Classification and diagnosis of psychological abnormality

228 Pages·2010·0.99 MB·English

by  Susan Cave

Classification and
Diagnosis of Psychological
Abnormality
How is psychological abnormality recognised? How many different
mental disorders are there, and what are their characteristics? Although
there are established guidelines for clinicians working in this area, these
have been subject to many criticisms. Exploring how views on this
subject have changed over time, and how they vary in different
societies, poses important questions about our current practices.
This book provides a brief overview of the current definitions and
various explanations for psychological abnormality and then focuses
on how society diagnoses and classifies behaviour that is deemed to
be ‘unusual’. Three key areas of the topic are covered: the procedures

involved in the diagnosis and classification of mental disorders (such
as schizophrenia); research into the history and origins of multiple
personality disorder; and a discussion of the implications of cultural
variability (including culture-bound syndromes) for the classification
and diagnosis of psychological abnormality.
Classification and Diagnosis of Abnormal Psychologyis an intro-
ductory text suitable for students and teachers of the AQA Psychology
A2 specification and is also useful for other groups who work in the
field of mental disorder, such as nurses, social workers and therapists.
Sue Caveis a senior examiner and coursework moderator for A level
Psychology, and a lecturer at the University of Kent.
Routledge Modular Psychology
Series editors: Cara Flanagan is a Reviser for AS and A2 level
Psychology and lectures at Inverness College. Philip Banyard is
Associate Senior Lecturer in Psychology at Nottingham Trent
University and a Chief Examiner for AS and A2 level Psychology.
Both are experienced writers.
The Routledge Modular Psychology series is a completely new
approach to introductory-level psychology, tailor-made to the new
modular style of teaching. Each short book covers a topic in more detail
than any large textbook can, allowing teacher and student to select
material exactly to suit any particular course or project.
The books have been written especially for those students new to
higher-level study, whether at school, college or university. They
include specially designed features to help with technique, such as a
model essay at an average level with an examiner’s comments to show
how extra marks can be gained. The authors are all examiners and
teachers at the introductory level.
The Routledge Modular Psychologytexts are all user-friendly and
accessible and include the following features:
• practice essays with specialist commentary to show how to achieve
a higher grade;
• chapter summaries to assist with revision;
• progress and review exercises;

• glossary of key terms;
• summaries of key research;
• further reading to stimulate ongoing study and research;
• cross-referencing to other books in the series.
Also available in this series (titles listed by syllabus section): 1
2
ATYPICAL DEVELOPMENT AND Introducing Research and Data in 3
ABNORMAL BEHAVIOUR Psychology: A guide to methods 4
and analysis
Psychopathology 5
Ann Searle
John D. Stirling and Jonathan 6
S.E. Hellewell Theoretical Approaches in
7
Psychology
Therapeutic Approaches in
Matt Jarvis 8
Psychology
Susan Cave Debates in Psychology 9
Andy Bell (forthcoming) 0
BIO-PSYCHOLOGY 11
SOCIAL PSYCHOLOGY
Cortical Functions 12
John Stirling Social Influences
13
Kevin Wren
The Physiological Basis of 14
Behaviour: Neural and hormonal Interpersonal Relationships
processes Diana Dwyer 15
Kevin Silber Social Cognition 16
Awareness: Biorhythms, sleep and Donald C. Pennington 17
dreaming 18
Evie Bentley COMPARATIVE PSYCHOLOGY
19
Determinants of Animal Behaviour
20
COGNITIVE PSYCHOLOGY JoAnne Cartwright
21
Memory and Forgetting Evolutionary Explanations of
John Henderson Human Behaviour 22
John Cartwright 23
Perception: Theory,
development and organisation Animal Cognition 24
Paul Rookes and Jane Willson Nick Lund 25
Attention and Pattern Recognition 26
OTHER TITLES
Nick Lund
27
Sport Psychology
28
DEVELOPMENTAL PSYCHOLOGY Matt Jarvis
29
Early Socialisation: Sociability and Health Psychology
attachment Anthony Curtis 30
Cara Flanagan Psychology and Crime 31
Social and Personality David Putwain and Aidan Sammons 32
Development Psychology and Education 33
Tina Abbott Susan Bentham 34
Psychology and Work 35
PERSPECTIVES AND RESEARCH
Christine Hodson 36
Controversies in Psychology
Philip Banyard STUDY GUIDE 37
38
Ethical Issues and Guidelines in Exam Success in AQA(A)
Psychology Psychology 39
Cara Flanagan and Philip Banyard Paul Humphreys (forthcoming) 40
(forthcoming)
41

