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Unit 4 Psychology Final Review Series
AOS 2: Mental Health
Concepts of Normality
• Normality: Normality is considered to be what
is acceptable or what can be expected to
happen in most circumstances.
• In a clinical context, it is a condition that does
not require treatment or assistance.
MODEL
BEHAVIOURAL
EXPLANATION OF NORMALITY
Behaviour is seen as the result of learning according to the
principles of classical and operant conditioning or modelling.
Abnormal responses can be treated through new learning via
counterconditioning within behaviour therapy
A more eclectic, holistic approach that incorporates psychological,
BIOPSYCHOSOCIAL biological and societal influences to define behaviour
COGNITIVE
FUNCTIONAL
HISTORICAL
EXAMPLE
Gambling
Phobias
Stress
Depression
Schizophrenia
Cognitive processes are at the centre of behaviour, thought and
emotions. They determine ones attitudes and assumptions and
Stress
views of the world. Dysfunctional behaviour results when this view Depression
is flawed or inaccurate. Treatment in this approach involves
Schizophrenia
therapy sessions, which work to change self-defeating beliefs and
behaviours by demonstrating their irrationality and rigidity
Focuses on how effectively an individual is able to do what is
expected in everyday life, taking into account the adaptiveness of
the behaviour and how it affects the wellbeing of the individual or
the social group
Addiction
Anxiety Disorders
Stress
Mood disorders
Smacking children was once
As many behaviours evolve and change over time, the definition of permitted, but is now
normal behaviour involves an examination of the customs, habits discouraged
and traditions within a particular society / culture to identify what
it views as acceptable during a particular era
Homosexuality was once
classified as a mental disorder,
but now it is not
MEDICAL
Describes normality in terms of physical health and its underlying
physiological causes. Abnormal behaviour is seen as caused by an Normal = Health
illness that usually has a physiological or biological cause, which
can be diagnosed according to symptoms and signs of disorder,
Abnormal = Sick, ill
treated and, in most cases, cured by therapeutic methods within
a hospital or clinical setting.
NEUROBIOLOGICAL An aspect of the medical approach to normality focussing on the
role of the brain and nervous system in behaviour
PSYCHODYNAMIC
SITUATIONAL
SOCIOCULTURAL
STATISTICAL
Human behaviour is determined by underlying, usually
unconscious, psychological influences. These influences (also called
forces) are dynamic in that the relationship between them gives
rise to behaviour. Abnormal behaviours result when conflicts arise
in the relationship.
Normality is related to the factors to do with context (location or
place) used to determine whether behaviour is typical or
acceptable within that context
Describes normality in terms of what a particular society or culture
views as acceptable. Normality is based on influences of
nationality, religion, ethnic group, peer group, family or other
relevant groups. This approach identifies inappropriate behaviour
so that social norms may prevail for the harmonious functioning
within a particular society or culture.
Conclusions about normality are made on the basis of the analysis
of numerical data and calculations as to the way that most people
behave. Common measures are mean, median and mode
pertaining to the normal distribution curve.
Dementia
Schizophrenia
Phobias
Depression
Wearing pyjamas is all right
for going to bed, but not
for attending school.
Wearing a kilt
Eating raw fish
Walking around naked
Height
Weight
IQ
Differentiation of Mental
Health from Mental Illness
• Mental Health: A state of emotional and social wellbeing in which a
person can fulfil his or her abilities, cope with normal stresses of life, work
productively and be able to contribute to the community. With sound
mental health, individuals feel good about themselves and are able to get
on with their lives smoothly.
• Mental Health Problem: Where a person’s feelings, thought and actions
are negatively affected in an intermittent, transient or short term
situation.
• Mental Illness: A health condition that affects the way a person thinks,
feels and acts and that causes the person distress and difficulty
functioning. The condition is overwhelming to the point where the
individual has great difficulty coping with day-to-day activities and
maintaining relationships. Symptoms occur for significantly longer periods
of time than is the case with a mental health problem.
Systems of Classification of Mental
Conditions and Disorders:
Categorical Approaches to classifying mental disorders
are those that place common symptoms in categories
or groups.
Examples of categorical approaches are:
• Diagnostic and Statistical Manual of Mental
Disorders – IV, text Revision (DSM-IV-TR)
• The International Classification of Diseases-10
(ICD 10).
Underlying Principles of Classification;
• Classification Systems allow clinicians and researchers to:
• Standardise the description and interpretation of mental disorders –
provides clarity and eliminates ambiguity
• Provide vocabulary and a clinical shorthand to facilitate communication
between professionals
• Predict a conditions prognosis (future course)
• Consider appropriate treatment
• Encourage research into their etiology (cause or origin)
• Encompass all known types (of mental disorders).
• Serve as an educational tool for teaching psychopathology
DSM-IV-TR
Prepared by the APA and regularly revised, the
DSM-IV-TR provides a classification of 365 mental
disorders in 16 categories.
• It also provides criteria sets to help guide the
process of differential diagnosis, descriptions of
how frequently the disorder occurs in the general
population & numerical codes for each disorder
for medical record keeping. It does not detail the
causes of conditions.
• It includes a system of 5 axes or dimensions
(Multiaxial System) for assessing all aspects of a
patient’s metal and emotional health.
DSM-IV-TR Multiaxial System
MULTIAXIAL
SYSTEM
DESCRIPTION
AXIS I


