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About statistical infrequency. Behaviour that is statistically rare is said to be abnormal. IQ is often used as an example of the definition because it is normally distributed throughout the population and people outside the normal limits is said to be abnormal. Abnormality is anything that is statistically infrequent. This links to normal distribution. With a characteristic, it is normally distributed if the mean average, median and mode fall in the same place- in the middle of the scores. There are roughly the same numbers of scores each side of the average. Scores are normally distributed around the average. A set of normally distributed scores will have a set percentage at each standard deviation from the mean. A person's trait, thinking or behaviour is classified as abnormal if it is rare or statistically unusual. Necessary to be clear about how rare a trait or behaviour needs to be before we class it as abnormal. Any human characteristic is spread in a normal way across the general population. When plotted on a graph, it will form a normal distribution curve. The majority of people will fall in the middle of the graph with the minority being at either extreme end of the graph. The same is true of normal and abnormal behaviour. If someone's behaviour falls in the top or bottom 2.5% then it is considered to be abnormal.
Evaluation STRENGTH - It is an objective definition, therefore one that all clinicians can use to ensure consistency in diagnosis. WEAKNESS - Does not give a clear-cut definition and takes away the subjectivity of clinicians diagnosis. WEAKNESS - Doesn't take account of cultural variations.
WEAKNESS - If a person's score is only one or two above what is classed as abnormal, they may not get the help that they need. WEAKNESS - Some behaviours that people show every day such as anxiety may be considered normal but abnormal in a clinical sense.
Another definition of abnormality. Every society has accepted standards of behaviour, these are sometimes written as part of the law. Others are implicit: they are generally accepted but not legally binding. Social norms allow for the regulation of normal behaviour. One approach to defining abnomality is to consider deviations from social norms as an indicator of abnormal behaviour. A person's thinking or behaviour is classed as abnormal if it violates the rules about what is expected or acceptable behaviour in a particular social group. Their behaviour may be incomprehensible to others or make others feel threatened or uncomfortable. To define people's mental health in terms of deviation from social norms suggests that those who behave in a socially deviant or incomprehensible way should be regarded as abnormal because they break with conventions and so not do what is normally expected. Some roles in society also come with what is considered to be normal behaviour, such as doctors are expected to be caring towards their patients.
Evaluation
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WEAKNESS - Can lead to an abuse of a person's rights based on what society sees as normal. WEAKNESS - It is culturally biased. What is unacceptable in one culture may be seen as acceptable in another culture.
WEAKNESS- At times, breaking with the dominant culture is something to be applauded (freedom fighters) STRENGTH - Allows us to consider different behaviour which may not on their own be classified as abnormal.
Strengths:
Reliable source as the researcher can replicate the procedures to check the results because they know the procedures and how the data was collected and analysed. The data will be more up-to-date. Using data which was gathered years previously is less likely to provide reliable answers to the question which the data needs to address. Taken directly from the population so it is best to collect for methods like surveys.
Weaknesses:
Researchers may be subjective in the data that they look for e.g. looking for data which matches their hypotheses. Because the data us gathered from scratch it involves finding a large enough sample to make the results credible and generalizable and gain a large volume of data meaning it is more costly and time consuming than collecting secondary data.
Strengths:
Saves time and expense which would otherwise be spent collecting data. It can provide a larger database than an individual researcher would hope to collect. Often the only resource and therefore the only way to examine large scale trends of the past e.g. historical documents.
Weaknesses:
The researcher cannot personally check the data so its reliability may be questioned. The researcher may have no knowledge of how the data was collected; therefore they do not know anything about the accuracy or bounds of error. May be out of date and therefore not suitable for current research.
The DSM Diagnostic and statistical manual of mental disorders used by psychiatrists to aid in the diagnosis of mental disorders. It is regularly updated and multi-axial i.e. it considers a number of factors (e.g. health and social factors) in making a diagnosis.
