Psychology www.curriculum-press.co.uk

Factsheets Number 38

Psychological Abnormality: Definitions and Classification

This Factsheet summarises definitions and classification of	3. Failure to function adequately
psychological abnormality. It looks at biological and psychological	·     Abnormality is seen as the inability to cope with models and the multidimensional approach to abnormality. This            day-to-day life. This inability is caused by topic is part of individual differences (AQA and OCR specification)            psychological distress or discomfort.
Defining psychological abnormality
and clinical psychology (Edexcel specification).	·     Rosenhan and Seligman (1989) identified seven characteristics of failure to function normally. The more of these features that
behaviour in order to:
characteristics are:
·     Psychological abnormality refers to people with mental ill-health.	are displayed, the more abnormal the behaviour. The ·     Psychologists need to distinguish normal from abnormal	1     Suffering – (how the person feels);
·     Abnormal is defined as deviating from what is ‘normal’ or usual.
life goals, e.g., good relationships);
·     decide what is psychologically abnormal; and	2     Maladaptiveness – (behaviour that prevents achievement of major ·     provide treatment.	3     Vividness and unconventionality of behaviour (unusual behaviour);
‘Normal’ is conforming to some sort of standard. We consider
4     Unpredictability and loss of control (inappropriate behaviour);
5     Irrationality and incomprehensibility (behaviour is not four different standards next.	understandable);
statistically rare in the population.
using eye contact); and
1. Statistical Infrequency	6     Observer discomfort (how behaviour affects observers, e.g., not ·     This is based on the idea that certain behaviours are	7     Violation of moral and ideal standards (behaviour seen as offensive).

are classed as abnormal. For example, how people score on a
E aluation of th fai ure to function approa h
·     Behaviours that are rare or deviate from the average	· v It recognisesethe l individual’s subjectivecexperience.
aluation of statistical approach
beh viour.
measure of anxiety. Those people with low/high anxiety are	·     It is relatively easy to assess the consequences of dysfunctional Ev regarded as psychologically abnormal.	·     Not aall people who have a mental disorder are aware of their ·     This approach does account for the judgements of other people/            failure to function. For example, schizophrenics often deny they
society.
have a problem (Stirling & Hellewell, 1999).
·     It ignores the desirability of behaviour. Some behaviours that	·     It requires judgements which are influenced by social and cultural
are statistically infrequent are desirable (e.g., genius). Other	beliefs and biases. For example, Rosenhan and Seligman’s behaviours are not statistically infrequent, but are undesirable	features are largely subjective.

4. Deviation from ideal mental health
(e.g., behaviour in Rwanda during genocide).
norm before being seen as abnormal.
·     It does not allow for cultural and sub-cultural differences.
·     It does not consider the impact of an individual’s behaviour on
others.
·     It is not clear how much behaviour should deviate from the	·     Abnormality is seen as a failure to achieve ideal mental health (self-actualisation - see glossary). A lack of positive feeling and respect from significant others may cause a failure to achieve ideal mental health. This lack affects self-esteem and the ability to achieve self-actualisation.
it is the expe ted and des rab e way of behaving. Behav our that
deviates from social norms is seen as abnormal.
the individual and society as a who
It is related to subjective standards. These standards vary
consi ered as socially devi nt.
health:
·     Personal growth (person’s growth and development)
terms of ability to cope with stress);
influences);
and social sensitivity); and
and well adapted).
2. Deviation from Social Norms                                                   ·     Jahoda (1958) suggests a list of values to define ideal mental ·     Social normscare the wayi the l majority of the populationi behave;      ·     Self-attitudes (e.g., high self-esteem, strong sense of ;identity); ·     This approach considers the desirability of behaviour for both      ·     Integration of self-attitudes and personal growth (assessed in Evaluation of social deviance approachle.                                                ·     Autonomy (how much the individual feels independent of social ·     depending on social attitudes. For example, in the UK, having a      ·     Perception of reality (free from distorting reality, have empathy childd outside marriage isa acceptable now but used to be      ·     Environmental mastery (extent to which individual is successful

