Psychological debates have spanned the decades and continue to change over time. With the 2013 release of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), psychologists continue to debate controversial issues in their field.

Defining "Normal" and "Healthy" 

One of the ongoing debates in psychology is how to define the concepts of "normal" and "healthy." Psychologists often rely on these terms to assess, diagnose, treat, and counsel individuals who are experiencing mental-health difficulties; however, these terms are subject to interpretation. What is normal or healthy behavior for one person may be unhealthy or ineffective for someone else. Behavior can be normal for an individual (intrapersonal normality) when it is consistent with the most common behavior for that person, even if that behavior leads to negative consequences. 

"Normal" is also used to describe when someone's behavior conforms to the most common or accepted behavior in society (known as conforming to the norm). Definitions of normality vary by person, time, place, and situation, and are overwhelmingly shaped by cultural and societal standards and norms. These standards and norms change over time, and perceptions of normality change along with them. Critics argue that perceptions of normality are inherently subject to value judgments, biases, and assumptions, and can have social ramifications. For example, someone being seen as "normal" or "not normal" can result in them being included, excluded, or stigmatized by larger society. In 2011, the British Psychological Society argued that the DSM-5 should consider mental disorders on a spectrum along with normality:

"[We recommend] a revision of the way mental distress is thought about, starting with recognition of the overwhelming evidence that it is on a spectrum with 'normal' experience, and that psychosocial factors such as poverty, unemployment and trauma are the most strongly-evidenced causal factors."

Nature vs. Nurture Debate

One of the central debates in psychology involves the origin of human behavior. Is behavior caused by biological factors present in the human body (nature), or is it caused by interactions between the individual and his or her environment (nurture)? 

Strict adherents of the nature philosophy often use genetic code as support for their theory. However, it is well documented that interaction with one's environment can provoke changes in brain structure and chemistry and that situations of extreme stress can cause problems like depression. Psychologists today generally believe that human behavior is affected by a combination of both biological and environmental factors. 

Changes to (and Controversies within) the DSM-5

Autism Spectrum Disorder

Many of the current debates in psychology can be seen in the recent changes to the DSM-5. One major change is within the category of autism spectrum disorders, which no longer contains Asperger's syndrome as a diagnosis. Rather, all children are classified under the term "autism spectrum disorder" (ASD) and given a rating or mild, moderate, or severe. 

Autism is a neurological disorder that has become increasingly prevalent in recent years, affecting about 20 per 1,000 children in the United States in 2012. It is unclear whether this growth is due to changes in autism's actual incidence or to changes in the rate of reporting. Disorders within the autism spectrum are characterized by impaired social interaction, impaired verbal and nonverbal communication, and restricted or repetitive behavior. For years, researchers have tried to find the cause of autism, and everything from vaccines to maternal depression have been cited but never proven. While the general treatment for autism is applied behavior analysis (ABA), or other behavioral therapies, many people look for alternative treatments such as diet or supplements. 

Controversies surrounding the diagnosis and its treatment include the relevance of rating the severity of the disorder, and whether or not to include children with varying severity of ASD in the general-education population. Controversy also exists around the use of ABA as a treatment for ASD. In this treatment, child-specific reinforcers (e.g., stickers, praise, candy, bubbles, and extra play time) are used to reward and motivate autistic children when they demonstrate desired behaviors such as sitting on a chair when requested, verbalizing a greeting, or making eye contact. Punishments, such as a timeout or a sharp “No!” from the therapist or parent, might be used to discourage undesirable behaviors such as pinching, scratching, and pulling hair. While it has been shown to be effective in shifting the behaviors of those with ASD, some argue that the treatment serves to pathologize and further marginalize those on the spectrum by trying to "normalize" autistic behaviors.

Reports of autism are on the rise

Reports of autism cases per 1,000 children increased dramatically in the US from 1996 to 2007. It is unknown how much, if any, of this growth is due to changes in autism's actual incidence (as opposed to changes in the rate of reporting).

Gender Dysphoria

Another recent change to the DSM-5 is the renaming of "gender identity disorder" to "gender dysphoria." The change separates adults, children, and adolescents appropriately by developmental stages, and was moved from the sexual disorders category to a separate category of its own. One of the major impacts of this change is the reduction of stigma by changing the language from "disorder" to "dysphoria," which serves as a step toward depathologizing people who identify as transgender or differently gendered. At the same time, transgender people seeking surgical or hormonal treatment have historically been forced to rely on the diagnosis of gender identity disorder in order to access the appropriate treatment, however stigmatizing the diagnosis may be. It is unclear what effect this change in language will have on individuals' ability to access appropriate medical care.

Depressive Disorders

Within the depressive disorders of the DSM-5, bereavement exclusion no longer exists; this means that people who are in severe depressive states due to grief can be diagnosed with clinical depression. Under the new guidelines, certain responses to grief could be labeled as pathological disorders, instead of being recognized as normal human experiences

Borderline Personality Disorder

In 2003, the Treatment and Research Advancements Association for Personality Disorders (TARA APD) campaigned to change the name and designation of borderline personality disorder (BPD), arguing that BPD as it currently stands is "confusing, imparts no relevant or descriptive information, and reinforces existing stigma." Instead, it proposed the name "emotional regulation disorder" or "emotional dysregulation disorder." There was also discussion about changing borderline personality disorder, an Axis II diagnosis (personality disorders and mental retardation), to an Axis I diagnosis (clinical disorders). However, the name, the diagnostic criteria, and the description of BPD remain largely unchanged from the previous DSM-IV-TR.

Electroconvulsive Therapy

Electroconvulsive therapy (ECT) is a controversial approach to the treatment of severe mental illness that involves inducing minor seizures within the brain through electrical impulses. Much of the treatment's controversy stems from its early usage in the 1940s, and popular-culture references, such as the film One Flew Over the Cuckoo's Nest. ECT has been dramatically improved over time and is generally used as a treatment of last resort for severe disorders—such as major depression, schizophrenia, or bipolar mania—that do not respond to other forms of treatment. About 70 percent of patients are women. Controversy continues to surround ECT due to its side effects on memory and general cognition after treatment, as well as its debated level of effectiveness. While some studies have shown ECT to drastically improve symptoms with perhaps fewer side effects than some medications, other studies point to high rates of relapse. It is unknown why the treatment is effective in many cases of severe mental disorders.