Chapter 12 : Normality, mental health and mental illness

Question 1

Define normality.

Answer 1

Normality is a pattern of thoughts, feelings or behavior that conforms to a usual, typical or expected standard.

Question 2

Name the six different approaches to defining normality.

Answer 2

Socio-cultural, situational, functional, historical, medical and statistical.

Question 3

Provide an example of the socio-cultural approach.

Answer 3

For example, praying at the crack of dawn would be considered normal in one culture/society and abnormal in another.

Question 4

Provide an example of the functional approach.

Answer 4

For example, hand washing would be considered abnormal if it is done so many times that it interferes with the individual’s ability to carry out their usual daily activities.

Question 5

Provide an example of the historical approach.

Answer 5

For example, 100 years ago, same-sex marriage would be considered abnormal, whereas it is considered to be increasingly normal now.

Question 6

Provide an example of the situational approach.

Answer 6

For example, cheering loudly at a football game would be considered normal, whereas cheering at a funeral would be considered abnormal.

Question 7

Provide an example of the medical approach.

Answer 7

For example, taking Ventolin for asthma.

Question 8

Provide an example of the statistical approach.

Answer 8

For example, the average weight for newborns is around 7 pounds.

Question 9

Fill in the blanks.
A behavior which is shown by the large majority of the people is called the ___. A behavior which is shown by the small minority of the people is called the ___.

Answer 9

Statistical average, statistical extremity.

Question 10

Define mental health.

Answer 10

Mental health is a state in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her own community.

Question 11

Name some characteristics of good mental health.

Answer 11

• The ability to form positive relationships with others.
• Can cope with the normal stresses in life.
• Think logically and clearly.
• Manage feelings and emotions.
• Experience pleasure and enjoyment.

Question 12

Why is mental health often being represented as a continuum?

Answer 12

Because mental health is not something we either have or do not have. Instead, we may be more or less mentally healthy at different point in our lives.

Question 13

What is a mental health problem?

Answer 13

A mental health problem can arise from major negative life events, and are referred to as a “rough patch”. They are very common and typically not very severe or long-lasting.

Question 14

What is a mental illness/mental disorder?

Answer 14

A mental illness is a psychological disorder that significantly interferes with an individual’s cognitive, emotional, and/or social abilities.

Question 15

What are the differences between a mental health problem and a mental illness?

Answer 15

A mental illness usually lasts longer than a mental health problem, and may cause more distress and disruptions to an individual’s life.

Question 16

Name some characteristics of a mental health problem.

Answer 16

• Feel tense, low, irritable, quiet, confused and angry.
• Experience increased or decreased sleep or appetite.
• Become withdrawn.
• Have difficulty concentrating.
• Experience a loss of energy and motivation.

Question 17

How many adult Australians experience a mental illness at some stage in their lives?

Answer 17

One in five (20%).

Question 18

What is atypical behavior?

Answer 18

This means that the individual is thinking, feeling or behaving in a way that is not considered typical of them.

Question 19

Define classification.

Answer 19

Classification is the organisation of items into groups on the basis of their common properties.

Question 20

Define a class or category.

Answer 20

A class/category is a group of items that shares a particular set of properties.

Question 21

Name the two main approaches to classifying mental disorders or illnesses.

Answer 21

The categorical and dimensional approach.

Question 22

Define categorical approach.

Answer 22

The categorical approach organizes and describes mental conditions and disorders in terms of different categories and subcategories, each with symptoms and characteristics that are typical to the specific mental condition or disorder.

Question 23

What are the key assumptions of the categorical approach?

Answer 23

• A mental illness can be diagnosed based on specific symptoms reported or presented in an individual.
• Thoughts, feelings and behaviors can be organized into categories representing disorders, and that there are clear boundaries around each disorder, and they do not overlap.
• An individual either has or does not have a diagnosable mental disorder.
• The system used for classification should be valid and reliable.

Question 24

Define validity.

Answer 24

Validity means that the classification system organizes mental disorders into discrete and distinct disorders. It accurately represents the symptoms that have been assessed.

Question 25

Define reliability.

Answer 25

Reliability means that the classification system produces the same diagnosis each time it is used in the same situation.

Question 26

What is inter-rater reliability?

Answer 26

Inter-rater reliability indicates the extent to which different mental health professionals diagnose the same client with the same disorder.

Question 27

Provide two examples of categorical approaches to classifying mental disorders.

