PSY240H1 Lecture Notes - Lecture 1: Gender Role, Schizophrenia, Blood Pressure
Week 1 – Wednesday January 13th, 2016
Definitions of “Abnormal”
1. Statistical Definition
• Deviation from average
o Is the behaviour rare?
• Problems
o Not all deviations are abnormal
• Ex. High IQ
▪ Not detrimental
o Where is the cut-off?
2. Personal Distress
• Is it causing the individual (or their family/friends) distress?
• Behaviour is only abnormal if:
o The individual suffers as a result, and
o The individual wishes to be rid of the behaviour
• Advantage: many disorders are distressing!
• Problems
o "Normal" distress
• Typical stress or manic episodes
o Some disorders don't involve suffering
o May not care about discomfort of others
o Poor insight
• Ex. Someone with schizophrenia has a different sense of reality and cannot be
convinced
▪ Won't believe you if you tell them there isn't a dragon there in the corner
3. Personal Dysfunction
• Is it affecting the individual's daily routine/tasks?
• AKA: Harmful dysfunction
• Disorder causes "functional" impairment
o Occupational
• Can't get out of bed to go to work
o Academic
• Slacking
o Social
• Alienated yourself
4. Violation of Norms
• AKA societal/cultural relativism
• Norm violation
• No universal standards or rules
• Ab/normality is relative to cultural norms
• Ex. Gender role expectations
o Males shouldn't wear pink
o Females should be motherly
• Problems
o Emphasizes conformity
o Cultural specificity
o Temporal specificity
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• Things change with time
o Potential for abuse
• Governmental power
o Some societies endorse bad things
o Society's implicit rules are hard to break
• Might risk being alienated from other people
• Might risk getting charged
Current Classification Model: Diagnostic and Statistical Manual of Mental Disorders (DSM)
• DSM-I (1952)
• DSM-II (1968)
• DSM-III (1980)
• DSM-III-R (1987)
o Revised version of DSM-III
• DSM-IV (1994)
• DSM-IV-TR (2000)
o Revised version of DSM-IV
• DSM-5 (2013)
• Section I: Basics
• Section II: Diagnostic Criteria and Codes
o Different chapters that are chunked into different disorders
• Section III: Emerging Measures and Models
DSM Basics
• A mental disorder is a behavioural or psychological dysfunction associated with …
personal distress
• Impairment in work, home, school, or social activities
• "Significantly increased risk of suffering in death, pain, disability, or an important loss of
freedom"
DSM Definition
• Mental disorders are not:
o An expected or appropriate response to an event
o Statistically deviant behaviour of minority groups
o A conflict between one individual and society
• Ghandi
DSM Example: Major Depressive Episode (MDE)
• 5+ of the following symptoms nearly every day (2+ weeks)
o Depressed mood
o Anhedonia
• No longer get any pleasure from anything
o Weight/appetite change
o Sleep change
o Change in psychomotor activity
o Loss of energy
o Guilt/worthlessness
o Impaired concentration
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o Suicidality
• Depressed mood and anhedonia must be two of the symptoms for it to qualify as MDE
Differing Opinions
• “As long as the research community takes the DSM to be a bible, we’ll never make
progress. People think that everything has to match DSM criteria, but you know what?
Biology never read that book.” – Dr. Thomas Insel
• “A classification system is like a map. And just as any map is only provisional, ready to
be changed as the landscape changes, so does classification.” – Dr. Sir Simon Wessely
DSM Classification
• Advantages
o Increases scientific communication
o Used in forensic situations
• To confirm that someone is not criminally responsible
• Ex. Eaton Centre shooter not excused because he did not have PTSD
o Necessitated by 3rd party payers
• Receive insurance
• Psychotherapy is not covered by OHIP
• Disadvantages
o Lose individual information
• Look at them as their classification and not as an individual
o Stigma and stereotyping
• Assume things about someone with a diagnosis that might not be true
• Person with diagnosis might live up to those assumptions
o Subject to political and social influences
• Ex. Homosexuality
Historical perspectives
• Supernatural tradition
• Sins, spirits
Biological tradition
• Physical breakdown in the body
Psychological tradition
• Experience, trauma
Ancient Stone Age Theories
Demonological or supernatural model
• Spirit possession
Potential treatments
• Exorcism
• Trephination
• Drilling holes in the skull to release the evil spirits
Ancient Egypt, Greece, and Rome
Origins of the medical model
Primarily "natural" theories
Still included supernatural/religious views
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