Bakground

• The Supernatural view was prevalent up to the middle ages and involved the idea of devils being trapped within a skull. They believed schizophrenia was caused by demons in the brain and used trepanning to drill a hole in the head which will allow the spirits to escape.
• The humorism view says the body is made up for 4 humors: blood, black bile, yellow bile, and phlegm. These must remain balanced to ensure good mental health. They believed someone who had melancholia (depression) had an excess of black bile and believed we could treat this through methods that rebalance the humors such as bloodletting.
• The definition of abnormality "deviation from social norms" says that people who do not abide by society's rules has abnormal behaviour. Such as a person with OCD will obsessively double check switches or locks. The weaknesses of this definition is that it is era dependent (social norms change with time), it is socially sensitive (label of mental disorders carry stigma) and it is ethnocentric (as social norms change across culture e.g. views towards homosexuality).
• The definition of abnormality "failure to function adequately" means if a person cannot live a normal life (e.g. have a job or maintain relationships) then their behaviour is abnormal. Such as a person with a gambling addiction may spend all their money betting so cannot afford a mortgage or rent. The weaknesses of this definition is that it is era dependent (standard for adequate function changes over time), socially sensitive (people may be labelled as lazy), reductionist (does not look at other factors why people cannot function such as a physical disability), and it is ethnocentric.
• The strength of being able to define abnormality is that it gives us a starting point to help people reach a diagnosis to understand their mental health better. This means they can seek treatment to improve their lives.
• To diagnose a disorder, a psychiatrist will use: clinical interviews, psychological tests (intelligence tests/ personality tests), physiological tests (brain scans) and observations of behaviour
• A psychiatrist may use the DSM5 to diagnose a patient. This is a diagnostic manual that lists the symptoms and criteria for mental illness diagnosis. It has over 300 mental illnesses organised into 20 categories.
• One issue of diagnosis is inconsistent diagnosis with other professionals leading to low inter-rater reliability. For example, a GP may see avolition as a thyroid problem causing fatigue whereas a psychiatrist may identify it as a symptom of schizophrenia. A patient should be tested many times and agreement should be above 80% . Inconsistent diagnosis can lead to wrongful treatment and the disorder may become worse.
• One issue of diagnosis is that people may feel embarrassment/stigma so they may down play their symptoms to avoid ridicule. For example a person with depression may be ashamed to mention suicidal thoughts to their psychiatrist as they feel stigma of not being appreciative of their life. This can lead to misdiagnosis and for symptoms to worsen.
• One issue of diagnosis is that it is ethnocentric as diagnostic manuals are often created in the west and are culturally Specific. The DSM was developed in the USA so certain disorders may be viewed differently in other cultures like tribal communities seeing schizophrenia symptoms as communicating with ancestors. This is a weakness as it can lead to misdiagnosis as the manual used does not consider the cultural norms.