3.1 Diagnostic criteria for emotional disorders
Formal diagnostic criteria exist to identify emotional disorders. Two international examples are the DSM-IV-TR (APA, 2000) or ICD-10 criteria (WHO, 2007)). Such systems are based on signs and symptoms, which psychologists sometimes group into four categories:
- mood or emotional symptoms, for instance feeling sad
- motivational symptoms, such as difficulty making decisions
- cognitive symptoms, involving thought, such as worry or pessimism, and
- physical symptoms, such as bodily aches or pains.
Diagnostic systems such as DSM-IV-TR have been criticised for a number of reasons, some of which will be considered in Section 4. However, they have been very influential, so it is important to consider them. They not only determine what diagnosis a patient seeking help receives, they underpin a great deal of research work into the causes and correlates of mental disorders.
How do diagnostic criteria underpin research work?
Researchers who are interested in (for instance) whether depression is linked to changes in the brain need to compare the brains of people who are and are not depressed. They often use DSM criteria to decide who is or is not depressed – so these criteria will determine who falls into each of the groups being compared.
Thus the process of diagnosis is clearly critical, as our understanding of emotional disorders is fundamentally underpinned by how we decide who suffers from them.
DSM-IV-TR, which we will focus on here, splits emotional disorders into two clusters, affective disorders and anxiety disorders.