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9/14/09




          PSYC 3553 – Psychopathology
           Week 2: Defining Abnormality • September 15, 2009




1




                What is normal?


     •  What is normal behaviour and what is
        abnormal behaviour?


     •  Why do we classify people into normal vs.
        abnormal?


                                   2




    Normal vs. Abnormal Behaviour

     •  Outside of societal norm       •  Mental weaknesses

     •  Variable in each culture       •  Confusing – few fit the
                                          normal standard…?
     •  Can include severe harm
        or violence                    •  May not be a bad thing –
                                          simply different
     •  Difficulty in abiding by
        social situations              •  Not capable of surviving
                                          in society
     •  Intentional?
                                       •  Relative categorization

                                   3




                                                                          1
9/14/09




    Elements of abnormality


  •  Deviant
  •  Distressful to self and/or others
  •  Dysfunctional or maladaptive
  •  Dangerous to self and/or others


                                 4




    Elements of abnormality


  •  Unpredictable /irrational
  •  Violates social norms or is incomprehensible
  •  Inappropriate to developmental stage




                                 5




Classification of abnormal behaviour

  •  Can get worse if not            •  To help others and
     treated as soon as                 improve understanding
     possible
                                     •  Better coping
  •  Don’t abide by normal
     rules – live by other set       •  Simplify the very
                                        subjective
  •  Otherwise chaos
                                     •  No longer a danger
  •  Improve functioning
                                     •  Dispel fears of the
  •  Take away pain                     unknown
                                 6




                                                                     2
9/14/09




           Your Interests…

•  Use of non-drug treatments, and role of drug
   companies in prescribing medications

•  Specific disorders: mood, anxiety, dissociative, sleep,
   cognitive

•  Specific populations: troubled youth, school
   psychology, First Nations

•  Legal determination of insanity

•  Gender differences in bipolar disorder
                            7




           Your Interests…

•  Murder/suicides among family members

•  Differentiate between disorders (i.e., bipolar disorder
   and schizophrenia)
•  Why some disorders without physiological
   explanation? Why are some seemingly “incurable”?

•  How people are born with them – or how they
   develop disorders?


                            8




Attitudes Toward Abnormality

•  Stereotypes – automatic beliefs
•  Stigma – shame & disgrace
•  Examples:
  • Canadian Medical Assoc. Report
  • Globe & Mail Breakdown Series
•  Video: Mental Health Commission of Canada:
   Stigma Symposium

                            9




                                                                  3
9/14/09




Attitudes Toward Abnormality

•  The Rosenhan
   studies
 •  Original study
 •  Slater’s update: has
    anything changed?

•  Why? Will it
 change?

                           10




         Cultural Aspects

•  “…different cultures have different
   perspectives”
•  Display rules for expression of some
   disorders appear (e.g., depression)
•  Lack of other disorders (e.g., amok)




                           11




          Cultural Aspects




                                          12




                                                    4
9/14/09




              Statistics Talk


  •  Epidemiology: study of disease statistics
  •  Prevalence: # active cases in time period
  •  Incidence: # new cases in given time period
  •  Co-morbidity: co-occurring disorders


                           13




              Statistics Talk


  •  Lifetime prevalence: 20% of Canadians
  •  Point prevalence: 300,000 Canadians
  •  Often in adolescence/young adulthood
  •  $$ = at least $7.9 billion (1998)


                           14




   The Mental Health Professions

•  Clinical psychologist
•  Psychiatrist
•  Psychoanalyst
•  Social worker
•  Counseling psychologist
•  Psychiatric nurse

                           15




                                                        5
9/14/09




    Different Viewpoints


•  Abnormality is…against social / cultural
   norms
•  Abnormality is…a social construction
•  Abnormality is…a diseased brain



                          16




  History of Abnormality


•  Demonology – spirits control us & cause
   abnormal behaviour
•  Methods of eviction:
   • Exorcism
   • Trepanning


                          17




                          18




                                                   6
9/14/09




  History of Abnormality


•  Somatogenesis vs. psychogenesis
•  Hippocrates: brain is central organ
   • Mania, melancholia, phrenitis
   • Personality: the “humours”
•  Galen: more scientific approach

                       19




  History of Abnormality


•  Middle Ages:
   • Tarantism: uncontrollable dancing
   • Lycanthropy: wolf possession
   • Witchcraft: smart gals angry with society
•  Treatment: exorcisms, priest spitting…


                       20




  History of Abnormality


•  1500’s: asylums
•  Bethlehem (Bedlam)
   • Deplorable conditions, “patient shows”
•  Benjamin Rush: transition
•  Moral treatment: Philippe Pinel

                       21




                                                      7
9/14/09




                                                 22




    History of Abnormality


 •  Mental hygiene movement: Dorothy Dix
 •  20th century: still cycled with preference
 •  Deinstitutionalization: meant to be good…




                         23




      Contemporary Thought

•  Early system of classification
   • Emil Kraepelin: syndromes
•  Empirical evidence of mental illness
   • General paresis and syphilis
   • Pasteur’s germ theory



                         24




                                                           8
9/14/09




     Contemporary Thought


•  Mesmer: magnetism
•  Charcot: hysteria
•  Breuer: catharsis
   • Anna O.
   • Freud: psychoanalysis

