Distress definition

Definitions of mental illness tend to contain two aspects a normative element and a functional element. Normative definitions delimit abnormal behavior in light of what is typical, usual, or the norm. Some degree of deviance from the norm is necessary for a behavior to be considered abnormal. Deviance alone, however, is never sufficient for a label of abnormality. High IQ is just as deviant as low IQ, but only mental retardation is labeled abnormal. This leads us to the functional element of the definition. Typically, the label of abnormality requires deviance plus maladaptation. Maladaptation suggests some diminished capacity to function relative to an average. For example, the DSM defines mental disorder as a syndrome that is associated with distress or impairment in functioning (American Psychiatric Association, 1994, pp- xxi-xxii). 

The DSM is careful to recognize that culture also determines definitions of mental illness. In the DSM, unusual and distressing behaviors such as culturally sanctioned responses to the death of a loved one are excluded from diagnosis. Most current conceptualizations of mental illness recognize that societal values play an important role in establishing whether something is a mental disorder (Lilienfeld Marino, 1995 Wakefield, 1992). The result is that the boundaries of mental illness are believed to shift as a function of culture, both across cultures and within cultures, over time. One important implication of cultural relativism is that definitions of mental illness will necessarily vary. 

Three factors are at work which make the issues of layoffs important to every professional wage earner. First, layoffs are obviously more prevalent in times of economic recession and undercapacity. In fact, since the last American Chemical Society (ACS) meeting in 1975, 29 separate layoffs have been brought to the attention of the ACS Employment Aids Office. Each layoff involved from three to as many as 31 chemists or chemical engineers. (A layoff for our consideration requires only that three people be laid off rather than the masses of people required by the older definitions). Distressing as these figures are, they are substantially below those for the years 1969-1971. 

Market expansion is particularly prevalent in so-called "lifestyle diseases." In the late 1990s, SmithKlineBeecham received approval to market paroxetine (Paxil ) for the treatment of social phobia. This disorder can be distressing and disabling for those who suffer from it, limiting their ability to interact with the outside world. But what we risk now is an extension of the definition of social phobia to include "shyness,"... 

When air is exhaled the small alveoli of the lungs could collapse if it were not for the surface active material (surfactant) present in the fluid that coats the lungs. e In fact, the lack of adequate surfactant is the cause of respiratory distress syndrome, a major cause of death among premature infants and a disease that may develop in acute form in adults. The surfactant material forms a thin film of high fluidity at the air-liquid interface and lowers the surface tension from the 72 mN/m of pure water to <10 mN/mfs (Pay attention to the definition of surface tension.11)... 

Obsessive-compulsive disorder (OCD) is a syndrome characterized by obsessions and/ or compulsions, which together last at least an hour per day and are sufficiently bothersome that they interfere with one s normal social or occupational functioning. Obsessions are experienced internally and subjectively by the patient as thoughts, impulses, or images. According to standard definitions in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), obsessions are intrusive and inappropriate and cause marked anxiety and distress. Common obsessions are listed in Table 9—1. 

The DSM-IV does not discuss the definition of disruptive behavior disorder. The DSM-III-R stated that DBD children are characterized by behavior that is socially disruptive and is often more distressing to others than to the people with the disorders. The so-called illness consists of being disruptive to the lives of adults—a definition tailored for controlling children, while exonerating adults. 

Besides the paucity of historic data, another difficnlty associated with mental health studies of disaster victims is the lack of standardization of criteria used for case definitions of mental health disorders following mass trauma, such as post-traumatic stress disorder (PTSD) (6,7). Diagnostic criteria for PTSD, as noted in the fourth edition of the diagnostic and statistical manual (DSM-IV), should go beyond specified combinations of symptoms to include requirements for symptom duration and the patient s ability to function (6,7). Specifically, for a PTSD diagnosis, the patient must have symptoms for more than 1 month, and the symptoms must cause clinically significant distress or impair the patient s ability to function (6,7). In addition, the symptoms must occur after the traumatic event and could not have existed before the event. Unfortunately, many studies have used questionnaires that fail to distinguish new symptoms following traumatic events from previous prevalent symptoms such as sleeplessness that many people have at various times (6). The consequence is that many studies tend to inflate the prevalence of PTSD. 

Abraham E, Matthay MA, Dinarello CA, et al. Consensus conference definitions for sepsis, septic shock, acute lung injury and acute respiratory distress syndrome time for a reevaluation. Crit Care Med 2000 28 232-235. 

In addition to the previous definition, withdrawal can be further described as the development of a substance-specific syndrome after cessation of or reduction in intake of a substance that was used regularly by the individual to induce a state of intoxication. Withdrawal causes significant distress to the individual and is associated with impairment in social, occupational, or other areas of functioning. Withdrawal is usually associated with substance dependence. Withdrawal generally is also associated with a craving to readminister the drug to relieve the symptoms. 

MCR, there is still no definitive mechanism for the final step of methanogen-esis. Furthermore, relatively little mechanistic work has been done using MCR, as opposed to model compounds, and more distressingly, this work is not that recent. 

Petty, T.L. (1982). Adult respiratory distress syndrome definition and historical perspective. Clin. Chest Med., 3, 3-7... 

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