EXAMPLE
Mental disorder/s that have been diagnosed. A person 
can suffer from more than one.

Includes all of the mental health conditions except
personality disorders and mental retardation
Bipolar disorder
Pathological Gambling
Borderline personality disorder
Moderate mental retardation
AXIS II

Personality disorders or mental retardation (intellectual 
disability)

AXIS III

General medical conditions


High Blood Pressure
Asthma
AXIS IV

Psychological and environmental factors





Death of a friend
Educational problems
Housing problems
Economic problems
Work difficulties
AXIS V


Global Assessment of functioning
Based on psychological wellness

A score of 1-10 indicates that
someone is severely unwell
A score of 91-100 indicates someone
has superior functioning

ICD-10
• The major international system for the
classification of mental disorders – prepared
by the World Health Organisation (WHO).
• Chapter 5 covers 300 ‘mental and behavioural
disorders’.
• The ICD-10 has more general categories using
a broad aetiology
Strengths & Limitations of Discrete Categorical
Assessment Tools: DSM-IV-TR & ICD-10
Strengths:
•
•
•
A major advantage of classification
systems for mental disorders is that
inappropriate behaviours can be
distinguished from functional ones.
A range of mental disorders are
arranged, organised and described
in a particular manner and order.
Psychologists and other mental
health practitioners use these
manuals as they provide a common
language for therapists,
researchers, social agencies and
health workers worldwide. This aids
diagnosis, selection of appropriate
treatments / therapies for the given
conditions.
It allows for consistent diagnoses
and treatments from hospital to
hospital, clinic to clinic, all over the
world.
Limitations:
•
•
•
•
•
The DSM-IV-TR does not explain the
causes of the various psychological
disorders.
This approach ‘boxes people into one
of the available categories,
sometimes inappropriately, and it
does not accommodate the unique
nature of the human condition.
These classifications do not account
for people who have ‘atypical’
symptoms or those that do not
clearly follow the ‘script.
Critics claim that categorical systems
reduce humans to one-dimensional
sources of data rather than
encouraging practitioners to treat the
whole person.
Critics also see these systems as tools
for social control – giving mental
health professionals control over
people’s lives.
Systems of Classification of Mental
Conditions and Disorders:
Dimensional Approach:
Example:
MMPI: Minnesota Multiphasic Personality Inventory:
• The dimensional approach is a method of categorising
mental illness where an individual has a profile of
scores on different continuums of diagnoses and
symptoms. Clinicians grade or rate the severity of the
symptoms or disorder by allocating a score or grade on
specified dimensions.
Strengths & Limitations of Dimensional Assessment
Strengths: Tools: MMPI etc Limitations:
•
•
•
•
•
•
Dimensional classification does not attempt to
place people into discrete, diagnostic
categories. Instead, key characteristics are
identified upon which all persons can be
placed, recognising that mental disorders lie
on a continuum with mildly disturbed and
normal behaviour, rather than being
qualitatively distinct.
The dimensional approach is better able to
capture many of the subtleties and
complexities of person’s life that are missed
within the categorical systems.
The dimensional approach evaluates
symptoms not only on their presence, but also
on their severity or degree.
The distinction between normal and abnormal
is not absolute, but rather a zone where there
can be a varying degree of the symptom or
characteristic.
Dimensional approach is more nuanced and
provides an accurate reflection of the state of
a given characteristic or symptom in a person.
It allows sufferers to see improvement in their
condition more readily and help to identify
which factors have the largest impact on their
well-being.
•
•
•
In making a diagnosis using the
dimensional approach there is much
scope for variable judgements on the
part of the clinician evaluating or rating
the symptom or characteristic – much
more inconsistency in its use.
The dimensional approach increases
the complexity of the communication
of the disorder to fellow professionals
and the public.
Most theorists cannot agree on how
many dimensions are required; some
say one dimension is enough, while
others have identified as many as 33
dimensions.
• End of current section