PSY 3171 Lecture Notes - Neuropsychological Test, Posttraumatic Stress Disorder, Child Neglect
Lecture 1—Abnormality
What is abnormal?
1. Statistical approach
2. Psychological distress
3. Behavioural dysfunction or impairment
4. Violation of social norms
1.Statistical Approach
Normal = approximately average
Abnormal = a certain behaviour, thought, ability, or other psychological phenomenon that is
relatively uncommon in a population
Certainly most psychological disorders are quite rare
Problems:
But what is the cut-off for normal?
oA symptom/behaviour that happens in only 10% of people? 5%?
Many psychological constructs are normally distributed (bell curve)
oHigh and low scores could both be defined as abnormal
oExtremely low IQ is considered abnormal (mental retardation), but the equivalently rare
high IQ is not abnormal
We all have unique qualities, behaviours, thoughts, etc that are perfectly normal (even if rare)
If a condition is too rare then it is probably not worth spending too much time/resources
researching or describing it
2.Psychological Distress
Intense, unpleasant emotions
oDiscomfort, fear, unhappiness, anger, worry
Certainly most of the symptoms of mental illness sound quite unpleasant
Ego-dystonic
oIn conflict with the needs, goals, or wishes of the self
But we all experience these emotions from time to time (grief, test anxiety)
Some mental illnesses are associated with pleasant emotions (bipolar disorder)
Some mental illnesses are not ego-dystonic (they are ego-syntonic)
oPersonality disorders, some eating-disorders, some addictions
3.Dysfunction
Maladaptive—interferes with normal functioning or is self-defeating
Contrary to the well-being of the individual
Can include emotions, cognitive functioning, behaviour
Who decides what is best for an individual?
Something can be functional and dysfunctional at the same time
oAnxiety can be motivating
oBut it can also impair functioning
Defining something as “dysfunctional” is dependent on the social context
4.Violation of Social Norms
Society defines normality, and anything outside of that norm could be labelled as pathological
We barely even notice that the norms are there until we see someone violating them
oWhere to sit
oHow to make eye contact or initiate a conversation
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oHow much and how truthfully we talk about our self
oHow happy we expect to be
oHow much and which substances we consume
So can something that is a mental illness in one society be normal in another?
We often make exceptions for people who are particularly talented or productive
This definition can also be used as a means of social control
oDrapetomania
Abnormalities and Social Norms
oPerhaps the most clear example of the limitation of using social norms to define abnormalities is
the history of homosexuality as a mental illness
1952—classified as “sexual deviation, sociopathic personality”
1968—classified as “sexual deviation”
1973—“sexual orientation disturbance”
1980—“Ego-dystonic homosexuality”
1987—“sexual disorder NOS, persistent and marked distress about sexual orientation”
2001—Chinese Psychiatric Association removes homosexuality from its manual of mental illness
December 2010—removed from the diagnostic manual of Alberta
Abnormality
No approach alone can define abnormality
“behavioural, emotion, cognitive dysfunctions that are unexpected in their cultural context, and cause
significant personal distress or impairment in functioning”
In the real world, if someone presents themselves (or are brought by family members) to a mental
health clinic, because of emotional, behavioural, or cognitive symptoms, there is a very good chance
that they are experiencing something that could be considered abnormal
But never assume this!
Abnormality in History
oThere are different ways of conceptualizing or understanding mental illness
oWe have made mistakes in the past and we continue to make them today
oEach way offers different explanations and treatments:
The supernatural approach
The biological approach
The psychological approach
The integrative (biopsychosocial) approach
The Supernatural Approach
Mental illness caused by supernatural forces
Hippocrates famously described mental illness as a natural process, but the supernatural explanation
remained prevalent for hundreds of years
Abnormal behaviour in some otherwise high functioning individuals was accepted because it was
assumed to be of divine origin
While some supernatural explanations emphasized external causes (demons), others pointed to
individual responsibility (sin)
Exorcisms were common in Europe through the Middle Ages, and often amounted to torture
The Biological Approach
During the Renaissance, natural explanations became more favoured, although we now know that the
specific explanations were generally wrong
oHumors
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o“Bad blood”
various “cured” were often no better than those advocated by proponents of supernatural explanations
oImmobility, ice baths, bleeding, shocks, isolation
With improved understanding of the process of evolution and heritability in the 1800’s, biological
explanations tended to become deterministic
oPhrenology
oEugenics
oEarly psychosurgery
The biological approach has seen a remarkable resurgence in the past century
oPharmaceutical companies have vested interest in promoting a simplistic biological
explanation of mental illness
oA simplistic understanding of mental illness (such as biological determination) deemphasized
prevention and the need for social change
The Psychological Approach
Most often associated with Freud, although at various times in history the roles of stress, interpersonal
conflict, and emotions has been described
The biopsychosocial approach
In psychology, if someone tells you that “X” causes “Y”, they are wrong
oEvery explanation is multi-dimensional
Environment, biological predisposition, and psychological factors vary in their importance,
depending on the disorder
oBut each plays at least some role
Defining a new disorder
•In order for a new disorder to become part of the professional language, we need to establish
several important features:
1Distribution in the population (who and how many)
2Temporal stability/course (what happens over time)
3Effects of treatment
•Taxon vs dimension
Lecture 2—Research and Diagnosis
Research
Psychopathology like other areas of psychology is based on empirical research
Much of there search methods used are the same or similar
But because of some unique circumstances where dealing with abnormality, there are a few
special issues we need to address
Research
Statistical significance – whether the fining is unlikely to have occurred by chance
Clinical significance – whether the finding has practical utility
Error
Every measurement contains error
oPolling, weight, depression, IQ
Reliable measures contain less error, but there will always be some
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Document Summary
What is abnormal: statistical approach, psychological distress, behavioural dysfunction or impairment, violation of social norms. Abnormal = a certain behaviour, thought, ability, or other psychological phenomenon that is relatively uncommon in a population. Certainly most psychological disorders are quite rare. Many psychological constructs are normally distributed (bell curve: high and low scores could both be defined as abnormal, extremely low iq is considered abnormal (mental retardation), but the equivalently rare high iq is not abnormal. We all have unique qualities, behaviours, thoughts, etc that are perfectly normal (even if rare) If a condition is too rare then it is probably not worth spending too much time/resources researching or describing it. Intense, unpleasant emotions: discomfort, fear, unhappiness, anger, worry. Certainly most of the symptoms of mental illness sound quite unpleasant. Ego-dystonic: in conflict with the needs, goals, or wishes of the self. But we all experience these emotions from time to time (grief, test anxiety)
