WHAT IS NORMAL?

WHAT
IS ABNORMAL?
Mark Cole - Conditioning, Motivation

Steve Erdle - Perception, Personality

Nelson Heapy - Intelligence, Social Psychology

Christine Tsang - Biopsychology, Developmental

Crazy Psycho Daft

Maniac Cracked Demented

Headcase Loony Fruitcake

Whacko Loopy Mad

Insane Out of your mind Maniacal

Mental case Nuts Deranged

 A Brief Test of
Knowledge of
Psychological Disorders
 (1) Which of the following terms
is a genuine psychological or
psychiatric term?
(a) Crazy
(b) Insane
(c) Nuts
(d) None of the above
2) The correct current psychological/
psychiatric term for "split personality"
is:
(a) Siamese Twins
(b) Schizophrenia
(c) Dissociative Identity Disorder
(d) None of the above
3) Which of the following is not
a current
psychological/psychiatric
disorder?
(a) Neurosis
(b) Psychopathy
(c) Homosexuality
(d) All of the above
4) Which psychiatric therapy is
no longer performed in Ontario?
(a) Lobotomy
(b) Electoconvulsive therapy
(c) Psychoanalysis
(d) None of the above
 The Problem of Diagnosis of
Mental Disorders
• line between normal and abnormal
is indistinct
• as a society, we value eccentricity
• but we deplore extreme deviancy
• when does eccentricity  concern?
How would you
respond to this
man if you did
not know who
he was?
• the three D’s criteria for
abnormal behaviour:
1. deviancy
2. dysfunctionality
3. distress

• still a tough call – recall

Rosenhahn (1973)
• since Hippocrates, such
abnormalities were seen as
part of medicine

• e.g., confusion, was assumed to

be a symptom of some “disease”
• but, the causes of such “diseases”
were unknown!
A major assumption:
• “symptoms” will disappear when
the cause (“pathogen”) is
discovered and eliminated!
• N.B., the causes were assumed to
be organic, NOT psychosocial
Sigmund Freud
(1856-1939)
• he argued that physical symptoms
can have non-organic causes
• i.e., the symptoms “serve” the
psyche (or mind)
• a classic example is hysteria …

• a functional paralysis
 • Thomas Szasz has been another
critic of the medical model.

(1) 2000+ years of research has

failed to find organic causes
• a rare exception is general paresis
caused by syphilis
(2)  treatment has been replaced
by custodial care and “restraint”

(3) the label mental illness has

stigmatized, not protected
 Szasz’s Alternative
• “mental disorders” are failures
of adjustment to life events
• the behaviours that define them
are not symptoms of disease!
• they are the problem!
• but the medical model has
endured

• we continue to favour terms like

“treat”, “cure”, “patient”

• and with medicine comes

diagnostic classification
 Emil Kraepelin
(1856-1926)

• created the first classification

system of mental disorders
 DSM IV

• Diagnostic and Statistical Manual

of Mental Disorders (4 Edition)
th

• descendent of Kraepelin’s system

• assessments are made on 5 axes:
 Axis I
• lists most of the disorders:
1. Disorders first diagnosed in infancy, childhood,
or adolescence (e.g., infantile autism)
2. Organic Mental Disorders (e.g., delirium)
3. Substance-related disorders (e.g., alcohol abuse)

4. Schizophrenia and other psychotic disorders

5. Mood disorders (e.g., bipolar disorder)

6. Anxiety disorders (e.g., panic disorder)

7. Somatoform disorders (e.g., conversion disorders)

8. Dissociative disorders (e.g., dissociative fugue)

9. Sexual and gender-identify disorders

(e.g., paraphilias)

10. Eating disorders (e.g., anorexia nervosa)

 Axis II
• lists just two disorders:

1. Personality disorders (e.g., borderline PD)

2. Mental retardation (e.g., Down’s Syndrome)

 Axis III
• general medical conditions that
may affect a mental disorder
• e.g., diabetes or epilepsy
 Axis IV
• psychosocial and environmental
stressors:
• range from mild to catastrophic:
 mild (e.g. relationship breakup
or school change)
 catastrophic (e.g., death of a
child or natural disaster)
 Axis V
• Global Assessment of Functioning
assesses coping resources of client
• these range from excellent to poor
 the best is no evidence of any
symptoms at all
 the worst is persistent danger to
self or others
 Summary
• the medical model has problems

• but it remains popular

• knowledge of DSM is essential