Examples and Definitions of

Abnormal Behavior
Learning Objectives
What do we do about
What is abnormal? What is the impact? it?
• What is the • How does the • Who provides help
difference between impact of mental for people with
normal and disorders compare mental disorders?
abnormal to that of other • Why do scientific
behavior? health problems? methods play such
• How does culture an important role
influence the in psychology's
definition of approach to the
mental disorders? study of mental
disorders?
What is abnormal?
 Overview
Abnormal
Psychology

Application of psychological
science to the study of mental
disorders

Psychopathology
 Psychopathology and
Abnormal Psychology is
actually made up of a
lot of different Overview
subdisciplines.

Nosology is the a Psychopathology

system of
classification

Nosology
Treatment
Has to do with
counting people
with a specific
problem.
Assessment Etiology
Understanding the
origins/causes
Epidemiology
 Do people with
mental illness
have cognitive
Overview
deficits?
Does mental
illness make
people more or
Cognitive Psychopathology less likely to Social
commit crimes?

Aspects of abnormal
Neuroscience psychology can actually Forensic
be found in a ton of
different subdisciplines.

Genetic Developmental

Are there
common Neuropsychology
How does
genetic mental illness
markers for change over
mental illness? time?
 Overview
What is mental illness?

What is psychopathology?
What is abnormal?
 Overview

What is abnormal?
There are a lot of
different options for
determining what is and
is not abnormal.
What is abnormal? Both options have drawbacks, but the
bigger drawback comes from trying
to define what is “normal.” It ends up
being based on biases and prejudices
(not that the other method doesn’t,
but this is a much quicker route).

Define what is
Define what is
normal,
abnormal,
everything
everything
else is
else is normal.
abnormal.

Option 2
Option 1
 Check out this quick
video on psychosis, linked
on d2l. What do you
implicitly see as being
“abnormal”? Why?
What is abnormal?
• What was abnormal about what he is telling us?

Auditory hallucinations Psychosis

Paranoia
Persecutory delusions We call this psychosis.
Though insertion
Isolation
These are some of the
technical terms we use for
what he is describing.
 What is abnormal?

Auditory hallucinations
Paranoia
Psychosis Syndrome
Persecutory delusions
Though insertion
Isolation A group of symptoms that
And apply a label to it.
appear together and are
assumed to represent a specific
type of disorders.
We take these symptoms.

Which is called a
syndrome.
What is abnormal?
• BUT determining what is a syndrome is complicated.
• Why?
What is abnormal?
• BUT determining what is a syndrome is complicated.
• Why?

Back in the day, people did not

understand what the root cause of
most physical disease was. It wasn’t
until germ theory was discovered
(and re-discovered) that we
understood why physical disease
occurred.

There is no germ theory in

psychology. We have some theories
and ideas, but no clear
understanding.
What is abnormal?
• BUT determining what is a syndrome is complicated.
• Why?
• Psychology does not really have its germ theory.
• No lab tests
• Have to rely on descriptions
• Will we ever have lab tests?
• See the Thomas Insel TED video on d2l!
What is abnormal?
• Defining what is abnormal is the real challenge!

Essentially, a medical doctor can Of course, medicine is complicated as well.

look in a microscope and see that X While bacterial and viral infections often have
bacteria should not be there and is clear etiologies, cancer, neurological diseases,
causing Y damage. The “disease” is the microbiome, cardiovascular diseases, and a
clear. host of other physical illnesses have unclear or
multiple/chaotic mechanisms.
In psychology we do not have that
luxury. Human thoughts, emotions,
and behaviors were designed to do
many things, some of which might
seem odd, but does that indicate it
is a disease?
What is abnormal?
• Defining what is abnormal is the real challenge!

Auditory hallucinations
Paranoia May seem obvious
Persecutory delusions
Though insertion
Isolation These problems may seem
obviously abnormal (though they
are not).
What is abnormal?
• Defining what is abnormal is the real challenge!

