Psychopathology: The Costs and Benefits of Labeling

The Costs and Benefits of Labeling

Before turning to specific mental disorders, we need to comment briefly on one important aspect of diagnoses, namely, the costs and benefits of labeling of mental disorders.

The diagnostic labels provided by the DSM have unquestionably been enor-mously useful. As one great benefit, the labels have improved the treatment of mental illness—by making sure that patients get the treatment (the therapy or medication) that is appropriate to their condition. A second benefit is providing a uniform framework for describing the difficulties a patient is having , so that different health-care providers, all working with the same patient, can coordinate their treatment efforts.

Diagnostic labels are also crucial in the search for the causes of mental disorders. Without accurate diagnoses, we’d have no way to know whether, for example, the patients with schizophrenia studied in one hospital actually had the same illness as the patients who received the same diagnosis in another hospital. With uncertainty on this fundamental point, we wouldn’t know whether we could legitimately compare the results of different studies, whether we could pool results across studies, and so on. The development of an increasingly reliable and valid set of diagnostic categories has increased the possibility of integrating very different approaches to psychopathology— including bringing together neuroscientific findings with clinical and first-person accounts of mental disorders (Hyman, 2007).

At the same time, diagnostic labels can be problematic. It is easy to fall into the trap of thinking that once we have labeled a disorder, we have explained a person’s prob-lems. But diagnostic labels are just a first step on the path toward explanation and treatment.

In addition, mental disorders are, sadly, marked with considerable stigma, and both people with mental disorders and their family members are often viewed negatively (Hinshaw, 2007). Labels can therefore have an unfortunate effect on how we perceive someone and, indeed, on how people perceive themselves: “I’m depressed, and so there is no point in seeking treatment” or “. . . and so nothing else in my life matters” (Corrigan, 2005). Unfortunately, these self-defeating attitudes are in many cases reinforced by media portrayals of the mentally ill as losers, or hopeless, or violent criminals (Diefenbach, 1997).

It is important to combat these destructive and ill-conceived stereotypes—and to humanize the face of mental illness. Specifically, psychologists prefer not to speak of someone as “a depressive” or “a schizophrenic,” as though the person had no iden-tity beyond the disease. Instead, we speak of a patient as “someone suffering from depression” or “a person with schizophrenia,” never losing track of the fact that people—no matter what their diagnosis—have an identity, value, and dignity.