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Chapter 1

Chapter 1- Concepts of Abnormality- 2310.pdf

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Psychology 2310A/B
Rod Martin

CHAPTER #1: CONCEPTS OFABNORMALITYTHROUGHOUT HISTORY ▯ -Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) of theAPA, is the most broadly accepted system for identifying particular types of disorders -Eccentric and unusual behaviour or beliefs are not necessarily abnormal according to diagnostic criteria -Behaviors that are repugnant and threatening to others, such as aggression and murder, are not always signs of an underlying psychological disorder -Psychological abnormality: Behaviour, speech, or thought that impairs the ability of a person to function in a way that is generally expected of him or her, in the context where the unusual functioning occurs -Mental illness: Often conveys the same meaning as psychological abnormality but it implies a medical rather than psychological cause -Psychological disorder: Specific manifestation of this impairment of functioning, as described by some set of criteria that have been established by a panel of experts -Psychopathology: The scientific study of psychological abnormality and and problems faced by people who suffer from such disorders ▯ ATTEMPTSAT DEFINING NORMALITY -The contribution of several criteria may be necessary in defining normality -To define someone as abnormal, no single criterion is either necessary or sufficient (enough on its own) ▯ Statistical Concept -Behavior is judged as abnormal if it occurs infrequently in the population -Relative infrequency would be a defining feature of abnormality, but not all infrequent behaviors are abnormal (innovative ideas or athletic prowess for example) -It is not clear how unusual a given behavior has to be in order to be abnormal ▯ Personal Distress -Distress is not present for all people identified as abnormal ▯ Personal Dysfunction -Definition of dysfunction is not clear-cut (What is appropriate functioning? In what context? -Sometimes feelings of vigilance and anxiety, though distressing, are normal given the circumstances - Ex. Scanning the environment for threats may be seen as an anxious behavior but it actually is adaptive, as it serves as a survival function -Unless there are dysfunctional consequences to the individual, in that he or she is unable to perform a natural function, it makes little sense to call behavior abnormal -In terms of evolutionary psychology, a trait may be dysfunctional if it harms an organism’s capacity to reproduce successfully (ex.Antisocial behavior) ▯ Violation of Norms - The behavior and thoughts of many psychologically disordered individuals run counter to what we might consider appropriate -On the other hand, criminals engage in behavior that we see as socially unacceptable, but this does not mean they meet the criteria for any disorder -Aflaw is that social norms vary over time and place —> few disorders are universal across different cultures (Ex. Depression is much higher in Canada than Korea, this may be due to the emphasis placed on physical symptoms and the avoidance of the stigma of mental disorders) -Culturally relative: The norms of a particular culture determine what is considered to be normal/abnormal behavior ▯ Diagnosis by an Expert - Clinical psychologists: Trained in generally psychology and then receive graduate training in the application of this knowledge to the understanding, diagnosis, and amelioration of disorders of thinking and behavior -Psychiatrists: Trained in medicine prior to doing specialized training in dealing with mental illnesses (focus on diagnosis and medical treatment) -Psychiatric nurses: Have received formal training in nursing before completing a specialization in psychiatric problems -Psychiatric social workers:Attend to the influence of the social environment on disordered clients - Occupational therapists: Sometimes involved in providing mental health care but may also provide a broad range of services on rehabilitation teams and focus on helping clients to improve their functional performance (training in community living skills) -The identification of a psychological disorder is ultimately left to a professional to judge ▯ HISTORICALCONCEPTS OFABNORMALITY - In 1928,Alberta passed a Sexual SterilizationAct under which individuals who were deemed “feebleminded”, “mentally deficient”, or “mentally ill” were to be involuntarily sterilized to prevent deterioration of the intellectual level of the general population (2832 were sterilized) -Earlier ideas about normality were accepted not only by those who made the decision about the insane, but also by the sufferers -Treatments that seem bizarre now may have been effective because they helped the sufferers believe the procedures were working -Changes in the acceptability, treatment, and theories of abnormal behavior have reflected the values of society at a particular time -Asociety that explains everyday events as a result of supernatural causes (causes beyond the understanding of ordinary mortals) will view madness similarly -Psychological dysfunction was thought to result from either possession by demons or the witchcraft of evil people -Treatment involved ridding the mad person of these influences by exorcism, etc. - When worldly events are seen to have natural causes, so too are mental afflictions, and