PSY 120 Lecture 34

Defining 'abnormal'

There are no clear boundaries for us to work with when defining it (no benchmarks)

Cognitive model when defining abnormal

Looks at abnormal thoughts or beliefs
Delusional states, where we believe in things that aren't grounded in reality

Sociocultural model when defining abnormal

Looks at violation of local social norms
Social norms vary quite a bit though

Biological model when defining abnormal

Looks at changes in biological functioning
Part of your brain missing, clear brain damage causing psychological abnormality

Abnormality is inextricably attached to cultural norms, expectations, and laws

ADHD in the US vs Europe
Disorders of sexuality
Cultural responses to abnormality and mental illness
Cultural norms

Cultural norms

Expect people to behave in certain ways

From the textbook, a psychological disorder is-

"A condition characterized by abnormal thoughts, feelings, and behaviors"
This is awfully broad though

Thomas Szasz, MD

Wrote The Myth of Mental Illness
Went to med school and saw that psychiatry wasn't very good back then
Argued that the mental disorder classification system is an attempt by society to control those who are different
Vehemently criticized the system of involuntary commitment

Involuntary commitment

Where you are committed for care in a psychiatry facility against your will

What else did he do?

Criticized the medical model as turning people into passive "patients" instead of active controllers of their own lives
Preferred the term "problems in living"

Criticized the medical model as turning people into passive "patients" instead of active controllers of their own lives

Said that those people couldn't get better if they were just kept in a passive state
They would be locked up and kept away from the rest of us
He claimed that this was a way to control people who were different

Preferred the term "problems in living"

Preferred this because he believed you could be an active 'solver' for your problems

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

The standard reference manual for disorder diagnosis and classification
Primary manual used in the US

Advantages of DSM

Can be a useful tool, when used properly, for diagnosis and treatment of disorders (doesn't tell you the best way to diagnose though)
Provides systematic structure for future research
Provides systematic structure for insurance reimbursement (creates an incentive for more diagnoses though)

Criticisms of the DSM

Number of disorders increases with each new edition
Providing classifications may lead to overdiagnosis
People may live up to the labels, use them as excuses
Some 'disorders' may just be everyday problems

Number of disorders increases with each new edition

From 66 in first DSM to over 400 in DSM-5

Providing classifications may lead to overdiagnosis

ADHD, MPD/DID (multiple personality disorder/dissociative identity disorder)
PD-NOS is most commonly diagnosed disorder despite there being 400 defined disorders
Particularly a concern with newer dimensional approach and risk syndromes

PD-NOS

Personality disorder- not otherwise specified
Not otherwise specified is used for people who meet some to have some of the problems in that domain but don't meet one of the other diagnoses

People may live up to the labels, use them as excuses

May hinder an effort at improvement

Some 'disorders' may just be everyday problems

"Mathematics disorder"
"Caffeine-induced sleep disorder"
Gives an illusion of objectivity

"Mathematics disorder"

Highlights some of the difficulties between how we conceptualize things scientifically and how they get implemented in the real world

"Caffeine-induced sleep disorder"

If you're drinking too much caffeine and then having trouble sleeping, that's just a bad choice, not really a diagnosis

Gives an illusion of objectivity

Still subject to individual judgment
Still subject to cultural norms (ex: homosexuality)
Subject to circumvention (NOS diagnoses)

Psychological disorder

A "syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning"

Psychopathology

Study of psychological disorders, including their symptoms

Etiology

Causes of psychological disorders

Atypical

Deviating from the norm
Not typical

Harmful dysfunction

How psychological disorders were defined as by Wakefield