Lesson 3: Normality vs Abnormality

Normality

Generally, Psychologists agree that _____________ refers to patterns of behavior or personality traits that are typical.

decision

Sometimes, it is very easy to distinguish what is normal and what is abnormal. At other times, it is harder to make a _______.

idk

Look at the ff. behaviors and decide which is normal and which is abnormal

•Being scared of spiders.

•Enjoy sky diving

•Wearing black makeup and clothing.

•Changing your plans because of horoscope prediction.

•Walking arm in arm down the street with a friend of the same sex.

•Having a belly button that sticks out.

•Being in love with someone you have never met.

•Preferring to live alone , isolated from others.

•Being able to provide help to someone in need of it but choosing not to.

physical, mental, and social

World Health Organization considers Normality to be a state of complete ______, ________, and _________ well-being.

It refers to patterns of behavior or traits that are typical OR that conform to some standard of proper and acceptable ways of behaving and being.

thought, mood, and behavior

Normality is also the successful performance of MENTAL FUNCTIONS in terms of ______, _______, and _________ that results in productive activities and the ability to change and to cope with adversity.

Mental health

is a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well (can work productively and fruitfully), and contribute to their community.

decision

Mental Health is an integral component of health and well-being that underpins (supports) our individual and collective abilities to make __________, build relationships and shape the world we live in.

human right

Mental health is a basic ___________ and it is crucial to personal, community, and socio-economic development.

absence

Mental health is more than the ________ of mental disorders. It exists on a COMPLEX CONTINUUM, which is experienced differently from one person to the next, with varying degrees of difficulty and distress and potentially very different social and clinical outcomes.

psychological disabilities

Mental health conditions include: mental disorders and ___________, as well as other mental states associated with significant distress, impairment in functioning, or risk of self-harm.

mental well-being

People with mental health conditions are more likely to experience lower levels of _______________ but this is not always or necessarily the case.

protect or undermine

Throughout our lives, multiple individual, social, and structural determinants may combine to ________ or _________ our mental health and shift our position on the mental health continuum.

emotional skills, substance use, and genetics

Individual psychological and biological factors such as __________, __________, and _________ can make people more vulnerable to mental health problems.

Exposure to unfavourable social, economic, geopolitical, and environmental circumstances — including poverty, violence, inequality, and environmental deprivation — also increases people’s risk of experiencing mental health conditions.

developmentally sensitive

Risks can manifest themselves at all stages of life, but those that occur during ____________________ periods, especially early childhood, are particularly detrimental.

For example, harsh parenting and physical punishment is known to undermine child health and bullying is a leading risk factor for mental health conditions

Promotion and prevention

____________ and ________ interventions work by identifying the individual, social, and structural determinants of mental health, and then intervening to reduce risks, build resilience, and establish supportive environments for mental health.

Interventions can be designed for individuals, specific groups, or whole populations.

education, labor, justice, transport, environment, housing, and welfare

Reshaping the determinants of mental health often requires action beyond the health sector and so promotion and prevention programmes should involve the _________, _________, _______, _______, _________, _______, and __________ sectors

health sector

The ____________ can contribute significantly by embedding promotion and prevention efforts within health services and by advocating, initiating and, where appropriate, facilitating multisectoral collaboration and coordination.

Suicide prevention

is a global priority and included in the Sustainable Development Goals.

Much progress can be achieved by limiting access to means, responsible media reporting, social and emotional learning for adolescents and early intervention.

pesticides

Banning highly hazardous ________ is a particularly inexpensive and cost-effective intervention for reducing suicide rates.

child and adolescent

Promoting __________ and ________ mental health is another priority and can be achieved by policies and laws that promote and protect mental health, supporting caregivers to provide nurturing care, implementing school-based programmes, and improving the quality of community and online environments.

learning programs

School-based social and emotional ______________ are among the most effective promotion strategies for countries at all income levels.

promoting and protecting mental health at: WORK

Supported through: LEGISLATION and REGULATION

Promoting and protecting mental health at _______ is a growing area of interest and can be supported through __________ and ___________, organizational strategies, manager training, and interventions for workers.

1. Socio-cultural approach

2. Functional approach

3. Historical approach

4. Situational approach

5. Medical approach

6. Statistical approach

What are the six different approaches for describing Normality and Abnormality?

Socio-cultural approach

Thoughts, feelings, behavior that are appropriate or acceptable in a particular SOCIETY or CULTURE are viewed as NORMAL and those that are inappropriate and unacceptable are abnormal.

