Definitions of abnormality

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  • Definitions of Abnormality
    • Statistical infrequency
      • Determining whether behaviour is 'abnormal' in relation to how many other people also display it
      • Example: IQ and Intellectual Disability Disorder
        • 2% of people have an IQ score under 70
        • Likely to be given a diagnosis of a mental disorder
      • Real-life application
        • The diagnosis of intellectual disability disorder
        • Useful part of clinical assessment
      • Unusual characteristics can be positive
        • IQ scores over 130 are just as unusual as those under 70 but aren't considered worthy of treatment
        • Can never be used alone to make a diagnosis
      • Not everyone unusual benefits from a label
        • There is no benefit of being labelled as abnormal when someone is living a happy, fulfilled life
        • Labels may have a negative effect on the way others view individuals and how they view themselves
    • Deviation from social norms
      • Groups of people choose to define behaviour as abnormal on the basis that it offends their sense of what is 'acceptable' or the norm.
      • Norms are specific to the culture we live in
        • May be different for each generation and every culture
        • There are relatively few behaviours that would be considered universally abnormal
        • E.g. homosexuality is seen as abnormal in some cultures and was considered abnormal in our society in the past
      • Example: Antisocial Personality Disorder
        • A person with antisocial personality disorder is impulsive, aggressive and irresponsible
        • One important symptom is an 'absence of prosocial internal standards associated with failure to conform to lawful or culturally normative ethical behaviour'
        • We are making the social judgement that a psychopath is abnormal because they don't conform to our moral standards. Psychopathic behaviour would be considered abnormal in a wide range of cultures
      • Not a sole explanation
        • Has a real life application in the diagnosis of antisocial personality disorder
        • Even in this case there are other factors to consider. For example, the distress to other people
      • Cultural relativism
        • Social norms vary from one generation to another and from one community to another
        • This means that a person from one cultural group may label someone from another culture as behaving abnormally according to their standards rather than the standards of the person behaving that way
      • Can lead to human rights abuses
        • In history, some diagnoses were really there to maintain control over minority ethnic groups and women
        • More radical psychologists suggest that some of our modern categories of mental disorder are really abuses of people's right to be different
      • Social versus statistical norms
        • Includes the issue of the desirability of a behaviour (statistical infrequency doesn't)
    • Failure to function adequately
      • A person may cross the line between 'normal' and 'abnormal' at the point when they can no longer cope with the demands of everyday life
      • We might decide that someone is not functioning adequately when they are unable to maintain basic standards of nutrition and hygiene
      • We might also consider that they are no longer functioning adequately if they can no longer hold down a job or maintain relationships with people around them
      • When is someone failing to function adequately?
        • When a person no longer conforms to standard interpersonal rules, for example maintaining eye contact and respecting personal space
        • When a person experiences severe personal distress
        • When a person's behaviour becomes irrational or dangerous to themselves or others
      • Example; Intellectual disability disorder
        • A diagnosis for this disorder is not made only on the basis of statistical infrequency
        • The individual must also be failing to function adequately before a diagnosis would be given
      • Patient's perspective
        • It attempts to include the subjective experience of the individual
        • It may not be an entirely satisfactory approach because it is difficult to assess distress, but at least this definition acknowledges that the experience of the patient is important
        • The failure to function adequately definition captures the experience of many of the people who need help. This suggests that this is a useful criterion for assessing abnormality
      • Is it simply a deviation from social norms?
        • We might think that not having a job or a permanent address is a sign of failure to function adequately, but what do we say when people choose to do these things?
        • Those who practise an extreme sport may be accused of behaving in maladaptive way, while those with religious or supernatural beliefs could be seen as irrational
        • If we treat these behaviours as 'failures' of adequate functioning, we risk limiting personal freedom and discriminating against minority groups
      • Subjective judgements
        • Someone must judge whether a patient is distressed or distressing
        • Some patients may say they are distressed but may be judged as not suffering
        • There are methods for making such judgements as objective as possible, including checklists such as the global assessment of functioning scale
          • However, the principle remains that someone has the right to make this judgement
      • Labelling
        • Deviation from ideal mental health
          • What does mental health look like?
            • We have no symptoms or distress
            • We are rational and can perceive ourselves accurately
            • We self-actualise (reach our potential)
            • We can cope with stress
            • We have a realistic view of the world
            • We have good self-esteem and lack guilt
            • We are independent of other people
            • We can successfully work, love and enjoy our leisure
          • Once we have a picture of how we should be psychologically healthy then we can begin to identify who deviates from this ideal
          • There is some overlap between what we might call deviation from ideal mental health and failing to function adequately
          • It is a comprehensive definition
            • It covers a broads range of reasons someone would seek help from mental health services or be referred for help
            • The sheer range of factors discussed in relation to Jahoda's ideal mental health make It a good tool for thinking about mental health
          • Cultural relativism
            • Ideas are specific to Western European and North American cultures (culture-bound)
            • The emphasis on personal achievement in the concept of self-actualisation would be considered self-indulgent in much of the world because the emphasis is so much on the individual rather than the family or community
            • Similarly, much of the world would see independence from other people as a bad thing. Such traits are typical of individualist cultures
          • It sets an unrealistically high standard for mental health
            • Few of us attain Jahoda's criteria for mental health and probably none of us achieve all of them at the same time
            • This approach would se everyone as abnormal
            • It makes clear the benefits of seeking treatment to improve their mental health
            • Deviation from ideal mental health is probably of no value in thinking about who might benefit from treatment against their will
        • When we make a judgement that someone is failing to cope we may end up giving them a label that can add to their problems
        • For example, it would be very 'normal' to get depressed after the loss of a job, home or relationship
          • Someone in this position might well benefit from psychological help. However, future employers, partners and even finance organisations may attach a permanent label to that person
    • Deviation from ideal mental health
      • What does mental health look like?
        • We have no symptoms or distress
        • We are rational and can perceive ourselves accurately
        • We self-actualise (reach our potential)
        • We can cope with stress
        • We have a realistic view of the world
        • We have good self-esteem and lack guilt
        • We are independent of other people
        • We can successfully work, love and enjoy our leisure
      • Once we have a picture of how we should be psychologically healthy then we can begin to identify who deviates from this ideal
      • There is some overlap between what we might call deviation from ideal mental health and failing to function adequately
      • It is a comprehensive definition
        • It covers a broads range of reasons someone would seek help from mental health services or be referred for help
        • The sheer range of factors discussed in relation to Jahoda's ideal mental health make It a good tool for thinking about mental health
      • Cultural relativism
        • Ideas are specific to Western European and North American cultures (culture-bound)
        • The emphasis on personal achievement in the concept of self-actualisation would be considered self-indulgent in much of the world because the emphasis is so much on the individual rather than the family or community
        • Similarly, much of the world would see independence from other people as a bad thing. Such traits are typical of individualist cultures
      • It sets an unrealistically high standard for mental health
        • Few of us attain Jahoda's criteria for mental health and probably none of us achieve all of them at the same time
        • This approach would se everyone as abnormal
        • It makes clear the benefits of seeking treatment to improve their mental health
        • Deviation from ideal mental health is probably of no value in thinking about who might benefit from treatment against their will

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