Evaluation of the ideal mental health approach
·     Social deviance is defined by the context in which a behaviour
but not in the High street
in one culture may be viewed as deviant in another.
so it can develop treatments.
·     The criteria are vague and difficult to measure.
occurs. For example, it is .acceptable to wear little on the beach	·     This approach is positive, focusing on needs for mental health ·     Cultural context is also important; behaviour that is acceptable	·     It relies on subjective judgements which may apply more to ·     Social deviance is not always bad. For example, people may            individualistic than collectivist cultures.

principles.
be classed as abnormal, when they are not.
adopt a non-conformist lifestyle to adhere to religious or political	·     The characteristics can be too idealistic and perfect. Few people ·     Szasz (1962, 1974) argues that society uses the idea of            ever achieve these healthy behaviours, so many people would
psychological abnormality as a means of social control by stigmatising and excluding those whose behaviour does not conform to the norms of society.	1

38- Psychological Abnormality: Definitions and Classification	Psychology Factsheet

Cultural relativism
·     All the definitions considered above are limited because they are specific to the culture they are in (cultural relativism). For example, for the statistical infrequency definition, the measurement (the statistical norm) is culturally relative.
·     Behaviour viewed as abnormal or deviant in one culture may be the norm or acceptable in another. For example, some cultures view hallucinations as normal under certain conditions whereas in Western culture they are seen as part of a mental disorder.
·     Definitions of what is abnormal may also vary within a culture over time. For example, in the UK homosexuality used to be considered abnormal but stopped being included in DSM in 1980. (see text box ‘classification of abnormality’ for details of DSM).
·     However, there are some cultural universals. For example, anti-social behaviour or chronic depression are universally viewed as abnormal and undesirable.

Exam Tip: You need to be able to describe and evaluate each of the four different definitions of abnormality. When referring to cultural relativity, relate it specifically to each definition by using examples.

Biological and Psychological Models of Abnormality

These offer another approach to abnormality, explaining why it happens.

Biological Models (medical model)
·     Mental disorders are regarded as having a physical cause.
·     Mental illnesses can be described in terms of symptoms. These symptoms can be identified using classification systems, leading to a diagnosis. (See textbox on ‘classification of abnormality’.)

1. Infection

Bacteria or viruses can cause illness. There is some evidence that links these to mental illness. For example, there is an increased incidence in schizophrenia in children whose mothers had the flu when pregnant (Fuller Torrey and colleagues, 2000).

2. Genetic factors
·     There is evidence for genetic factors in many mental disorders. For example, relatives of people with eating disorders are four or five times more likely to also suffer (Strober and Humphrey, 1987). For schizophrenia, relatives are 18 times more likely to be diagnosed than is normal (Kendler et al., 1985).
·     Twin studies have also shown a genetic influence for some disorders (e.g., anorexia, alcoholism).
·     Gene-mapping studies have found specific genes which may be implicated in particular disorders (e.g., bipolar disorder).

3. Brain Chemistry (Biochemistry)
·     Some disorders are associated with imbalances in chemicals in the brain. For example, schizophrenia is associated with excessive amounts of dopamine.
·     Drug studies support this approach. For example, Prozac (a drug that increases serotonin activity) has been found to significantly reduce the symptoms of depression (Hirschfeld, 1999).

4. Neuroanatomy

Mental illness may be due to abnormal brain structure. For example, post-mortem studies of people with schizophrenia have shown differences from normal brains, such as larger cerebral ventricles (Johnstone et al., 1976).

Evaluation of the biological model
·     There is evidence that biology may account for some mental disorders.

·     This model has had a big influence on the treatment of mental disorders.

·     It has been successful in treating some mental disorders. For example, phenylketonuria (PKU), a cause of mental retardation, can be treated by physical means.

·     Drug therapies have also been successful in reducing symptoms of other disorders although there can be unpleasant side effects.

·     This approach focuses on physical symptoms, ignoring psychological and social factors.

·     Symptoms of most mental disorders are often subjective. The model may therefore be more appropriate to some conditions (e.g., schizophrenia) than others (e.g., phobias).

2

38 - Psychological Abnormality: Definitions and Classification	Psychology Factsheet

Psychological Models 1. Psychodynamic Model
·     This model believes that mental illness is due to unresolved unconscious conflicts, traumas or personality development in early childhood.
·     Treatment is based on psychotherapy, trying to gain insight into unresolved conflicts and traumas.

