5.1 Normality vs Abnormality

Abnormal Psychology

Refers to the study of atypical or abnormal behaviour, thoughts, or emotions that deviate from culturally accepted norms.

Focuses on diagnosis, explanation, and treatment of abnormal behaviour

Psychopathology

Scientific study of mental disorders, their symptoms, causes, and treatments

What are the main four approaches to defining abnormality

Deviation from social norms

Inadequate functioning

Deviation from ideal mental health

Statistical infrequency

What are social norms in the context of abnormal psychology

Unwritten rules that govern social behaviour, which varies across cultures and time periods

Key problem when defining abnormality using social norms

Societies are different and changeable, so definitions of abnormality vary across cultures and time

Abnormality in terms of social norms

behaviour that falls outside the boundaries of what is accepted in a given society

How does statistical infrequency define abnormality

behaviour or traits that are statistically rare or unusual

What might be considered ‘severely abnormal’ under statistical infrequency

Falling outside the 99.9% range in a given trait or behaviour

Why is a common language (e.g. classification systems) necessary in psychology?

To identify problems precisely and determine appropriate treatment strategies

What is a common issue across all definitions of abnormality

None are free from controversy

What does the medical model of abnormality assume

That mental disorder have causes, which are inferred through observable symptoms

What is implied by the medical classification of abnormal behaviour

That each disorder has a recognisable pattern of symptoms

What is a strength of the medical model

Flexibility - it accommodates multiple perspectives on mental illness and allows diagnosis regardless of theoretical stance

What is another challenge of the medical model

Deciding which symptoms correspond to which specific disorder

How do classification systems help

They address these difficulties by providing standardised categories for diagnosis

Study for Normality vs Abnormality ERQ Question

Chmeilewski and Temerlin

Chmeilewski et al. Year

2015

Aim

To investigate whether differences in diagnostic reliability between DSM-iV and DSM- 5 are due to changes in diagnostic criteria or differences in methods used to assess reliability

Method

Correlational

Design

Repeated Measures

Sampling Strategy

Purposive; 339 psychiatric outpatients

Independent Variable

Whether clinicians used the audio-video or test-retest method of diagnosis

Dependent Variable

Concordance rate of diagnosis

Procedure

Ppts completed a self-report measures and diagnostic interview

Audio-recording group: Diagnoses were independently rated by a second clinicians using the audio recording

Test-retest group: Different clinicians conducted two interviews approximately one week apart

Interrater reliability was calculated

Stability of self-reported symptoms was also assessed across the interval

Findings

IRR:

Audio = 0.8

Test-retest = 0.47

Self-reported symptoms were highly stable

Changes in diagnosis were not related to changes in self-reported symptoms

Conclusion

Differences in reliability between DSM-IV and DSM-5 likely due to methodological issues, not flaws in diagnostic criteria

Study Used With Chmielewski Normality vs Abnormality

Temerlin

Temerlin year

1968

Aim

To investigate how diagnostic labelling by mental health professionals could be influenced by prior suggestion

Method

True Lab Experiment

Design

Matched Pairs

Sampling Strategy

Purposive; 45 graduate students in clinical psychology, 25 practising clinical psychologists, and 25 psychiatrists

Independent Variable

Whether clinicians were told in advance that the patient exhibited neurotic tendencies

Dependent Variable

Diagnostic Outcome

Procedure

Clinical psychologists watched a video of an interview with a healthy individual. One group heard a respected psychologist say, “A very interesting man because he looked neurotic but actually was quite psychotic.”

After reviewing the tape, participants selected their best-guess diagnosis from a list of 30 choices: 10 psychotic disorders, 10 neurotic disorder, and 10 miscellaneous personality types, including “normal or healthy personality.”

Findings

Majority (60%) of the psychiatrists, 28% of the clinical psychologists, and 11% of the graduate students diagnosed the patient as psychotic, whereas in the control group, none of the participants made this diagnosis

Conclusion

E.g. of confirmation bias; after hearing the respected psychologist make an informal diagnosis, the participants paid attention to behaviours that agreed with the idea that the man was psychotic. This shows that having a previous diagnosis and making that known to a doctor may influence the objectivity of a second opinion.