Attempts by psyhologists to define and diagnose abnormalities - Essay Example

? ATTEMPTS BY PSYCHOLOGISTS TO DEFINE AND DIAGNOSE ABNORMALITIES SUBMITTED BY: SUBMITTED INSTITUTE: TASK With 18thcentury, when the era of moral treatment gave way to medical and scientific era, some logical definitions of abnormality began to emerge (Cave, 2002). Different and relatively modern approaches to define abnormality include: statistical infrequency, deviation from social and metal norms and failure to function properly. This calls for a further advanced system of classifying abnormality. Two diagnostic systems, namely the ‘Diagnostic and statistical manual of mental disorders’ (DSM) and the ‘International Statistical classification of diseases and related health problems’ (ICD) have been devised and are commonly referred to by clinicians on order to diagnose a health related problem (Gross, 2010). According to the statistical infrequency definition, abnormality is anything that is statistically infrequent (Gross, 2010). All behaviours that occur rarely therefore fall in the criteria of abnormality according to this definition. The statistical definition ‘represents the literal sense of abnormality, whereby any behaviour that isn’t typical or usual is by definition abnormal’ (Gross, 2010). The strength of this definition is that is enables one to distinguish between normal and abnormal behaviour in an objective, quantitative and unbiased manner (Cardwell & Flanagan, 2005). The main weakness of this definition is, as Gross (2010) points out, this definition does not allow one to distinguish whether or not the abnormality is in a desirable sense or an undesirable one. The weakness of statistical infrequency definition is that it is essentially a neutral one and not very comprehensive or explanatory (Gross, 2010). Another definition of abnormality has defined it as deviation from social norms. “Deviating from the norm implies not behaving or feeling as one should or ought to.” (Gross, 2010). This definition makes use of the term deviant in the sense of deviant behaviour, or socially unacceptable behaviour, which is out of the realm of the common behaviour in any society (Cardwell & Flanagan, 2005). This strength of this definition is that it distinguishes among desirable and undesirable behaviour, but it has three limitations/weaknesses of subjectivity. Firstly, it complicates the concept of abnormality. According to Gross (2010), there are various forms of norms, like developmental, situational and cultural etc. Secondly, this definition is also limited in the sense that it does not provide for those elements in the society that give rise to a social change. For example, Cardwell & Flanagan (2005) explain, that homosexuality was considered abnormal few decades back; however it is accepted in many countries now. This changing status of social norms places the appropriateness and adequacy of this definition into jeopardy. Thirdly, the problem of cultural relativism also applies to this definition, making it far from universal. Social norms vary from society to society (Cardwell & Flanagan, 2005). The ‘deviation from mental health’ model claims that any behaviour that deviates from ideal concept of mental health should be termed as abnormal (Cardwell & Flanagan, 2005). Jahoda (1958; Cited in Cardwell & Flanagan, 2005) has given the concept of ideal mental health in terms of following six criteria: having high self esteem and strong sense of identity, moving towards personal growth and self actualization, having the ability to cope with stressful situations, being independent and self regulatory, having accurate perception of reality and having a mastery over the environment. The basic strength of this definition is that it is based on a positive approach. Mental health is a desirable thing. Social deviation on the other hand ‘judges’ abnormality against deviation rather than comparing it against a positive element of health (Cardwell & Flanagan, 2005). The limitation to this definition is also the same as that of the previously discussed definition; cultural relativism, because the concept of mental health is also more or less culture bound (Cardwell & Flanagan, 2005). Another limitation to this is the inclusion of an ideal concept of mental health in criteria of abnormality. Viewing the above stated six criteria for ideal mental health, many of us would be classified as abnormal, because there is a great difference between ‘ideal’ and ‘normal’ mental health (Cardwell & Flanagan, 2005). Another way to define abnormality is on the basis of ability to function adequately (Gross, 2010). ‘Failure to function adequately refers to a person’s inability to cope with everyday life’ (Cardwell & Flanagan, 2005). The positive points of this definition are that it not only allows viewing abnormality from the patient’s perspective; whether he or she can manage daily life activities in an effective manner, but is also easy to measure by matching the patient’s behaviour against a list of daily life tasks (Cardwell & Flanagan, 2005). The limitation of this definition is again cultural relativity, because this ‘list of functions’ one is expected to perform is also culture dependent. The question remains: ‘who judges that this list of behaviours is a normal list of behaviours?’ Therefore, subjectivity of this definition is the very limitation of it (Cardwell & Flanagan, 2005). Image Source: Google Images, 2011. Each of the definitions of abnormality has its strengths and weaknesses. Abnormality according to Gross (2010) can only be well defined in relation to its counterpart; normality, therefore, the definitions will vary with the concept of normality, However, drawing collectively from all the approaches, abnormality can be anything deviant, dysfunctional, maladaptive and infrequent. Abnormality can be better understood via proper systems of classification that help in distinguishing among different kinds of abnormality. Two diagnostic manuals are available for classification of mental health disorders. These are DSM (Diagnostic and statistical manual for mental disorders) and ICD (International statistical classification of diseases and related health problems). As the names indicate, DSM is specifically meant for the classification of mental disorders, while ICD is a more general classification system, with a whole section devoted to mental health (Cave, 2002). DSM, first published in 1992, has undergone four revisions till date (DSM IV, 1994). The DSM IV uses five criteria axes to code and classify disorders in a person (Gross, 2010). The two statistical manuals are used by clinicians all over the world to classify the mental disorders, diagnose them, rate them against the Global assessment of functioning scale and code them in numeral format (Cave, 2002). DSM IV defines phobia as “an intense, irrational fear of an object, person or situation that can drive the patient to great lengths in attempting to avoid it” (DSM IV, 1994). Phobic disorders fall under the broad category of Anxiety disorders. The DSM IV identifies the criteria for various forms of phobias including: Social phobia, specific phobias and agoraphobia etc. These are further classified as per co-occurrence of certain other features like panic attack history or another anxiety disorder (DSM IV, 1994). The ICD on the other hand, places phobias under the broad category of phobic anxiety disorders, defined as ‘A group of disorders in which anxiety is evoked only, or predominantly, in certain well-defined situations that are not currently dangerous. As a result these situations are characteristically avoided or endured with dread.’ (ICD-10, 1993). Definition of phobia as per both the diagnostic systems is more or less overlapping and similar. There has been considerable debate on classification systems. It does in a way label the disorders, but this classification is very essential for research and clinical purposes (Gross, 2010). Conclusion In light of above discussion, it can be concluded that there are many ways to define abnormality and each definition has its strengths and weaknesses. These definitions are used by clinicians and researchers as per the situational requirements. DSM and ICD are two popular statistical manuals for classification of diseases, which are amended from time to time to incorporate the classification changes based on latest research. REFERENCES Cardwell, M & Flanagan, C. (2005). Psychology as the complete companion. Cheltenham: Nelson Thomes Ltd. Cave, S. (2002). Classification and diagnosis of Psychological abnormality. New York: Taylor & Francis. DSM IV. (1994). Diagnostic and statistical manual of mental disorders. Washington, D.C: American Psychological Association Gross, R. (2010). Psychology: The science of mind and behaviour. (6th ed.). Dubai: Hodder Education. Google Image. (2011). Phobia. Available at: http://listsoplenty.com/blog/?attachment_id=12024 [Accessed: May 10th, 2011]. ICD-10. (1993). World health organization. Available at: http://www.who.int/classifications/icd/en/GRNBOOK.pdf. [Accessed; May 11th, 2011]. TASK 2: PHOBIA- SYMPTOMS, EVALUATION AND TREATMENT Phobia: Phobia is defined as an irrational, persistent fear of an object, place, person or situation that is so intense, that the patient will go to great lengths in order to avoid it (DSM IV, 1994). The symptoms, Diagnostic criteria of phobia, different explanations of phobia, two interesting case studies and treatment options available for phobia are discussed below: Symptoms of Phobia: Phobic disorders have many forms depending on the type of phobia. Some phobias do not impact the person’s daily life at all, while others can abrupt the normal daily life functioning of individuals (Costello, et al; 1995). Common types of phobias include: social phobia, specific phobias and agoraphobia etc. The criteria for phobias also vary with the type, however, DSM IV states the following criteria for phobia. Marked and persistent fear of a situation, place or object. Anxiety is provoked on exposure to the feared object/ situation/ place. The person admits that the fear is irrational. The duration of symptoms among below 18 individuals is at least 6 months. The behaviour can’t be explained by a general medical condition. The behaviour is not the result of a drug intake, Different Approaches to Phobia: History of diagnosis, explanations and treatment has seen various cases of different disorders. Two phobic cases are discussed briefly. One popular case is that of little Hans, who was a five year old boy, phobic of horses. He underwent psychotherapy in detail and was finally cured (Gross, 2010). Fear of horses prevented little Hans from leaving home. Freud analyzed this case in light of the oedipal theory, whereby the boy perceived his father as a horse, who was taking away his mother’s affection. He displaced his father’s fear onto horses (Gross, 1998). However, the behaviourists have strongly challenged this interpretation. According to the behavioural school of thought, phobias can be explained on basis of association and conditioning. The child saw a horse bus accident, and then as a result, developed a fear of horses (Gross, 1998). Approaches to phobia can also be studied in light of another interesting case, i.e of little Albert. This healthy, normal nine month old baby was emotionally a bit unresponsive. The famous behaviourist Watson experimented on him. By pairing a loud sound of a hammer with stimulus of a rat, he developed a rat phobia in the baby. Image source: Google Images, 2011. Fear on seeing the rat, which was a conditioned response later served as conditioning stimulus, and was used to develop phobia of dogs and rabbits as well via association and generalization (Gross; 1998). This study clearly revealed the process of conditioning where by phobias can be developed. On basis of the biological approach, studies by Slater & Shield (1969) have revealed a high percentage of concordance in phobic disorders among MZ as well as DZ twins. The biological model therefore suggests the presence of a genetic role in development of phobias (Gross, 1998). Therefore, we can conclude that various approaches view and explain phobia differently. Freud explains it on behalf of internal sexual and oedipal conflicts, behaviourists offer a social view, namely conditioning as source of phobias, while the biological approach suggests a genetic role on the development of phobic disorders. Treatment: Image Source: Google Images, 2011. REFERENCES: DSM IV. (1994). Diagnostic and statistical manual of mental disorders. Washington, D.C: American Psychological Association. Costello, T.W; Costello, J. T & Holmes, D. (1995). Abnormal Psychology. London: Harper Colleges Publisher. Gross, R. (2010). Psychology: The science of mind and behaviour. (6th ed.). Dubai: Hodder Education. Gross, R. (2008). Key studies in Psychology (4th ed.). London: Hodder and Stoughton educational. Google Image. (2011). Little Albert. Available at: http://s182.photobucket.com/albums/x5/amyponder13/psychopics/?action=view¤t=LittleAlbert.jpg&newest=1 [Accessed: May 10th, 2011]. Google Image. (2011). Phobia. Available at: http://www.hypnotherapysheffield.net/phobia.htm [Accessed May 10th, 2011]. McIlveen, R & Gross, R. (1998). Psychology: A new introduction. London: Hodder and Stoughton educational. Read More