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Psyc 162-001 Abnormal Psychology Spring, 2004

Lecture 2 Abnormality -A cultural (social, moral, religious) construct

Case Studies
‡ Mr. Simpson -Under surveillance ‡ Jorgen -- Oslo Factory worker ‡ Joe College ‡ The Wealthy Widow

The Elements of Abnormality
Facets of the behavior we factor in to our decision about normality/abnormality: ‡ Is the person suffering? ‡ Is the behavior maladaptive? ‡ Is the behavior irrational? ‡ Is the person in control? ‡ Is the behavior vivid or unconventional? ‡ Are observers affected? ‡ Are moral rights or ideal standards violated?

Integrating the 7 Elements ‡ Very rarely do all 7 elements appear in any single disorder or in any single clinical patient ‡ Therefore. degrees of abnormality ‡ What combination of the elements in what measure determines abnormality? ‡ Taxonomies aspire to fit the Aristotelian model -.necessary & sufficient conditions .

Necessary conditions of group membership A NECESSARY condition is one in which: ‡ A characteristic or feature must be present to obtain membership Consider: Are there necessary conditions for a geometric shape to be included in the group µsquare¶? .

sufficient condition for membership to the group µtriangle¶? . guarantees membership in the group Consider: Is there a single. if present.Sufficient conditions of group membership A SUFFICIENT condition is one in which: ‡ A characteristic or feature.

are there any of the 7 elements which MUST be present for behaviors to be called µabnormal¶? ‡ Consider: Are there any sufficient conditions for abnormality? ± That is.Aristotle¶s formulation applied to abnormality ‡ Consider: Are there any necessary conditions for abnormality? ± That is. are there any features of abnormality which ALONE guarantee membership? .

but is not considered to be abnormal and is not included as a mental disorder .Is Suffering Necessary or Sufficient? ‡ Not Necessary: ± Rarely present in Antisocial Personality Disorder ± Rarely present in manic phase of Bipolar ‡ Not Sufficient: ± Bereavement includes suffering.

are adaptive . BUT what about ASPD? ‡ Not Sufficient: ± Underachievement Disorder? ± their behavior is maladaptive even as defined by their own goals ± Some aspects of Bipolar.g.Is Maladaptiveness Necessary or Sufficient? ‡ Not Necessary: ± Certainly coded for in most cases as ³significant impairment of social or occupational functioning´.. e.

in few diagnoses would we call it irrational ‡ Not Sufficient: ± Some cases of µirrationality¶ are called ³art´ .Is Irrationality Necessary or Sufficient? ‡ Not Necessary: ± In most diagnoses the patient¶s thinking is somewhat distorted BUT.

g.Is Loss of Control Necessary or Sufficient? ‡ Not Necessary: ± e.. some psychosexual disorders are due to the inability to surrender control ‡ Not Sufficient: ± In DSM is always loss of control + negative outcome .

g..g. what about genius? ..Is Vividness & Unconventionality Necessary or Sufficient? ‡ Not Necessary: ± e. up to 20% of females experience clinical depression ‡ Not Sufficient: ± e.

BUT each PD requires additional criteria ± What about the work of a surgeon? . µsolo¶ disorders such as agoraphobia ‡ Not Sufficient: ± Most often coded for in the PDs.Is Observer Discomfort Necessary or Sufficient? ‡ Not Necessary: ± e.g..

g.. not present in unipolar depression ‡ Not Sufficient: ± Certainly not from a cross-cultural perspective .Is Violation of Moral Rights and Ideal Standards Necessary or Sufficient? ‡ Not Necessary: ± e.

Wittgenstein¶s Family Resemblance Model ‡ Wittgenstein proposed a classification system based on degree of shared characteristics ‡ This is the Family Resemblance Model ‡ For each specific case/instance. the more features possessed the more likely the case/instance belongs in the family ‡ This model allows for fuzzy boundaries -borderline cases that don¶t fit neatly into the model .

The Elements of Abnormality -Revisited ‡ Core Elements ± Suffering ± Maladaptiveness ± Irrationality ‡ Peripheral Elements ± Loss of Control ± Vividness & Unconventionality ± Observer Discomfort ± Violation of Moral and Ideal Standards .

Wittgenstein & Psychopathology Unipolar Depression _ Suffering + Maladaptiveness Bipolar + + Schizophrenia _ Irrationality Specific Phobia _ .

Historical Perspectives on Abnormality .