                        25




     Mental Hospitals in Canada



•  Medicare
•  Provincial psychiatric hospitals
•  Milieu therapy
•  Community treatment orders (CTOs)


                        26




        Lessons of History


•    Cycles of persecution, neglect and
     humanitarianism
•    Future generations may regard some of
     our practices as cruel and inhumane
•    Recent reforms may easily be reversed
     during adverse conditions

                        27




                                                  9

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Defining Abnormality

  • 1. 9/14/09 PSYC 3553 – Psychopathology Week 2: Defining Abnormality • September 15, 2009 1 What is normal? •  What is normal behaviour and what is abnormal behaviour? •  Why do we classify people into normal vs. abnormal? 2 Normal vs. Abnormal Behaviour •  Outside of societal norm •  Mental weaknesses •  Variable in each culture •  Confusing – few fit the normal standard…? •  Can include severe harm or violence •  May not be a bad thing – simply different •  Difficulty in abiding by social situations •  Not capable of surviving in society •  Intentional? •  Relative categorization 3 1
  • 2. 9/14/09 Elements of abnormality •  Deviant •  Distressful to self and/or others •  Dysfunctional or maladaptive •  Dangerous to self and/or others 4 Elements of abnormality •  Unpredictable /irrational •  Violates social norms or is incomprehensible •  Inappropriate to developmental stage 5 Classification of abnormal behaviour •  Can get worse if not •  To help others and treated as soon as improve understanding possible •  Better coping •  Don’t abide by normal rules – live by other set •  Simplify the very subjective •  Otherwise chaos •  No longer a danger •  Improve functioning •  Dispel fears of the •  Take away pain unknown 6 2
  • 3. 9/14/09 Your Interests… •  Use of non-drug treatments, and role of drug companies in prescribing medications •  Specific disorders: mood, anxiety, dissociative, sleep, cognitive •  Specific populations: troubled youth, school psychology, First Nations •  Legal determination of insanity •  Gender differences in bipolar disorder 7 Your Interests… •  Murder/suicides among family members •  Differentiate between disorders (i.e., bipolar disorder and schizophrenia) •  Why some disorders without physiological explanation? Why are some seemingly “incurable”? •  How people are born with them – or how they develop disorders? 8 Attitudes Toward Abnormality •  Stereotypes – automatic beliefs •  Stigma – shame & disgrace •  Examples: • Canadian Medical Assoc. Report • Globe & Mail Breakdown Series •  Video: Mental Health Commission of Canada: Stigma Symposium 9 3
  • 4. 9/14/09 Attitudes Toward Abnormality •  The Rosenhan studies •  Original study •  Slater’s update: has anything changed? •  Why? Will it change? 10 Cultural Aspects •  “…different cultures have different perspectives” •  Display rules for expression of some disorders appear (e.g., depression) •  Lack of other disorders (e.g., amok) 11 Cultural Aspects 12 4
  • 5. 9/14/09 Statistics Talk •  Epidemiology: study of disease statistics •  Prevalence: # active cases in time period •  Incidence: # new cases in given time period •  Co-morbidity: co-occurring disorders 13 Statistics Talk •  Lifetime prevalence: 20% of Canadians •  Point prevalence: 300,000 Canadians •  Often in adolescence/young adulthood •  $$ = at least $7.9 billion (1998) 14 The Mental Health Professions •  Clinical psychologist •  Psychiatrist •  Psychoanalyst •  Social worker •  Counseling psychologist •  Psychiatric nurse 15 5
  • 6. 9/14/09 Different Viewpoints •  Abnormality is…against social / cultural norms •  Abnormality is…a social construction •  Abnormality is…a diseased brain 16 History of Abnormality •  Demonology – spirits control us & cause abnormal behaviour •  Methods of eviction: • Exorcism • Trepanning 17 18 6
  • 7. 9/14/09 History of Abnormality •  Somatogenesis vs. psychogenesis •  Hippocrates: brain is central organ • Mania, melancholia, phrenitis • Personality: the “humours” •  Galen: more scientific approach 19 History of Abnormality •  Middle Ages: • Tarantism: uncontrollable dancing • Lycanthropy: wolf possession • Witchcraft: smart gals angry with society •  Treatment: exorcisms, priest spitting… 20 History of Abnormality •  1500’s: asylums •  Bethlehem (Bedlam) • Deplorable conditions, “patient shows” •  Benjamin Rush: transition •  Moral treatment: Philippe Pinel 21 7
  • 8. 9/14/09 22 History of Abnormality •  Mental hygiene movement: Dorothy Dix •  20th century: still cycled with preference •  Deinstitutionalization: meant to be good… 23 Contemporary Thought •  Early system of classification • Emil Kraepelin: syndromes •  Empirical evidence of mental illness • General paresis and syphilis • Pasteur’s germ theory 24 8
  • 9. 9/14/09 Contemporary Thought •  Mesmer: magnetism •  Charcot: hysteria •  Breuer: catharsis • Anna O. • Freud: psychoanalysis 25 Mental Hospitals in Canada •  Medicare •  Provincial psychiatric hospitals •  Milieu therapy •  Community treatment orders (CTOs) 26 Lessons of History •  Cycles of persecution, neglect and humanitarianism •  Future generations may regard some of our practices as cruel and inhumane •  Recent reforms may easily be reversed during adverse conditions 27 9