Clinical psychology
1. Concerned with what makes bhv abnormal
2. Seeks to diagnose mental health problems so they can be treated
3. Investigates explanations + treatments for mental disorders
4. Studies issues related to diagnosis by looking at reliability + validity of different
diagnostic systems
Diagnosis of mental disorders
Assessment of abnormality
Diagnosis: propose cause for medical problem
Clinicians take note of:
- Symptoms + how long
- General health
, 2
- Social psychological problems
Take into account patient’s context + situation
Prognosis: prediction how problem develop with/out treatment
Issue: point at which bhv so “abnormal” that it requires clinical diagnosis + treatment
No physiological signs of MDs
DEVIANCE
Extent bhvs, thoughts + emotions “rare” + “deviant” (viewed as extreme, unusual,
bizarre, undesirable + differ from statistical & social norms) within society =clinical
disorder
Bhvs + emotions viewed as socially unacceptable
Statistical norms: behaviour frequent =normal but rare / unusual= abnormal
Normal distribution curve: majority of scores cluster around mean =normal
Truly abnormal at top / bottom of scale
+ Objective
- Ignores how we feel about abnormality
Social norms: shared standards of acceptable behavior
Violated = abnormal (eccentric rebellious, threatening)
1. Culture: different social norms
2. History: once abnormal may become normal later
3. Situation: bhv normal in 1 place/context may be abnormal in different situation
4. Age + gender: different expectations for men +women, young + old
+ Popular feelings + moral values
+ Norm-breaking useful indicator of psychological abnormality as failure to
conform to statistical / social norms lead to negative attention from others &
social exclusion
+ Standardised tests assess symptoms of disorders
, 3
- Subjective : therapist influenced by whether they personally find bhv shocking /
upsetting
- Curtailing of human rights as social norms change with time
- Some cultures deem bhvs as desirable rather than deviant
- Some problematic bhvs not that rare: clinician weighs up all 4 diagnostic
dimensions for whether patient requires further psychiatric care
- Decision of whether bhv needs further diagnosis relies on what’s discussed btw
patient - clinician : reliable = all 4Ds explored with everyone so they are measured
in standardised way & any decision over level of “deviance” is based on a
standardised measure
DYSFUNCTION
Abnormal bhv significantly interferes with everyday tasks and unable to cope
with demands of everyday life
Discuss carefully all aspects of patient’s everyday life b/C disturbances in not
obvious areas
Rosenhan & Seligman (1989): failure to function adequately :
● Unpredictable loss of control
● Irrational, incomprehensible
● Discomfort to observers
● Suffering / distress
● Maladaptiveness (risk to yourself and others)
● Vividness & unconventionality (deviance)
● Violate moral standards
+ More objective than appealing to social norms
+ Help determine when MH “issue” is MH “disorder”
- Abnormal bhv may actually be helpful for individual
- Lacks objectivity: disagree on what’s considered dysfunctional bhv =
clinician take into account how person is coping with bhv b/C what’s
considered to be dysfunctional by 1 is seen differently by another
, 4
DISTRESS
Abnormal bhv causing upset, unhappiness
Negative feelings occur inappropriately / persist too long
E.g. anxiety, isolation, confusion, fear
Treated in isolation from other Ds: patient extremely distressed by current situation but
still able to function completely normally in other life areas
Patient’s subjective experience important: face great difficulty but feeling no distress /
very distressed by smth others view as trivial (little importance)
What 1 person finds dysfunctional might not affect some1 else so much (degree of
distress dependent on job + levels of support)
Stress: belief of not having enough resources to cope = INDIVIDUAL BELIEF
+ Connects abnormality to quality of life
- Subjective judgment + interpretation of patient’s experience
DANGER
Bhv puts at risk individual + others around them
Based on “harm principle”: right to behave in any way if don’t cause harm
On scale of severity: many engage in bhv that could be dangerous but don’t cause
immediate harm, but if problematic bhv risky + not addressed = need diagnosis
- Lead people to equate mental illness with being dangerous
5TH D: DURATION
Deviant, dysfunctional, distressing + dangerous bhvs in short term but if persist =
symptom of an illness requiring psychiatric attention
ISSUES AND DEBATES
★ ETHICS / SOCIAL SENSITIVITY
Issues of diagnosing MDs
