Psychopathology: Abnormality

1. Psychopathology:Abnormality In psychology individual differences involves the study of the ways that individuals differ in terms of their psychological characteristics. People differ in many ways: in their intelligence, aggressiveness, willingness to conform, masculinity and femininity, etc. An important individual difference is in the degree to which a person is mentally healthy. This is Psychopathology and it is this area of individual differences we study in AS Psychology. In order to protect and/or treat people with an abnormality psychologists need to be able to define them as having abnormal psychopathology. So how do we define someone as being abnormal? What parameters do we use? 1

2. Is this Abnormal?

3. What makes someone abnormal?Your Ideas…… on board So do these ideas fit into one of the four following categories? Statistically rare, Going against social norms, Mentally ill Or Inability to function safely (danger to self or others) 3

4. Definitions of Abnormality • Defining a person or behaviour as ‘abnormal’ implies something undesirable and requiring change • Therefore, we must be careful how we use the term • Psychologists need methods for distinguishing ‘normal’ from ‘abnormal’

5. How do we decide what is abnormal? • Deviates from social norms • Leads to Failure to Function adequately • Deviates from “Ideal Mental Health” • Statistical infrequency • Describe these for your A01 • Evaluate them for your A02

6. Learning objectives • To know the ‘deviation from social norms’ definition of abnormality • To understand how different types of abnormal behaviour can be described as deviating from social norms, but also some of the problems with their explanations • Be able to describe and evaluate deviation from social norms as a definition of abnormality.

7. Definitions of Abnormality Statistical infrequency/deviation from statistical norms Certain behaviours are statistically rare & so ‘abnormal’ Deviation from social norms Behaviour that is socially deviant is regarded as abnormal Failure to function adequately Maladaptive behaviour ~ a danger to self or others ~ an inability to cope with everyday life. Deviation from ideal mental health Mentally illness: The lack of a “contented existence” Not being mentally ‘healthy’ 7

8. A very unusual behaviour or trait will be more than 2 standard deviations from the mean. i.e. over 130 or under 70 IQ score. This statistically ‘rare’ behaviour or trait is likely to be seen as being abnormal. 8

9. Statistical Infrequency ~Is all rare behaviour abnormal and if not how do we decide what is ~ is this? 9

10. Statistical Infrequency: Limitations/Criticisms Mental Health By this definition all rare behaviour would be seen as abnormal however, depression and anxiety are not rare but clinical depression is rare (but is only diagnosed if patient attends the doctors – so how do we know how rare it is?) Gender Issues (Females are more likely than males to consult a GP). (In our culture females can wear makeup and skirts without seeming abnormal …… males ??? Well David Beckham manages it!) Cultural Issues (Jewish people mourn by tearing their clothes and wailing in public.) (In India mentally ill people are thought to be cursed) (In china being mentally ill carries such a stigma that it is rarely diagnosed) (Some cultures walk around naked and you are in the minority if you are clothed!) (In the USA 48% of people were treated for psychological disorders at some point – by this definition that would make them normal!) Age Thumb sucking and bed wetting may be considered statistically normal at 2 years old but not at 20! Desirability of behaviourMany behaviours are rare but considered highly desirable (High IQ, Great athletic ability). It is difficult to know how far you have to deviate from the average to be considered abnormal? 10

11. Advantages of this approach Statistical Infrequency is an obvious and relatively quick and easy way to define abnormality. It has face validity that odd or rare behaviour is seen as abnormal Applications of statistical definitions: It is relatively easy to determine abnormality using psychometric tests developed using statistical methods.E.g. there is a test for O.C.D. – Obsessive compulsive disorder. You can have a go at the test if you like – could you be a potential sufferer? First watch an O.C.D. sufferer in action! 11

12. Deviation from social norm

13. L3 Society sets up rules for behaviour based on a set of moral standards which become social norms (V.I.M.). Any deviation is seen as abnormal (Szasz 1972) This suggests that madness is a term manufactured in order to label the people in society who do not conform to the rules of society. These unwritten social rules are culturally relative (i.e. you cannot judge behaviour properly unless it is viewed in the context from which it originates as different cultures have different social norms and behaviour may differ across cultures). A lack of cultural relativism can lead to ethnocentrism, where only the perspective of your own culture is taken. Social norms can also be era-dependent. For example, homosexuality was once illegal and considered to be a mental disorder because it deviated from the social norm. Now there are campaigns for gay marriages to be recognized and afforded the same benefits as heterosexual marriages This shows the extent to which this definition of abnormality is subject to change. Deviation from social norm 13

