Abnormal Psychology: Definition & Diagnosis

Terminology Evolution

• Labels shifted from “madness” → “abnormal psychology” ($1970s$) → “psychopathology” (current), mirroring changes in definition, diagnosis, and treatment.

Historical Perspectives

• Prehistoric trephining: skull punctures to expel evil spirits.
• Hippocrates: mental suffering (melancholia, mania) due to bodily‐fluid imbalance—first naturalistic model.
• Collapse of Greco-Roman world → return to demonology for ~$2000$ years.
• Kraepelin ($1883$): launches modern psychiatry; later joined by psychoanalysis, behaviourism, CBT.
• Non-Western cultures may still interpret disorders as spirit possession.

Social Construction of Abnormality

• Normal/abnormal decided by cultural norms, not pure science (Mar Chechin & Hare-Mustin $2009$).
• Behaviour lies on a continuum, not a strict dichotomy (Gross $2009$).
• Homosexuality: listed as disorder until $1980$; removed after DSM vote ($1973$); still in Chinese CCMD-$3$.
• Johnstone: overnight “cure” shows classification power.

Marginalization & Bias

• Sexism: female sexuality long deemed less normal (Freud; Gergen $1994$).
• Racism: “drapetomania” pathologized slaves’ escape; UK study showed schizophrenia diagnoses $6$× higher in Black males, but Caribbean comparison erased difference (Cochrane $1983$).

Diagnostic Classification Systems

• ICD (WHO): mental-disorder chapter added $1948$; current ICD-$10$ (rev. $2007$) lists $10$ main categories + “unspecified.”
• DSM (APA): launched $1952$; current DSM-IV-TR ($2000$); DSM-V planned $2013$; most widely used for clarity/ease.
• CCMD (China): first $1979$; CCMD-$3$ ($2001$); views mind–body as unified and stresses cultural specificity.

Reliability & Validity Issues

• Misdiagnosis arises from tool bias & context neglect; behaviour must be interpreted within cultural/social setting (Fine $1989$, Altamese case).
• Over- vs under-diagnosis: diagnostics guide attention to some factors, ignore others (Mar Chechin & Hare-Mustin $2009$).
• Call to widen systems to include cultural background, environment.

Prevalence & Societal Impact

• Lifetime risk in UK ≈ $\frac14$ people.
• $94\%$ believe a diagnosis would harm employment.
• Accurate, culturally sensitive diagnosis is therefore essential.