Abnormal Psychology

Abnormal Psychology Discuss to what extent biological, cognitive, and sociocultural factors influence abnormal behaviour Evaluate psychological research (theories and studies) relevant to the study of abnormal behaviour Examine the concepts of normality and abnormality Discuss validity and reliability of diagnosis Discuss cultural and ethical considerations in diagnosis

Abnormal psychology – the branch of psychology that deals with studying, explaining and treating abnormal behaviour. • Three groups of disorders: • Anxiety disorders • Affective disorders • Eating disorders

Different definitions of abnormal: • Statistical abnormality – useful for quantitative descriptions (I.Q.) leading to descriptive and inferential ways of defining abnormal objectively as extremely rare. • However, situational and dispositional factors for behaviour must be known to define behaviour as rare. Not all behaviour that is statistically infrequent is a sign of mental illness.

Deviation from social norms • behaving contrary to socially expected ways. In a given context, this approach assumes that there is an expected behaviour • Problems: • Social norms vary across and within cultures • Social normality has changed across time • Social normality has been defined to reinforce gender or power relations among classes

Maladaptiveness and adequate functioning • assumes that we all seek out things that are good for us and positively affect our capacity to function well • Useful for clinical definitions - eating disorders and alcoholism – but not for other behaviours – thrill seeking, etc.

Suffering and distress • focusses on the patient’s needs and on the result of behaviours rather than defining behaviours as in themselves abnormal. Allows for the patient to define for themselves which interventions are required. • Effective clinical definition but assumes that patients will always have clarity/insight to assess their own state – not always the case. • Further – some distress/suffering should occur as a healthy reaction to crisis. Actually a sign of psychological health.

Jahoda’s positive mental health • developed by Marie Jahoda (1958) – tried defining normal rather than abnormal. • 6 components of ideal mental health: • Positive attitude toward self • Growth, development, self-actualization • Integration • Autonomy • Accurate perception of reality • Environmental mastery • It logically follows that the opposite of these states defines abnormal. • An effective definition however few people would attain all 6 components and in some ways we shouldn’t • Taylor and Brown (1988) – some people with depression actually have a more accurate picture of the world and healthy functioning required some elements of self-delusion

Diagnostic systems and the validity and reliability of diagnosis • DSM-IV-TR - published by the APA first in 1952. Fourth edition revised and fifth recently released. • Seeks to make diagnosis more reliable, valid, and standardized across different clinicians. Groups disorders into categories and lists symptoms required for diagnosis when cultural, other medical conditions, social and environmental factors, and general functioning are taken into considerations. • ICD – International Classification of Diseases – conceived by the WHO to standardize records of cause of death. In 10th revision. Used more widely than DSM. Focus is on classification rather than diagnosis • CCMD – Chinese Classification of Mental Disorders – in 3rd revision. Focussed on Chinese culture omitting some diagnoses viewed as specific to Western culture

Ethical concerns • Medical usage of diagnostic systems varies from country to country. Causes compulsory incarceration, involuntary treatment, some diagnoses are considered a treatable disorder in some countries and not abnormal at all in others.

Reliability – 2 main issues • Inter-rater reliability – Nicholls et al (2000) – 81 children at an eating disorder clinic diagnosed according to three different systems resulted in differing rates of agreement between each other – some not diagnosed at all • Test-retest reliability – Seeman (2007) – literature review showed that women diagnosed with schizophrenia would have changing diagnoses as their clinicians learned more and more about the patients

Validity issues • Liang – systematic diagnosis is made by categorizing behaviour rather than with biomedical data. Making diagnosis a social label rather than a scientific one. Diagnosis comes with political, legal and financial consequences – particularly for medications and the pharmaceutical industry. • Szasz – invalid to view behaviours as contrary to expectations and therefore diseases. Biological factors are not fully known and underlying causes unknown therefore courses of treatment may not have basis for judging success. • Eg. Life events may be a valid explanation for symptoms and therefore medications would not be appropriate

Relevant research • Caetano (1973) - Labelling Theory • Aims – • Methods – • Conclusions – • Rosenhan (1973) • Aims – • Methods – • Conclusions –

Abnormal Psychology