- Describe how psychological disorders are defined, and the challenges in defining them
- Describe the basic features of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5-TR) and how it is used to classify disorders
- Discuss perspectives on the origin of psychological disorders
Distinguishing Between a Psychological Abnormality and Eccentricity: The 4 Ds
It can be difficult, even for trained experts to distinguish between a psychological abnormality (psychological disorder) and eccentricity. Psychologist, professor, and licensed clinical social worker (LSCSW) Tim Davis developed a helpful mnemonic to remember the criteria for diagnosing psychological disorders. He identified four main D’s to help make distinctions between behavior that is merely eccentric or odd and behavior that may be indicitive of a psychological disorder:
- Deviance: the behaviors, thoughts, or emotions experienced by the individual deviate from societal norms or expectations.
- Dangerous: This aspect considers whether the individual’s behavior or symptoms pose a danger to themselves or others. This could include self-harm, suicidal ideation, or aggressive behavior towards others. Note that this needs to be considered during diagnosis, but people with mental disorders are not generally dangerous.
- Distress: this considers whether the individual is experiencing significant personal distress as a result of their symptoms. This could include emotional pain, anxiety, or other forms of suffering that negatively impact their well-being.
- Dysfunction: this looks at whether the individual’s symptoms are interfering with their daily life and functioning. This could include impacts on work, relationships, or basic self-care.
Some models also include additional considerations such as duration (how long symptoms last) and disturbance (disruptions in thinking, emotion, or behavior).
Consider a simple example. Imagine someone who prefers wearing mismatched socks. This behavior may be considered deviant because it differs from what most people typically do, but it is harmless. Deviance alone does not indicate a disorder. However, if the person becomes extremely upset about sock choices and cries for hours, this suggests significant distress. If they refuse to go to work or school because they cannot find mismatched socks, their behavior now reflects dysfunction, as it interferes with daily responsibilities. If they threaten to harm themselves or someone else over the situation, concerns about danger arise.
The key idea is that psychological disorders are not defined simply by eccentricity or difference. Instead, clinicians look for patterns in which thoughts, emotions, or behaviors cause meaningful suffering, interfere with daily life, or create risk of harm. In other words, diagnosis is based on impact and impairment—not quirks or individuality.
Be Stigma Free
Hopefully, your reading from this module will also help you to better understand mental illness and be less inclined to judge or stigmatize those who are managing an illness. While we often refer to people experiencing a mental disorder in general terms and say “They may experience this or that…” you should be careful not to make blanket statements or false assumptions about those with mental disorders as every person has a unique experience. You, or classmates, friends, or family members close to you, are likely dealing with one or more of the mental disorders discussed in this module. Try to be understanding, kind, and open-minded as you learn about and talk about mental illness.
Also note that there is often a tendency while reading through this material for students to self-diagnose, as it is easy to identify with various descriptions of mental disorders. Be wary of self-diagnosis; if you do think you may be suffering from a mental illness (defined as significant disturbances in thoughts, feelings, and behaviors causing impairment in one’s life), then please seek help from a counselor, doctor, or other trained professional. If you or someone you know is dealing with suicidal thoughts, please seek help or call the national suicide and crisis lifeline using the number 988.
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