Evaluation of the psychodynamic model
·     It focuses specifically on psychological factors (both for cause and treatment). ·     It is mainly applied to anxiety disorders and depression.
·     Research supports the idea that early childhood experiences are important (e.g., Barlow & Durand, 1995). However, this does not prove causation.
·     This model is not based on scientific research and is difficult to disprove. ·     It ignores genetic factors and the importance of cultural and social factors.
·     It implies individuals are not responsible for their disorder. However parents/caregivers are seen as partly responsible which may cause them distress.

2. The Behavioural model
·     This model assumes that mental disorders are caused by learning maladaptive behaviour via classical or operant conditioning. It views environmental factors as the main cause of abnormality.
·     Behaviour can be changed using the same principles.

Evaluation of the behavioural model

ƒ The basic concepts are easy to observe and measure. It is therefore more relevant to disorders that have easily observable symptoms (e.g., phobias).
ƒ There is evidence that conditioning plays a role in the development of some disorders (e.g., phobias). ƒ It is sensitive to cultural and social factors as it focuses on the individual and is non-judgemental.
ƒ It offers hope to those with mental disorders as it implies behaviour can be changed.

ƒ However, supportive research is highly artificial since it has been carried out in laboratory settings; it is impossible to know all the details of the real world learning experiences of those with mental illness.
ƒ It ignores genetic factors and internal processes (e.g., thinking, feeling).

ƒ Treatment assumes that the patient and therapist share the same goals for behaviour.

ƒ There are ethical issues over some treatments. For example, aversion therapy involves presenting patients with unpleasant stimuli.

3. The cognitive model
·     This model regards mental disorders as due to distorted and irrational thoughts and beliefs, originating in childhood.
·     Beck (1976) proposes the term ‘cognitive triad’ to refer to the negative thoughts depressed patients have about three things; themselves, the world and the future.

Evaluation of the cognitive model
·     It has become a very influential model since distorted beliefs are common in anxiety disorders, depression and eating disorders (e.g., Newmark et al., 1973). Its relevance to other disorders is unknown.
·     There is some support for the view that unrealistic thoughts occur before the disorder develops and play a part in the subsequent occurrence of a disorder (Lewinsohn et al., 2001), but this remains unclear.
·     It ignores the role of genetic factors.
·     It implies sufferers are to blame for their problems, which raises ethical issues. ·     Negative thoughts of those with mental disorders are not always irrational.
·     Recently, this approach has been combined with the behavioural model, producing ‘cognitive-behavioural therapy’. This therapy views mental disorders as involving distorted thoughts and beliefs as well as maladaptive behaviour.

The multi-dimensional approach

The diathesis-stress model combines information from all the models and proposes that psychological disorders depend on both:
a) diathesis: a genetic vulnerability or predisposition to disease or disorder, and
b) stress: some severe or disturbing environmental event.

Exam Hint: you need to be able to explain the assumptions of the different models of abnormality. Remember to state the underlying assumption of each model and two possible causes for each model.

Critical Issue: Eating Disorders (AQA specification)
You need to apply the above (definition and models of abnormality) to eating disorders. This is covered in the Curriculum Press Factsheet “Eating disorders”.

3

38 - Psychological Abnormality: Definitions and Classification	Psychology Factsheet

Classification systems of abnormality
·     Classification is deciding what a mental illness is and its characteristics. ·     There are three main reasons for classifying psychological abnormality:
1. for treatment (allows a diagnosis which determines appropriate treatment); 2. for research (allows different treatments to be tested); and
3. for the individual and their family (it may be reassuring to be given a diagnosis that may help recovery).

Diagnostic and Statistical Manual (DSM)
·     This manual is the most widely-used system of classifying psychological disorders. The current version is DSM-IV (the ‘IV’ means it is the fourth edition).
·     It is based on the findings of field trials and experience of earlier versions.
·     Disorders are defined by observable symptoms.
·     Each category is based on a set of features characteristic of the category.
·     It assumes that some, but not all, symptoms are essential.
·     The patient is evaluated on five different axes. For example, axis 1 covers clinical disorders (includes all recognised disorders), and axis 4 covers psychosocial and environmental problems (any significant, stressful events that have occurred within 12 months of the onset of the disorder, such as divorce or loss of job).

