Failure to function adequately

• Failure to function adequately

  An individual who is failing to continue with their normal everyday activities, such as going to work, washing or taking part in social activities, would be considered abnormal using this definition
• Day to day living is difficult for these people, they may feel as if they cannot go to the shops or attend a friend's birthday
• Failing to function adequately is a general sign of having a mental illness and is not specific to a disorder
• Shares of behaviour that indicate whether or not a person is failing to function adequately (Rosenhan and Seligman, 1990)

  • Observer discomfort
  • Unpredictability
  • Irrationality
  • Maladaptiveness
  • Personal suffering and distress
• Observer discomfort

  This is when a person's behaviour causes distress and discomfort to the observer
• Unpredictability


  We rely on behaviour around us to be predictable, so if a person's behaviour seems unpredictable and uncontrolled it suggests there is something wrong
• Unpredictability

  • Example
• Irrationality

  We can usually interpret the behaviour of others as being rational, but if the behaviour does not seem to be rational and hard to understand it can suggest there is a problem
• Irrationality

  • Example
• Maladaptiveness


  Maladaptive behaviour is behaviour which is not helpful (or adaptive), it limits the ability of a person to adjust to a particular situation
• Personal suffering and distress

  This is when the inability to cope with everyday life causes personal distress/suffering to the individual themselves
• Personal suffering and distress


  • Example
• A positive is that it is relatively easy to judge who is considered abnormal using FFA
• DSM V uses the World Health Organsization Disability Assessment Schedule 2 (WHODAS 2.0) which is a self-report assessment tool that evaluates the patient's ability to perform activities in six areas of functioning (eg, communicating, self-care) over the previous 30 days
• Each item is rated on a scale of 1-5 and the individual is given an overall score out of 180, this score represents global disability
• This is beneficial as if we have an objective judgement of abnormality, we are more likely to have a reliable (and consistent) diagnosis of abnormality
• One strength of FFA is that it takes the Individual's own interpretation of their experiences into account
• This is because it considers the individual's own personal distress and suffering when deciding whether someone is suffering from an abnormality or not
• This supports FFA as if other people (such as clinicians) are solely responsible for deciding whether somebody is abnormal this can be interpreted subjectively depending on the person who is deciding
• However, this is a subjective process-somebody has to decide the extent to which the distress is deemed as distressing enough to be abnormal
• This is the same for the other features, for example it is not clear the extent to which observer discomfort needs to occur to be classed as abnormal
• This is a problem of FFA because some patients may feel distressed but not be judged as suffering and therefore not get the treatment needed
• One limitation of the failure to function adequately definition is that some people can still function adequately with a mental illness
• For example, psychopaths can cause a great deal of distress to others but they can still function in society as somebody without a mental illness
• Harold Shipman murdered 215 of his patients over a 23 year period and this was undetected by others and he did not appear to function inadequately at all
• This is a weakness as it means that people suffering from a mental illness may be missed and their condition may worsen without treatment
• A further limitation is that FFA does not consider the context of the behaviour
• For example somebody who is not eating would be defined as abnormal according to FFA because this behaviour is maladaptive and is not beneficial
• However, if the context of the behaviour was a prisoner on a hunger strike the behaviour is unlikely to be a sign of an abnormality
• Therefore this is an issue as it means we may incorrectly identify somebody as suffering from an abnormality if they are not
• This can have negative consequences such as giving people medication they do not need