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McGill University
PSYC 410
Richard Koestner

Lecture #27 Mental Disorders (Part I) Ÿ Mental disorders have at the heart that people have abnormal thoughts and behaviours, not entirely clear what abnormal refers to Ÿ For e.g. abnormality can be a deviation for the average, statistically rare, however this treats all abnormal behaviours as equally abnormal, genius incurs as much as stupidity, positive deviations and classified the exact same way as negative deviations, not preferred Ÿ Abnormalities reflect deviations from group, developmental or cultural norms, generally accepted expectations of how we should think, feel and act (behave), abnormalities would then be the failure to meet those expectations, but the problem is the expectations are changing from one cultural context to the next, and we would prefer a definition that does not depend on the characteristic thats depend on the viewer (man or woman, young or old, all with different expectations) Ÿ Specify an ideal for mental health, a standard, and say that abnormality is the failure to achieve that idea, on the basis of a theory, this is what good mental health looks like, so abnormality is the failure to show that mental health (e.g. sense of personal integration, healthy person has well integrated ego, superego and id, ability to cope with stress, see things in the world as they are, unconditional sense of self acceptance) Ÿ Many theories of what a person is and looks like, but all of these standards together is a depiction of functioning which none of us can achieve, meaning we are all abnormal Ÿ Abnormality is what is personally distressing about us, this definition covers a lot of ground, almost every disorder in encyclopaedia or dictionary involves a type of distress Ÿ Problem is its ALMOST all, there are occasions where there are abnormal behaviours where there is no distress, for e.g. narcissism, abnormal behaviour in which narcissists aren’t bothered by their behaviour, odd but not distressing to the person Ÿ Pragmatic point of view, you will not be locked up and towed away just because you have odd thoughts, delusions or odd thoughts, once you become bothersome to other people, then they lock you up, extremely important quality, abnormality and mental health have an interpersonal quality Ÿ Narcissistic personality disorder, they are not bothered about it, but their attitude annoys everyone else that makes him abnormal, similar with anti-personality disorder Ÿ Final notion critical is impairment, whatever abnormality is, it involves failure of a functioning, ability to thrive in personal, occupational of social domains, at the end of the day, a very critical idea Ÿ To what extent do the symptoms you experience, impair your behaviour in love, friendships, etc. Ÿ You are no disordered from the dsm point of view, unless your social (14 minute) Ÿ All of these definitions tap into what we think about mental disorders, we are talking about infrequencies, negative ideas of social standards, etc. Ÿ Lot of theories about what caused abnormality, psychodynamic model originating with Sigmund Freud, what we see constituting for abnormal behaviour most likely is an issue of the unconscious to the personality between id, superego or ego. (source of anxiety, or other frameworks, hidden underlying unconscious problems) Ÿ Cognitive-behavioural model, learning theorist point of view, we expect normal behaviour to be learned, because they learn to act that way, abnormal behaviours are discouraged or punished, what is the reinforcement behaviour of this individual Ÿ Humanistic-existentialist model, abnormal behaviour as a failure to receive unconditional positive regard, like from or parents, failure to become a fully complete, functioning person Ÿ The most prevailing widely used model, is the medical model, most prevalent model for describing mental disorder (inappropriate application), explains symptoms by postulating disease, you see signs of symptoms and the explanation for that is a disease, and the disease is different from the symptoms Ÿ e.g. you have symptoms of exhaustion, fatigue, difficulty concentrating, runny nose, and the explanation is the flu, the cause of the symptoms Ÿ This works in all sorts of domains, all sorts of tests to indicate diseases, but this is th esame framework used for disordred behaviour, so when you ask why is she sad, its because she has depression, the disease entity that explains sadness Ÿ Why is that wrong? Int aht case, the symptom and disease is wrong, why is she sad? She has depression, what is depression? Depression is sadness Ÿ Tries to explain symptom with the symptoms, circular reasoning Ÿ What we call disorders are not diseases, it is diagnostically and statistical recognition that they are group of symptoms that tend to cluster together Ÿ Very common practise that symptoms and diseases interchange, when we speak of something like depression, you speak about underlying disease, biological based, which medicine is cure Ÿ Another approach, socio cultural approach, acknowledges the general to use symptoms as explanatory mechanisms for symptom
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