Psychopathology - Definitions of Abnormality Flashcards
What is abnormality?
- Psychopathology is the scientific study of psychological disorders (mental illnesses).
- Abnormal - we are talking about mental illness.
- For definitions of abnormality, it is about how health professionals decide whether someone is ‘normal’ (mentally healthy) or ‘abnormal’ (mentally ill).
- There are four definitions of abnormality: deviation from social norms, failure to function adequately, statistical infrequency and deviation from ideal mental health.
- No single definition is adequate on its own, but each captures some aspect of what we might expect from the term ‘abnormality.’
1 - Deviation from social norms
- Social norms are the rules that a society has about what are acceptable behaviours, values and beliefs adhered to by those socialised into that group
- Some of these rules are explicit, where violating them may mean breaking the law e.g. not drinking and driving.
- Other rules are implicit (unspoken), but are agreed upon as a matter of convention within a society e.g. not standing too close to someone in a face-to-face conversation (although the definition of ‘too close’ may change in different cultures).
- People who violate (deviate from) such norms are often regarded as abnormal.
- The definition draws a line between desirable and undesirable behaviours and labels individuals behaving undesirably as social deviants - this allows interference into their lies in order to help them e.g. putting them into a mental hospital
Examples:
- Showing inappropriate affect (emotion) may be a symptom of schizophrenia such as laughing when someone has died
- Paedophilia and voyeurism
- Psychopathy - not conforming to moral standards
1 - Evaluation the deviation definition - Weaknesses
1) Social norms vary as times change. What is socially acceptable now may not have been 50 years ago. For example, homosexuality is acceptable today but in the past it was included under the sexual and gender identity disorders in the DSM.
- This shows that social norms change with time, which adds to the understanding that this is subjective. So our grandparents may find something abnormal which we would now consider normal, lacking temporal validity.
2) Social norms are defined by the culture. This means that a person from one cultural group may label someone from another culture as behaving abnormally according to their standards rather than the standards of the person behaving in that way. For example, hearing voices is socially acceptable in some cultures but would be seen as a sign of mental abnormality in the UK. This is the problem of cultural relativism (the idea that a concept only applies in the culture that it was created in). This creates problems for people from one culture living within another culture group.
- This shows that it is not generalisable to all cultures as standards differ across different cultural groups. This is a weakness as it means that someone may be labelled differently depending on where they are born
1 - Evaluation of the deviation definition - Weaknesses (+partial strength; no 4)
3) Too much reliance on this definition can lead to violations of human rights. Historical examples of deviation from social norms, such as drapetomania (black slaves running away) and nymphomania (women being sexually attracted to working-class men), are clearly diagnoses that were used to maintain control over minority ethnic groups and women. These appear ridiculous today, but this is because our social norms have changed. Some radical psychologists argue that even today’s definitions of deviation from social norms are abuses of people’s rights to be different.
- This shows that the idea of social norms can be used to maintain control which has implications on wider society. It would be seen as unethical as labelling people as abnormal may be an abuse of human rights
4) It includes the issue of the desirability of the behaviour. This means that behaviours that are numerically rare (and so statistically abnormal) can be socially acceptable and therefore not abnormal. For instance, being a genius is statistically abnormal but we wouldn’t want to suggest that is an abnormal behaviour in terms of psychopathology.
- Some rare behaviours are seen as socially acceptable, although again this presents the issue of desirability where we decide what is desirable based on what we want to see in society, such as genius traits, and label other types of behaviours as undesirable.
2 - Statistical infrequency
- A person’s trait, thinking or behaviour would be considered an indication of abnormality if it was found to be numerically (statistically) rare/uncommon/anomalous.
- What is regarded as numerically rare depends on normal distribution. Any individual who falls outside the ‘normal distribution’ (i.e. they are two standard deviations away from the mean, which is about 5% of the population) are considered to be abnormal.