Consider whether behavior is typical according to the cultural values and beliefs of a particular society— whether the behavior fits in the norms of that society.

example: In some cultures, crying and wailing at the funeral of a stranger is expected and considered normal, whereas in other cultures it is abnormal.

Historical approach

What is considered normal and abnormal in a particular society or culture depends on the era or period of time when the judgment is made.

Ex: Prior to 20th century, if a parent smacked their child for misbehaving, few people would consider this normal but in todays world such behavior would be considered abnormal and perhaps, illegal.

Situational approach

Within a society or culture, thoughts, feelings and behavior that may be considered normal in one situation, may be considered abnormal in another.

The approach depends on or refers to the social situation or behavioral setting in which the behavior occur.

Ex: If you were to come to school wearing pajamas, most of your friends would think that was abnormal, however, it is considered normal to wear PJs during a slumber party.

Medical approach

Abnormal thoughts, feelings, or behavior are viewed as having an underlying biological cause and can usually be diagnosed and treated.

According to this approach, an individual is considered normal if they are physically healthy while abnormality is determined by having an illness that has an underlying physical cause.

Ex: Someone who is colour blind would not be considered as normal. Neither with someone with common cold.

Statistical Approach

Any behavior or characteristic in a large group of individuals is distributed in a particular way that is in a normal distribution.

This approach defined normality based on the experiences and behaviors of the statistical MAJORITY.

Generally, if a large number of people called “Statistical Average”— think, feel, or act in a certain way, it is considered normal.

Ex: It is normal to laugh when tickled because most people do, but to laugh when someone dies would be abnormal because not many people would do this.

Statistical average

Generally if a large number of people called ____________ think, feel, or act in a certain way, it is considered normal.

Functional approach

thoughts, feelings, and behavior are viewed as normal if the individual is able to cope with LIVING INDEPENDENTLY IN SOCIETY but considered abnormal if the individual is unable to function effectively in society.

Normality is defined by the level of one’s ability to interact and involve oneself in society.

Ex: Being able to feed and clothe oneself, find a job, make friends is normal but being so lethargic that you cannot go out of bed, cannot eat properly, and cannot find a job is abnormal.

1. Normality as Health

2. Normality as Utopia

3. Normality as Average

4. Normality as Proces

What are the Functional Perspectives of Normality (Offer & Sabshin)?

Normality as Health

is a traditional approach to health and illness by physicians and health-allied professionals.

• Equates normality with health and view health as a universal phenomenon.

psychopathology

According to “Normality as Health”, Behavior is within normal limits when no ___________ is present.

A healthy person is free of undue pain (excessive), discomfort, and disability.

continuum

Normality encompasses major portion of the __________ and abnormality would be the small remainder.

Normality as utopia

refers to the harmonious and optimal (best) blending of the diverse element that culminates in optimal functioning.

This approach can be traced back to FREUD who stated that, “A normal ego is like normality in general, an IDEAL FICTION”

In this model, what is highlighted in defining normality is on OPTIMAL FUNCTIONING responsibility for personal and social world.

Freud

Normality as Utopia can be traced back to _________ who stated that, “A normal ego is like normality in general, an ideal fiction”

optimal functioning

In Normality as Utopia, normality is an ___________ responsibility for personal and social work.

Utopia

is a place of ideal perfection especially in laws, government, and social conditions.

Normality as Average

This functional perspective of normality is based on the mathematical principles of the BELL-SHAPED CURVE.

middle range: normal

both extremes: deviant

“Normality as Average”, as a functional perspective of normality, considers the middle range _________ and both extremes _________.

Variability

In the “Normality vs Average” approach, __________ is described only within the context of groups not within the context of individual.

Normality as Process

In this approach, Normal behavior is the end result of interacting systems. The perspective stresses changes or processes rather than a cross-sectional definition of normality.

Ex: Erik Erikson’s conceptualization of personality development and the developmental stages essential in attaining of mature adult functioning.

Trust vs Mistrust

Stages of PSYCHOSOCIAL DEVELOPMENT:

Infant

Autonomy vs Shame and Doubt

Toddler

Initiative vs Guilt

Pre-schooler

Industry vs Inferiority

Grade-schooler

Identity vs Role Confusion

Teenager

Intimacy vs Isolation

Young Adult

Generativity vs Stagnation

Middle-Age Adult

Integrity vs Despair

Older Adult

1. Mental Health as Above Normal

2. Mental Health as Maturity

3. Mental Health as Positive Psychology

4. Mental Health as Resilience

What are the EMPIRICAL APPROACHES to Mental Health?

