Explain Two Classification Systems Of Mental Illness

Concepts of Normality and Mental Health – Questions

SECTION 1 – DEFINING ABNORMALITY

1. Explain how social norms can be used to identify abnormality including examples of strengths and weaknesses (1.1).

 

Social norms are unwritten rules of how to behave in all social situations. Those social norms will vary on a person’s country of residency, religion believes, age and sexual orientation. Wearing a bikini in the shop in the UK won’t be appreciate but, on the beach, more likely to happen.

The strength of this definition is its flexibility. We will define something as abnormal or normal depends on the social situation. This clarity makes other people predict behaviour of others and flowing it make society in order.

Unfortunately, the rules can fade away with overtime. Homosexuality was illegal and also classified as a mental illness until the late 80s. Today, no longer the case. It makes it subjective definition depend on what people think. It might lead to abuse as we would accept people behave in certain way (Mcleod, 2020).

 

2. Outline two problems with using statistical infrequency to identify abnormality (1.1).

Normal Distribution Curve (bell-shaped curve)   (HighIQPro, 2016)

Having IQ 115 is defined as normal but very low and high IQ statistically is defined as abnormal. It takes only 2 standard of deviations away of the mean to classified behaviour or trait as abnormal. 95% of population will be considered normal and last 5% abnormal.

 

Phobias and depression are very common in the society. Regarding to this definition of abnormality, there are classified as normal but there are mental health disorders and need to be treated. This definition is more objective because it uses facts. Its data is not based on personal opinions but result might not be truthful. People participating in those tests might lie on questionaries, might not answer it correctly and the most important, it’s not possible to test everyone (Mcleod, 2020).

 

3. Discuss one alternative approach to identifying abnormality (1.1).

 

Maria Jahoda (1958) created six ‘elements for optimal living’ (Hayes, 2000):

1. Positive view of the self (person should have a good sense of self-esteem);
2. Capacity for growth and self-actualisation (clear goals and willing to achieve them, self-grown is it ongoing prosses and doesn’t stop at certain age);
3. Autonomy and independence (inability to control your own life is characteristically to abnormality);
4. Accurate perception of reality (individual needs to see the world like anyone ease sees it);
5. Positive friendships (surrounds itself with positive, warm people will establish clear normality. Poor relationships will have narrative influence to our mental health and then accordingly it would be abnormal);
6. Environmental mastery (in order to be normal, we need to be able to adopt to life turbulences and react to them we ease. We need to be able to handle any life circumstances without falling into any negative behaviours (addictions etc)) (Hayes 2000).

 

Jahoda’s classification is very positive and there are too many criteria’s which people must achieve to be normal and therefore it makes very idealistic. The concept of having the same perception of reality could be a very subjective experience. With this definition all people who suffer with some mental disorder like schizophrenia would be concerned to be abnormal. Jahoda’s definition of ideal mental health is based on Western, individualistic cultures where individual success is valued than population as a whole. (Willard, 2018).

7. Explain two classification systems of mental illness (1.2).

 

Classification	ICD	DSM
	The International Classification of Diseases	The Diagnostic and Statistical Manual of Mental Disorders
Country	More in the UK; worldwide accepted	USA
Created	World Health Organisation (WHO)	The American Psychiatric Association (APA)
Guidelines	It contains guidelines on signs and symptoms, causes and physical and mental treatments of all disorders.	A manual that offers guidelines, mainly those associated with mental illness, for classifying clinical diagnosis.
Created	The ICD-1O was written in 1983 and adopted by WHO in 1994.	First was published in 1917, as the ‘Statistical Manual for the Use of Institutions for the Insane’.
Current	Newer version ICD-11 came to use n 2018 as a preliminary trial. The ICD-11 is expected to come into official use in 2022.	The DSM-5 was published 2013
Changes	It allows professionals more control in interpreting “guidelines” as opposed to “criteria” preventing “symptoms counts” or need for “precise durations”. This will give doctors more control and ability to diagnose those conditions.	Pervious, DSM-IV used multiaxial system, current the DSM-5 doesn’t use axes

 

8. Outline some of the problems associated with the classification of mental illness (1.2).

 

Who	Found
Beck et al., (1962)	Few psychiatrists were asked to independently interview 153 patients by using DSM I and Beck’s found that only 54% of their examinations were the similar (Cave, 2002)
Copper el al., 1972	The Diagnostic Project (Copper el al., 1972) compared practise in the USA and the UK. Cooper found that schizophrenia was more likely to be diagnosed by psychiatrists in New York than London. London psychiatrists when shown videotaped interviews diagnosed bipolar disorder (Spitzer and Fleiss, 1974)

The diagnostic of disorders appeared not be reliable or accurate and depending on county of testing.