Auditory hallucinations
Paranoia General Principles
Persecutory delusions
Though insertion
Isolation But how do we figure out general
principles for what is and is not
“abnormal?”
What is abnormal?
• What strategies would you use?
 What is abnormal?
Good thinking! (Yes, we are
pretending to be in
conversation). Subjective
Subjective distress distress is a good starting place!
Or, what if someone is
distressed by something that is
not clearly a problem?
What if there is no distress? Unfortunately, many mental
(Anagnosia) illnesses have a problem where A patient I had once asked for
the individual cannot recognize therapy because they were
(Lack of insight) that something is wrong. A troubled by their sexual urges.
What if they are distressed person who is depressed may Upon assessment, their sexual
without cause? not realize they are urges were common. However,
“depressed,” but simply believe their sociocultural background
they are seeing the world more made their sexual urges a
accurately than those around source of consternation. How
them. Or a person whose do I label their problem? Do I
substance use is interfering treat the problem they have?
with their work and
interpersonal life may no see
the substance use as the source
of problems.
 What is abnormal?

Subjective distress Statistical Norms

• How far outside the norm?
• Some things outside the norm have
The previous example might lead you to think about
using statistical norms. For example, we might not positive effects.
diagnose the previous example with a sexual • What if there is no harm or
disorder, but what if someone came in with
something that was uncommon, or experienced by
impairment?
only a few people? • How do we distinguish between
idiosyncrasies/social constructions of
This creates new problems outlined to the right.
deviance?
 Harmful Dysfunction
• Jerome Wakefield
1. The condition results from the inability of some internal mechanism
(mental or physical) to perform its natural function.
2. The condition causes some harm to the person as judged by the
standards of the person’s culture. The negative consequences are
measured in terms of the person’s own subjective distress or
difficulty performing expected social or occupational roles.

The idea of harmful dysfunction continues to heavily

influence diagnosis and assessment.
Harmful Dysfunction

Auditory hallucinations Dysfunctions in…

Paranoia
Persecutory delusions Harm in…
Though insertion
Isolation
Harmful Dysfunction
Maybe the function of the auditory system is to
accurately report on external stimuli, then we could
consider this a dysfunction.

Auditory hallucinations Dysfunctions in…

Paranoia
Persecutory delusions Harm in…
Though insertion
Isolation
Paranoia and persecutory delusions are preventing him
from having meaningful, positive relationships.
Harmful Dysfunction
Here is a more thorough breakdown of this idea.

1. A syndrome (groups of associated features) that is characterized by

disturbance of a person’s cognition, emotion regulation, or behavior.
2. The consequences of which are clinical significant distress or disability
in social, occupational, or other important activities.
3. The syndrome reflects a dysfunction in the psychological, biological, or
developmental processes that are associated with mental functioning.
4. Must not be merely an expectable response to common stressors and
losses or a culturally sanctioned response to a particular event (e.g.
trance states in religious rituals).
5. That is not primarily a result of social deviance or conflicts with society.
 Of course, you may start to see some drawbacks to this
definition already. Even the broadest definition is beset

Harmful Dysfunction
l?
by definitional questions.

n t a P
m e o w e isrcharacterized by
t is
1. A syndrome (groups of associated features) that
i neorqbehavior.
disturbance
2. Theh
a of a person’s cognition, emotion regulation,
u ities
W consequences of which are clinical significant distress or disability
in social, occupational, or other important activities.
Soc in the psychological, biological, or
3. The syndrome reflects a dysfunction
ial c with mental functioning.
developmental processes that are associated
otontcommon stressors and
4. Must not be merely an expectable response
rol event (e.g.
losses or a culturally sanctioned response to a particular
C o l o n i
trance states a l
in is m
religious rituals).
5. That is not primarily a result of social deviance or conflicts with society.
Culture
• Values, beliefs, and practices shared by a specific community or group
of people.
• Profound impact on defining what is abnormal.
• “only dysfunctions that are socially disvalued are disorders”
• Homosexuality and the American Psychiatric Association (Diagnostic
and Statistical Manual)
• Not removed until 1973