Mental Health as above normal

IDENTIFY WHAT EMPIRICAL APPROACH TO MENTAL HEALTH

According to Jahoda (1958), a mentally healthy individual should:

1. Be in touch with his or her own identity and feelings

2. Be oriented toward the future and remain fruitfully invested in life

3. Possesses autonomy, perceive reality without distortion and yet possess empathy

4. Be able to work, love, play, and to be efficient in problem solving

5. Global Assessment of Functioning (GAF) Scale: 91-100

6. Superior functioning in a wide range of activities such as life’s problems— no symptoms

Global Assessment of Functioning Scale

What GAF Scale: 91-100 stand for?

Mental health as maturity

Greater Maturity reflects greater mental health

1. Capacity for love and work

2. Absence of stereotyped and unproductive patterns of problem solving

3. Realistic acceptance of the destiny imposed by one’s time and place in the world

4. Appropriate expectations and goals

5. Capacity for hope

What is maturity defined as? (5) CARAC

1. Talent

2. Enablers

3. Strengths

4. Outcomes

Mental Health as Positive Psychology:

What are the Four components of positive mental health?

Talent

• inborn

• genetic

• not affected by intervention

Enablers

social interventions that can modify to enhance one’s strengths

Strengths

character traits that are amenable (susceptible) to change.

ex:

• curiosity

• open-mindedness

• kindness

• generosity

• forgiveness

• leadership

• humor

• spirituality

Outcomes

dependent variables that provide evidence that strengths could be altered

Mental Health as Resilience

Coping Mechanisms that help overcome stressful situations

ex:

• Consciously seeking social support

• Conscious cognitive strategies

• Defense mechanisms

1. Deviant

2. Danger

3. Distress

4. Dysfunction

What are the 4D’s of ABNORMALITY?

Deviance

refers to abnormal behavior, specifically behavior, thoughts, and emotions that differ markedly or vary from society’s ideas about proper functioning that can reasonably or legally be considered inappropriate or unacceptable

behavior, thoughts, emotions that break norms of psychological functioning

1. Deviance from Cultural Norms

2. Deviance from Statistical Norms

2 types of Deviance

Deviance from cultural norms

means “away from the normally accepted behaviors in society.”

The behaviors which violates SOCIAL NORMS or EXPECTATIONS might be considered as abnormal.

Social Norms

varies a lot across cultures and ethnic groups. A behavior which is acceptable or normal in one culture or in an ethnic group may be unaccepted or abnormal in another.

Example:

The most recent example of deviance is homosexuality and homosexual marriages. They are culturally accepted in many western countries now. Although, they are culturally unacceptable and considered abnormal in Pakistan as well as in many Muslim countries.

Similarly, marrying in a young age i.e. age 16 or 18 is considered normal in a Pakistani society but it’s considered abnormal in western culture.

Deviance from Statistical Norms

means different from the majority. It means a behavior is abnormal if it occurs infrequently among the members of a society or culture.

Example

Example of deviance from statistical norms is, if a person starts telling jokes in a funeral ceremony will be considered abnormal because he is acting weird as compared to other members in that particular situation. Telling jokes in a funeral is an unacceptable behavior.

Some other examples of deviant behaviors which are considered abnormal in each and every culture are: suicidal bombing, terrorism, murder, robbery or any illegal act that disturbs the society.

Distress

According to many clinical theorists: behavior, ideas, or emotions usually have to cause _________ before they can be labeled ABNORMAL.

These symptoms are upsetting and unpleasant to the person experiencing them and/or others around them

upset

Distress is when the individual showing any behavior is extremely ________.

In other words, the abnormal behaviors are those that lead to personal distress, anxiety, insomnia, various pains, and aches.

Ex. A young boy or girl is grieving over the loss of both parents in an airplane accident or an earthquake disaster as no one will support him/her now. The distressing effects such as endless crying, difficulty in sleeping, agitation, anxiety, loss of appetite or feelings of pain remain for so long that it becomes a psychological disorder, and considered to be abnormal or maladaptive

manic state

So, the human condition is such that suffering and distress are very much part of our life.

On the other hand, there are many disorders who doesn’t show any kind of distress and unhappiness, rather sufferers enjoy their ________ and feel elated during it.

