Failure to function adequately

• Can no longer cope the demands of everyday life
• Unable to maintain basic standards of hygiene and nutrition and hygiene
• Cannot hold down a job or maintain relationships with people around them

When is someone failing to function adequately

• Rosenhan and Seligman
  • When a person no longer conforms to standard interpersonal rules, 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

• Individual must also be failing to function adequately before a diagnosis would be given.

• Does attempt to include the subjective experience of the individual
• Difficult to assess distress but at least acknowledges that the experience of a patient and/or others is important
• Captures the experience of many people who need help
• Useful criterion for assessing abnormality

• We might think that not having a job or permanant address is a sign of failure to function adequately but what about people with alternative lifestyles?
• Those who practise extreme sports could be accused of behaving in a maladaptive way while people with religious or spiritual beliefs may be seen as irrational.
• Risk limiting personal freedom and discriminating against minority groups.

• Someone must judge whether a patient is distressed or distressing.
• Some patients may say they are distressed but might be judged as not suffering.
• Methods for making such judgements as objective as possible. (Global assessment of functioning scale)
• Principle remains that someone has the right to make this judgement.