Classification
and Diagnosis of
Psychological
Abnormality
Susan Cave
First published 2002
by Routledge
27 Church Road, Hove, East Sussex, BN3 2FA
Simultaneously published in the USA and Canada
by Taylor & Francis Inc.,
29 West 35th Street, New York, NY 10001
Routledge is an imprint of the Taylor & Francis Group
This edition published in the Taylor & Francis e-Library, 2005.
“To purchase your own copy of this or any of Taylor & Francis or Routledge’s
collection of thousands of eBooks please go to www.eBookstore.tandf.co.uk.”
All rights reserved. No part of this book may be reprinted
or reproduced or utilised in any form or by any electronic, mechanical,
or other means, now known or hereafter invented, including
photocopying and recording, or in any information storage or
retrieval system, without permission in writing from the publishers.
British Library Cataloguing in Publication Data
A catalog ue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
Cave, Susan, 1949–
Classification and diagnosis of psychological abnormality / Susan Cave.
p. ; cm. – (Routledge modular psychology series)
Includes bibliographical references and index.
1. Mental illness–Classification. 2. Mental illnes–Diagnosis. I. Title.
II. Routledge modular psychology.
[DNLM: 1. Mental Disorders–diagnosis. 2. Mental Disorders–classification.
WM 141 C378s 2002]
RC455.2.C4 C385 2002
616.89–dc21 2001048729
ISBN 0-203-99397-7 Master e-book ISBN
ISBN 0-415-23101-9 (hbk)
ISBN 0-415-23102-7 (pbk)
Contents
List of illustrations xi
Preface xiii
Acknowledgements xv
1 Introduction 1
Historical background 1
Prehistory and evil spirits 1
Ancient Greece and medical explanations 2
The Middle Ages and demonology 2
The ‘Age of Reason’ and moral treatment 3

The modern era and mental illness 5
Criteria for defining abnormality 6
Legal criteria 7
Statistical criteria 8
Deviation-from-the-norm criteria 9
Mental health criteria 10
Psychological and social criteria 11
The four Ds 12
Mental illness criteria 12
Perspectives on abnormality 14
Issues 14
Debates 16
Approaches/models 18
The medical (or biomedical) model 18
CONTENTS
The psychodynamic model 19
The behavioural model 20
The cognitive model 21
The social constructivist model 22
The humanistic/existentialist model 23
The evolutionary approach 23
The family systems model 24
The socio-cultural model 25
The feminist model 25
The eclectic approach 25
Chapter summary 27
2 Classification, assessment and diagnosis 29
Background 29
Diagnostic and Statistical Manual of Mental Disorders
(DSM) 30
Axes I and II: Major categories 37
Schizophrenia 37
Major depression 39
Obsessive-compulsive disorder 41
Bulimia nervosa 42
Antisocial personality disorder 44
International Classification of Diseases (ICD) 46
Comparing DSM and ICD 47
Clinical assessment procedures 47
Principles o f assessment 48
Methods of assessment 51
Evaluation of classification and diagnosis 62
Criticisms of the existing systems of classification 63
Practical issues regarding classification 69
Ethical issues regarding classification 70
Chapter summary 72
3 Multiple personality disorder (MPD) 75
What is MPD? 75
Diagnosis 75
Measurement 76
History 77
Evaluation: reasons for variation in prevalence 79
viii
CONTENTS
Case studies 83
Eve 83
Sybil 86
Billy Milligan 88
Origins of MPD 92
The biological approach 92
The psychodynamic approach 93
Self-hypnosis approach 94
The behavioural approach 94
Socio-cultural approach 94
MPD and child abuse 95
Treatment 95
Does the treatment work? 95
How frequent are recovered memories of child
abuse? 97
Are the recovered memories accurate? 98
Does childhood abuse lead to adult disorder? 104
Are traumatic memories repressed? 105
Conclusion 105
Evaluation: spontaneous or iatrogenic? 106
Trends in prevalence 106
Social changes 106
The mass media 107
Conclusion 108
Chapter summary 109

4 Cultural and subcultural issues in abnormality 111
The relevance of culture and subculture 111
Some definitions 111
Relevance 112
Cultural differences in behaviour 113
Culture and mental disorder 113
How culture defines what is normal and abnormal 114
Response to unusual behaviours 114
Differences in interpretation of symptoms 115
Conclusion 116
Differences in prevalence and expression of mental
disorders 117
Differences in prevalence in different cultures 117
ix