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      Brain Disease or Emotional Distress? Modern Psychology, Ancient Asceticism, and the Hermenutics of DSM-5

      1 , 2
      Open Library of Humanities
      Open Library of the Humanities

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          Abstract

          This article examines descriptions of emotional distress and social alienation from two interdisciplinary perspectives: modern clinical psychology and late antique hagiography. The first case study examines the current method of classification in psychiatry: the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Offering a broad perspective on how the DSM-5 came to be, we look at the strengths but also the pitfalls of this classification system. We argue that societal context is important when identifying a disorder, but it, ironically, only plays a small part when applying the DSM-5 in everyday psychiatric practice. Furthermore, it will be argued that historical contexts may usefully inform modern clinical practice (for instance, because they show how the interpretation of ‘abnormal’ behaviour is in flux). The second section will examine descriptions of emotions and distress in hagiographic sources from Late Antiquity. It analyses a hagiographic collection, the Historia Lausiaca as a taxonomy that both describes and regulates Christian pious life. In Late Antiquity, social developments, such as the growth of and enthusiasm for the ascetic movement, led to the introduction of new concepts for how to deal with and integrate expressions of emotional distress. Ultimately, by occupying the intersection of religion and medicine, this article aims to further psychologists’ understanding of how past societies used religious ideas to shape individual behaviour and its interpretation. Additionally, it will inform historians about modern classification methods in psychiatry and how these have influenced the interpretation of behavioural traits.Banner image: Mondino Dei Luzzi, Section of Brain in Dissected Skull, Anatomia Mundini, Ad Vetustis, 1541. Public domain via Wikimedia Commons {{PD–US}}.

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          Most cited references100

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          The need for a new medical model: a challenge for biomedicine

          G. Engel (1977)
          The dominant model of disease today is biomedical, and it leaves no room within tis framework for the social, psychological, and behavioral dimensions of illness. A biopsychosocial model is proposed that provides a blueprint for research, a framework for teaching, and a design for action in the real world of health care.
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            The clinical application of the biopsychosocial model.

            G L Engel (1980)
            How physicians approach patients and the problems they present is much influenced by the conceptual models around which their knowledge is organized. In this paper the implications of the biopsychosocial model for the study and care of a patient with an acute myocardial infarction are presented and contrasted with approaches used by adherents of the more traditional biomedical model. A medical rather than psychiatric patient was selected to emphasize the unity of medicine and to help define the place of psychiatrists in the education of physicians of the future.
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              The DSM-5: Classification and criteria changes.

              The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) marks the first significant revision of the publication since the DSM-IV in 1994. Changes to the DSM were largely informed by advancements in neuroscience, clinical and public health need, and identified problems with the classification system and criteria put forth in the DSM-IV. Much of the decision-making was also driven by a desire to ensure better alignment with the International Classification of Diseases and its upcoming 11th edition (ICD-11). In this paper, we describe select revisions in the DSM-5, with an emphasis on changes projected to have the greatest clinical impact and those that demonstrate efforts to enhance international compatibility, including integration of cultural context with diagnostic criteria and changes that facilitate DSM-ICD harmonization. It is anticipated that this collaborative spirit between the American Psychiatric Association (APA) and the World Health Organization (WHO) will continue as the DSM-5 is updated further, bringing the field of psychiatry even closer to a singular, cohesive nosology. Copyright © 2013 World Psychiatric Association.

                Author and article information

                Journal
                Open Library of Humanities
                Open Library of the Humanities
                2056-6700
                June 30 2022
                July 18 2022
                : 8
                : 2
                Affiliations
                [1 ]GGNet - Geestelijke gezondheidszorg
                [2 ]Austrian Academy of Sciences
                Article
                10.16995/olh.4672
                ff80290c-7c4d-431d-936a-67f9971ba8b1
                © 2022

                https://creativecommons.org/licenses/by/4.0

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