ABSTRACT
Prior to the Second World War, psychology was primarily an academic discipline with a small number of practitioners. In 1947, the scientist-practitioner model was adopted by the American Psychological Association for accreditation in professional psychology. Grounding psychology and other helping professions in the scientific method enabled transition to evidence-based practices. This resulted in increased clarity concerning the complimentary roles played by psychiatry and clinical psychology in treating maladaptive behavior: biology informs psychiatric (medical) explanations and interventions; psychology informs experiential explanations and interventions. Behavior modification is a generic term for psychology-based, empirically validated interventions. This chapter reviews the psychiatric medical model. Behavior modification will be described in Chapter 13.
258A medical model treats behavioral disorders as though they are diseases. The American Psychiatric Association compiles a comprehensive listing of mental illness disease labels and definitions (i.e., criteria) in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Unlike diseases that are defined by the relationship between a specific pathogen (e.g., bacteria or virus) and a syndrome of symptoms, DSM disorders are defined exclusively by behavioral “symptoms.” This readily leads to DSM disorder labels being used in a circular fashion to “explain” the behaviors by which they are defined. Summaries of diagnostic criteria, suspected cause and current treatment approaches were described for: neurodevelopmental disorders (e.g., Down’s syndrome, autism spectrum disorders); psychotic disorders (e.g., schizophrenic spectrum disorders); bipolar, depressive, anxiety, and post-traumatic stress disorders; disruptive, impulse-control, and conduct disorders; substance-related and addictive disorders; and, personality disorders. Advances in the neurosciences are enabling transition from DSM, symptom-based diagnosis, to classifying disorders based on findings in neuroscience and genetics. Psychiatry would then resemble other medical subfields which define most pathological conditions based on their etiology (i.e., maintaining conditions) in addition to symptomology.
