Abnormal Flashcards
What are the criteria of defining abnormality? x
A. Statistical deviation from the norm
B. Social norms criteria
C. Rosenhaun & Seligman’s criteria for abnormality - MIS VOUV
What are Rosenhaun & Seligman’s criteria for abnormality - MIS VOUV? x
Maladaptiveness - Behavior which makes life more difficult
Irrationality - The person is unable to communicate in a rational manner that is understood by others
Suffering - The behavior causes suffering
Vividness / unconventionality - The person experiences reality in a unconventional way
Observer discomfort - The behavior makes other people uncomfortable
Unpredictability - The person’s behavior is erratic and difficult to predict
Violation of moral standards - The behavior violates accepted standards for right and wrong
Why may deviations from statistical norms be faulty in assessing abnormality? x
The statistical deviation from the norm criteria is simple, reliable, and seemingly objective - it is based on statistics, not on values or beliefs. However, it is far from adequate, because not all statistically unusual behavior is considered undesirable or problematic.
Why may deviations from social norms be faulty in assessing abnormality? x
The social norms criteria, much like statistics-based definitions, is also simple and reliable. Most of us would agree on whether behavior has violated social norms or not. However, social norms vary a great deal between one country and the next, and also evolve over time
Why may MIS VOUV be faulty in assessing abnormality? x
The criteria is more subjective than the others, as two people may come to different conclusions.
It is not clear how many of the seven items must be met for a behavior to be considered abnormal.
Many of the items are clearly related to social norms and judgments, which vary across time and place.
What are the assumptions of the medical model in abnormality? x
-Abnormal behavior is a symptom of a mental disorder
-Mental disorders are related to biological abnormalities in the brain. For instance, depression is thought to be related to a lack of serotonin. Mental disorders are often thought of as a “chemical imbalance” in the brain
-Mental disorders are no different than other diseases. Just as your heart or liver can carry a disease, so can your brain
-Mental illness can be treated by correcting the biological abnormalities that caused the disorder. For example, antidepressant drugs increase levels of serotonin in the brain, thereby treating depression
-Normal behavior is simply the absence of any problems in the brain
Pros and Cons of the medical model in abnormality x
PROS
Removes blame. If someone was suffering from a broken leg, you wouldn’t blame them for not being able to run very fast. Similarly, the idea that mental disorders are real, biological illnesses, just like any other illness, removes much of the blame from the patient.
Enables research into causes and treatments. Once psychological disorders are understood as real illnesses - rather than just character flaws - scientists can begin studying the causes of these disorders, and most importantly, how they can be treated
CONS
Uncertainty about which disorders are “real”. A controversial example is the huge increase in the number of children (mainly boys) who have been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) in the United States.
No way to objectively diagnose mental disorders. For most mental disorders, there is no way to objectively test who has the disorder, and who doesn’t. This makes the process of diagnosis rather subjective and unreliable, and raises questions over what behavior should be considered abnormal.
Diagnosis can lead to stigmatization. Being labeled with a mental disorder can cause employers, family, friends or romantic partners to perceive you differently.
Pros of the medical model in abnormality x
PROS
Removes blame.
If someone was suffering from a broken leg, you wouldn’t blame them for not being able to run very fast. Similarly, the idea that mental disorders are real, biological illnesses, just like any other illness, removes much of the blame from the patient.
Enables research into causes and treatments.
Once psychological disorders are understood as real illnesses - rather than just character flaws - scientists can begin studying the causes of these disorders, and most importantly, how they can be treated
Cons of the medical model in abnormality x
CONS
Uncertainty about which disorders are “real”.
A controversial example is the huge increase in the number of children (mainly boys) who have been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) in the United States.
No way to objectively diagnose mental disorders.
For most mental disorders, there is no way to objectively test who has the disorder, and who doesn’t. This makes the process of diagnosis rather subjective and unreliable, and raises questions over what behavior should be considered abnormal.
Diagnosis can lead to stigmatization.
Being labeled with a mental disorder can cause employers, family, friends or romantic partners to perceive you differently.
What are the ethical issues of diagnosis? x
Stigmatization. - Being called “mentally ill” can have profound consequences for how others perceive and respond to you
Stickiness of labels. - One of the consequences of diagnosis is that it is very difficult to completely shed the label of being mentally ill
Confirmation bias. - Once someone has been labeled as mentally ill, there is a tendency to see evidence of their mental illness in all of their actions
Rosenhan 1973 x
Aim: To investigate the experience of being labeled mentally ill, and the ethical issues that are raised by psychiatric diagnosis
Procedure:
8 healthy adults were recruited to take part in the experiment. They all checked themselves into mental hospitals, claiming (falsely) that they heard voices saying words like “empty”, “dull”, and “thud”
After being admitted, the “pseudo-patients” acted normally, and reported that the voices had stopped. During therapy sessions, the patients answered truthfully about their life
Results
All participants were diagnosed with schizophrenia, admitted to hospital, and forced to take psychiatric medication
Patients were kept in the mental hospital in average of 19 days (in one case, 52 days) despite showing no symptoms of mental disorders after being admitted
At no point did doctors or nurses suspect that the patients did not, in fact, suffer from a mental disorder. In fact, hospital staff interpreted many examples of normal behavior as signs of mental illness, demonstrating confirmation bias.