What is and is not labeled a mental disorder is not purely

scientific.
Culture
• Impacts what is seen as a mental disorder and how intensely the
disorder is experienced.
Culture
• Culture-bound syndromes (ethnospecific syndromes)
• Koro – Southeast Asia, India, China
• Uqamairineq- Inuit 
• Ghost Sickness- American Indians (Muscogee/Creek)
• Amok- Malaysian/Indonesian
• Anorexia- Americas, Western Europe
• Culture-different syndromes
• Panic disorder and anxiety
• Sleep paralysis
• Psychosis
Frequency and Impact
Who experiences abnormal behavior?
• Epidemiology
• The scientific study of the frequency and distribution of
disorders within a population
• Incidence
• The number of new cases of a disorder that appear in a
population during a specific period of time
• Prevalence
• The number of active cases (old and new) present in a
population during a specific period/time
• Lifetime prevalence
• Total proportion of people in a given population who have been
affected by the disorder at some point during their lives
What percentage of people receive at least
one lifetime diagnosis?
Frequency of Mental
Disorders in the
Community- Lifetime
Prevalence Rates
(NCS-R)
Who experiences abnormal behavior?
• Often individuals do not just experience one disorder at a time, and
often a mental disorder is not the only struggle in a person’s life.
• Comorbidity
• The presence of more than one condition within the same period of
time

Depression Anxiety Heart

Disease
Who experiences abnormal behavior?
• Individuals experience different levels of impact on their
lives depending on many factors.

Mortality Morbidity
Who experiences abnormal behavior?
• Individuals experience different levels of impact on their
lives depending on many factors.

Disease
Burden
Comparison of the
Impact of Mental
Disorders and
other Medical
Conditions on
People’s Lives
The Scientific Approach
Scientific Approach
• Case Studies
• Useful for clinical training and practice
• Learning about unique or fundamentally rare disorders
• Not useful for almost anything else
Scientific Approach
• Psychometrics
• How to measure, quantify, and compare aspects of human cognition,
emotion, and behavior.
• Reliability and validity of diagnostic categories.
• Can sometimes be difficult to understand for outside observers due to the
complexities of the methods used.
• Psychologists are especially trained in the development and application of
psychological tests.
Scientific Approach
• Intervention Science
• Using scientific experimentation (basic, applied, translational) to demonstrate
the efficacy and effectiveness of psychosocial interventions.
 Being a client or a therapist Brief Psychodynamic
Therapy
• Unfortunately, in psychology, there
tends to be a large number of Eye-Movement
treatments that are unsupported by Desensitization Behavioral Activation
the research. Reprocessing

• This can make it difficult to determine

what treatment you should seek out Cognitive Therapy
Emotion Focused Therapy
or enact (depending on your role).
• For example, if seeking out a
treatment for depression you might Emotional Freedom
be confronted with multiple Technique
possibilities, including
Scientific Approach
• Intervention Science
• Using scientific experimentation (basic, applied, translational) to demonstrate
the efficacy and effectiveness of psychosocial interventions.
• This can actually be a fairly large debate.

We cannot measure and

We can measure and compare psychosocial
compare psychosocial treatments or such
treatments measurement unfairly
favors certain theories
Scientific Approach
• Intervention Science
• Using scientific experimentation (basic, applied, translational) to demonstrate
the efficacy and effectiveness of psychosocial interventions.

Hypothesis Null Hypothesis Competing Hypothesis

•
 Scientific Approach CBT refers to a specific type of therapy you will learn
about later.

Hypothesis

CBT is effective at
reducing depressive
symptoms.
 Prescreen

Scientific Approach
Depressed
People
Hypothesis

CBT is effective at Measurement 1

reducing depressive
symptoms.

Treatment

This experimental design is clearly insufficient. We do not

know for sure that therapy “made” the person better, it
could simply have been time, or outside circumstances. Measurement 2
 Scientific Approach
Hypothesis Null Hypothesis

CBT is effective at Nothing is needed to

reducing depressive reduce depressive
symptoms. symptoms

We have to add in a competing hypothesis.

