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Ch 1. Concepts of Abnormality.pdf

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PSYC 3230
James Alcock

1. Concepts of Abnormality Monday, January 7, 2019:00 AM Prevalence of mental disorders • Mental disorders account for a substantial proportion of hospitalizations • Drug therapy has greatly reduced the hospitalization rate • 20% of Canadians will personally experience a mental illness in their lifetime ○ 8% Depression ○ 5% Anxiety Disorders ○ 1% Bipolar Disorder ○ 1% Schizophrenia • Suicides account for 24% of all deaths among 15-24 year olds and 16% among 25-44 year olds • More young aboriginal people commit suicide than attend university What is "abnormal"? • There are a number of possible criteria: 1) Statistical deviance: behavior that is unusual, that departs from the social norm, or is socially unacceptable  Throughout history, people who violated social norms were often considered to be "sick" □ E.g., wandering around talking out loud □ E.g., dressing head-to-toe in warm clothing on a hot day  Yet, deviant behavior is not always abnormal □ Context is important  What is considered deviant varies greatly from society to society, subculture to subculture, era to era  Until 1987, the American Psychological Association's Diagnostic and Statistical Manual (DSM) included nymphomania as a mental disorder □ Any sexually active unmarried woman of today could have been considered to be suffering from a mental disorder fifty years ago  Prior to 1 December 1973, homosexuality was a mental illness according to the APA DSM-II 2) Faulty reality testing is considered by some therapists to define mental illness- e.g., hallucinations  [Reality testing-- determining what is reality and what is not]  Again, what about religious visions-- do they mean that the person is mentally ill?  Religious visionaries of yesteryear might be considered psychotic today 3) Severe personal distress-- some therapists believe that this is the key element of psychological abnormality  But sometimes such distress is an appropriate response  Some people are not distressed, even if apparently "mentally ill" 4) Maladaptive behavior-- interferes with well-being, personal growth, and day-to-day functioning  But not so easy to delineate  E.g., smoking?  Not doing homework? 5) Dangerous behavior-- danger to oneself or others  Again, context is important  E.g., bungee jumping? • Thus: it is very difficult to define what is truly "abnormal," for that depends on the culture and the situation ○ In practice, psychologists define particular combinations of thoughts, emotions, and actions as defining particular disorders ○ This is useful for communicating with each other, but even these definitions ..?? Commonerroneousbeliefs 1) Normal behavior and abnormal behavior are totally different ○ Normal and abnormal behavior form a continuum 2) A mental disorder is something of which to be ashamed ○ Competitive western societies look down on people who cannot compete ○ Leads to prejudice, discrimination 3) Once one has a "mental disorder," one will never totally recover ○ Most people, with good treatment, will recover 4) Many people with mental disorders are unpredictable and dangerous ○ Even people who suffer from psychosis are rarely violent Historical views • In earlier times, throughout the various regions of the world, mental disorders were often viewed as the result of possession by demons • 10,000 BC: Earliest surgeries performed to release evil spirits from the skull (trephination) ○ Survival rate may have been 70%, most deaths due to infection • 800 BC: At the time that Homer wrote the Iliad and the Odyssey, disturbed behavior believed to be divine retribution for offences against the Gods ○ Therapy in temples dedicated to Asclepius, God of healing • 5th Century BCE: Ancient Greece-- Hippocrates (460-377 BC) ○ Hippocrates: natural causes for mental illness ○ Emphasized the importance of the brain for the explanation of behavior (before Hippocrates, the heart was viewed as the seat of mental and emotional) ○ Concluded that  Epileptic seizures are caused by dysfunction in the brain  Stress could cause mental problems  Imbalances amongst the four humors could lead to mental disorders ○ Wrote about melancholia (depression), dementia (psychosis), phobias, and hysteria Hysteria due to a wandering uterus, and recommended marriage (in order to provide regular sexual activity) Lecture Notes Page 1  Hysteria due to a wandering uterus, and recommended marriage (in order to provide regular sexual activity) ○ Not a scientist, but his method of questioning laid a foundation for scientific inquiry ○ Stressed self-exploration and reasoning as keys to good life and happiness • Plato-- Invented the philosophic argument, wrote several works involving Socratic dialogue ○ Disturbed behavior is due to conflict between emotion and reason ○ He suggested mentally disturbed people should be for the most part cared for at home, by relatives ○ When they require institutionalization, treatment should involve rational challenges to their ideas • 4th Century BCE- Aristotle • Galen (129-198 CE), a Greek physician living in Rome, followed Hippocrates' teaching ○ Believed that it was therapeutic to have a troubled person talk to an empathetic listener ○ Proved that the bod
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