Psychology - Abnormality

Definitions of Abnormality
1. Deviations from social norms
  1. Goes against the standards that are set by the social groups
    1. Deviates from statistical norm
  2. Limitations
    1. Cultural relativism
      1. Social norms are defined by cultures
      2. Diagnosis for mental illnesses may be different in different cultures
      3. No universal standards/rules for labelling a behaviour as abnormal
    2. Susceptible to abuse
      1. It varies as times change- what is acceptable now may not be in 50 years
      2. If we define abnormality in terms of deviation from social norms, we open the door to definitions based on prevailing social morals and attitudes
        This allows mental health professionals to classify people who transgress against social attitudes as mentally ill
      3. Szasz (1974) said that mental illness was just a way to exclude nonconformists from society
    3. Deviance is related to context and degreee
      1. Judgements on deviance is often related to context
        What someone is wearing on a beach may be normal but the same thing is not acceptable in a classroom
      2. What is deviance and what is eccentricity?
        Where's the line?
      3. Social deviance cannot offer a complete definition of abnormality because of this
2. Failure to function adequately
  1. Being unable to cope
  2. If behaviour interferes with life then it may be deemed as abnormal and help may be needed
  3. Limitations
    1. Who judges?
      1. Someone would need to decide that the person is failing to function adequately
        Either the person determines that their behaviour is undesireable
        Or the person believes that they are fine/are unaware but others judge the behaviour as abnormal
        Their erratic behaviour may be distressing or dangerous to others but they may not see a problem
    2. Adaptive or maladaptive?
      1. Some seemingly abnormal behaviour may be functional for the individual
        Mental disorders may lead to welcome extra attention
    3. Cultural relativism
      1. Defining adequate functioning is relative to the cultural ideas of how one's life should be lived
      2. Failure to function criteria would produce different diagnoses in different cultures
        Non-traditional lifestyles would be seen as failing to function adequately, when these are normal in other cultures
3. Deviation from ideal mental health
  1. Marie Jahoda (1958)
    1. We define physical illness by looking for the absence of signs of physical health, so why not do the same for metal illness
    2. Identified six categories that were commonly referred to in mental health:
      1. 1. Self Attitudes - having high self-esteem and a strong sense of identity
        2. Personal growth and self-actualisation - the extent to which an individual develops their full capabilities
        3. Integration - such as being able to cope with stressful situations
        4. Autonomy - being independent and self-regulating
        5. Having an acute perception of reality
        6. Mastery of the environment - including the ability to love, function at work, in interpersonal relations, adjust to new situations and solve problems
  2. Limitations
    1. Who can achieve all of the criteria?
      1. According to this, most of us are abnormal to some degree
      2. They are ideal but how many do we need to be lacking to be defined 'abnormal'
    2. Are mental and physical health the same?
      1. Can mental illness be detected in the same way?
        Physical illnesses usually have physical causes, so they can be easy to detect and diagnose but mental illnesses are usually a consequence of experiences so it is hard to diagnose them in the same way
    3. Cultural relativism
      1. Many of these criteria are culture-bound
        If applied to other cultures or class groups there would be a higher incidence of abnormality
        i.e. 2 - reaching one's full potential is relevant in an individualist culture but not a collectivist culture, where people strive for the good of the community rather than self-centred goals
The biological approach/model
1. Mental disorder as the consequence of malfunctioning biological systems
  1. Treatments aim to repair these using somatic therapies - drugs, ECT and psychosurgery
  2. Causes
    1. Genetics
      1. Mental illness as a result of faulty inherited gene or group of genes
        AO1: Gottesman (1991) carried out a meta-analysis of 40 twin studies and found that having an identical twin with schizophrenia gave you a 48% chance of developing the condition compared to 17% in non-identical twins showing that schizophrenia has a strong genetic basis.
        AO2: The meta-analysis was carried out on field studies giving it high ecological validity. Twins share 100% of their genes so it is expected that they would always suffer from the same conditions. The fact that both twins developed schizophrenia in only half the cases shows that another variable must be involved. Identical twins are usually treated more similarly than non-identical twins so family environment may play a role.
        Meyer et al (2001) found that mutation in gene WKL1 showed in seven family members with a particular form of schizophrenia but not in six others who had no symptoms
    2. Faulty neuro-transmission
      1. Neuro-chemical imbalance
        The use of drugs that target neurotransmitters suggest that they are related to psychological disorders
        Increased level of dopamine is linked to schizophrenia - drugs like cocaine increase dopamine levels and can lead to symptoms of schizophrenia
        Depression is treated with SSRI drugs- they manage serotonin levels in the brain
        Gama-amino butyric acid (GABA) is linked to anxiety/Glutamate - arousing
    3. Infection
      1. General paresis is a condition involving delusions and mood swings, leading to paralysis and death. It is caused by syphilis and can now be treated.
      2. Brown et al (2004) investigated the link between pregnant women getting the flu and their child having schizophrenia. They found that women who were exposed to the flu virus in the first few months of pregnancy were more likely to have a child who develops schizophrenia than those who didn't.
    4. Brain Trauma
      1. Case study- in 1819 an explosion sent an iron rod through Phineas Gage's head, destroying parts of his frontal lobes. He survived but became more impulsive/disorganised, couldn't plan for future and had a strangely different personality
2. A.K.A The medical model because it treats abnormality like a physical condition/illness
3. Biological therapies
  1. Drug treatments
    1. Drugs can be used to change neurotransmitter levels in the brain.
    2. SSRIs - Selective Serotonin Re-uptake Inhibitors manage levels of serotonin in the brain. Research shows that people with depression have less serotonin than average. They work by making more serotonin available in the brain by stopping the synapses taking it up when it's released
  2. Psychosurgery
    1. Brain surgery that involves the destruction/separation of parts of the brain
    2. Egaz Moniz developed the 'frontal lobotomy' in 1930's - the separation of parts of the frontal lobe from the brain
      1. It reduced aggression, made patients more placis but the irreversible changes may just make them easier to handle. It is only used today as a last resort for some disorders
  3. Electroconvulsive Therapy (ECT)
    1. Patient is anaesthetised, injected with muscle relaxants and has electrodes attached to their head
      1. 225 volt shock is briefly transmitted to the brain causing a seizure lasting up to a minute, a rubber stop is placed in their mouth so they don't bite their tongue and patient wakes up from anaesthetic about 20 minutes later
        Most popular theory for how it works is that it causes an alteration in how the brain responds to chemical signals or neurotransmitters
        Patient may have up to 12 treatments total with one or more a week
4. Strengths
  1. Has a scientific basis in biology with a lot of evidence that biological causes can produce psychological symptoms
  2. Ethical as people are not blamed for their disorders, they just have an illness
  3. Biological therapies have relieved conditions that were not treated well previously
5. Weaknesses
  1. Biological therpiees may raise ethical concerns
  2. The effects of psychosurgery are irreversible
  3. Psychological disorders may not be linked to any physical problem and psychological therapies can be just as effective without interference to biological structures
The psychodynamic approach/model
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