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McGill University
GEOG 216
Meredith Chivers

Psych 235 Concept of Abnormal Psychology  11/28/2013 Lecture One How do we define “abnormal” behaviour • Mental disorder ♦ Personal distress ♦ Violation of cultural norms ♦ Statistical infrequency ♦ Dysfunction/disability ♦ Metal illness Standard 1: Cultural Relativism • No universal standards for “abnormal” • Abnormal=violation of cultural norms ♦ Abiological male presenting as a women? ♦ Koro: anxiety disorder that is the belief males have that their penis will retract into their body – SoutheastAsia • Pros: uses context to define • Cons: Thomas Szaz- definition a means of social control ♦ Took a contradicting look wouldn’t look at the context or cultural side Standard 2: Unusualness • Is the behaviour unusual or rare? • How do we determine what is “unusual”? ♦ Statistical infrequency • Pro: an objective criterion • Cons: ♦ What is the cutoff for “rare”? ♦ Not all “rare or “unusual” behaviours are problematic ie. high IQ Standard 3: Discomfort 1. Suffering as a result of the behaviours 2. Wish to be rid of them Pro:Avoids constraints of cultural relativism • 1. Adistressed trans women in Thailand • Con: people are not always aware of the suffering behaviour may create for themselves or others e.g. personality disorders – sex offender might not feel as if they did anything wrong Standard 4: Mental illness • Is the behaviour caused by an identifiable disease? • Pro: Objective process • Con: No medical test that identifies this process if it does exist (?) • Diagnosis is a label for symptoms not the naming of an identifiable disease Standard 5: Maladaptiveness • Psychological dysfunction, distress & atypical • The 3 d’s: 1. Dysfunction 2. Distress 3. Deviance (Atypical) • Majority of metal health professionals endorse this set of criteria • Pro: captures essence & avoids pitfalls of other criteria • Con: subjective judgment remains &relies on disclosure by client 1. Other criteria influence incidence of deviance • Wakefield’s concept of “harmful dysfunction” 1. “…a disorder exists when the failure of a person’s internal mechanism to perform their functions as designed by nature impinges harmfully on the persons well-being as defined by social values and meanings. The order that is disturbed when one has a disorder is thus simultaneously biological and social; neither alone is sufficient to justify the label disorder.” (Page. 373 Wakefield,92) 2. “Dysfunction is a scientific and factual term based in evolutionary biology that refers to the failure of an internal mechanism to perform a natural function for which it was designed, and harmful is a value term referring to the consequences that occurs to the person because of the dysfunction and are deemed negative by social cultural standards” 3. Why take so much time to talk/ think about how to define abnormal? 4. Concept is a philosophy- guiding principle that determines what behaviours normal Is this abnormal? • Case of Margaret: insists that garlic is hung from the door, rarely looks at people in the eye, keeps her eye to the floor, talk to herself , always caries garlic in her pocket • If Margaret is an old lady living in Greece: Margaret is very superstitious- we use the cultural relativism to prove her behaviour is not abnormal 1. She believes in the “evil eye” • If Margaret is 16 miss American teen: still lives a normal life • If it controls Margaret’s life- don’t leave your house then it can definitely be abnormal depending in what culture -> does it cause her stress? • If Margaret is violent due to other people not warding off the “evil eye”- she feels fine but this distresses others DSM-IV-TR Definition “Behavioural, emotional or cognitive dysfunction that are unexpected in their cultural context and associated with personal distress or substantial impairment in functioning.” – missing the biological impairment connection Shifting cultural norms for abnormality “ThisAmerican life” episode on the removal of homosexuality from the DSM in 1973 ** Web Link*** History ofAbnormal Psychology Historical Perspectives Causes of abnormal behaviour Supernatural theories divine intervention curses demonic possession personal sin Biological theories Similar to physicals diseases, breakdown of same systems of the body Psychological theories Mental disorder as the result of traumas Ancient Theories ofAbnormal Psych Stone Age 10 000BC supernatural theories trephination ( drill a hole in the skull to release the “demons”) Ancient China Frist written accounts of abnormal behaviour Yin & Yang ( balance of female/male & hot/ cold) Emotions controlled by internal organs- biological theory Treatment through diet Ancient Egypt Biological causes to mental problems Belief that various metal problems in women caused by a wandering uterus- Hysteria Choking, breathlessness, palpitations, faintness, weight gain, weight loss, too much or too little interest in sex, insomnia or excessive sleep etc. Women are imperfect- uterus is an analog of the penis that remains inside the body because of a developmental defect 19 century: doctors believed hysteric (emotional excesses like anxiety) due to lack of sexual stimulation women went to their doctors to get treatment for hysteria they were masturbated to orgasm created a market for electrical vibrators because doctors got tired Ancient Greece Supernatural theories Abnormal behaviour = punishment from gods Treatment= temple, rest, diet, exercise Cutting edge thinkers of the time thought differently… Hippocrates (460-377 BC) Somatogensis= physical cause Psychogenesis = psychological cause Galen ( Hippocrates student) Imbalance human: phlegm (Lethargy), black bile (depression) blood (mania), yellow bile (aggression) Personality typing Phlegmatic, melancholy, sanguine, bilious/choleric Abnormal behaviour results from social-cultural influences and learning Treatment is to re-educate through rational discussion (cognitive therapy) Importance of fantasies, dreams & thoughts Precursor to psychoanalysis & cognitive science Middle ages Supernatural theories dominate th Prior to 11 Century, physical illness or trauma Abnormal behaviours caused by possession Treatment= exorcism th th Early modern period ( late 15 century- early 17 Century) Supernatural model continues Persecution of witches Pope innocent Vlll Asylums = places for confining “mentally ill” “Belam” (craziness) Psychological perspective on mental illness industrialization causes separation from nature & rapid social change Advocates for humane treatment of the mentally ill Tuke & “Moral Treatment: Dorthy Dix in NorthAmerica Pinel & the Bicetre in Paris Moral treatment fails for many Modern biological perspectives ( 19/20 Century) Growing knowledge of anatomy, physiology neurology & chemistry influences beliefs about mental disorders Kraepelin-:founder of modern psychiatry” 19 Century development of categorical classification mental disorders, the psychiatric Compendium Discovery of syphilis as the cause of psychiatric disorder ** Modern Mental Health Care Discovery of antipsychotic medications transformed psychiatric care Canadian psychiatrist Heinz Lehmann Chlorpromazine, known commercially as Thorazine Severely affected patients could be treated in the community Patients Right Movements Deinstitutionalization: community based treatment and reintegration Limited community resources means many fall through cracks Caused by a lack of social resources Multiple short admissions-revolving door syndrome Still under reform- CAMH & community integration Chapter 1: Abnormal Behaviour in Historical Context Psychological Disorder: a psychological dysfunction within an individual that is associated with distress or impairment in function and a response that is not typical or culturally expected Chapter 1: Abnormal Behaviour in Historical Context Psychological dysfunction Distress or impairment Atypical response I.e. The boy who fainted at the sight of blood It refers to the breakdown in cognitive, emotional, or behavioural functioning Personal distress: when the dysfunction causes such a distress that it ruins normal functions or evidently effects your life negatively Not culturally expected Some thing’s will be considered abnormal because it deviates from the average Many people can be seen as far from average but we will still never call them disordered This applies to many actors, athletes, singers i.e. Lady Gaga This is why deviating from the average cant work as a definition Cultures that “hear voices” and “kill goats” thought that is was crazy when a woman did it but when the Masai does it its okay Harmful dysfunction Beyond the individuals control Behavioural. Psychological or biological dysfunctions that are unexpected in their culture context & associated with present distress and impairment in functioning, or increased risk of suffering, death, pain, or impairment Its hard to define therefore we think the best way is to match it to a “typical” profile using the DSM-IV- TR The Science of Psychopathology • Psychopathology: the scientific study of psychological disorders o Counseling psychologists Chapter 1: Abnormal Behaviour in Historical Context o Psychiatrists o Psychiatric social workers o Psychiatric nurses o Counselors • Scientist-practitioners o Must keep up with the latest scientific developments & treatment procedures o Evaluate their own assessments or treatment procedures o Might conduct research • Studying psychological disorders o Clinical description  First need to present the problem  Represents the unique combination of behaviours, thoughts, and feelings that make up a specific disorder  Specifying what makes the disorder different from normal behaviour or from other disorders  Prevalence: how many people in the population as a whole have the disorder  Incidence: statistics on how many new cases occur during a given period such as a year  Course: the pattern of the disorder  Prognosis: the anticipated course of a disorder • The prognosis is good= will most likely recover  Age & gender is important o Causation, treatment & Outcome  Etiology: study of origins has to do with why a disorder begins & includes biological, psychological & social dimensions Chapter 1: Abnormal Behaviour in Historical Context • The past historical conceptions of abnormal behaviour : supernatural model, biological model & psychological model • The supernatural model: o Demons & witches  Religious and lay authorities supported the notion of the supernatural and society as a whole began to believe in the reality of demon & witches  The bizarre behaviour of people afflicted with psychological disorders was seen as the work of the devil & witches  Treatment included exorcism, shaving a pattern of a cross on the victims th  This continued into the 15 century Stress & melancholy The view that insanity was a nature phenomenon, caused by mental or emotional stress, and that it was curable Mental depression & anxiety were recognized as illness The symptoms of lethargy were identified by the church with the sin of acedia or sloth Treatments: rest, sleep & healthy & happy environments Bath ointments & various potions The case of King Charles Vl Treatments for possession It is logical to conclude that a person is largely responsible for his or her own d
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