1. Concerned with what makes bhv abnormal
2. Seeks to diagnose mental health problems so they can be treated
3. Investigates explanations + treatments for mental disorders
4. Studies issues related to diagnosis by looking at reliability + validity of different
diagnostic systems
Diagnosis of mental disorders
Assessment of abnormality
Diagnosis: propose cause for medical problem
Clinicians take note of:
- Symptoms + how long
- General health
, 2
- Social psychological problems
Take into account patient’s context + situation
Prognosis: prediction how problem develop with/out treatment
Issue: point at which bhv so “abnormal” that it requires clinical diagnosis + treatment
No physiological signs of MDs
DEVIANCE
Extent bhvs, thoughts + emotions “rare” + “deviant” (viewed as extreme, unusual,
bizarre, undesirable + differ from statistical & social norms) within society =clinical
disorder
Bhvs + emotions viewed as socially unacceptable
Statistical norms: behaviour frequent =normal but rare / unusual= abnormal
Normal distribution curve: majority of scores cluster around mean =normal
Truly abnormal at top / bottom of scale
+ Objective
- Ignores how we feel about abnormality
Social norms: shared standards of acceptable behavior
Violated = abnormal (eccentric rebellious, threatening)
1. Culture: different social norms
2. History: once abnormal may become normal later
3. Situation: bhv normal in 1 place/context may be abnormal in different situation
4. Age + gender: different expectations for men +women, young + old
+ Popular feelings + moral values
+ Norm-breaking useful indicator of psychological abnormality as failure to
conform to statistical / social norms lead to negative attention from others &
social exclusion
+ Standardised tests assess symptoms of disorders
, 3
- Subjective : therapist influenced by whether they personally find bhv shocking /
upsetting
- Curtailing of human rights as social norms change with time
- Some cultures deem bhvs as desirable rather than deviant
- Some problematic bhvs not that rare: clinician weighs up all 4 diagnostic
dimensions for whether patient requires further psychiatric care
- Decision of whether bhv needs further diagnosis relies on what’s discussed btw
patient - clinician : reliable = all 4Ds explored with everyone so they are measured
in standardised way & any decision over level of “deviance” is based on a
standardised measure
DYSFUNCTION
Abnormal bhv significantly interferes with everyday tasks and unable to cope
with demands of everyday life
Discuss carefully all aspects of patient’s everyday life b/C disturbances in not
obvious areas
Rosenhan & Seligman (1989): failure to function adequately :
● Unpredictable loss of control
● Irrational, incomprehensible
● Discomfort to observers
● Suffering / distress
● Maladaptiveness (risk to yourself and others)
● Vividness & unconventionality (deviance)
● Violate moral standards
+ More objective than appealing to social norms
+ Help determine when MH “issue” is MH “disorder”
- Abnormal bhv may actually be helpful for individual
- Lacks objectivity: disagree on what’s considered dysfunctional bhv =
clinician take into account how person is coping with bhv b/C what’s
considered to be dysfunctional by 1 is seen differently by another
, 4
DISTRESS
Abnormal bhv causing upset, unhappiness
Negative feelings occur inappropriately / persist too long
E.g. anxiety, isolation, confusion, fear
Treated in isolation from other Ds: patient extremely distressed by current situation but
still able to function completely normally in other life areas
Patient’s subjective experience important: face great difficulty but feeling no distress /
very distressed by smth others view as trivial (little importance)
What 1 person finds dysfunctional might not affect some1 else so much (degree of
distress dependent on job + levels of support)
Stress: belief of not having enough resources to cope = INDIVIDUAL BELIEF
+ Connects abnormality to quality of life
- Subjective judgment + interpretation of patient’s experience
DANGER
Bhv puts at risk individual + others around them
Based on “harm principle”: right to behave in any way if don’t cause harm
On scale of severity: many engage in bhv that could be dangerous but don’t cause
immediate harm, but if problematic bhv risky + not addressed = need diagnosis
- Lead people to equate mental illness with being dangerous
5TH D: DURATION
Deviant, dysfunctional, distressing + dangerous bhvs in short term but if persist =
symptom of an illness requiring psychiatric attention
ISSUES AND DEBATES
★ ETHICS / SOCIAL SENSITIVITY
Issues of diagnosing MDs
