What is a disorder and how does a diagnosis work?

In clinical psychology there is a manual called the DSM-IV. This manual provides psychologists with information related to every recognized and agreed upon disorder. This manual has gone through five revisions in its history, and revisions have expanded, collapsed, or abandoned disorders for many reasons. Because disorders are culturally bound (what constitutes a disorder in one place may not be abnormal or problematic in another), the DSM-IV discusses disorders generally recognized in Western countries.

If a person goes to see a psychologist, they are communicating that the symptoms they are experiencing are maladaptive and distressing and that they need help correcting it. If a person does not believe anything is wrong, they are unlikely to seek behavioral health help. Therefore, only people who go to see a psychologist can be officially diagnosed with a disorder. This is not to say that only people who go to see a psychologist can receive help. In fact, there are many alternatives to visiting a psychologist depending on the presence and severity of symptoms. Options range from self-help books, to changes in diet and exercise, yoga and meditation, substance abuse treatment, and many other things. For some people, a psychologist can be their most beneficial option.

Though, if a person sees a psychologist and an assessment is conducted, they can leave with a formal diagnosis if they meet the requirements. For the most part, a diagnosis is helpful for insurance purposes. Some insurance companies will not cover specific treatment options if a person does not have a diagnosis that shows that the treatment is required. For others, a diagnosis is helpful for disability reasons. Some organizations, such as educational systems, allow students to use disability resource centers if they can prove that they have a condition that warrants the resources.

All in all, a diagnosis is a series of symptoms that have been said to be occurring over a certain amount of time. For many diagnoses, the symptoms and therefore the disorder can be reduced and eliminated. For some diagnoses, the symptoms can only be minimized. Regardless, disorders are just a method of categorization for symptoms and symptoms are just your bodies way of telling you that something isn’t right.

Similar to health, mental health is susceptible to “sickness”. Every person, place, and thing we encounter has the potential to impact our mental health. If we watch our diet, exercise, sleep, and interpersonal relationships, and we reduce stress, we are likely to minimize the impact of trauma on our well-being. If we find that we are struggling to cope and we realize that we need help, this is okay. It is important to recognize that just like physical health, mental health can recover.

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What is Psychology?

What is psychology?

Most generally, psychology is the study of emotions, cognitions, and behaviors. This means that any questions related to emotions, cognitions, or behavior are fair game for researching. Have you ever wondered “Why is gambling addictive?”, or “Why do some people develop PTSD after experiencing a traumatic event while others do not?” These are examples of questions in psychological research!

Because most of psychology is rooted in research, psychology is a science. Researchers study topics by applying the scientific method to their hypotheses to investigate the causes of behavior. They also use theory to make generalizations and predictions in light of their results.

Although often referred to as “psychology”, the field of psychology is actually quite broad and encompasses many different sub-disciplines. You are probably aware of the most popular discipline, clinical psychology, but are you aware that there are well over 100 other sub-disciplines? Each of these sub-disciplines has their own respective professions, academic journals, experts, preferred research methodologies, phenomena, and outstanding questions that still require research. Here are just a few examples of other sub-disciplines: Abnormal psychology, Behavioral Analysis, Neuropsychology, Cross-cultural psychology, Industrial and organizational psychology, and Social psychology.

Because psychology is closely related to other social sciences, its research is informative and influential for sociology, anthropology, criminal justice, and social work among many other disciplines. This relationship is symbiotic, in that research from psychology informs and influences these other disciplines, but research from these other disciplines also informs and influences psychology. For instance, in the 2016 election, there was discussion about criminal justice reform. In particular, there was talk of abandoning the tough on crime approach and enacting a more rehabilitative approach. Many components of rehabilitation are a mix of psychology and criminal justice. This approach discards deterministic beliefs of human behavior, meaning that long, indeterminate prison sentences and the death penalty are questioned, and instead believes that human beings can change, meaning that treatment and community supervision become viable options. This mix of psychology and criminal justice is often coined “forensic psychology”, though “criminology” or “psychology and law” are also closely related.

In fact, many of the sub-disciples of psychology are a blend of psychology and some other disciple. This is what makes psychology such a widely popular and versatile disciple. Think of any interest that you have. I bet you there is a blend of that interest and psychology. For instance, if you like biology there is biopsychology; if you like thinking about how humans interact with their surroundings, there is environmental psychology; if you like examining drug interactions, there is psychopharmacology. The list goes on and on.

