1 Describing and Explaining Abnormality
HOW WE CONCEPTUALISED ABNORMALITY & NORMALITY
Statistical deviance
Advantages = reasonable, reliable psychometric methods
Disadvantages = very subjective, what really is "abnormal"
Maladaptive behaviour
Advantages = intuitive appeal
Disadvantages = very subjective
Subjective distress/disability
Advantages = lets people judge their own abnormality
Disadvantages = subjectivity, some pathologies aren't related to distress
Breaking of social norms
Disadvantages = varies across context & time
Thus, scientifically defining psychopathology is difficult - multi-criterion approach
ABNORMALITY IN A HISTORICAL CONTEXT
6,500 BC = supernatural theory (cave drawing, trephination)
400 BC = somatogenic approach (hippocrates, body fluids)
Middle Ages = supernatural theory (famine, plague, witches)
End of Middle Ages = somatogenic approach (humane care, physical treatments)
Mid-18th century = psychogenic approach (philip pinel, moral treatment, york retreat, worthwhile activities)
Mid-18th century = somatogenic approach (franz mesmer, magnetic fluid, mesmerism, hypnosis)
Late 19th century = somatogenic approach (Kraeplin & DSM-1)
Early 20th century = psychogenic approach (Freud, human psyche, unconscious conflicts, catharsis cure, transference, dream analysis). Both somatogenic & psychogenic used today.
1940s and 1950s = behaviourists (unscientific of psychoanalysis, objective knowledge, conditioning, flooding, systematic desensitisation, token economy.
1980s = cognitive revolution (Beck, negative thinking, look at content, "learnt reflexes", negative biases, CBT).
There are 3 theories which try and explain the cause of mental disorders, which influenced how abnormality/normality was seen - cyclical. This was supernatural, somatogenic, psychogenic
DIAGNOSTIC SYSTEM IN PSYCHOPATHOLOGY
Usefulness of classification
Aids communication, indicates the treatment that's appropriate for each condition, helpful to the patient
History of classification
Kraeplin (1896), need to communicate disorders, DSM, ICD, continuously updated
Requirements for classification systems IN GENERAL
Mutually exclusive (have it or not - continuum though), reliability (same on multiple occasions, by different people, inferred constructs, cross-cultural issues, unspecified categories are unreliable), Validity (reflect real life, individual has co-morbidity, a real entity, reification, sub-clinical presentations)
CRITICISMS OF CLASSIFICATION SYSTEMS & DIAGNOSIS
Does fit true nature of reality
Label reduces uniqueness (two very different cases, lack of detail, given very little value)
Diagnosis leads to stigma (labels are damaging, both from public and how patient feels about themselves)
Socially constructed concepts - people in power, discriminatory, sensitivity to culture
Continuum in reality - there shouldn't be a categorical system
Drug companies can profit - financial gain, e.g., ADHD.
Normal experiences seen as pathological e.g., bereavement, then given medication
Co-morbidity, shouldn't just give 1 label, that's not how reality is like
DSM-5 backwards steps
Lowered threshold for diagnosing (GAD, ADD, Depression), new disorder which hadn't been researched (issues with treatment), too much emphasis on biological theory (diathesis-stress is still v important), subtle change in how mental disorder is seen (not primarily social deviance)
NEW FRAMEWORK
Research Domain Criteria
Looks at different constructs, e.g., negative valence, positive valence, cognitive and social processes. Variations underlie behavioural dimensions - internalising and externalising problems
Trait theory
OCEAN - some diagnosis due to extreme levels of diff combinations of traits - e.g., personality disorders
Transdiagnostic framework
Constructs which underlie diff labels, more realistic esp bc we have co-morbidity