Sociologist T. J. Scheff (1966) in his book “Being Mentally Ill” introduced labelling theory. The doctors “label” patients with mental disorders and it will make them behaving like mentally ill. This self-fulfilling prophecy can worsen the disorder rather improve it and it could have a tremendous impact on person’s self-esteem and on individual’s identity. In that case, labelling will lead to reification or oversimplification. The label can affect other people perception of behaviour. Ordinary behaviour will be unnoticed or even taken as portentous disorder (Pasman, 2011).

 

SECTION 2 – EXPLAINING ATYPICAL BEHAVIOUR

To answer the questions below, you should choose one recognised mental health condition and apply each question/answer to that disorder where possible.

 

1. With accurate detail, discuss at least one biological explanation of mental illness. Your discussion could include both strengths and weaknesses (2.1 & 2.2).

 

OCD, obsessive compulsive disorder is one of biological disorder and it caused by genetic (inherited) and biochemistry.

Genetic explanations are focused on certain genes, including the COMT and SERT which can make us more vulnerable to OCD. The COMT gene is linked with regulation process of neurotransmitter dopamine. People with higher level of dopamine are more likely to develop OCD in certain compulsive behaviours. Other gene, the SERT (known as the 5-HTT gene) is related to the neurotransmitter called serotonin. Serotonin is responsible of mood levels, lower levels of serotonin it might cause depression. In the case of OCD reduced levels of serotonin are related with OCD and depression.

Brain structures, as natural explanation of OCD, play role in developing OCD, exactly the part of the brain called the basal ganglia (coordination of movement) (Figure 2) and orbitofrontal cortex (related to our personality, emotions and our social behaviour). On PET scans people with OCD have increased activity thought also stops patients and adaptation of sensory information into thoughts which preventing suffering with OCD stopping their behaviours (Sparks, 2010).

 

Figure 2. (International OCD Foundation, 2010)

 

Strengths of biological model were delivered by Lewis (1936). 37% participants with OCD had parents with the same condition and 21% siblings were as well affected by OCD.

Additional explanation came with twin studies. Nestadt el al. (2010) base his research on previous research and found that 68% of identical twins and 31% of non -identical twins experience OCD and this indicate a very solid genetic factor.

One of the weakness of biological explanation of OCD that it can be very deterministic. Basing knowledge only on biological explanation the condition might not be fully understood and treated.

It doesn’t take individual free will and the environment a person was born and how this influenced their behaviour by classical or operant conditioning. There is a possibility that with patients with low serotonin developed depression not OCD (Sparks, 2010).

 

2. Explain one problem with the biological model of mental illness (2.2).

 

The biological model has been criticised because it takes into account only biological processes happening the body and it makes it a reductionist model.

Human beings are more than biological possesses in the brain. What makes as unique are our thoughts, emotions, education, and the culture we come from (Mcleod, 2019).

There is no biological test available for mental disorders (e.g. blood tests, scans) (Wickelgren, 2012).

Furthermore, chemical imbalance theory which is commonly used by doctors and pharmaceutical companies, believe that with one pill will rebalance brain chemical reactions and cure mental disorders. It looks too good to be true and definitely it is not realistic (Cafasso, 2019)

 

3. Identify and evaluate an appropriate biological treatment for mental illness (2.3).

 

(Mcleod, 2019)

There are two treatments available.

First treatment would be a psychological therapy. It can be cognitive behavioural therapy (CBT) with exposure and response prevention (ERP). The therapy might involve talking about the fears and might include different activities like journaling, which will help put thoughts on the paper; dealing with difficult obsessive thoughts, behaviours. Second treatment, if the therapy didn’t help, will be treating a patient with antidepressant medicine called selective serotonin reuptake inhibitors (SSRIs) to help balance chemicals in the brain. The SSRI increases the levels of a chemical called serotonin and it can improve OCD symptoms. It might take up to 12 weeks to notice any benefits. Some medication can have minor side effects such a nausea, drowsiness and can be very unpleasant and can lead to dependence (NHS Choices, 2018).

4. Explain how behavioural psychologists would explain mental illness (2.1).

 

The behaviourist psychologists said that humans are born “tabula rasa” which means “blank slate”. Our behaviour is determined by the environment past learning experiences, classical and operant conditioning (Mcleod, 2020b).

