Chapter 1 – Abnormal Behaviour in Historical Context
Understanding Psychopathology
Psychological disorder is defined as a psychological dysfunction within an individual that is associated with distress or impairment in
functioning and a response that is not typical or culturally expected.
A phobia is a psychological disorder characterised by marked and persistent fear of an object or situation.
DSM-5 instructs practitioners to include gender and cultural features when using the classification system.
Mental disorders are defined in relation to cultural, social and familial norms and values.
Culture provides the interpretative frameworks that shape the experience and expression of the symptoms, signs and behaviours that are
criteria for the diagnosis.
Boundaries between normality and pathology vary across cultures for specific types of behaviours.
Thresholds of tolerance for specific symptoms or behaviours differ across cultures, social settings and families. Hence, the level at which
an experience becomes problematic or pathological will differ.
Judgement that a given behaviour is abnormal and requires clinical attention depends on cultural norms that are internalised by the
individual and applied by others around them.
A psychological dysfunction is characterised by a breakdown in cognitive, emotional or behavioural functioning.
E.g. out on a date should be fun, but if you experience severe fear all evening and just want to go home, even though there is nothing to be
afraid of, your emotions are not functioning properly.
Simply having a dysfunction is not enough to meet the criteria for a psychological disorder.
, This criterion does not define abnormal behaviour.
Often quite normal to be distressed (someone close to you dies).
The concept of impairment is useful, although not entirely satisfactory.
Most psychological disorders are simply extreme expressions of otherwise normal emotions, behaviours and cognitive processes, and are
guided by world views.
This is insufficient to determine abnormality by itself.
At times, something is considered abnormal because it occurs infrequently, it deviates from the average.
The greater the deviation, the more abnormal it is.
Another view is that your behaviour is abnormal if you are violating social norms, even if a number of people are sympathetic to your point
of view. (useful in considering important cultural differences in psychological disorders).
E.g. to enter a trance state and believe you are possessed reflects a psychological disorder in most Western cultures, but not in many
other societies, where the behaviour is accepted and even expected.
An Accepted Definition
Most widely accepted definition used in DSM-5 describes behavioural, psychological or biological dysfunctions that are unexpected in their
cultural context and associated with present distress and impairment in functioning, or increased risk of suffering, death, pain or
impairment.
When most or all symptoms that experts would agree are part of the disorder are present, we call this typical profile a prototype.
Patient may have only some symptoms or features of the disorder and still meet criteria for the disorder because of his or her set of
symptoms is close to the prototype.
A Brief Overview of Psychological Disorders in South Africa
South Africa has a particularly high lifetime prevalence of substance use disorders.
High prevalence of psychiatric disorders in South Africa due to stressors such as racial discrimination and political violence, gender
inequality and criminal violence.
Poverty remains a significant problem, and is likely to contribute to vulnerability to common psychiatric disorders in developing countries.
, The country’s socio-economic history has resulted in different racial populations having distinct socioeconomic profiles, with whites
advantaged, and blacks disadvantaged.
Socioeconomic privilege might protect against stressors and reduce prevalence of psychiatric disorder.
The Science of Psychopathology
Psychopathology is the scientific study of psychological disorders.
Working within this field are specially trained professionals, including clinical and counselling psychologists, psychiatrists, psychiatric social
workers and psychiatric nurses, as well as marriage and family therapists and mental health counsellors.
The Scientist-Practitioner
Most important development in recent history of psychopathology is the adoption of scientific methods to learn more about the nature of
psychological disorders, their causes and their treatment.
Mental health practitioners may function as scientist-practitioners in one or more of three ways.
May keep up the latest scientific developments in their field and therefore use the most current diagnostic and treatment
procedures.
They evaluate their own assessments or treatment procedures to see whether they work.
Might conduct research often in clinics or hospitals, producing new information about disorders or their treatment, thus becoming
immune to the fads that plague our field, often at the expense of patients and their families.
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