14. Historical Issues: Until early 20th century, unmarried women who became pregnant were interred in mental institutions. Until 1960's in the UK homosexual acts were criminal offences Until 1973 in USA homosexuality was a mental disorder! Cultural Issues: Russia - a diagnosis of insanity was used to detain political dissidents. Japan - You are deemed insane if you do not want to work! Western Societies - you can plead insanity as a defence - Lorena Bobbit cut of her husband's penis - pleaded / temporary insanity! Expected Behaviour: African/Indian cultures consider it normal to talk to the dead. Nakedness normal in some cultures. Context: Singing in park understood if you see the film crew! SUMMARY: Social norms is a subjective measurement of abnormality as norms change over time and differ between cultures. This approach has been used as a form of social control. Social norms are necessary and specific to each society to enable members of each society to know the ‘rules’ in order to get along together! Anti-Social Behaviour can be viewed as abnormal under this definition e.g. AO2: Deviation from Social Norms Limitations / Issues ! Hello! 14

15. Deviation from ideal mental health Jahoda (1958) six criteria

16. Marie Jahoda (58) • There are 6 criteria for living a healthy normal life according to this psychologist. Moving away from these could lead to a mental health problem

17. Deviation from Ideal Mental Health:Six Categories that Clinicians Typically Relate to Mental HealthPRAISEMarie Jahoda (1958) Personal growth (Self Actualisation: should reach your potential) Reality perception (should know what’s real) Autonomy (should be independent) Integration (should ‘fit in’ with society and be able to cope with stressful situations) Self-attitudes (should be positive: high self esteem) Environmental mastery (should cope in your environment, be able to function at work and in relationships, adjust to new situations and solve problems) 17

18. Deviation from Ideal Mental Health Limitations/Criticisms Jahoda 1958 said that it was better to focus on positive aspects of mental health rather than the negative – so this is seen as a positive attempt to define abnormality. Positive self attitude (Many people have a negative self image due to such things as – Bullying, Persecution of gender and/or race etc – but are they abnormal?) Growth to one’s potential or ‘self actualisation’ ( Very few people reach their full potential due to such things as – Family commitments, Money, Social / peer pressure, Gender OR Culture: some countries women are not allowed to work! – are they abnormal? CULTURAL RELATIVISIM!) Resistance to stress (Integration) Should ‘fit in’ without suffering stress. Some people thrive on stress, Personality may make you more susceptible, Some people crack under enormous amounts of stress – prisoner of war camps – are they abnormal?) Autonomy (independence)– ability to make our own decisions (Some people cannot – due to disability – illness – age – culture e.g. arranged marriages, collectivist societies ‘WE not ME’ – prisoners – poverty – are they abnormal?) Perception of reality (Other things than mental illness affect our perception of reality e.g. Alcohol, drugs/LSD, illness/diabetes – are they abnormal?) Adapting to the environment (More difficult if you are poor, black, female, disabled etc. but are they abnormal?) SUMMARY Criteria are so demanding that almost everyone is bound to fall into the category of mental ill health! 18

19. Do all cultures contain members who want to be independent, fulfilled and happy in work and play?

20. Failure to function adequatley Can this person cope? Are they showing signs of failure to function?

21. Failure to function adequately A definition of abnormality based on an inability to cope with day-to-day life caused by psychological distress or discomfort which may lead to harm of self or others. 21

22. Failure to Function Adequately • Rosenhan & Seligman (1989) suggest the following characteristics: • Suffering • Maladaptiveness (danger to self) • Vividness & unconventionality (stands out) • Unpredictability & loss of control • Irrationality/incomprehensibility • Causes observer discomfort • Violates moral/social standards

23. Failure to Function Adequately This is seen as a humane way of addressing psychological problems as it allows the individual to decide if they need or wish to seek help. However it does have some limitations as a method of defining abnormality such as: Labelling – a label gives a stigma that may stick around long after the problem has gone. Can affect employment prospects and personal relationships. Gender issues – Bennett 1995 found that societies have created masculine stereotypes that alienate men from seeking help for psychological problems. Enforced detaining in mental institutions – If behaviour appears abnormal there is no institutionalisation providing the individual can function adequately and is not harming self or others. Before 1983 people could be detained in mental institutions against their will on the authority of a health professional guardian or husband. (NOTE: Wives could not have husbands detained!) Psychiatric prison is the only place in the UK that people can be detained against their will. Care in the community – means that there are not enough hospital places for those who want residential care. So health professionals leave people alone unless there is severe dysfunction. SUMMARY Leaves power with the individual. Not functioning adequately is not seen as serious in mental disorder terms. Individuals may be aware or unaware of their own dysfunction – so how can psychiatrists be sure of a diagnosis – and how can they know for sure when a patient is ‘cured’? 23

24. A list can give us an easy measure of whether people are functioning or not. But who decides what’s on the list and how may this affect the items on it?