Classical conditioning theory highlights how phobias are the result of a fear response becoming paired with a neutral stimulus – this can sometimes be traced back to a negative experience.

Operant conditioning explains how phobias are maintained – avoidance of the stimulus ‘negatively reinforces’ the phobia. When we are faced with the stimulus, our fear response returns which may represent punishment (Praveen Shrestha, 2019).

 

5. Critique the behaviourist approach to mental illness (2.2).

 

Behaviourist approach it’s been criticised world widely by psychologist. It doesn’t take for consideration biological model and it can appear very judgmental believing that we are conditioned by our past experiences. It very deterministic and its limiting humans to not have a free will. “Unnatural”, unethical human experiment like “Litte Albert”, Watson & Rayner and animals’ experiments Pavlov are bringing questions to our minds whatever those experiments were worth attempting to gain all that that knowledge.  Comparing human behaviour makes conflict with humanistic psychology because humans’ behaviour in not are not animals because humas are more complex (Theresa Lowry-Lehnen, 2015).

 

6. Briefly outline behavioural treatments of mental illness, including their strengths and weaknesses (2.3).

 

Psychological Treatments	What it is?	Strengths	Weaknesses
Flooding (exposure therapy)	parent is expose to the thing they fear	–  for some phobias can be very effective fear of feathers but fear of hights, agoraphobia e.g.	–  dangerous, it can worst the fears
Systematic desensitisation	The fear response is gradually replaced with relaxation response; patient cannot be relaxed and anxious at the same time	–  patient is exposed hierarchy to fears –  a lot of evidence supports this treatment –  the most ethical –  good for phobias not for mental illness	–  very slow process, it might take 6-8 sessions –  patient must know how to relax
Token therapy	There are two types of reinforcer in this therapy: –   Primary – we need (e.g. food). –    Secondary – what can be exchanged for something (e.g. money).	–    used in many hospitals for the mental treatments –    people rewarded for socially acceptable behaviours – reward with token	–       not everyone will response to token system –       can lead to dependency –       if reward are sweats can make children put on weight
Aversion therapy (behavioural therapy)	Used to get rid of unwanted behaviour by paring it with discomfort	–    can help alcoholics alongside with another treatment	–  might not be ethical –  doesn’t last long

(Mcleod, 2019b)

 

7. Using key theory, explain the psychodynamic causes of mental illness (2.1).

 

Psychodynamic model explains causes of mental illness via Erikson’s lifespan development stage maturity called ego integrity via despair (wisdom). The questions about life will appear when looking back at his life and ask yourself if you lived full life is there anything to regret. If an elderly doesn’t feel sense of accomplishment it might lead to regret, anger and despair which can cause depression and dissatisfaction (Mcleod, 2018).

 

Erikson’s Psychosocial Stages of Development

Figure1. (Purpoz, 2016)

 

8. Explain problems with psychodynamic theory (2.2).

One of the weakness of psychodynamic model is that these theories haven’t been scientifically proven. Psychoanalysis will depend on the therapist’s subjective interpretation and psychodynamic model becomes more ambiguous. Its base knowledge on case studies of single individuals, small samples. Psychodynamic psychologist cannot accurately predict an individual future behaviour (Mcleod, 2007).Freud’s approach overstates childhood experience and it becomes a very imitating theory because it takes away people’s freedom to take control of their life rather be stuck in childhood chairs forever.  It makes this approach be deterministic. Freud’s theory focuses too much on sexual issues, and doesn’t take for consideration value of interpersonal and social influences which play a huge role in our mental health.Future more, Erikson’s Psychosocial Stages of Development is not well defined or established. It doesn’t provide clarity how to determinate conflicts of moving from one stage of development to the next (Cherry, 2020).

 

9. Explain how psychodynamic therapy may work when treating mental illness, including strengths and weaknesses (2.3).

 

Freud’s traditional psychoanalysis began with the recognition of the problem to unlock the unconscious mind. Freud’s “talking cure” helped patients to open up and talk about their repressed dilemmas (Mcleod, 2007). By the identification, acceptance and interpretation of the problem. The patient will be able to understand their behavior better.

Freud, who is the father of psychology, acknowledged importance of childhood experiences and its impact on further behaviour. Before Freud, nobody noticed that relation.

Psychodynamic therapy has its own weaknesses. It will make it a is very expensive therapy if anyone would like to go to the counsellor and it will be hard to find a specialist with the right qualification.

Additional, patients can experience false memory. Our memory is not reliable and over time people can interpreted events in a completely different way that they really happened or didn’t happen at all (Mcleod, 2007).

 

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