Earliest Conceptions of Abnormality ‡ Ebers papyrus dates to 3000 BC ± details anatomy of the brain ± recognizes brain-behavior relationship ± documents mental disorders ± treatment -.000 years . prayer ‡ Reflects etiological view dating back 30.incantations. magic.

possession of the head ‡ animus possession versus evil spirit versus angry god ‡ Treatment was a logical corollary to the etiological model ± Trephining .Spirit possession as etiology ‡ Site of function -.

Trephining .

prayer. flogging .Jesus cures a man with an ³unclean spirit´ (Mark 5:1-13) ‡ Treatment options: ± magic.Biblical references to abnormality ‡ Ancient Hebrews -. noisemaking ± purgatives including potions of wine and sheep dung ± starving.madness as the retraction of God¶s protection ‡ New Testament -.

walking. recreational measures (plays. suggestion. different treatment model . harmonious music) ± patients slept in temples of the god Asclepius to capture dreams which point to treatment ‡ reminiscent of anyone? ± Note: same etiological formulation. riding.The Greek Reformation ‡ Athens under Pericles (461-429 BC) ± Ancient Greek priests supplement exorcism with alternative strategies ‡ kindness.

Harmonious music -. reward & punishment centers Blood & Zatorre (2001) .mechanisms of change ‡ McGill study: subjective experience of harmonious music correlated with: ± activation of dorsomedial midbrain and R thalamus ± suppression of R amygdala ± enhanced affect.

first biological formulation ‡ Revolutionary concepts ± defied demonology ± advocated biological causes and biological treatments ± mental disorders = brain pathology ± heredity & predisposition ± clinical observation & taxonomy 460-377 BC ‡ Ironically without knowledge of anatomy .Hippocratres -.

vegetable diet. exercise short of fatigue. removal of patients from family . celibacy.sobriety. bleeding ‡ some indications of theory of mind-body nexus ± tranquil life.Hippocratic Taxonomy ‡ 4 humors from the 4 elements ± blood fire ± phlegm water ± black bile earth ± yellow bile air ‡ treatments concepts follow: ± melancholia .

Greek practicing in Rome ‡ Human autopsies still banned . 200 ‡ Contributions ± experimental approach to diagnosis ± µbodily health can be affected by the suffering of the psyche¶ .D.Expansion of Hippocratic Typology ‡ Galen -.studied animal anatomy ‡ Expanded 4 humors to theory of personality and disorder ± misled as to psychological cause for centuries ‡Fall of Roman Empire at end of C5th ‡µDark Ages¶ for Abnormal Psychology with death of Galen in A.

1500 A.Abnormality through the Middle Ages (500 .) ‡ Reversion to etiological models based on demonic possession ‡ Fueled by emerging trend of µmass madness¶ ± Tarantism .Germany and rest of Europe ± Lycanthropy ‡ 1541 case tragic example of the misinterpretation of somatic delusions ‡ Mass hysteria peaked during C14th & C15th ± consider the events of this time . Italy ± Saint Vitus¶s Dance .D.early C13th.

canonized for exorcisms . Catherine .St.

³the typical accused witch was not a mentally ill person but an impoverished woman with a sharp tongue and a bad temper.´ .Witchcraft as Insanity ‡ Church doctrine on demonology and witchcraft culminated in publication of Malleus Maleficarum in 1486 ‡ Condoned and encouraged ritualized torture of an estimated 1 million people across next 3 centuries ‡ What proportion of these were psychotic? ± ³intercourse with the devil´ (Zilboorg interpretation.1984 . 1941) ± Schoeneman .

980-1037 . humane treatment C.the protector ‡ Author of µThe Canon of Medicine´ ‡ The ³prince of physicians´ ‡ Kept alive the concept of abnormality due to physical and psychical disorder ‡ Advocated creative.Avicenna -.

II.Henry VIII officially creates asylum at monastery of St. who. sometime with prayers.(1547-1792) ‡ 1547 . with roaring voices. Paris 1641. sometime with lunatic bans. µLunatics¶ Tower in Vienna 1784 . Moscow 1764. iii) ‡ Mexico 1566. Mary of Bethlehem ‡ Origin of term µbedlam¶: ± ³bedlam beggars.The Era of Asylums . enforce their charity´ (King Lear.

Humanitarian Reform ‡ Phillipe Pinel .1792 ± received grudging approval of Revolutionary Committee to remove chains ± destroyed dungeons & created light & airy rooms ‡ Benjamin Rush ± continued the trend in US ± established Pennsylvania Hospital in 1783 .

Rushian innovations .

A Final Note .Phillipe Pinel -.