Answer 27

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and the International Classification of Diseases and Related Health Problems (ICD-10).

Question 28

Which categorical approach is more widely used by mental health professionals in Australia?

Answer 28

The DSM-IV-TR.

Question 29

Describe the DSM-IV-TR.

Answer 29

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) was developed by the American Psychiatric Association (APA), and is a categorical system for diagnosing and classifying mental disorders based on recognizable symptoms that are precisely described for each disorder. The DSM-IV-TR classifies mental disorders into 16 major categories. It also provides information on the typical course of the disorder, the degree of impairment, the prevalence of the disorder,etc.

Question 30

What is an important feature of the DSM-IV-TR?

Answer 30

The DSM-IV-TR does not mention any specific causes of any disorder or how the disorder should be treated.

Question 31

How many dimensions/axes does the DSM-IV-TR have?

Answer 31

Five dimensions/axes.

Question 32

What do the five axes address?

Answer 32

Axes 1,2,3 addresses the individual’s present condition, whereas axes 4 and 5 provides additional information about the individual’s situation and functioning in everyday life.

Question 33

State the name of each of the five axes.

Answer 33

1: Clinical disorders and other conditions that may be a focus of clinical attention
2: Personality disorders and mental retardation
3: General medical conditions
4: Psycho-social and environmental problems
5: Global assessment of functioning

Question 34

Describe the ICD-10.

Answer 34

The International Classification of Diseases and Related Health Problems (ICD-10) is developed by the World Health Organization (WHO) and is a categorical system for diagnosing and classifying diseases and mental disorders based on recognizable symptoms that are precisely described for each disease and disorder.

Question 35

Name the key similarities and differences between the DSM-IV-TR and the ICD-10.

Answer 35

Similarities…
- Both use a categorical approach to classifying mental disorders.
- Both prefer the use of the term “mental disorder” over the term mental illness.
Differences…
- The DSM-IV-TR provides a more detailed description of mental disorders.
- The ICD-10 distinguishes between mental disorders and behavioral disorders, whereas the DSM-IV-TR does not.

Question 36

What is the Australian version of the ICD called?

Answer 36

The International Classification of Diseases, Tenth Revision, Australian Modification (ICD-10-AM).

Question 37

Name the ICD-10 chapter that relates to mental disorders.

Answer 37

Chapter V.

Question 38

Name the key strengths of the categorical approach.

Answer 38

• Useful in promoting the growth of a body of expert knowledge about mental disorders among mental health professionals and the community in general.
• Enhance communication among mental health professionals by providing a common language.
• Enables consistent diagnoses and treatment all over the world.

Question 39

Name the key limitations of the categorical approach.

Answer 39

• Substantial loss of valuable clinical information.
• Involves the use of diagnostic labels to describe the various disorders in specific ways, which can result in the individual experiencing social stigma.
• “Boxes” people into one of the available categories and does not accommodate the unique nature of the human condition.

Question 40

Define the dimensional approach.

Answer 40

The dimensional approach quantifies a person’s symptoms or other characteristics of interest and represents them with numerical values on one or more scales or continuums, rather than assigning them to a mental disorder category.

Question 41

Name the key assumptions of the dimensional approach.

Answer 41

• Normality and abnormality are the end points on the same continuum with no clear line dividing them.
• A mental disorder is not considered in terms of whether it is absent or present.

Question 42

What is a dimension?

Answer 42

A cluster of related psychological and/or behavioral characteristics that tend to occur together and can be measured.

Question 43

Name the key strengths of the dimensional approach.

Answer 43

• Reduces the stigma usually associated with the diagnosis of a specific mental disorder.
• Provides a more detailed description of an individual’s mental condition in the form of a profile.
• Does not label people.

Question 44

Name the key limitations of the dimensional approach.

Answer 44

• There is no widely accepted standardized system that can be used, which can lead to greater inconsistency.
• Most mental health professionals cannot agree on how many dimensions are required.

Question 45

What is the biopsychosocial framework?

Answer 45

The biopsychosocial framework is an approach to describing and explaining how biological, psychological and social factors combine and interact to influence an individual’s physical and mental health.

Question 46

What is a holistic view of health?

Answer 46

The individual should be considered as a “whole person” functioning in their unique environment.

Question 47

Define abnormality.

Answer 47

Abnormality refers to a pattern of thoughts, feelings or behaviors that are deviant, distressing and dysfunctional.