Normal Negative Emotions and Mental Disorders
Title
Normal Negative Emotions and Mental Disorders
Author
Horwitz, Allan V.
Research Area
Psychopathology
Topic
Mental Illness Diagnosis and Treatment
Abstract
The basic goal of psychiatric diagnosis is to distinguish genuine mental dysfunctions from normal, albeit distressing, emotions. This task is especially difficult because, unlike other medical specialties, psychiatry does not have biological markers that can validate diagnoses of mental disorders. Therefore, diagnostic criteria have an outsized role in psychiatry compared to other medical fields. Until the development of the DSM‐III in 1980, psychiatric diagnoses were general, continuous, and causal. In contrast, the diagnostic system that emerged in the DSM‐III and that has remained basically intact until the present has been specific, categorical, and a causal. This type of classification, however, is prone to mistake contextually appropriate symptoms as indicators of mental disorders. Cutting‐edge research incorporates the context in which symptoms emerge and persist to separate normal, distressing emotions from mental illnesses. It also develops alternatives to the DSM's categorical diagnoses. Other valuable studies try to differentiate conditions that stem from evolutionarily normal genes that no longer fit modern environments rather than from genetic or psychological dysfunctions within individuals. Going forward, research must attempt to use biological, psychological, and social factors to develop definitions that adequately distinguish normal responses to stressful environments, evolutionary mismatches, and mental disorders. It will also try to find biomarkers that can set appropriate boundaries between natural and pathological conditions. Finally, it will consider the best ways to optimize the balance between under‐ and over‐diagnosing mental illnesses.