AXIS I- Disorders, clinical and mental e.g. schizophrenia Diagnostic category with appropriate sub-classification e.g. schizophrenia; paranoid type. Include substance related disorders e.g. drug and alcohol abuse, schizophrenia and other psychotic disorders, mood disorders, anxiety, sexual and gender identity disorders and sleep disorders. AXIS II- Personality (underlying including mental retardation) Personality and developmental disorders are listed here if presen.t These include: paranoid, schizoid, anti-social, dependent, obsessive-compulsive.
AXIS III- Medical and physical conditions A list of any current physical disorders that may be relevant to understanding and treating the person. Any relevant general medical condition from which the person is currently suffering.
AXIS IV- Environmental factors Documentation of preceding stressful events. These include: emotional problems, occupational, housing, finance, access to healthcare, legal/criminal problems, other psychosocial problems e.g. death of a loved one or divorce. AXIS V- Global functioning An evaluation of how well the individual had functioned socially and occupationally prior to onset of illness. Here, social, psychological and occupational functioning is considered on a scale from 0-100, 1-10 severe danger of self-harm or harm to others or a persistent lack of personal hygiene or serious suicidal acts with clear expectation of death.
Predictive validity Present if a diagnosis can lead to a prediction of future behaviours caused by the disorder. If a diagnosis has predictive validity we should be able to say whether the person is likely to recover or whether symptoms will continue, it should also be possible to predict how someone with a specific disorder will respond to particular treatments. E.g. the drug lithium carbonate is effective for bipolar disorder, but not for other mental disorders. If a classification system has good predictive validity and diagnoses someone with bipolar disorder, they should respond to lithium carbonate.
Convergent validity When tests results converge or get close to another test result that measures the same thing. A correlational test would be carried out. If two scales measure the same construct, for example, then a persons score on one should converge with (correlate with) their score on the other. The difference between convergent validity and predictive/concurrent validity is that in convergent validity the two measures should be measuring exactly the same thing, whereas in the other two types of validity there can be a different way of measuring each case.
Traditionally, reliability is calculated mathematically, often using a measure known as positive predictive value (PPV). The PPV of a disorder shows the reliability, taking the example of depression, of the DSM with that disorder; so if depression had a PPV value of 80, this means that 80% of diagnosed depression patients will have the same subsequent diagnosis when re-assessed.
However, there may also be a cultural element to reliability, for example with Cooper et al. (1972) who showed the same patient interview tapes to various American and British psychiatrists, and American clinicians diagnosed schizophrenia twice as often as the British, and the British clinicians diagnosed depression twice as often as the Americans.
Spiritual view
Thought disorders: Cause your speech to be hard to follow. You may lose concentration or complain of muddled thinking. Further, you may believe in thought insertion or thought broadcasting.
Features of Schizophrenia
schizophrenia appears to be a universal disorder (the condition can affect anyone in any place, males and females) the profile of sufferers seems to be as follows: of patients will have one episode of schizophrenia and then fully recover of patients will suffer chronic schizophrenia, having continuous schizophrenic episodes of patients will have occasional schizophrenic episodes but do not have a chronic disorder positive symptoms (those added to the sufferers being) can be overcome (e.g. hallucinations, delusions), whereas the negativ e symptoms (those lacking in sufferers) tend to remain male sufferers tend to experience a more severe course of the disorder than females (Goldstein, 1988) there are five categories which psychiatrists and diagnosticians use to describe different types of schizophrenia
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It is believed that high levels of dopamine in the mesolimbic pathway contribute to the positive symptoms of schizophrenia and dopamine in the mesocortical pathway contributes to the negative symptoms. Neurotransmitters like dopamine are chemical substances released through an electrical impulse into neurones where they carry messages which control the behaviour of the brain and the body. The electrical impulses are converted into chemical processes and pass through a synaptic gap between the pre synaptic and post synaptic neurones. The post synaptic neurone contains receptor sites where the levels of dopamine are observed and this is thought to be the cause of positive symptoms of schizophrenia, alternatively the excess dopamine which is usually reabsorbed into the pre synaptic neurone may be going into receptors once they become empty, giving double the amount of dopamine to the body.