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information:
DIAGNOSES*
conveniently describe clusters of symptoms. Insurance
companies and medical research require them. Diagnoses are helpful in
guiding treatment.
But,
there are problems. How high a blood pressure is
"hypertension?" Is memory loss part of "natural
aging" or a disease? How much anxiety is "generalized
anxiety disorder." These guidelines constantly change. Furthermore,
common
problems, such as chronic "stress," do not correspond to any
particular psychiatric diagnosis.**
Apart
from "labels" a better approach would look at:
1 - Presenting
problems (self-observed and observed by others)
2 -
Degree of discomfort - variation over time and circumstances
3 - Social dynamics - how others affect you and you affect them
3 -
Strengths and "weaknesses"
including
strategies that have worked in the past
4 - Identified areas for change
*Note:
Dr. Kottler participated in the field trials which were used to troubleshoot the
DSM IV (Diagnostic and Statistical Manual of Mental Disorders 4th Ed-Revised)
regarding measures of validity and reliability. A DSM V is in the works
but not yet published. It will emphasize that people fall within a
spectrum for various diagnoses. Of course, this still begs the question
at what point does a problem require treatment, and at what point is
psychopharmacology indicated.
**Note:
The DSM IV diagnosis of "acute stress disorder" pertains to a
reaction to a particular, stressful event, not generalized stress.
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