

Deciding when behavior is abnormal requires several criteria, attention to culture and careful assessment. Dana's worry meets the criteria of distress and dysfunction, fits the idea of a harmful dysfunction and appears consistent with a DSM anxiety disorder, though a full assessment is needed. Seeing her experience through the biopsychosocial model, and recognizing how common such struggles are, supports understanding rather than stigma.

References

Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196(4286), 129-136. https://doi.org/10.1126/science.847460

Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593-602. https://doi.org/10.1001/archpsyc.62.6.593

Wakefield, J. C. (1992). The concept of mental disorder: On the boundary between biological facts and social values. American Psychologist, 47(3), 373-388. https://doi.org/10.1037/0003-066X.47.3.373