 Prescreen

Scientific Approach Depressed

People

Hypothesis Null Hypothesis

Measurement 1
CBT is effective at Nothing is needed to
reducing depressive reduce depressive
symptoms. symptoms
 Prescreen

Scientific Approach Depressed

People

Hypothesis Null Hypothesis

Measurement 1
CBT is effective at Nothing is needed to
reducing depressive reduce depressive
symptoms. symptoms

Treatment No Treatment

With the competing hypothesis comes a control group.

We want to see what happens to comparable groups of
people if they receive treatment or don’t.

Measurement 2A Measurement 2B
 Prescreen

Scientific Approach Depressed

People

Hypothesis Null Hypothesis

Measurement 1
CBT is effective at Nothing is needed to
reducing depressive reduce depressive
symptoms. symptoms

Treatment No Treatment

These results would suggest that the treatment is not

needed, or no more effective than no treatment.

Measurement 2A Measurement 2B
 Prescreen

Scientific Approach Depressed

People

Hypothesis Null Hypothesis

Measurement 1
CBT is effective at Nothing is needed to
reducing depressive reduce depressive
symptoms. symptoms

Treatment No Treatment

These results would suggest that the treatment is

effective.

Measurement 2A Measurement 2B
 Prescreen

Scientific Approach Depressed

People

Hypothesis Null Hypothesis

Measurement 1
CBT is effective at Nothing is needed to
reducing depressive reduce depressive
symptoms. symptoms

Treatment No Treatment

These results would suggest that the treatment is not

needed, or no more effective than no treatment.

Measurement 2A Measurement 2B
 Scientific Approach
Hypothesis Null Hypothesis

CBT is effective at Nothing is needed to

reducing depressive reduce depressive
symptoms. symptoms

Of course, we are usually not interested just in whether

Competing Hypothesis or not one treatment is better than nothing, we usually
have some comparison in mind (even if it is just
relaxation or chicken soup).
BA is more effective at
reducing symptoms.

BA is another type of therapy for depression (behavioral

activation).
 Prescreen

Scientific Approach Depressed

People

Hypothesis Null Hypothesis

Measurement 1
CBT is effective at Nothing is needed to
reducing depressive reduce depressive
symptoms. symptoms

Competing Hypothesis

BA is more effective at
reducing symptoms.
 Prescreen

Scientific Approach Depressed

People

Hypothesis Null Hypothesis

Measurement 1
CBT is effective at Nothing is needed to
reducing depressive reduce depressive
symptoms. symptoms

Competing Hypothesis

BA is more effective at No Treatment

reducing symptoms. Treatment 1 Treatment 2

Measurement 2A Measurement 2B Measurement 2C

 Prescreen

Scientific Approach Depressed

People

Hypothesis Null Hypothesis

Measurement 1
CBT is effective at Nothing is needed to
reducing depressive reduce depressive
symptoms. symptoms

Competing Hypothesis

BA is more effective at No Treatment

reducing symptoms. Treatment 1 Treatment 2

Measurement 2A Measurement 2B Measurement 2C

 Prescreen

Scientific Approach Depressed

People

Hypothesis Null Hypothesis

Measurement 1
CBT is effective at Nothing is needed to
reducing depressive reduce depressive
symptoms. symptoms

Competing Hypothesis

BA is more effective at No Treatment

reducing symptoms. Treatment 1 Treatment 2

Measurement 2A Measurement 2B Measurement 2C

 Prescreen

Scientific Approach Depressed

People

Hypothesis Null Hypothesis

Measurement 1
CBT is effective at Nothing is needed to
reducing depressive reduce depressive
symptoms. symptoms
Of course, this is being vastly over-simplified, and there
Competing Hypothesis
are an infinite variety of experiments you could run and
questions you could ask.

BA is more effective at No Treatment

reducing symptoms. Treatment 1 Treatment 2

Measurement 2A Measurement 2B Measurement 2C

 Prescreen

f an
Scientific Approach
Is i t eff
ve o
ecti al conte
e nt
d e
utsi xt?
o
What about cultu
competencies?
ral
Depressed
What about the cost
effectiveness?
ri m
expe People

Hypothesis Null Hypothesis

What d Measurement 1
CBT is effective at How is needed to oes it m
Nothing e
are y
ou m depress an to be
reducing depressive reduce depressive
easu ed?
symptoms. symptoms ring
it?

