Subjective models of psychological disorders: mental health professional's perspectives

Abstract

This exploratory study is an extension of previous studies which have applied personal construct theory (PCP) methodology toward a better understanding of the structure and dynamics of multidisciplinary mental (and physical) health care (Kirkcaldy and Pope, 1992; Kirkcaldy et al., 1993, 2000, 2005; Kirkcaldy and Siefen, 1999). In this study we wanted to use similar cluster statistical analyses, not unlike PCP analysis, to identify the diverse subjective models of psychological ailments such as anxiety, depression, psychosis, mania, obsessive compulsive disorder (OCD), post stress traumatic disorder (PTSD), etc., using not the idiosyncratic constructs generated by individual triadic element comparisons, but by selecting those constructs which have been clearly identified in various psychiatric and psychological rating scales (e.g. somatic preoccupation, social withdrawal, conceptual disorganization, hostility, disinhibition and controlling). Clinical experts (psychological psychotherapists, and medical psychotherapist and psychiatrist) each with over 25 years of clinical and research experience were required to complete the ratings of each disorder listed in terms of the pre-formulated behavioral, emotional and cognitive concepts. What emerged are several multivariate (grid) analyses based on mental health professionals' perception of diverse elements (disorders) and their interrelationship derived from the similarity of composite profiles of ill-related constructs. Overall, the analyses revealed clear associations between the subjective evaluations of psychological ailments suggesting some uniformity in mental health assessment of such disorders. The implications of these findings are discussed within the theoretical framework of improved mental health care.