74 CHAPTER 3
Unusual beliefs may not have been the only factor that motivated Rose Mary
and Rex’s behavior; they also seemed to have a kind of tunnel vision that led them
to see their own needs and desires while being indifferent to those of their children.
When Jeanette was 5 and the family was again moving, her parents rented a U–Haul
truck and placed all four children (including the youngest, Maureen, who was then
an infant) and some of the family’s furniture in the dark, airless, windowless back of
the truck for the 14 hours it would take to get to their next “home.” Rex and Rose
Mary instructed the children to remain quiet in this crypt—which was also without
food, water, or toilet facilities—for the entire journey. The parents also expected the
children to keep baby Maureen silent so that police wouldn’t discover the children
in the back: It was illegal to transport people in the trailer. What explanation did
the parents give their children for locking them up this way? They said that only
two people could fi t in the front of the truck.
In order to determine whether Rex and Rose Mary Walls had psychological dis-
orders, we would have to compare their behavior and psychological functioning to
some standard of normalcy. A diagnostic classifi cation system provides a means of
making such comparisons. We saw in Chapter 1 that various classifi cation systems
were used over the centuries; these systems categorized different types of disorders
according to different principles. The ancient Greeks, for instance, classifi ed mental
disorders based on behavior that was attributed to either too much or too little of
bodily humors.
The fi rst modern classifi cation system for characterizing mental disorders
was developed by Emil Kraepelin (1856–1926), a distinguished German psychi-
atrist (Boyle, 2000). Kraepelin focused on both the symptoms themselves and
theircourse—how they progressed over time. Through systematic and lengthy
observations of patients, he outlined some of the hallmarks of what would later
be called schizophrenia. Today’s modern diagnostic system is based, in part, on
Kraepelin’s system.
Let’s first examine general issues about classification systems and diagnosis
and then consider the system that is now most commonly used—the system
described in the most recent edition of the Diagnostic and Statistical Manual of
Mental Disorders.Why Diagnose?
You’ve probably heard that categorizing people is bad: It pigeonholes them and
strips them of their individuality—right? Not necessarily. Imagine that classifi cation
systems for psychological disorders did not exist—that different sorts of unusual
behavior could be described, but there were no labels for them. For instance, sup-
pose that the diagnosis “depression” didn’t exist. How, then, could clinicians and
patients distinguish between a common response to a negative event (such as having
a relationship break up)—feeling sad, rejected, and unlovable—and an episode of
depressed mood that might lead to a suicide attempt or to chronic alcohol abuse?
Moreover, without a classifi cation system and the consequent ability to label disor-
ders, such as depression, there would not be a word or a phrase to describe people’s
experiences. Said another way, there would be no yardstick of normality against
which to measure people’s experiences—their thoughts, feelings, and behaviors. It
would therefore be diffi cult for clinicians and researchers to learn from one case to
the next or to decide how best to help each person with unusual symptoms or com-
binations of symptoms.
By categorizing psychological disorders, clinicians and researchers can know
more about a patient’s symptoms and about how to treat the patient. To be specifi c,
classifi cation systems of mental disorders provide the following benefi ts:- They provide a type of shorthand, which enables clinicians and researchers to
use a small number of words instead of lengthy descriptions. For instance, Kitty
Dukakis, wife of 1988 Democratic presidential candidate Michael Dukakis, suf-
fered from depression (Dukakis & Scovell, 1991). By using the term depression,