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Summary Psychology: Themes and Variations, ISBN: 9781305498204 Psychology 144
Chapter 15 from textbook notes as well as lecture notes.
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Abnormal Psychology15.1.2 Defining abnormal behaviour
o Abnormality is characterized by an individual displaying behavior that is rare
or unusual. Behaviour that is regarded as unhelpful or maladaptive to
situations or the context in which an individual lives is also seen as
constituting abnormal behavior.
o Context of mental health: Abnormality suggests impairments in an
individual’s daily functioning.
o Emil Kraepelin- founder of modern psychiatry defined mental illness as being
rooted in a biological or medical model.
o The medical model of mental disorders proposes that it is useful to think of
mental illness as a disease and to identify and classify symptoms in a similar
way as the symptoms and signs of physical disease are diagnosed.
o Today diagnostic manuals used to accurately identify, describe, classify and
inform the treatment of abnormal behaviour.
o Two medical classification systems are commonly used:
1. The international classification of diseases (10th edition) (ICD-10) by WHO.
2. Diagnostic and statistical manual of mental disorders (5 th edition) (DSM-5) by
the American psychiatric association.
o DSM-5 classification is based on observable behaviour and not on the
presumed etiology of mental disorders. DSM-5 provides professionals with a
common language of categories to communicate the key features and
symptoms of mental disorders. Each category is a collection of related
disorders and each disorder compromises specific diagnostic criteria.
o Diagnostic criteria are key features of a disorder that identify symptoms,
behaviours, cognitive functions, personality traits, physical signs and duration
of the key features of the disorder.
o Classifications systems of mental disorders (ICD and DSM) continue to evolve
in light of advances in light of advances in scientific research. DSM-5:
- Neurodevelopmental disorders
- Schizophrenia spectrum and other psychotic disorders
- Bipolar and related disorders
- Depressive disorders
- Anxiety disorders
- Obsessive compulsive and related disorders
- Trauma and stressor related disorders
- Dissociative disorders
- Somatic symptom and related disorders
- Eating disorders
- Elimination disorders
- Sleep-wake disorders
, - Sexual dsyfunctions
- Gender dysphoria
- Substance related and addictive disorders
- Personality disorders
- Paraphilic disorders
- Neurocognitive disorders
15.1.3 The medical model applied to abnormal behaviour
o Disorders refers to conditions in which there is disturbance of the usual
orderly processes of an individual’s biopsychosocial development.
o Symptoms are the reported subjective experience of the individual.
o Prior to the 18th century, mental illness was attributed to supernatural forces,
and the mortality of the afflicted individual.
o Medical model proposes that it is useful to think of abnormal behaviour as a
disease. Model utilizes key terms to refer to abnormal behaviour, such as
mental illness, psychological disorder and psychopathology.
o Some critics say medical model may have outlived its usefulness. Critics
concerned that diagnosis pin potentially derogatory labels on people. Labels
can lead to stigmatization.
o Those characterized as mentally ill are often viewed as erratic, dangerous,
incompetent, and inferior. The stigma is not impossible to shed but it
undoubtedly creates additional difficulties for people who are already
struggling.
o Stigma associated with psychological disorders appears to be deep-rooted.
o Research shows that many psychological disorders are at least partly
attributable to genetic and biological factors, making them appear more
similar to physical illnesses.
o Thomas Szasz criticism: abnormal behaviour usually involves a deviation
from social norms rather than an illness. Contends that such deviations are
problems in loving rather than medical problems.
o Allen Frances, raised concerns that the DSM-5 has over-pathologized
everyday human distress.
15.1.4 Criteria of Abnormal behaviour
1. Deviance: People often said to have a disorder because their behaviour
differs from what their society considers acceptable. What constitutes
normality varies from one culture to another, and changes over time within
society. All cultures though have norms.
Eg. Transvestic fetishism is a paraphilia in which a man achieves sexual
arousal by dressing in clothing traditionally only worn by women. Behaviour is
disordered because a man wearing a dress is contrary to western culture’s
norms.
, 2. Dysfunctional behaviour: People often judged for having a psychological
disorder because their ability to perform their day-to day activities becomes
impaired, or their behaviour becomes maladaptive or dysfunctional.
Eg. Bank manager who can no longer perform his occupational role because
he is so depressed that he doesn’t get dressed to go to work, but stays in
bed. In such a case, the maladaptive quality of the behaviour makes it
disordered.
3. Personal distress: Frequently diagnosis is based on individual’s report of
significant personal suffering. People often viewed as disordered when one
criteria is met. Diagnosis involves value judgements about what represents
normal or abnormal behaviour. Criteria of mental illness are not value free.
Judgements reflect cultural values, social trends and political forces.
Eg. Found that language barriers in South African hospitals impact diagnostic
and treatment procedures.
o Often difficult to draw the line that clearly separates normality from
abnormality. On occasion everyone act in deviant ways, everyone displays
some dysfunctional behavioural or impairment and everyone experiences
personal distress from time to time.
15.1.5 Psychodiagnosis: The classification of disorders
o Key issue for authors of DSM-5 was whether to reduce the systems
commitment to a categorical approach. Many have questioned the
assumption that people can reliably be placed in non overlapping diagnostic
categories. However, there is an enormous overlap among various disorders
in terms of symptoms, resulting in vague boundaries.
o Dimensional approach- would describe individuals pathology in terms of how
they score on a limited number of continuous dimensions.
o Individuals presenting with mental health problems often meet the criteria for
more than one diagnosis, which is termed comorbidity- coexistence of two or
more disorders.
15.1.6 The prevalence of psychological disorders
o Epidemiology- the study of the distribution of mental or physical disorders in
a population.
o Prevalence refers to percentage of a population that exhibits a disorder
during a specified time period.
o In SA using 4th edition DSM found that survey respondents reported lifetime
prevalence of the following: alcohol abuse (11.4%), major depression (9.8%)
and agrophobia (9.8%). The most prevalent category appeared to be anxiety
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