definitions of abnormality

DSM-5

• diagnostic and statistical manual

• book that has a list of all mental disorders and is used by psychiatrists to diagnose mental disorders, for each disorder a list of clinical characteristics is given i.e. the symptoms that should be looked for

definitions of abnormality- statistical infrequency

• occurs when an individual has a less common characteristic eg being more depressed or less intelligent than most of the population

• most obvious way to define abnormality, uses mean, median and mode (descriptive statistics), used as a way to represent the typical value in any set of data

• any behaviour less common than the average is 'abnormal'

example of statistical infrequency- IQ and intellectual disability disorder

• the average IQ is 100, people with an IQ of 70 or under are classified as mentally retarded or intellectual disability disorder (abnormal)

• they have a characteristic that is outside the normal distribution and can be reliably measured, different or rare behaviour is abnormal

strength of statistical infrequency- real world application

• its useful in diagnosis eg intellectual disability disorder as this requires an IQ in the bottom 2%

• its also helpful in assessing a range of conditions eg the BDI assesses depression, only 5% of people score 30+ (=severe depression)

• this means statistical infrequency is useful in diagnostic and assessment processes

limitation of statistical infrequency- unusual characteristics can be positive

• if very few people display a characteristic, then the behaviour is statistically infrequent but doesn't mean we would call them abnormal

• IQ scores above 130 are just as abnormal as those below 70, but not regarded as undesirable or needing treatment

• this means although statistical infrequency can be part of defining abnormality, it can never be the sole basis

limitation of statistical infrequency- benefits vs problems

• when someones living a happy and fulfilled life, there's no benefit to them being labelled abnormal

• however the label of abnormality eg intellectual disability disorder may carry social stigma

• this means labelling someone abnormal just because their statistically unusual is likely to do more harm than good

definitions of abnormality- deviation from social norms

• in society there are standards of acceptable behaviour set by a social group and adhered to by those socialised into that group, anyone who behaves differently (deviates) from these norms is classified as abnormal

• there are relatively few behaviours that are universally abnormal so definitions are related to cultural context, includes historical differences in the same society eg homosexuality, viewed as abnormal in the past and some cultures

example of deviation from social norms- antisocial personality disorder

one important symptom is failure to conform to 'lawful and culturally normative ethical behaviour' i.e. they deviate from social norms and generally lack empathy, are impulsive, aggressive and irresponsible

Broverman et al. (1970) deviation from social norms experiment- procedure

asked therapists to complete a questionnaire where they were asked to describe the characteristics of people in terms of 122 opposite pairs of traits

Broverman et al. (1970) deviation from social norms experiment- findings

• double standards of mental health for males and females

• healthy males was described and rated in the same way as a healthy person, healthy female described differently to both eg submissive, emotional, sensitive, easily influenced etc, socially undesirable for a healthy adult

strength of deviation from social norms- real world application

• its useful in the diagnostic of antisocial personality disorder as this requires failure to conform to ethical standards

• its also helpful in diagnosing schizotypal personality disorder which involves 'strange' beliefs and behaviour

• means its useful for psychiatric diagnosis

limitation of deviation from social norms- social norms are situationally and culturally relative

• a person from one culture may label someone from another culture as abnormal using their standards not the persons standards

• eg hearing voices is socially acceptable in some cultures but would be seen as a sign of abnormality in the UK

• this means its difficult to judge deviation from social norms from one context to another

limitation of deviation from social norms- human rights abuses

• reliance on deviation from social norms to understand abnormality can lead to abuse of human rights eg nymphomania (disorder) to control female behaviour

• however we need to be able to use it to diagnose conditions eg APD

• suggests that overall, the use of deviation from social norms to define abnormality may do more harm than good due to the potential for abuse

definition of abnormality- failure to function adequately

• occurs when someone is unable to cope with ordinary demands of day to day living eg not being able to maintain basic standards of nutrition, hygiene, hold down a job or maintain relationships

• causes distress and suffering for the individual and others, sometimes the individual may not be distressed as they lack insight into their condition

• may be situations where someone isn't coping with everyday life 'normally' eg may be content not holding down a job, if it doesn't cause distress to them or others a judgment of abnormality is inappropriate

example of failure to function adequately- intellectual disability disorder

a very low IQ is a statistical infrequency, but diagnosis wouldn't be made on this basis alone, definitions often work together/ aren't individual, there would have to be clear signs they're also failing to function adequately

strength of failure to function adequately- threshold for professional help

• in any year 25% of us experience symptoms of mental disorder to some degree

• most of the time we press on, but when we cease to function adequately people seek or are referred to professional help

• means it provides a way to target treatment and services to those who need them

limitation of failure to function adequately- can lead to discrimination/ social control

• its hard to distinguish between failure to function and a conscious decision to deviate from social norms

• eg people may choose to live off grid as part of an alternative lifestyle choice or take part in high risk leisure activities

• means people who make unusual choices can be labelled abnormal and their freedom of choice restricted

limitation of failure to function adequately- failure to function can be normal

• in some circumstances, most of us can't cope eg bereavement, its unfair to give someone a label for reacting normally to difficult circumstances

• however, failure to function is real regardless of the circumstances, a person may need professional help to adjust to bereavement

• means its hard to know when to base a judgement of abnormality on failure to function

definitions of abnormality- deviation from ideal mental health

• occurs when someone doesn't meet a set of criteria for good mental health, deviates from being normal and psychologically healthy

• overlap between definitions: someones inability to keep a job may be a sign of failure to cope with pressures of work (failure to function) or deviation from the ideal of successfully working

what was Jahoda's (1958) criteria for ideal mental health?

1. we have no symptoms or distress

2. we're rational + perceive ourselves differently

3. we can self actualise

4. we can cope with stress

5. we have a realistic view of the world

6. we have good self esteem + lack guilt

7. we're independent of other people

8. we can successfully work, love and enjoy our leisure

strength of deviation from ideal mental health- approach is comprehensive

-ideal mental health includes a range of criteria for mental health, it covers most of the reasons we might need help with mental health

-means mental health can be discussed meaningfully with a range of professionals eg psychiatrists or CBT therapists

-therefore it provides a checklist against which we can assess ourselves and others

limitation of deviation from ideal mental health- may be culture bound

• some criteria for ideal mental health are limited to the US and Europe eg self actualisation isn't recognised in the most of the world

• even in Europe there are variations in the value of independence (high in Germany, low in Italy)

• means its very difficult to apply the concept of ideal mental health from one culture to another

evaluation of deviation from ideal mental health- extremely high standards

• few of us attain all Jahoda's criteria for mental health and none of us maintain them for long, an impossible set of standards can be disheartening

• on the other hand, having such a comprehensive criteria for mental health may be of value to someone wanting to improve theirs

• means a set of comprehensive criteria for mental health may be helpful for some but not others