Psychological diagnosis? Yes or no?

Since the beginnings of psychology as the science responsible for the study of human mind and behavior, much research has been carried out to determine the origins, consequences and perpetuators of the vast majority of psychological disorders.

But … Does this initiative to name psychological phenomena present any drawbacks?

    Research on mental disorders

    The American Psychiatric Association (APA) and the World Health Organization (WHO) are two of the organizations that have invested the most time and effort in trying to understand more in depth and provide insight into how mental disorders work, What are the symptoms associated with each of them, how to detect them – (how many symptoms must be present in order to be able to make an accurate diagnosis and for how long), etc. This information is reflected in its corresponding diagnostic manuals: the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and the International Classification of Diseases (ICD-10).

    Also the APA and other institutions such as the National Institute for Excellence in Health and Care (NICE) have been tasked since the 90s to verify which treatments are most effective for each type of disorder, by trying to establish empirical validations of the different ways of carrying out a therapeutic process.

    Concretely, the 12th division of the APA, created in 1993 a working group on the promotion and the diffusion of psychological treatments on the basis of the conclusions of its research, leading to the development of treatment guidelines with a theoretical and practical basis adapted to the characteristics of each disorder.

    On the other hand, the action of NICE includes information, education and guidance, the promotion of prevention and the proposal of ways of proceeding in primary care and specialized services.

      Different perspectives from which to investigate

      The main difference that one can find between one organism and another is the way APA focuses on finding “classic” or “pure” disorders, while NICE addresses questions that do not necessarily answer the question. a clinical diagnosis, but which implements strategies to improve overall mental health (Pregnancy, adherence to treatment, suspicion of child abuse, well-being of old age, etc.).

      In the case of APA, “Purism” is a factor that generally limits clinical performance Because it is rare for a disorder to appear in its purest and most easily recognizable form, they usually meet criteria for other disorders (comorbidity) or have more complex variations.

      Therefore, in psychology today we have a wide range of research not only on the different types of disorders that we can find, but on the most appropriate ways to approach them (to date).

      Is psychological diagnosis useful?

      Usually the procedure for performing some kind of psychological treatment is start with an evaluation phase. At this stage, the so-called clinical interview provides us with a wealth of information on the situation of the patient in question.

      Depending on the therapy stream from which each psychologist works, interviews may have a more open or more structured format, but they will always aim to learn more in depth. the functioning and environment of the person in front of you.

      The evaluation phase can allow us to establish a diagnosis in the event of a disorder, because some of the difficulties presented in consultation (called Z codes) are not included in the diagnostic manuals because the situations are taken into account. as mental disorders (cases of separation, marital dissatisfaction, difficulties in managing children’s behavior, duels, etc.).

      In the event of a disorder, in the assessment phase (in which, in addition to interviews, standardized questionnaires can be used) we could have clarified the symptomatology, the course and the evolution of the patient’s condition, In addition to giving a name to the experience you are having.

      This diagnosis, based on what has already been mentioned, allows us to know in a very useful way what difficulty we are related to and to establish the most suitable mode of treatment for each person, so that we approach the problem in the same way. as efficient and effective as possible. efficient way possible.

      Should we always offer a diagnosis?

      As healthcare professionals, we must keep in mind that every person is completely different from every other, And that what we pass on to one patient may be harmful to another.

      Diagnosis helps professionals understand and clarify the situation in front of us, as well as model and plan how we act to resolve it. However, one must be very careful during the diagnosis, because there are several dangers:

      The label can indirectly become a definition of the person

      In other words, we no longer speak of “X has schizophrenia”, but we can incur “X is schizophrenic”.

      The diagnosis can lead to victimization of the patient

      Whether cautiously or not, make a diagnosis this can lead the person to get engrossed in their label: “I cannot do X because I am agoraphobic”.

      An inaccurate diagnosis can lead to a state of confusion in the patient

      If the information provided is not sufficient and the patient does not understand what is really happening to him, it is very likely that he will “fill” the information gaps with data that he can extract from sources less reliable than a health professional, generating negative and unrealistic expectations about their mental state.

      The diagnostic label can generate feelings of guilt

      “Something I did to deserve this.”

      conclusion

      With this in mind, it goes without saying that it is extremely complicated for psychologists not to make a mental diagnosis of the situation presented to us, such as diagnostic labels. they make it easier for us to understand the information contained in our mental diagrams.

      But even so, if the patient does not directly ask for a diagnosis for some reason, he probably does not need to know what the name of the experience he is going through, and is simply looking to resolve it.

      On the other hand, if we see a strong emphasis on “labeling” what is going on, it is important to first clarify whether the application has a solid basis in the person or it can be influenced and pushed by other means with which it relates (Social links, data on the Internet, etc.).

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