The Individual Differences Approach

What is Abnormal Behaviour?

Some definitions of abnormality

Stratton & Hayes (1993) .. Abnormality IS

Behaviour which deviates from the norm most people dont behave that way Behaviour which does not conform to social demands most people dont like that behaviour Behaviour which is maladaptive or painful to the individual its not normal to harm yourself

Categorising Mental Illness

Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) International Statistical Classification of Diseases and Related Health Problems (ICD)

Diagnoses or Labelling?

Social Stigma?

Many people misunderstand and may even fear those with a mental illness. Frank Bruno, one of the nations favourite Boxers who won the ABA Heavyweight Championship at just 18 had to be sectioned in 2003 for Depression. This shows how anyone can be affected by mental illness, whether famous, successful or otherwise.

How did it feel?

If you had a mental illness how would you like to be treated?

The Question
If sanity and insanity exist How shall we recognise them?

D.L. Rosenhan (1973)

The ground breaking study :

On being sane in insane places

The volunteers

EIGHT sane people

one graduate student three psychologists a paediatrician a painter housewives

What did they do?

The procedure:
telephoned 12 psychiatric hospitals for urgent appointments gave false name and address complained of hearing unclear voices saying empty, hollow, thud

Simulated existential crisis Who am I, whats it all for?

What happened?
All were admitted to hospital All but one were diagnosed as suffering from schizophrenia

Once admitted the pseudo-patients stopped simulating ANY symptoms Took part in ward activities

How did the ward staff see them?

Normal behaviour was misinterpreted Writing notes was described as

The patient engaged in writing behaviour

Arriving early for lunch described as

oral acquisitive syndrome Behaviour distorted to fit in with label

How long did they stay in hospital?

The shortest stay was 7 days The longest stay was 52 days
The average stay was 19 days

They had agreed to stay until they convinced the staff they were sane.

Discuss: How would YOU convince someone you are sane?

Were they treated in the same way as normal patients?

Given total of 2100 medication tablets

they flushed them down the loos Noted that other patients did the same and that this was ignored as long as patients behaved themselves!

What sorts of records did they keep?

Nurses stayed in ward offices 90% of time Each real patient spent less than 7 minutes per day with psychiatric staff

Perhaps they behaved abnormally

Pseudo-patients visitors detected No serious behavioural consequences

DID ANYONE SUSPECT?

What about the REAL patients?

35 out of 118 patients voiced their suspicions

On release

The pseudo-patients were diagnosed as Schizophrenia IN REMISSION

Rosenhan: The follow up study

A teaching & research hospital was told of the first study

and warned that Over the next three months ONE OR MORE pseudo-patient will attempt to be admitted

What happened?

Staff members rated new patients on scale 1 - 10 as how likely to be a fraud

193 patients assessed 41 rated as a pseudo-patient (by staff) 23 rated as pseudo-patient (by psychiatrist) 19 rated as pseudo-patient (by both)

How many of these SUSPECTS were pseudo-patients?

NONE No pseudo-patients were sent the staff were rating their regular intake

Rosenhans conclusion

It is clear that we are unable to distinguish the sane from the insane in psychiatric hospitals
In the first study : We are unable to detect sanity In the follow up study : We are unable to detect insanity

Rosenhans study highlighted

The depersonalisation and powerlessness of patients in psychiatric hospitals

That behaviour is interpreted according to expectations of staff and that these expectations are created by the labels SANITY & INSANITY

Study 3! (last but certainly not least!)

Aim: to investigate patient-staff contact.
Method: In 4 of the hospitals pseudopatients approached a member of staff and asked~

Pardon me, Mr/Mrs/Dr X, could you tell me when I will be eligible for ground privileges?

Method continued:

The pseudopatient did this as normally as possible and avoided asking the same person more than once a day.

Results

A brief reply as the member of staff continued walking and did not make eye contact.

4% psychiatrists stop to talk 0.5% nurses stopped Overall 2% in each group paused and chatted.

Results continued: The Control

Young female participant Stanford University Campus Asked 6 questions All staff stopped and answered all questions and made eye contact.

Conclusion:

The lack of eye contact between staff and patients depersonalises the patients.

Why use triangulation?

Often the purpose of triangulation in specific contexts is to obtain confirmation of findings through convergence of different perspectives. The point at which the perspectives converge is seen to represent reality.

Is VSA a good school?

Types of Triangulation: There are four basic type of triangulation

a. data triangulation, involving time, space, and persons b. investigator triangulation, which consist of the use of multiple, rather than single observers; c. theory triangulation, which consists of using more than one theoretical scheme in the interpretation of the phenomenon; d. methodological triangulation, which involves using more than one method and may consist of within-method or between-method strategies. e. multiple triangulation, when the researcher combines in one investigation multiple observers, theoretical perspectives, sources of data, and methodologies.