Clinical Diagnosis and Assessment 75
Without a classifi cation system for psychological
disorders, the problems that Pete Wentz, Carolina
Reston, and Keith Urban appear to have suffered
from—bipolar disorder, anorexia nervosa, and
substance abuse, respectively—would be nameless.
Among other purposes, a classifi cation system
allows clinicians to diagnose and treat symptoms
more effectively, allows patients to know that
they are not alone in their experiences, and helps
researchers to investigate the factors that contribute
to psychological disorders and to evaluate
treatments.
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clinicians don’t need to spell out the various elements that constitute her disorder:
for example, that she had depressed mood and a signifi cant lack of energy and
enthusiasm (Dukakis & Tye, 2006).
- They allow clinicians and researchers to group certain abnormal thoughts, feel-
ings, and behaviors into unique constellations. To say that someone has a di-
agnosis of depression effectively communicates to a mental health professional
that the patient has a particular constellation of symptoms. When a clinician
hears that Kitty Dukakis suffered from depression, for instance, the clinician can
infer that she has some or all of the following symptoms: depressed mood,
reduced pleasure in activities, fatigue or tiredness, a sense of worthlessness, dif-
fi culty concentrating, recurrent thoughts about death, and signifi cant changes
in appetite, sleep, and energy level (American Psychiatric Association, 2000).
Notice how long this list of symptoms is—the term depression conveys much of
the needed information more succinctly.
- A particular diagnosis may also convey information about the etiology (causes)
of the disorder, its course, and indications for its treatment. Depression, for
instance, can further be specifi ed as either a single—that is, fi rst—episode or
as a recurrence. A diagnosis of recurrent depression implies a heightened neu-
rological and/or cognitive vulnerability to depression and a longer and more
variable course, and it indicates that the disorder may require multiple types
of treatments in order to reduce symptoms (Peterson et al., 2007). Despite
treatment, Kitty Dukakis suffered numerous bouts of depression, which sug-
gests that many types of factors contributed to her disorder and that she was
at signifi cant risk for additional episodes.
- Classification systems also enable researchers to study the causes, the
course, and the effects of treatments for various disorders. If there were no
diagnoses, then how would researchers be able to study mental illness and
its treatment? They wouldn’t be able to group together individuals with similar
problems systematically and reliably. Not only did Kitty Dukakis suffer from
depression, but she was also dependent on amphetamine pills—“uppers”—and
alcohol (Dukakis & Tye, 2006). Some researchers investigate differences be-
tween people who suffer from both depression and substance abuse (as Dukakis
did) and those who suffer only depression. Researchers have also examined the
effect of substance abuse on the course of depression (Agosti & Levin, 2006).
Kitty Dukakis became intimately familiar with
her symptoms of depression: “It is June 20, 2001,
Michael’s and my 38th wedding anniversary. It also
is the end of my fourth month of depression, my
crisis period. I’m normally a person with enormous
enthusiasm for and interest in the world. All that
is just missing now. Fun or enjoyment are things I
cannot even imagine. I don’t speak to my kids on
the phone, or to my sister” (Dukakis & Tye, 2006).
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