A new article in Psychological Review by researchers Yulia E. Chentsova-Dutton and Andrew G. Ryder argues that internalizing disorders, such as depression, anxiety, and trauma-related conditions, are not stable or discrete entities, but rather “shapeshifters” that defy the categorical logic of modern psychiatric diagnosis.
This finding challenges the foundational assumption behind many dominant classification systems: that mental disorders can be neatly separated, named, and universally applied.
“This heterogeneity is observed over time within individual sufferers, across different sufferers, and across groups of sufferers in different sociocultural contexts,” the authors write. “Rather than understanding these types of heterogeneity as a problem in need of a solution, we argue that variability in symptom presentation is a core feature of internalizing distress: These disorders are, in their essence, shape-shifters.”
The authors focus on internalizing disorders, referring to conditions that affect mood, emotion, and perception. They highlight how these diagnoses often appear highly comorbid and inconsistently expressed. For example, depression in one person may be marked by fatigue and self-blame, and in another, by agitation and existential despair. Across cultures, too, these disorders do not take a singular form. Despite this, mainstream diagnostic systems such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) rely on what’s known as a polythetic approach. Sometimes likened to a “Chinese menu,” this method allows clinicians to diagnose a disorder if an individual meets a sufficient number of listed symptoms, although not necessarily all of them. While this provides some flexibility, the authors argue that it also reinforces an illusion of diagnostic stability that obscures more than it reveals.
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Liam:
If the dis-order is transitory, moving across the spectrum of the whole mind, then whose benefit does a label justify? And if the prevailing social psychology shapeing the community in which one lives is experiencing serious abuse in social existence due to polluted or corrupted business practices, then who or which communities have the knowledge to shape an economy affirming “To LIFE”? Would the scientist/artist be reading accurately if the context is one of belief of a heterogenity or homogentity across “the mind”? Fuller Torey and the NIMH were trying to analyze brains through theft, when the courtesy of decision making was not understood in a working brain with a soul. Hence, how do the parts contribute to convey the “whole” with heart and emotion?
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