Psychopathology - Defining Abnormality

Question 1

How can you define abnormality?

Answer 1

• statistical infrequency
• deviation from social norms
• failure to function adequately
• deviation from ideal mental health

Question 2

How do you define abnormality in terms of statistics?

Answer 2

The most obvious way to define anything as ‘normal’ or ‘abnormal’ is in terms of the number of times it is observed. Statistics is about analysing numbers.

Question 3

How does abnormality link to behaviour?

Answer 3

Any relatively ‘usual’, or often seen, behaviour can be thought of as ‘normal’.

Any behaviour that is different, or rare, is ‘abnormal’, i.e. a statistical infrequency.

Question 4

Give an example of statistical infrequency.

Answer 4

IQ is normally distributed. The average IQ is 100. Most people have an IQ between 85 and 115, only 2% have a score below 70. Those individuals scoring below 70 are statistically unusual or ‘abnormal’ and are diagnosed with intellectual disability disorder.

Question 5

How is abnormality based on social context?

Answer 5

When a person behaves in a way that is different from how they are expected to behave they may be defined as abnormal. Societies and social groups make collective judgements about ‘correct’ behaviours in particular circumstances.

Question 6

How are norms specific to the culture we live in?

Answer 6

There are relatively few behaviours that would be considered universally abnormal therefore definitions are related to cultural context.

This includes historical differences within the same society. For example, homosexuality is viewed as abnormal in some cultures but not others and was considered abnormal in our society in the past.

Question 7

Give an example of deviation from social norms.

Answer 7

One important symptom of antisocial personality disorder (formerly psychopathy) is a failure to conform to ‘lawful and culturally normative ethical behaviour’.

In other words, a psychopath is abnormal because they deviate from social norms or standards. They generally lack empathy.

Question 8

How is the inability to cope with everyday living seen as abnormal?

Answer 8

A person may cross the line between normal and abnormal at the point that they cannot deal with the demands of everyday life - they fail to function adequately.

For instance, not being able to hold down a job, maintain relationships or maintain basic standards of nutrition and hygiene.

Question 9

What did Rosenhan and Seligman (1989) propose as the signs of failure to cope?

Answer 9

• Suffering and personal distress is a common feature of abnormality but not always present.
• Maladaptiveness is when a behaviour neither helps an individual or the groups they belong to.
• Irrationality and incomprehensibility is when behaviour seems to have no rational meaning.
• Unpredictability and loss of control: we expect people to be consistent, predictable and in control of themselves.
• Vividness and unconventionality refers to behaviours that stand out and shock us (may be irrational or dangerous).
• Observer discomfort refers to behaviour that makes us feel uncomfortable because it breaks some unwritten rules about how we behave.
• Violation of ideal and moral standards: the rules we think people should live by.
• They no longer conform to interpersonal rules, e.g. maintaining personal space.

Question 10

Give an example of failure to function adequately.

Answer 10

Having a very low IQ is statistical infrequency but diagnosis would not be made on this basis alone. There would have to be clear signs that, as a result of this, the person was not able to cope with the demands of everyday living. So intellectual disability disorder is an example of failure to function adequately.

Question 11

How can you change the emphasis to identify ‘abnormal’ people?

Answer 11

A different way to look at normality and abnormality is to think about what makes someone ‘normal’ and psychologically healthy. Then identity anyone who deviates from this ideal.

Question 12

What did Marie Jahoda (1958) suggest as the 8 criteria for ideal mental health?

Answer 12

1. We have no symptoms of distress.
2. We are rational and perceive ourselves accurately.
3. We self-actualise.
4. We can cope with stress.
5. We have a realistic view of the world.
6. We have good self-esteem and lack guilt.
7. We are independent of other people.
8. We can successfully work, love and enjoy our leisure.

Question 13

How is there an inevitable overlap between definitions?

Answer 13

Someone’s inability to keep a job may be a sign of their failure to cope with the pressures of work (failure to function). Or as a deviation from the ideal of successfully working.

Question 14

What are the strengths of the definitions of abnormality?

Answer 14

• statistical infrequency has real-life application
• failure to function adequately recognises the patient’s perspective
• deviation from ideal mental health is comprehensive

Question 15

What are the weaknesses of the definitions of abnormality?

Answer 15

• unusual characteristics can also be positive
• not everyone unusual benefits from a label
• deviation from social norms is not a sole explanation of abnormality
• social norms are culturally relative
• the definition could lead to human rights abuses
• failure to function is the same as deviation from social norms
• this is a subjective judgement
• definition of ideal mental health may be culturally relative
• unrealistically high standard for mental health
• how is it measured?

Question 16

How is statistical infrequency having real-life application a strength?

