49-1 How should we draw the line between normality and disorder?

A psychological disorder is a syndrome (collection of symptoms) marked by a “clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior” (American Psychiatric Association, 2013). Disturbed, or dysfunctional thoughts, emotions, or behaviors are maladaptive—they interfere with normal day-to-day life. Believing your home must be thoroughly cleaned every weekend is not a disorder. But if cleaning rituals interfere with work and leisure, as Marc’s did in this module’s opening, they may be signs of a disorder. And occasional sad moods that persist and become disabling may likewise signal a psychological disorder.

Distress often accompanies dysfunctional behaviors. Marc, Greta, and Stuart were all distressed by their behaviors or emotions.

Over time, definitions of what makes for a “significant disturbance” have varied. From 1952 through December 9, 1973, homosexuality was classified as a psychological disorder. By day’s end on December 10, it was not. The American Psychiatric Association made this change because more and more of its members no longer viewed same-sex attraction as a psychological problem. Such is the power of shifting societal beliefs. (Later research revealed, however, that the stigma and stresses that gay, lesbian, and transsexual people often experience can increase the risk of mental health problems [Hatzenbuehler et al., 2009; Meyer, 2003].) In the twenty-first century, other controversies swirl over new or altered diagnoses (such as attention-deficit/hyperactivity disorder) in the most recent classification tool for describing disorders. (You’ll hear more about this later.)

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