Difficulties in classifying psychological abnormality
·     The symptoms of mental illness may be very subjective.
·     Studies have raised serious questions about the reliability and validity of psychiatric diagnoses (e.g., Rosenhan, 1973).
·     Many of the symptoms defining the categories are found in the general population who are not mentally ill. For example, obsessions and compulsions found in those patients with obsessive-compulsive disorder are also found in over half the ‘normal’ population (Rachman and de Silva, 1978).
·     Labelling patients may be self-fulfilling (Scheff, 1966). Labels given create expectations for both the patient and others, which can lead to behaviours that confirm the diagnosis.
·     Classification systems are affected by cultural relativism.

Example Exam Question:

(a) Outline two approaches in identifying psychological abnormality.

(b) What are the strengths and weaknesses of the approaches you have outlined in part a)? (c) Outline and evaluate one approach to explain the causes of abnormality.

In part (a) any of the four approaches to defining abnormality may be given (i.e., statistical, social, adequate function or ideal mental health). You need to state the assumptions of the approached you choose. For part (b) remember to give examples in your evaluation relating to the specific approach you have chosen. For part (c) you may use any of the biological or psychological models of abnormality outlined in this factsheet. Make sure your evaluation is not general but specifically relates to the approach selected.

Glossary

Bipolar disorder: a disorder in which there are depressive and manic (elated) episodes. Cerebral ventricles: fluid-filled hollow spaces in the brain.
Classical conditioning: a form of learning by associating one factor with another.

Collectivist culture: a culture that emphasises interdependence and sharing (e.g. Japan, China).

Dopamine: a chemical in the brain (a neurotransmitter). Raised levels of dopamine are associated with schizophrenia. Field trial: an experiment in a natural setting.
Individualistic culture: a culture that emphasises independence and individuality (e.g., most Western cultures).

Operant conditioning: a form of learning where the consequences of a behaviour determine future behaviour. If a behaviour is followed by a desirable consequence it becomes more frequent; if it is followed by an undesirable consequence it becomes less frequent. Reliability: the extent to which a measurement produces consistent findings over time.
Self-actualisation: fulfilment of one’s potential.

Serotonin: a chemical in the brain (a neurotransmitter) that is associated with lower arousal, sleepiness and reduced anxiety. Low levels are involved in depression.
Significant others: those people who are most important to us (e.g., partner, family, friends). Validity: the extent to which something measures what it claims to measure.

Acknowledgements: This Psychology Factsheet was researched and written by Louise Hope. The Curriculum Press, Bank House, 105 King Street, Wellington, Shropshire, TF1 1NU.
Psychology Factsheets may be copied free of charge by teaching staff or students, provided that their school is a registered subscriber. No part of these Factsheets may be reproduced, stored in a retrieval system, or transmitted, in any other form or by any other means, without the prior permission of the publisher. ISSN 1351-5136

4

38 - Psychological Abnormality: Definitions and Classification	Psychology Factsheet

Worksheet: Psychological Abnormality: Definitions and Classification Name

1. What is psychological abnormality?

--------------------------------------------------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------------------------------------------------2. Briefly describe the four different standards that are used to define abnormality.

--------------------------------------------------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------------------------------------------------

-----------------------------------------------------------------------------------------------------------------------------------------------------

3. Give the strength of, and two limitations of, each of the approaches in question 2.

--------------------------------------------------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------------------------------------------------4. What is ‘cultural relativism’?

--------------------------------------------------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------------------------------------------------5. Briefly describe and evaluate two biological models of abnormality.

--------------------------------------------------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------------------------------------------------6. Briefly describe and evaluate two psychological models of abnormality

--------------------------------------------------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------------------------------------------------7. What are the main reasons for classifying psychological abnormality?

--------------------------------------------------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------------------------------------------------8. What are the difficulties in classifying psychological abnormality?

--------------------------------------------------------------------------------------------------------------------------------------------------------------

--------------------------------------------------------------------------------------------------------------------------------------------------------------

5
--------------------------------------------------------------------------------------------------------------------------------------------------------------