Psychopathology

• Statistical infrequency = Implies that a disorder is abnormal if its frequency is more than two

standard deviations away from the mean incidence rates represented on a normally-distributed

bell curve.

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• Statistical infrequency is almost always used in the clinical diagnoses of mental health disorders

as a comparison with a baseline or ‘normal’ value. This is used to assess the severity of the

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disorder e.g. the idea that Schizophrenia only affects 1% of the general population, but

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subtypes are even less frequent (such as hebephrenic or paranoid Schizophrenia).

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— Statistical infrequency makes the assumption that any abnormal characteristics are

automatically negative, whereas this is not always the case. For example, displaying abnormal

levels of empathy (and thus qualifying as a Highly Sensitive Person) or having an IQ score above

130 (and thus being a genius) would rarely be looked down upon as negative characteristics

which require treatment.

• The failure to function adequately definition of abnormality was proposed by Rosenhan and

Seligman (1989) and suggests that if a person’s current mental state is preventing them from

leading a ‘normal’ life, alongside the associated normal levels of motivation and obedience to

social norms, then such individuals may be considered as abnormal. This occurs when the

patient does not obey social and interpersonal rules (e.g. standing precariously close to others),

are in distress or are distressing, and their behaviour has become dangerous (not limited to

themselves, but may also pose a danger to others).

• A major strength of this definition of abnormality is that it takes into account the patient’s

perspective, and so the final diagnosis will be comprised of the patient’s (subjective) selfreported symptoms and the psychiatrist’s objective opinion. This may lead to more accurate

diagnoses of mental health disorders because such diagnoses are not constrained by statistical

limits, as is the case with statistical infrequency.

— A major weakness of using this definition of abnormality is the idea that it may lead to the

labelling of some patients as ‘strange’ or ‘crazy’, which does little to challenge traditional negative

stereotypes about mental health disorders. Not everyone with a mental health disorder requires a

diagnosis, especially if they have a high quality of life and their illness has little impact upon

themselves or others. Instead, such labelling could lead to discrimination or prejudice faced

against them by employers and acquaintances.

• The deviation from social norms definition of abnormality suggests that ‘abnormal’ behaviour is

based upon straying away from the social norms specific to a certain culture. There are general

norms, applicable to the vast majority of cultures, as well as culture-specific norms. For

example, an individual would be diagnosed with antisocial personality disorder (APD) if they

behave aggressively towards strangers (breaching a general social norm) and if they experience

certain hallucinations (which breaches the social norms of multiple cultures also, whereas other

cultures may encourage this as a sign of spirituality).

— The fact that mental health diagnoses based on this definition vary so significantly between

different cultures has historically led to discrimination, as a mechanism for social control. For

example, in the nineteenth century within Great Britain, ‘nymphomania’ described the mental

health disorder suffered by women who demonstrated sexual attractions towards working-class

men. In reality, this diagnosis was simply made to prevent infidelity, cement the differences

between social classes and further discriminate against women, thus being a reflection of a

patriarchal society.

— Due to its reliance on subjective social norms, this explanation also suffers from cultural

relativism. One such example would be the hearing of voices which have no basis in reality, or

‘hallucinations’. Some African and Asian cultures in particular would look upon this symptom

positively, viewing it as a sign of spirituality and a strong connection with ancestors, as opposed

to a symptom of Schizophrenia. This therefore suggests that the use of this definition of

abnormality may lead to some discrepancies in the diagnoses of mental health disorders,

between cultures.

• Deviation from ideal mental health is the fourth definition of abnormality, and was proposed by

Jahoda (1958). Instead of focusing on abnormality, Jahoda looked at what would comprise the

ideal mental state of an individual. The criteria include being able to self-actualise (fulfill one’s

potential, in line with humanism!), having an accurate perception of ourselves, not being

distressed, being able to maintain normal levels of motivation to carry out day-to-day tasks and

displaying high self-esteem.

— The main issue with this definition of abnormality is that Jahoda may have had an unrealistic

expectation of ideal mental health, with the vast majority of people being unable to acquire, let

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Psychopathology

alone maintain, all of the criteria listed. This means that the majority of the population would be

considered abnormal, even if they have missed a single criteria e.g. being able to rationally cope

with stress (which most people would agree does not merit a diagnosis). Therefore, deviation from

ideal mental health may be considered a very limited method of diagnosing mental health

disorders.

— This definition, just like deviation from social norms, suffers from cultural relativism. For

example, the concept of self-actualisation, which suggests that we must each put ourselves first

in order to achieve our full potential, may be viewed as selfish in collectivist cultures (e.g. China)

where the needs of the group are valued more than the needs of the individual. On the other hand,

self-actualisation may be a more popular concept in individualist cultures (e.g. the UK), where

personal achievement is celebrated and the needs of the individual are greater than the needs of

the group. This suggests that deviation from ideal mental health would only be accepted as a

definition for abnormality in some (individualist) cultures.

Part 2 — Characteristics of Phobias

• The behavioural characteristics of phobias

are panic, avoidance and endurance.

• Panic — the patient suffers from heightened

physiological arousal upon exposure to the

phobic stimulus, caused by the

hypothalamus triggering increased levels of

activity in the sympathetic branch of the

autonomic nervous system.

• Avoidance — avoidance behaviour is

negatively reinforced (in classical

conditioning terms) because it is carried out

to avoid the unpleasant consequence of

exposure to the phobic stimulus. Therefore,

avoidance severely impacts the patient’s

ability to continue with their day to day lives.

• Endurance — this occurs when the patient

remains exposed to the phobic stimulus for

an extended period of time, but also

experiences heightened levels of anxiety during this time.

• The main emotional characteristics of phobias are anxiety (the emotional consequence of the

physiological response of panic) and an unawareness that the anxiety experienced towards the

phobic stimulus is irrational (from an evolutionary perspective, the phobic anxiety is not

proportionate to the threat posed by the stimulus).

• The cognitive characteristics of phobias are selective attention to the phobic stimulus, irrational

beliefs and cognitive distortions.