they are treated in a way that addresses these presumed natural causes ▯ Evidence From Prehistory - Trephination: Stone tool used to cut holes in the skull to let out evil spirits that were causing the victim to engage in abnormal behavior (found in human remains) -Egyptian papyri from almost 4000 years ago described supernatural explanations for various disorders and the use of magic and incantations as treatment procedures -Hunter-gatherer societies do not distinguish mental from physical disorders; both are seen as having supernatural causes ▯ Greek and Roman Thought - Temples of healing were introduced that emphasized natural causes for mental disorders and that developed a greater understanding of the causes and treatments -Hippocrates, the father of modern medicine, denied that psychological disabilities were caused by gods and demons —> first recorded instance of rejection of supernatural causes for mental illness - He did not distinguish mental illness from physical illness —> believed all disease had natural causes -Believed stress could affect mental functioning -Dreams were important -Advocated a quiet life, vegetarian diet, exercise, and abstinence from alcohol, but if this didn’t work he considered bleeding or vomiting -Aristotle accepted Hippocrate’s bodily fluids theory and denied the influence of psychological factors in the etiology of dysfunctional thinking and behaving -Advocated the humane treatment of mental patients -Methodism: Regarded mental illness as a disorder that resulted either from a constriction of the body tissue r from a relaxation of those tissues due to exhaustion -Soranus of Ephesus -Head was primary site of this affliction - Mania resulted from overexertion or alcoholism -Natural bloodletting would would provide an avoidance of the disorder, but when this did not happen, mania would result -Rejected the common mind-body distinction -No difference between mental and physical disorders - all problems in the body -Greeks provided the first clinical observations of disorders -Treatment was primarily physical -Galen (Rome) continued the work of Hippocrates -2 sources: mental (stress, loss of love, fear) and physical (head injuries, alcohol abuse, menstrual disturbances) - Suggested the idea of having people talk about their problems ▯ TheArab World - The Quran reflects compassionate attitudes toward the mentally ill -Asylums: Place of refuge and protection -Avicienna wrote the Canon of Medicine - Emphasis on natural causes - Ex. Prince believing he was a cow and should be eaten,Avicienna saved him by saying he “was too lean to eat- needed to fatten up” —> treatment? ▯ Europe in the MiddleAges - Back to supernatural explanations and unpleasant procedures meant to free the afflicted person go possession by the devil -Some of Galen’s theories survived though and were expressed in naturalistic ways -People identified as witches were mad and that their madness was considered to result from possession by the devil - The majority of these “witches” who were tortured or killed were accused of exercising evil powers over other by people who simply wanted to be rid of them -Treatment and care was provided by the clergy —> only ones with sufficient concern and resources -Exorcism became more and more severe over the years, and patients were tortured until they were cured or dead- both considered cures -Paracelsus was the first to attack the beliefs about supernatural possession during the Renaissance - Rejected the 4 humours - All mental illnesses resulted from disturbances of the spiritus vitae (breath of life) —> sometimes it is upset by the stars, or disturbed by vapours arising in various parts of the body - This is a good attempt at offering naturalistic ideas rather than magical ones -St. Vitus’dance: Epidemic of mass hysteria, where groups of people would suddenly be seized by an irresistible urge to leap about, jumping and dancing, and sometimes convulsing - People claimed to have been bitten by tarantulas to hide their behaviours - Paracelsus suggested that this was a disease and suggested that psychic conflicts might cause mental illness, and he treated disordered people with what appears to have been an early version of hypnotism -Weyer still accepted that the devil was a cause but advocated natural and physical treatments, while rejecting exorcism - Fantasies could be traced in some patients to their use of belladonna ointments ▯ THE GROWTH OF MENTALHEALTH SERVICES IN CANADA ▯ - Reluctance on part of the various provinces (except Quebec) to deal with the issue during the early days of settlement -The early British and then provincial, leaders were content to place the insane in prisons along with criminals -Hotel Dieu in Quebec was the first asylum to house the mentally ill and indigents and cripples -Asylums were not created in other parts of Canada until the nineteenth century -1841 was when the first mental asylum in Toronto first took in patients ▯ Recent Developments (PAPER) - Mental Health Commission of Canada (MCHH): Goal is to develop an integrated mental health system that encourages better co-operation among governments, mental health providers, employers, the scientific community, and Canadians who live with or care for those with mental disorders (Harper) -Goals: - Be a catalyst for the reform of mental health
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