How has society understood mental health, and how is one specific disorder defined, explained and treated?
Issues in mental health: the historical context of mental health, defining and diagnosing abnormality, and the characteristics, incidence, explanations and treatment of one specific disorder.
An OCR A-Level Psychology answer to the compulsory issues in mental health topic, covering the historical context of mental health, definitions and diagnosis of abnormality, and the characteristics, incidence, explanations and treatment of a specific disorder such as schizophrenia, for Component 3.
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What this dot point is asking
Issues in mental health is the compulsory section of Component 3. You must know how understandings of mental health have changed historically, how abnormality is defined and diagnosed, and the characteristics, incidence, explanations and treatment of one specific disorder (commonly schizophrenia). This topic is examined with description, application and extended evaluation questions.
The answer
The historical context of mental health
Defining and diagnosing abnormality
Characteristics and incidence of a specific disorder
Explanations and treatment
- Biological explanation. The dopamine hypothesis: schizophrenia is associated with overactive dopamine transmission, supported by antipsychotics (which block dopamine) and amphetamines (which raise it and can induce psychosis). Genetic and brain-structure factors also feature.
- Cognitive explanation. Faulty information processing and impaired metacognition produce symptoms such as hallucinations.
- Treatments. Biological treatment is antipsychotic drugs (typical and atypical), targeting dopamine. Psychological treatment includes CBT for psychosis (challenging delusional beliefs) and family therapy.
Examples in context
Example 1. Why diagnosis can lack reliability and validity. Two clinicians using different systems (DSM versus ICD) or weighting symptoms differently might disagree about whether a patient has schizophrenia, threatening reliability. Validity is threatened if symptoms overlap with other disorders (such as bipolar disorder) or if cultural differences in expressing distress are misread. This is why standardised criteria and trained clinicians matter, and why diagnosis is a core issue in mental health.
Example 2. Why the medical model alone is incomplete. The dopamine hypothesis explains why antipsychotics help many patients, but drugs do not work for everyone and ignore psychological and social factors such as stress, trauma and family environment. A patient who responds partly to medication and partly to CBT shows that a combined, diathesis-stress approach explains the disorder better than biology alone, which sets up the comparison with alternatives to the medical model.
Try this
Q1. Name two systems used to diagnose mental disorders. [2 marks]
- Cue. The DSM (Diagnostic and Statistical Manual) and the ICD (International Classification of Diseases).
Q2. Distinguish between positive and negative symptoms of schizophrenia. [2 marks]
- Cue. Positive symptoms add to experience (hallucinations, delusions); negative symptoms involve a loss (flat affect, avolition, social withdrawal).
Q3. Explain one limitation of defining abnormality as deviation from social norms. [3 marks]
- Cue. Social norms vary across cultures and over time, so behaviour judged abnormal in one context may be normal in another, making the definition subjective and open to social control.
Exam-style practice questions
Practice questions written in the style of OCR exam questions on this dot point, with worked answer explainers. The year tag is the paper they imitate, not the source.
OCR 201910 marksDescribe the historical context of mental health and how definitions of abnormality have changed over time. [10 marks]Show worked answer →
A description item testing knowledge of the topic (AO1).
Historical context: understandings of mental illness have shifted dramatically. Early supernatural explanations attributed disorder to demons or possession (with treatments such as exorcism or trephining). The moral treatment movement of the eighteenth and nineteenth centuries (for example, Pinel) urged humane care in asylums. The twentieth century saw the rise of the biological/medical model (treating mental illness as physical illness, with drug treatments), the growth of psychological models (psychodynamic, behavioural, cognitive), and the deinstitutionalisation movement moving care into the community.
Defining abnormality: definitions include deviation from social norms (behaviour society disapproves of), failure to function adequately (cannot cope with daily life), statistical infrequency (rare behaviour), and deviation from ideal mental health (Jahoda's criteria). Each has limitations: social norms vary across time and culture, and statistical rarity does not always mean a disorder.
Markers reward the historical shift (supernatural to moral to medical and psychological models, plus deinstitutionalisation) and at least two definitions of abnormality with a limitation.
OCR 202115 marksDescribe the characteristics and explanations of one specific mental disorder you have studied, and evaluate one explanation. [15 marks]Show worked answer →
An extended item: describe a disorder (AO1) and evaluate an explanation (AO3). Using schizophrenia as the example.
Characteristics: schizophrenia is characterised by positive symptoms (hallucinations, delusions, disorganised speech) and negative symptoms (avolition, flat affect, social withdrawal), diagnosed using DSM or ICD criteria over a sustained period.
Explanations: a biological explanation is the dopamine hypothesis, that schizophrenia is associated with overactivity of dopamine transmission in certain brain pathways, supported by the action of antipsychotic drugs (which block dopamine) and amphetamines (which raise dopamine and can induce psychosis). Genetic and neuroanatomical factors also feature. A cognitive explanation attributes symptoms to faulty information processing and impaired metacognition.
Evaluation of the dopamine hypothesis: strengths include strong drug evidence and biological plausibility; weaknesses include that dopamine drugs do not help all patients and that the hypothesis may confuse cause with effect, plus it is reductionist, ignoring psychological and social factors (a diathesis-stress model is more complete).
Markers reward accurate characteristics, a clear explanation, and a balanced evaluation reaching a judgement (for example, biological factors matter but a diathesis-stress account is stronger).
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Sources & how we know this
- OCR Level 3 Advanced GCE in Psychology (H567) specification — OCR (2015)