Competing Hypothesis

tm ent
BA is more effective at he trea No Treatment
d oe st Treatment 1 ure the 2
Treatment
reducing symptoms.
w long to last? a ke
you m sistent?
s
Ho nee d Ho w do
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How long do
es the effect la treat
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Measurement 2A Measurement 2B Measurement 2C

Important Terms for Intervention Science
• Randomized Controlled Trial
• Gold standard in determining the efficacy of a given intervention.
• Individuals are assigned to treatment or control at random and then an
intervention is tested.
• Meant to eliminate spurious causality.
• Efficacy
• Determine whether an intervention produces expected results under ideal
circumstances
• Effectiveness
• Determine whether an intervention produces the same degree of beneficial
effect under “real world” conditions.
 One issue with many intervention studies is that
they can tell us that a treatment works, but the
question of why it works often and who it works for
can elude use!
Important Terms for Intervention Science
• Mediation
• What is the causal mechanism that makes the intervention work?

B
A
 Important Terms for Intervention Science
• Mediation
• What is the causal mechanism that makes the intervention work?

B
A
Cognitive Behavioral Depression
Therapy for depression decreases
 Important Terms for Intervention Science
• Mediation
• What is the causal mechanism that makes the intervention work?

B
A
Cognitive Behavioral
Therapy for depression
? Depression
decreases
 Important Terms for Intervention Science
• Mediation
• What is the causal mechanism that makes the intervention work?

B
A
Cognitive Behavioral
Therapy for depression

C B Z
? Depression
decreases
 Important Terms for Intervention Science
• Mediation
• What is the causal mechanism that makes the intervention work?

We know that CBT for depression is made of

different components. Things like therapist
relationship, location, specific techniques, etc.

B
A
Cognitive Behavioral
Therapy for depression

C B Z
? Depression
decreases
 Important Terms for Intervention Science
• Mediation
• What is the causal mechanism that makes the intervention work?

B
A
?
Cognitive Behavioral And we can design experiments that let us break Depression
Therapy for depression apart these components and test them individually. decreases

C B Z
 Important Terms for Intervention Science
• Moderation
• Are there circumstances or characteristics under which a treatment won’t work?

?
B
A
Cognitive Behavioral Depression
Therapy for depression decreases
 Important Terms for Intervention Science
• Moderation
• Are there circumstances or characteristics under which a treatment won’t work?

Men

B
A Women

Cognitive Behavioral Depression

Therapy for depression decreases

For example, does the treatment work differently for

men and women?
 Important Terms for Intervention Science
• Moderation
• Are there circumstances or characteristics under which a treatment won’t work?

Men

B
A Women

Cognitive Behavioral Depression

Therapy for depression decreases

Maybe it doesn’t work at all for men?

 Important Terms for Intervention Science
• Moderation
• Are there circumstances or characteristics under which a treatment won’t work?

Men

B
A Women

Cognitive Behavioral Depression

Therapy for depression decreases

Or maybe it works better for men?

Does psychotherapy work?

• Placebo effect
• A person’s belief in the effect may lead to actual change.
• Really it is more complicated than that.
• Active ingredients
• Placebo effect is annoying, because we want to be able to control the effect.
• Placebo control groups
Does psychotherapy work?

• Common Factors
• All therapies share common factors.
• “Interpretation”
• Warmth, empathy, genuineness
• Self-understanding
• Coping skills
• Therapeutic Allegiance/Relationship
Does psychotherapy work?

• Motivational Interviewing
• Designed to be a placebo therapy
• Focused on basic humanistic principles
• Empathy
• Interpersonal
• Eliciting promises to change
Important Terms for Intervention Science
• Randomized Controlled Trial
• Gold standard in determining the efficacy of a given intervention.
• Individuals are assigned to treatment or control at random and then an
intervention is tested.
• Meant to eliminate spurious causality.
• Efficacy
• Determine whether an intervention produces expected results under ideal
circumstances
• Effectiveness
• Determine whether an intervention produces the same degree of beneficial
effect under “real world” conditions.