2 - Evaluation of statistical infrequency - Weaknesses
1) There are many statistically infrequent behaviours that are actually quite desirable - e.g. very few people have an IQ over 150 but we would not say this is undesirable; and there are statistically frequent behaviors that are undesirable such as depression which is a mental illness that isn’t counted as abnormal by this definition. Therefore, using this definition makes it hard to distinguish between desirable and undesirable behaviours and in order to identify behaviours that need treatment there needs to be a way of identifying infrequent and undesirable behaviours
- It does not take into account situational or qualitative variables such as unusual traits are desirable, and therefore it is too narrow as a definition and too reductionist
2) Behaviours that are statistically infrequent in one culture may be statistically frequent in another e.g. one of the symptoms of schizophrenia is claiming to hear voices, however this is an experience that is common in some cultures especially after a person has died. In some cultures, spiritualists take part in religious rituals believing they are communicating with the dead, and so it is a culturally relative definition
- The cultural relativism of this definition means that it lacks universality and external validity
2 - Evaluation of statistical infrequency cont.
3) When someone is living a happy and fulfilled life, there is no benefit to them being labelled as abnormal, regardless of how unusual they are - for example, with someone with a low IQ but is capable of working would need an intellectual disability disorder. If a person is labelled as abnormal, it could have negative consequences and an effect on the way others view them and how they view themselves
- It can therefore be considered an unethical explanation as it is socially sensitive and means unnecessary diagnosis’ are provided for people, which can impact their mental health
Strength -
1) The definition can be useful as part of clinical assessment - for example, it has a real-life application in diagnosis of intellectual disability disorder - there is therefore a place for statistical infrequency in thinking about normal and abnormal behavioural characteristics - one of the assessments made of patients with mental disorders includes some kind of measurement o the severity of symptoms compared to statistical norms
- It has external validity as it can be applied to real-world diagnostic tools, which can be helpful for accessing treatment
3 - Failure to function adequately
- People with psychological disorders often experience considerable suffering and a general inability to cope with their everyday activities – they are unable to function adequately. Therefore, they are classed as abnormal; it is when their behaviour suggests they can no longer cope with everyday life
- Behaviour becomes abnormal when it causes distress leading to an inability to function properly - these people are often characterised as not being able to experience the usual range of behaviours and emotions
- The definition also suggests that a person is classed as abnormal if their behaviour causes distress to themselves or others - it focuses on personal dysfunction and individual suffering, therefore drawing attention to the personal experiences associated with mental disorders
3 - Failure to function adequately application
- For example, having to clean the germs off items may mean that they are late for work and so get fired i.e. they cannot maintain (cope with) a job. Therefore, they are classed as abnormal (OCD).
- In order to assess how well individuals cope with everyday life clinicians use the Global Assessment of Functioning scale (GAF) which rates their level of social, occupational and psychological functioning
(in exam questions: For failure to function adequately, you must make it clear within your answer how the person is no longer functioning adequately e.g. will they get fired? Will they no longer have satisfying relationships? Can they not maintain basic personal hygiene standards?)
3 - Failure to function adequately - Rosenhan and Seligman (1989)
- Suggest there are seven features to personal dysfunction and the more an individual has, the more abnormal their classification
Features of personal dysfunction -
1) Personal distress - a key feature of abnormality which involves anxiety or depression disorders
2) Maladaptive behaviour - behaviour stopping individuals from attaining life goals socially and occupationally
3) Unpredictability - displaying unexpected behaviours characterised by loss of control, like attempting suicide after failing a test
4) Irrationality - displaying behaviour that cannot be explained in a rational way
5) Observer discomfort - displaying behaviour causing discomfort to others
6) Violation of moral standards - displaying behaviour violating society’s moral standards
7) Unconventionality - displaying unconventional behaviours
Examples of deviants under these definitions
Harold Shipman - serial killer doctor; deviation from social norms
Steven Gough - naked rambler; believed he had a right to walk around naked and that it was separate from sexual behaviour, was arrested several times attempting to walk from John O’Groats to Land’s End in 2003-2004 and in other occasions upon release and on a walk from Scotland to Hampshire when he passed a children’s playground. He saw no issue with his behaviour, was inconsiderate, intolerant and confrontational of authorities and can be considered abnormal under almost all definitions