That’s why, defining abnormality by distress only doesn’t work. Although, it is an important concept in defining it.

Kach Umandap; eccentric

At just 36 years old, ________ the San Pablo City, Laguna native became the first and youngest Filipino to travel to all 193 United Nations (UN)-recognized countries and two observer states, using only a Philippine passport—a feat that highlights not just her personal achievements, but also her advocacy for fellow Filipinos. Growing up with her mother and grandparents in Laguna, she has always dreamed of traveling the world. She shared that her initial goal was to become a diplomat. Being a digital nomad allowed me to work remotely while traveling. If I can make the same amount of money while staying in Cebu or Manila, why not do it in Ethiopia, right?

For instance, a solo world traveler rides his bike to 100 countries worldwide.  We may think its abnormal but as long as it doesn’t give distress to the individual and others around him, it is simply ______ instead of abnormal. When interviewed, the solo bike rider may even feel proud of his achievement as the first person who travels the world on a bicycle.

Dysfunctional

Abnormal behavior tends to be ____________ that is, it interferes with daily functioning.

It distracts people to the point that they cannot care for themselves properly, participate in ordinary social interactions or work productively.

It interferes with the person’s ability to carry out their usual daily tasks in an effective way.

Dysfunction

means cognitive, emotional, and behavioral breakdown.

It is an inability to perform daily functioning or everyday activities. In other words, a behavior is considered abnormal if it impairs functionality.

Example

In severe depression, a person feels so isolated and grieved that he withdraws himself from daily activities and stops communicating with his family and friends. Moreover, he doesn’t like to eat as well. He limits himself in his room. He continues to spend his days staring blankly at the television screen. This behavior considered to be maladaptive or abnormal

ultimate

Becoming dangerous to oneself or others is the ______ in psychological dysfunctioning.

careless, hostile, or confused

Individuals whose behavior is consistently _______, __________, or __________ may be placing themselves or those around them at risk.

exception

Danger does not occur in every case of abnormality, as many psychological pathologies do not result in suicide or homicide.

Though it is an ________ instead of a rule, any threat to kill or harm oneself or others is definitely a vivid red flag.

Dangerous or violent behaviors directed at oneself or others are abnormal.

Example

A person trying to commit suicide is deemed to be abnormal. Similarly, if an aggressive person tries to cut or harm himself with a knife or attack someone else with it is also considered to be abnormal. 

Thomas Szasz

_____________ places such emphasis on society’s role that he finds the whole concept of mental illness to be invalid & a myth.

problems of living

According to Thomas Szasz the deviations that society calls abnormal are simply “______________”, not signs of something wrong with the person.

control or change

Thomas Szasz believes that societies invent the concept of mental illness so that they can better ____ or _____ people whose unusual patterns of functioning upset or threaten the social order.

World War 2

Thomas Szasz challenged mental health practice perhaps more than any other American psychiatrist in the decades after ________

The Myth of Mental Illness in 1961 and The Manufacture of Madness: A Comparative Study of the Inquisition and the Mental Health movement in 1970

Szasz promoted doubts about whether mental illness existed at all with his publication of __________ in 1961 and ________________________________ n 1970, along with many other writings, lectures, and public appearances.

diagnosis of neurological disease or damage

Szasz is perhaps best known for his view that without a ___________________, a psychiatric diagnosis was meaningless.

He argued that for most people categorized as mentally ill, a more appropriate classification of their behavior would be “Problems in living”.

Nosology

a branch of medical science dealing with the classification of diseases.

biochemical, genetic, and physiological

Szasz's unyielding critique of psychiatry helped to alter the trajectory of the field. In the second half of the 20th century many psychiatrists began to rethink their rationale for disease nosology and to more aggressively search for the underlying _____, _______, and ____________ bases of mental health disorders—a strategy bearing fruit today.

American civil libertarians

Szasz's attack on psychiatry was most controversial in the realm of the treatment of severe mental illness, and his influence was most profound with regard to what happened to such people in the USA. Szasz's greatest admirers were ________________. They took up Szasz's anti-psychiatry cause with an enthusiasm that had mixed results for those with severe mental illness, their families, and society

the delegitimization of the field of mental health care in favour of a philosophical response —to mental illness that focused on autonomy and rights

The combination of American respect for individualism, doubts about the efficacy and decency of psychiatric treatment, the rise of an anti-paternalism movement with respect to medicine, and a shaky early foundation for some psychiatric diagnoses led to a dramatic shift in US health care:_______________________________________.