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Psychopathology AS/A-level Paper 1
Full set of notes on psychopathology, brilliant - I got an A* in my Paper 1 having revised from these. Very detailed and easy to learn from.
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PSYCHOPATHOLOGYDefinitions of abnormality, including deviation from social norms, failure to function
adequately, statistical infrequency and deviation from ideal mental health
Statistical infrequency occurs when an individual has a less common characteristic e.g.
being more depressed or less intelligent than most of the population
- According to the statistical definition any relatively usual behaviour or characteristic
can be thought of as ‘normal’ and any behaviour that is different is ‘abnormal’
Example: IQ and intellectual disability disorder
- Statistical approach works when characteristics can be reliably measured e.g.
intelligence
- In any characteristic the majority of people’s scores will cluster around the average
and the further from the average the less people that will obtain the score
- This is called normal distribution
- 68% have an IQ in range from 85-115
- Only 2% have a score below 70; this is abnormal and these people are likely to
receive a diagnosis of a psychological disorder - intellectual disability disorder
Evaluation
Strengths
- Real life application; a strength of statistical definition is it has real-life application in
the diagnosis of intellectual disability disorder. For example, there is a place for
statistical infrequency in thinking about what are normal and abnormal behaviours
and characteristics. All assessment of patients with mental disorders include some
kind of measurement of how severe their symptoms are as compared to statistical
norms, this is a strength as it shows that statistical infrequency is a useful part of
clinical assessment.
Weaknesses
- Unusual characteristics can be positive; for example, IQ scores over 130 are just as
unusual as those below 70, but we wouldn’t think of super-intelligence as an
undesirable characteristic that needs treatment. Just because very few people
display certain behaviours does make the behaviour statistically abnormal but
doesn’t mean it requires treatment to return to normal. This is a serious limitation to
the concept of statistical infrequency and means that it would never be used alone to
make a diagnosis
- Not everyone unusual benefits from a label; another issue with statistical infrequency
is that, where someone is living a happy fulfilled life, there is no benefit to them being
labelled as abnormal regardless of how unusual they are. So someone with a very
low IQ who was not distressed, quite capable of working etc. would simply not need a
diagnosis of intellectual disability. If that person was labelled as abnormal this might
have a negative effect on the way others view them and the way they view
themselves
Deviation from social norms concerns behaviour that is different from the accepted
standards of behaviour in a community or society
Norms are specific to the culture we live in
- Of course those social norms may be different for each generation and every culture,
so these are relatively few behaviours that would be considered universally abnormal
on the basis that they breach social norms
- e.g. homosexuality continues to be viewed as abnormal in some cultures e.g. 2019
Brunei introduced new laws that make sex between men an offence punishable by
stoning to death
Example: antisocial personality disorder
, - A person with antisocial personality disorder is impulsive, aggressive and
irresponsible. According to DSM-5 one important symptom of antisocial personality
disorder is an absence of prosocial internal standards associated with failure to
conform to lawful or culturally normative ethical behaviour
- We are making an assumption that a psychopath is abnormal because they don’t
conform to our moral standards
Evaluation
Strengths
- Social vs statistical; a strength of deviation from social norms is that it includes the
issue of the desirability of a behaviour. The statistical infrequency approach doesn’t
take desirability into account. e.g. genius is statistically abnormal but we wouldn’t
want to include that in our definition of abnormal behaviours. This means that social
norms can be more useful than statistical norms
Weaknesses
- Not a sole explanation; a strength of deviation from social norms definition is that it
has real-life application in the diagnosis of antisocial personality disorder. There is
therefore a place for deviation from social norms in thinking what is normal and
abnormal. However, even in this case, there are other factors to consider. e.g. the
distress to other people resulting from APD. So, in practice deviation from social
norms is never the sole reason for defining abnormality
- Cultural relativism; another problem with using deviation from social norms to define
behaviour as abnormal is that social norms vary tremendously from one generation
to another and from one community to another. This means for example, 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 e.g. hearing voices is socially acceptable in some cultures but
would be seen as a sign of mental abnormality in the UK. This creates issues for
people from one culture living within another culture
Failure to function adequately occurs when someone is unable to cope with the ordinary
demands of day to day living
When is someone failing to function adequately?
- Rosenhan and Seligman 1989 proposed some signs that can be used to determine
when someone is not coping
- No longer conforms to interpersonal roles e.g. respecting personal space
- Severe personal distress
- Behaviour becomes irrational or dangerous to themselves or others
Example: intellectual disability disorder
- To be diagnosed with intellectual disability disorder the person must have a low IQ
- However, they would also have to fail to function adequately to be given the
diagnosis
Evaluation
Strengths
- Patient’s perspective; a strength of failure to function adequately is that it does
attempt to include the subjective experience of the individual. However, it may not be
an entirely satisfactory approach because it is difficult to assess distress. Yet, at least
this definition acknowledges that the experience of the patient is important. In this
sense the failure to function adequately definition captures the experience of many of
the people who need help. This suggests that failure to function adequately is a
useful criterion for assessing abnormality
Weaknesses
- Is it simply a deviation from social norms; e.g. in practice it is difficult to say whether
someone is failing to function adequately or if they are just deviating from social
, norms. e.g. we might think that not having a job or permanent address is a sign of
failure to function adequately. If this is the case then what do we say about the
people who choose not to have these things as they have an alternative lifestyle.
Similarly, those who practice extreme sports may be accused of behaving in a
maladaptive way. If we treat these behaviours as ‘failures’ of adequate functioning,
we risk limiting personal freedom and discriminating against minority groups
- Subjective judgements; e.g. when deciding whether someone is failing to function
adequately, someone has to judge whether a patient is distressed or distressing. In
some cases, patients may be judged as not suffering. There are methods for making
such judgements as objective as possible, including checklists such as Global
Assessment of Functioning Scale. However, the principle remains that someone e.g.
a psychiatrist has the right to make this judgement.
Deviation from ideal mental health occurs when someone does not meet a set of criteria
for good mental health
What does ideal mental health look like?
- Jahoda 1958 suggested that we are in good mental health if we meet following
criteria
- No symptoms or distress
- Rational and can perceive ourselves accurately
- Self-actualise (reach potential)
- Cope with stress
- Realistic view of the world
- Good self-esteem and lack guilt
- Independent of other people
- Successfully work, love and enjoy our leisure
- Some overlap between deviation from ideal mental health and failure to function
adequately
- Can think of someone’s inability to keep a job as either a failure to cope with
pressures of work or as a deviation from the ideal of successfully working
Evaluation
Strengths
- It is a comprehensive definition; e.g. it covers a broad range of criteria for mental
health. In fact it probably covers most of the 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
Weaknesses
- Cultural relativism; some ideas of Jahoda’s classification of ideal mental health are
culture-bound and specific to Western European and North American cultures. e.g.
the emphasis on personal achievement in the concept of self-actualisation would be
considered self-indulgent in much of the world because of the emphasis is so much
on the individual rather than 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
- Sets unrealistically high standard for mental health; few of us obtain Jahoda’s criteria
for mental health, and probably none of us achieve all of them at the same time.
Therefore, this approach would see pretty much all of us as abnormal. On the
positive side it makes it clear to people the ways in which they could benefit from
seeking treatment - say counselling - to improve their mental health. On the other
hand, deviation from the ideal mental health is probably of no value in thinking about
who might benefit from treatment against their will
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