3 - Evaluation of the failure to function adequately definition - Weaknesses
1) Psychopaths (people with dangerous personality disorders) can cause great harm and yet still appear normal - Harold Shipman, the English doctor who murdered at last 215 of his patients over a 23 year period seemed to e a respectable doctor ; he maintained a job, personal hygiene, interpersonal relationships (married children) etc. He was abnormal, but didn’t display features of functioning inadequately and so would be considered normal under this definition
- This makes the definition lack some external validity as it fails to identify abnormality that isn’t dysfunctional and so is too narrow as a definition to be applicable to all abnormalities
2) Suffers from cultural relativism - in some cultures, women are not expected to maintain a job, or people are expected to go without food for significant periods of time. Using this definition, such people would be classified as abnormal simply because their cultural norms differ from our own. This may explain why lower class and non-white parents are more often classified as abnormal as their lifestyles are different from the dominant culture and this may lead to a judgement of failing to function adequately
- This definition is therefore not generalisable to all cultures and lacks ecological validity, suffering from cultural relativism
3 - Evaluation of the failure to function adequately - Weaknesses cont. + Strengths
3) When deciding whether someone is failing to function adequately, someone has to judge whether a patient is distressed or distressing others. Some patients may say that they are distressed but may not be judged as suffering, and there are methods for making such assessments as objective as possible, such as the GAF, but the principle remains that someone has the right to make this judgement
- This suggests that the definition lacks some inaccuracy due to diagnostic bias and therefore the definition is limited and it also has some determinism and ethical issues as it could unnecessarily diagnose someone; it is influenced by subjectivity
Strengths -
1) It attempts to include the subjective experience of the individual and it may not be an entirely satisfactory approach because it is difficult to measure distress but the definition acknowledges that the experience of the patient is important and therefore the definition captures the experience of many who need help
- This suggests that the definition is more accomodating of the individual and therefore has more external validity as a definition and has real-world applications in helping many people
3 - Failure to Function Adequately - Definition
- The failure to function adequately defines individuals as abnormal when their behaviour suggests that they cannot cope with everyday living. ‘Functioning’ refers to going about everyday life e.g. eating regularly, washing clothes, getting up to go to work, being able to communicate with others, having some control over your life etc. Behaviour is considered abnormal when it causes distress, leading to an inability to function properly e.g. disrupting the ability to work or conduct satisfying interpersonal relationships.
- Therefore, not functioning adequately could include having to wash your hands so frequently to rid yourself of germs that you are late for work. When this happens frequently, you get fired i.e. you cannot maintain (cope with) a job, which is a part of everyday living. Consequently, you are classed as abnormal (in this case, it may be OCD).
- Not functioning adequately causes distress and suffering for the individual, and/or may cause distress to others (or be irrational or dangerous to themselves or others). The latter is important because in the case of some mental disorders, the individual may not be distressed at all. People with schizophrenia generally lack awareness that anything is wrong, but their behaviour (hallucinations, believing that they are being persecuted) may be distressing to others.
- There may be situations where a person is not coping with everyday life in a ‘normal’ way (e.g. they are content living in unwashed clothes and do not have a job). If this doesn’t cause distress to self or others, the person is not considered abnormal.
4 - Deviation from the ideal mental health - Definition
- This definition perceives abnormality in a similar way to how physical health is assessed, by looking for signs of an absence of wellbeing - any deviation from normal wellbeing is abnormal
- This definition has a set of characteristics that define what it means to be normal provided by Jahoda (1958) who devised the concept of ideal mental health
- Proposed by Jahoda (1958), this definition looks at the positives rather than the negatives – the idea of mental health rather than mental illness.
- Jahoda identified 6 major criteria for optimal living, which she believed promoted psychological health and well-being, enabling an individual to feel happy (free of distress) and behave competently.
- The more characteristics one fails to meet the further away they are from realising individual characteristics and the more abnormal they are
- She claimed that anyone lacking any of these qualities would be vulnerable to mental disorder, and therefore ‘abnormal’.
- Similar to the deviation from social norms definition and the failure to function adequately definition, this definition focuses on behaviours and characteristics seen as desirable, rather than what is undesirable
