Abnormal Psychology

1. Abnormal Psychology PSYC 3140 3.0D(F)

2. What are we studying? • Abnormal Behaviour • Psychopathology • Mental Disorder • Mental Illness • Deviant Behaviour

3. The study of mental disorder involves: • Definition: What do we mean by mental disorder? • Classification: How do we distinguish between different mental disorders? • Explanation: How do we understand mental disorder? • Treatment: How do we treat mental disorder?

4. Why study abnormal psychology? • Abnormal behaviour is part of our common experience • Lots of unanswered questions and complexities • Preparation for future careers • www.apa.org/students/

5. Mental Health Professionals • Clinical Psychologist (Ph.D., C. Psych.) • Psychiatrist (M.D.) • Psychiatric Social Worker (M.S.W.) • Psychoanalyst • Therapist

6. Obtaining Personal Help • Room 145 Behaviour Science Building 416.736.5297

7. What do we mean by mental disorder? • Who has a mental disorder? • Mass murders? • People who want to cut off their arms and legs? • People who can’t pay attention and concentrate?

8. Is the concept of ‘Mental Disorder’ problematic? • “I should like to make clear, therefore, that although I consider the concept of mental illness to be unserviceable, I believe that psychiatry could be a science. I also believe that psychotherapy is an effective method of helping people – not to recover from an ‘illness’ but rather to learn about themselves, others and life.” Szasz

9. Why clarify the definition of mental disorder? • Influences what is seen as pathological • Influences explanation, classification and treatment • Clarifies the role of professionals

10. Why clarify the definition of mental disorder? • Safe-guard against abuses • Clarify contentious cases

11. Two broad ways to define mental disorder • In general, the concept of “mental disorder” can be defined as: • A biomedical, culturally independent, value-free concept • Or as a social, culturally relative, value-based concept.

12. Overview of definitions that will be discussed • Mental disorder as a statistical deviation • Mental disorder as dysfunction • Mental disorder as personal discomfort • Mental disorder as maladaptive behaviour • Mental disorder as norm or value violation

13. Mental disorder as statistical deviance • A person has a mental disorder when their behaviour, ability, or experience is significantly different from average.

14. Mental disorder as statistical deviance

15. Mental disorder as statistical deviance • Problems: • We want to use the term disorder to describe some conditions that are statistically frequent • “positive” deviations are not distinguished from “negative” deviations • we do not want to call all “negative deviations a disorder

16. Uggo Betti: • “All of us are mad. If it weren’t for the fact that every one of us is slightly abnormal, there wouldn’t be any point of giving each person a separate name.”

17. Mental disorder as a dysfunction • A person has a mental disorder when a mental mechanism is not performing the natural function it was designed to perform. • Problems: • Natural selection does not “design” mechanisms

18. Sedgwick (1982): • “All sickness is essentially deviancy from some alternative state of affairs which is considered more desirable…The attribution of illness always proceeds from the computation of a gap between presented behaviour (or feeling) and some social norm.”

19. Mental disorder as a dysfunction • Problems cont: • For many mechanisms there is a wide range of adaptive functioning across people and situations (fear response).

20. Mental disorder as a dysfunction • Problems cont: • Many things that we want to call a disorder might actually be adaptive reactions.

21. Mental disorder as personal discomfort • A person has a mental disorder if they experience personal distress. • Problems: • What about the person who abuses drugs or believes they are receiving messages from outer-space – without experiencing distress?

22. Mental disorder as maladaptive behaviour • A person has a mental disorder if they engage in behaviour that prevents them from meeting the demands of life. • Problems: • There may be situations that people should not adapt to • This approach emphasizes “fitting in” as being ultimately important

23. Mental disorder as norm or value violation • A person has a mental disorder if they have experiences and exhibit behaviours that are inconsistent with the norms and values of society. • Examples: • Behaviour that is harmful to oneself or others • Poor reality contact • Inappropriate emotional reactions • Erratic behaviour

24. Mental disorder as norm or value violation • Problems: • What if violation is result of external circumstances • Such a criteria can seem too arbitrary and open to abuse

26. DSM-IV definition of mental disorder • A mental disorder is “conceptualized as a clinically significant behavioural or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or disability or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom.”

27. DSM-IV definition of mental disorder • “The syndrome or pattern must not be merely an expectable and culturally sanctioned response to a particular event, for example, the death of a loved one.” • “It must currently be considered a manifestation of a behavioural, psychological, or biological dysfunction in the individual.”

28. Cross cultural issues • How one thinks about the role of culture depends on your definition of mental disorder

29. Cross cultural issues • If biomedical, then culture influences how a disorder impacts members of different cultures • Different risk • Idiom of distress

30. Cross cultural issues • If culturally based, then influences what will be considered a disorder • Behaviour or experience may not be a “disorder” in all cultures

31. Non-Western approaches to mental disorder • Often do not separate psychology and spirituality • Disruption in relation to spirit world • Often based on more collective and less individualistic conceptualizations • Disruption in interpersonal relations

32. The study of mental disorder involves: • Definition: What do we mean by mental disorder? • Categorization: How do we classify mental disorder? • Explanation: How do we understand mental disorder? • Treatment: How do we treat mental disorder?

33. Further exploration: • Linienfeld, S. O., & Marino, L. (1995). Mental Disorder as a Roschian Concept: A critique of Wakefield’s “Harmful Dysfunction” analysis. Journal of Abnormal Psychology, 104(3), 411-420. • Szasz, T. (2000). Second commentary on “Aristotle’s function argument. Philosophical Psychiatry and Psychology 7(1), 3-16. • Wakefield, J. (1992). The concept of mental disorder: On the boundary between biological facts and social values. American Psychologist, 47(3), 373-388.