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.