Field concerned with the nature and development of abnormal behaviour, thoughts, and
The domain of abnormal psychology, clinical psychology, counselling psychology and
Defining Abnormal Behaviour
Violation of norms
Disability of dysfunction
None of these by themselves yield a fully satisfactory definition. However, OCD has all
The Four D's of Abnormality
Deviance- norms and averages; culture
Dangerosity- threat to oneself or others
Not easy to define what is normal- the line between what I normal and what is abnormal
isn't always clear-cut and easy to specify and arbitrary line. Mental disorder is best viewed
as a continuum.
Insanity also tends to be confused with mental illness when it is actually a legal term. The
insanity defense infrequently used; generally unsuccessful. Insanity is when the individual
is unaware of actions and unable to control actions.
In Canada, since 1991, correct designation is "not criminally responsible on account of
A psychological dysfunction associated with distress or impairment in functioning that is
not a typical or culturally expected response.
o Objectivity is always a concern
o Meaning of behaviour is jointly determined by its content and context
Judgements about where the line between normal and abnormal should be drawn
differ depending on the time and culture
o Judgements of abnormality have been made by individuals to preserve their moral
or political power
Ex. Drapetomania- the disease called Freedom written by Dr. Samuel Alright
Society Socialist Realism- Stalin required all artists to practice this form of art
and people who didn't conform were labelled crazy.
Homosexuality was finally removed from the DSM in 1973
It is current practice in China to institutionalize members of the Falun Gong
religion. Mental Illness
Emilie Durkheim, 1895, The Rules of Sociological Method
Ruth Benedict, 1934, wrote about Shamanism; Western doctors would consider
Sociological Model of Mental Illness- in the mind of the beholder
Thomas Szasz (1961)- mental illness- as myth
o What we call "mental illness" is really a contrivance of the medical community,
government and organized religion to control, oppress, and manipulate people.
o That the mind is not the brain
That mental functions are not reducible to brain functions and that mental diseases
are not brain diseases. Indeed that mental diseases are not diseases at all.
o Doesn't claim anxiety, depression, and conflict do exist, but are intrinsic to the
human condition, but they are not diseases in the pathological sense.
o His views part of a small, minority opinion
Influence diminished greatly
Influential in changing law (people used to be locked up without consent).
Latest book (2001) continues his long quest to "comfort the afflicted and
afflict and comfortable."
Diagnosis is a way to stigmatize people a society considers deviant.
Labeling is dangerous as it turns people into "patients" and leads to discrimination. This
becomes a self-fulfilling prophecy.
Rosenhan (1973) classic study: being sane in an insane .
On Being Deceitful
Critics argued that the study led to some very dramatic, but largely incorrect conclusions.
Clearly labeling has grains of truth, but labeling theory hasn't held up well because the
understanding of diseases has increased.
o Many disorders are recognized cross-culturally
o Need to categorize
Most clinical work is there for those who want it.
DSM- IV (Diagnostic and Statistical Manual of Medical Doctors)
APA (1994, 2000); first published in 1952
A descriptive, theoretical aid to diagnosis
Assumes the disease model
Groups~ 230 psychological disorders into 17 major categories.
Novel feature- Multi-axial organizations
When making a diagnosis the clinician must describe the patient's condition
according to each. o Axes I and II make up the mental disorders per se (state and trait disorders).
o Axis III lists any physical disorders believed to bear on the mental disorder (ex.
o Axis IV indicates psychosocial and environmental problems (stressors)
o Axis V rates the person's current level of adaptive functions (GAF)- like the
continuum shown earlier in this set of notes. This axis helps determine which actions
Pros and Cons
Naming and describing disorders facilitates communication, treatment, and research
DSM-1 (1952)- 100 diagnoses
DSM-4 (1994)- Almost 400
o Advocates explain this as a need to distinguish disorders precise to treat them
Critics explain this as insurance companies requiring clinician to assign clients
appropriate DSM code numbers.
Kutchins and Kirk (1997)
Unreliable and invalid; includes more and more things that we used t think are
normal (ex. Bad handwriting).
o Danger of over diagnosis
o Power of labels
o Confusion with normal problems
o Illusion of objectivity and universality
DSM-V- "Oppositional Defiant Disorder"
Not getting along with your parents
o "Relational Disorders"- completely normal except near spouse.
o "Compulsive shopping"
o "Self-defeating personality disorder" (thankfully defeated)- described women who
stay in abusive relationships
o Internet Addiction Disorder proposed by Kimberly Young (1998, 1999)
Pathological Internet use similar to pathological gambling insofar as it also
involves a failure of impulsive control without involving and intoxicant
Preoccupation with the internet to the extent of thinking about it when offline
Inability to control internet use
Using the internet to escape problems
Going through withdrawal symptoms
William Glasser- "Few if any, mental health professionals embrace mental health [ rather
than mental disorders]".
Canadian Institute for Health Information 2005-2006
o People who are homeless are more likely to experience mental illness or poor
mental health, but which comes first?
o People with mental illness and/or substance abuse problems are over-represented
among the homeless o The biggest increase occurred in the 1990s when many provinces lowered welfare
rates and limited investment in social housing.
GAD- excessive/chronic working
o Chronic state of diffuse, free-floating anxiety with no ingle identifiable source
o Live in a world of perpetual fear
Panic Disorder- recurrent episodes, or attacks, of extremely intense fear or dread. This will
occur suddenly and unpredictably.
o Cued panic attacks are linked to specific situations and may reflect phobias.
o Uncued- recurrent required for diagnosis
Will develop a fear of fear
May be diagnosed with or without agoraphobia
Phobia- persistent, irrational fear of a specific object/situation
o May be social or specific
Social- an incapacitating fear of social interactions; this is fair common
(occurring in 11% of men and 15% of women). The onset is usually in
Specific- highly focused fear of animals, natural environments, or other specific
OCD- Unwanted repetitive thoughts (obsessions) and/or actions (compulsions)
o Compulsion is a reaction to obsession
Pursuing cleanliness and orderliness; avoiding particular objects, performing
repetitive, magical, protective practices; checking, performing a particular act slowly.
o Obsessions tend to focus on fears, doubts, and impulses
o Ego dystonic- aware it is irrational
At least 10 types