Abnormal-Concepts and diagnosis Flashcards
Deviation from social norms
Norms are unwritten rules created by society to guide behaviour. Breaking these rules might be considered abnormal
Limitations of deviation from social norms
- Social norms change over time e.g. homosexuality in 1970s compared to now
- Social norms must be considered in context
- Who decides social norms? *cultural differences
Failure to function adequately
Sometimes people engage in behaviours that are somehow ‘not good for them’. Relationships and day-to-day living may be difficult.
Limitations of failure to function adequately
X Functioning adequately can be a subjective judgment
X Some behaviours, although unacceptable, may not be maladaptive to the person, e.g. a ‘happy’ murderer is someone who is abnormal but not maladaptive. Maladaptive does not necessarily mean abnormal
X What is ‘adequate’ behaviour?! Cultural differences, e.g. mourning practices
Deviation from ideal mental health
If we can recognize what is ‘normal’ then whatever fails these criteria is necessarily ‘abnormal’. Jahoda (1958) suggested six criteria for ‘normality’, or optimal living:
- Positive view of self
- Actualisation
- Autonomy
- Accurate view of reality
- Environmental adaptability
- Resistance to stress
Limitations of deviation from ideal mental health
X Very few people meet all these criteria, e.g. ‘actualisation’ is reached by few people in life
X The criteria are open to interpretation, e.g. what is real for one is not real for another – reality for a soldier is very different from that of an accountant.
X What is ‘ideal’ in one culture might not be considered ‘ideal’ in another, e.g. they stress personal fulfillment, which is a value not always shared by non-Western cultures.
Cultural considerations in diagnosis
SEE CULTURAL VARIATIONS IN PREVALENCE
Ethical considerations in diagnosis: Stigma
- Szasz (1974): people are diagnosed as mentally ill, provides the patient with a new identity e.g. manic-depressive
- other people may ignore/exclude on basis of new identity due to ignorance and fear about what it means to be mentally ill.
Langer & Abelson (1974)
- demonstrated prejudice that can result from labelled as mentally ill:
- subjects shown video younger man telling older man about job experience
- told before job applicant=attractive+conventional looking
- told patient=tight,defensive,dependent,scared of own aggressive impulses
- **power of stereotypes
DSM recommends ‘individual with schizophrenia’ rather than ‘schizophrenic’
‘in remission’ rather than no longer mentally ill tf still carrying label
*Rosenhan study
Ethical considerations in diagnosis: Labelling
Scheff (1966): labels are internalised and so affect the behaviour of the person who is labeled
=self fulfilling prophecies where begin to act as they think they’re expected to
Doherty (1975): reject MI label, tend to improve more quickly than who accept
Kleinman-“sick role” individual embraces idea they’re patient & changes behaviour accordingly
- exempt from normal social rules e.g. work
- embraced=hard to give up
Ethical considerations in diagnosis: Institutionalisation
Institutionalisation – being confined in an institution such as a mental
- confirmation bias: once labelled and institutionalised, likely behaviour interpreted through the lens of supposed illness
- Rosenhan (1973): normal actions of participants interpreted as symptoms of mental illness.
Ethical considerations in diagnosis: Powerlessness and depersonalisation
- > other negative effects of institutionalisation
produced: lack of patient rights, constructive activity, choice and privacy, verbal and physical abuse
Now greater emphasis on “care in community”-trying to avoid negative effects of institutionalisation by not locking people up
Service user movement provided strong voice for patients and former patients=helped improve standards within psychiatric institutions.