Overall, because psychology is the study of emotions, cognitions, and behaviors, psychology is really the study of being. If you find your interest piqued by psychology, it should be! Psychology is really the study of you and everyone around you.

 

 

 

What is conditioning? What is reinforcement?

I’m sure you have heard of the concepts “conditioning” and “reinforcement”. Does the story of Pavlov and his dogs ring a bell?

But did you know that Pavlov’s experiment can explain how behaviors are created and maintained in a variety of contexts?

Think about drug or alcohol addiction.

Classical conditioning describes how an addiction is formed. In classical conditioning, one single event can lead to a person associating a certain action with a positive outcome. In addiction, think about a person taking an opioid and then experiencing pain relief.

Then these behaviors are maintained by operant conditioning.

Positive reinforcement is any action that makes the behavior occur more often. In addiction, when the person takes the opioid and experiences euphoria, they are more likely to continue taking opioids than if they took the opioid and experienced no effects.

Negative reinforcement is any action that makes the behavior occur more often, but that also relieves something negative. In addiction, this describes why some people self-medicate, as it removes stress, anxiety, or otherwise unpleasant feelings.

The combination of the experience of reward and the removal of negative feelings maintain the likelihood that a person will continue the behavior.

These concepts can explain the formation and maintenance of all addictions: gambling, sex, food, and so forth.

 

If you are interested in this subject, please read:

Gormezano, I., & Moore, J. W. (1966). Classical conditioning. Experimental methods and instrumentation in psychology1, 385-420.

O’BRIEN, C. P., Childress, A. R., McLELLAN, A. T., & Ehrman, R. (1992). Classical Conditioning in Drug‐Dependent Humans. Annals of the New York Academy of Sciences, 654(1), 400-415.

 

Pharmacology 101

There are many disciplines that study chemical reagents (drugs) and influence pharmaceutical drug consumption in the U.S.

Pharmacology, the study of the interaction between chemical reagents (drugs) and living organisms; Toxicology, the study of harmful effects of drugs; Pharmacotherapeutics, the study of the therapeutic effects of drugs, and Pharmacodynamics the study of how a drug produces its biological effect, are only a few disciplines that are relevant to the conversation.

In pharmacology, drug classification is conducted by 1) behavioral classification, 2) pharmacodynamic classification, and 3) legal classification.

Drugs that are classified using behavioral classification generally are grouped by their behavioral characteristics:

  • Stimulants: drugs that produce arousal (i.e. cocaine, nicotine)
  • Opioids: drugs that produce analgesia (pain reduction) (i.e. morphine, heroin)
  • Sedative hypnotics: drugs that decrease arousal (i.e. benzodiazepines)
  • Antipsychotics: drugs that treat psychosis (i.e. zyprexa)
  • Antidepressants: drugs that treat depressive symptoms (i.e. Prozac)
  • Psychedelics: drugs that produce psychedelic experiences or hallucinations (i.e. LSD)

Drugs that are classified using pharmacodynamic classification describe the effects of the drug on the brains neurotransmission:

  • Stimulants: acts as indirect dopamine agonists.
  • Opioids: acts as direct opioid receptor agonists

…and so forth. (for more in depth information please read Drugs, Addiction, and the Brain by Koob et al., 2013).

Drugs that are classified using legal classification are classified based on their abuse potential.

  • Prescription
  • Non-prescription and drug abuse

For the purposes of this article, each of the above behavioral classification categories is responsible for altering the brains chemical structure and effecting cognitions, emotions, and/or behavior.

Take for instance morphine or oxycontin. These drugs are opioids. Opioids are typically prescribed for pain patients because of their analgesic properties. Opioids drugs work by mimicking the brains natural opioid peptides (b-endorphin, enkephalin, and dynorphin) and binding to opioid receptors (mu, Delta, and/or Kappa). Depending on the receptor that the drug binds to, there can be different effects. For instance, an opioid drug that binds to a mu receptor will cause euphoria, while a drug that binds to the Kappa receptor will cause dysphoria. Also depending on dose, frequency, and length of time taking the medication, decreased rewarding effects, dependence, and addiction are all possible liabilities.

 

If you  would like to read more please check out the following resources:

Koob, G. F., Arends, M. A., & Le Moal, M. (2014). Drugs, addiction, and the brain. Academic Press.

Volkow, N. D., & Morales, M. (2015). The brain on drugs: from reward to addiction. Cell, 162(4), 712-725.