Answer 16

All assessment of patients with mental disorders includes some comparison to statistical norms. Intellectual disability disorder demonstrates how statistical infrequency can be used. Statistical infrequency is thus a useful part of clinical assessment.

Question 17

How is failure to function adequately recognising the patient’s perspective a strength?

Answer 17

This may not be an entirely satisfactory approach because it is difficult to assess distress.

However, the definition acknowledges that the experience of the patient (and/or others) is important. It captures the experience of many people who need help and is useful for assessing abnormality.

Question 18

How is deviation from ideal mental health being comprehensive a strength?

Answer 18

The definition covers a broad range of criteria for mental health. It probably covers most of the reasons someone would seek help from mental health services or be referred for help. The sheer range of factors discussed in relation to Jahoda’s criteria make it a good tool for thinking about mental health.

Question 19

How are unusual characteristics also being positive a weakness?

Answer 19

If very few people display a behaviour, that makes the behaviour statistically abnormal but doesn’t mean the person requires treatment. IQ scores over 130 are just as unusual as those below 70, but not regarded as undesirable and requiring treatment. This is a serious limitation of the concept of statistical infrequency and means it should never be used alone to make a diagnosis.

Question 20

How is not everyone benefiting from a label a weakness?

Answer 20

When someone is living a happy and fulfilled life, there is no benefit to them being labelled as abnormal. Someone with a very low IQ who was not distressed or out of work etc. would not need a diagnosis of intellectual disability. Being labelled as abnormal might have a negative effect on the way others view them and the way they see themselves.

Question 21

How is deviation from social norms not being a sole explanation of abnormality a weakness?

Answer 21

Antisocial personality disorder (APD) shows there is a place for deviation from social norms in thinking about what is abnormal. However, there are other factors to consider, e.g. distress to other people due to APD. So in practice, deviation from social norms is never the sole reason for defining abnormality.

Question 22

How are social norms being culturally relative a weakness?

Answer 22

A person from one cultural group may label someone from another group as abnormal using their standards rather than the person’s standards. For example, hearing voices is socially acceptable in some cultures but would be seen as a sign of abnormality in the UK. This creates problems for people from one culture living within another cultural group.

Question 23

How is deviation from social norms leading to human rights abuses a weakness?

Answer 23

Too much reliance on deviation from social norms to understand abnormality can lead to systematic abuse of human rights.

Drapetomania (black slaves trying to escape) and nymphomania (women attracted to working-class men) are examples of how diagnosis was used for social control. Such classifications appear ridiculous but some psychologists argue that some modern abnormal classifications are abuses of people’s right to be different.

Question 24

How is failure to function being the same as deviation from social norms a weakness?

Answer 24

It can be hard to say when someone is really failing to function or just deviating from social norms. People who live alternative lifestyles or do extreme sports could be seen as behaving maladaptively. If we treat these behaviours as ‘failures’ of adequate functioning, we may limit freedom.

Question 25

How is this being a subjective judgement a weakness?

Answer 25

Someone has to judge whether a patient is distressed or distressing. Some patients may say they are distressed but may be judged as not suffering. There are methods for making such judgements as objective as possible, including checklists such as the Global Assessment of Functioning Scale. However, the principle remains whether someone, e.g. a psychiatrist, has the right to make this judgement.

Question 26

How is the definition of ideal mental health being culturally relative a weakness?

Answer 26

Some of the ideas in Jahoda’s classification of ideal mental health are specific to Western European and North American cultures. For example, the emphasis on personal achievement (self-actualisation) would be considered self-indulgent in much of the world where the focus is on community rather than oneself. Such traits are typical of individualist cultures and are culturally specific.

Question 27

How is unrealistically high standards for mental health a weakness?

Answer 27

Very few people will attain all Jahoda’s criteria for mental health. Therefore, this approach would see most of us as abnormal. On the positive side, it makes it clear to people the ways in which they could benefit from seeking help to improve their mental health. However, it is probably of no value in thinking about who might benefit from treatment against their will.

Question 28

What is Maslow’s hierarchy of needs?

Answer 28

1. Physiological: breathing, food, water, sex, sleep, homeostasis, excretion
2. Safety: security of body, of employment, of resources, of morality, of the family, of health, of property.
3. Love/Belonging: friendship, family, sexual intimacy
4. Esteem: self-esteem, confidence, achievement, respect of others, respect by others
5. Self-actualisation: morality, creativity, spontaneity, problem-solving, lack of prejudice, acceptance of facts

Question 29

What is the stigma behind mental illness?

Answer 29

This is often the most traumatising part both for the patient and their relatives. There is often a fear of mental illness as it is seen as something beyond our control. It is seen to be a label.

Records are kept and go with the individual. Unfortunately, people are viewed as the label they receive, insane, and not the person they are. This causes a problem.