When participants were released, they were diagnosed with “schizophrenia in remission” rather than being considered as cured
How does Rosenhan 1973 fall short in modern times? x
In the 1970’s, a large proportion of mentall ill people were kept in mental health facilities, which became notorious for poor conditions and mistreatment of patients. Nowadays, most people diagnosed with mental illness remain in their homes and communities, and are encouraged to integrate in society to the greatest extent possible
At the time of Rosenhan, knowledge of mental illness was still in its infancy, and certainly far less developed than it is nowadays. The current DSM V has far more detail on specific disorders and symptoms than the DSM II version that was used at the time of Rosenhan’s study
Psychiatry has developed better methods of diagnosis, such as structured interviews, which check for specific symptoms. These methods of diagnosis had still yet to be developed in the early 1970’s
Langer and Abelson 1974 x
Aim: Investigate how stigma, labels and confirmation bias affects perceptions of the mentally ill
Procedure
The participants in this study were two groups of clinical psychologists. The first group were analytic psychologists, who tend to view mental illness as a consequence of internal conflicts and childhood trauma. The second group were behavioral psychologists, who tend to focus more on identifying and changing negative patterns of behavior, in the here and now
Participants watched a video of a man being interviewed about his feeling and experiences concerning his past work
Half of the participants were told that the man was a “job applicant”, while the other half were told that the man was a “patient”. The label given to the man was the independent variable in this study
Participants then rated the man according to how “disturbed” or “well-adjusted” he was. The rating of the man’s mental health was the dependent variable in this study
Results
The behavioral psychologists tended to rate the man as fairly normal, regardless of the label
The analytic psychologists, on the other hand, rated the man as significantly more disturbed when they were told that he was a “patient”
Same man who was described as “realistic”, “unassertive”, “attractive”, “innovative” became “tight, defensive”, “dependent, passive aggressive” and had a “conflict over homosexuality” when labeled a patient
Weisman et al 2005
Aim: To investigate the prevalence of depression in different countries
Procedure
This study was carried out in 10 countries across the world, including a range of different cultures - the United States, Canada, Puerto Rico, France, West Germany, Italy, Lebanon, Taiwan, Korea, and New Zealand.
Participants in each country were randomly selected using telephone registries. A trained interviewer would call the people selected and interview them about their mental health history. A total of 38,000 participants were interviewed
Results
Rates of depression varied tremendously in different countries. The lifetime prevalence of depression was only 1.5% in Taiwan, but as high as 19% in Beirut, Lebanon
Surprisingly, the rate of depression in France (16.4%)
In spite of the large variation in depression rates, some patterns were noticed across the world. In each country, the rate of depression in women was 2-3 times higher than in men. And people who were separated or divorced had much higher rates of depression than people who were currently married
Why may depression prevalence vary?
Different socioeconomic conditions - In some countries, many people struggle with poverty, constant stress, the threat of violence or war, or long periods of unemployment. Living in such difficult conditions may lead to higher rates of depression than living in stable, safe and prosperous countries
Different rates of urbanization - As countries develop economically, more people tend to move out of villages and small towns, and into crowded, stressful cities. Some researchers believe that urban living is linked to higher rates of depression, since city dwellers are more likely to be stressed and socially isolated, living busy, chaotic lives in the midst of thousands of anonymous strangers
Differences in cultural stigma - In some countries, mental illness is still considered a shameful topic, one which is kept hidden behind closed doors. In these countries, more people suffer depression in secret, without ever being diagnosed. If they do seek help, they may report physical symptoms only (like being unable to sleep, or muscle pain), and hence may never be given the correct diagnosis
Differences in how depression is diagnosed - In some countries, psychiatrists may be more likely to diagnose depression than others, depending on the culture of mental health treatment. The line between mild depression and ordinary sadness is somewhat blurry, and so rates of depression could vary because of different mental health training and practices
Discussion points may include, but are not limited to:
* age (for example, higher prevalence rates for depression in the elderly population and
increasing rates among youth)
* gender (for example, higher prevalence for depression in women)
* risk factors such as exposure to conflicts, traumatic events, physical or psychological
abuse
* social and cultural factors (for example, poverty, social, and cultural norms)
* availability of mental health services and treatment (for example, social determinants in
relation to access to treatment and health services)
* Diagnostic criteria and classification systems
* Risk of relapse once the research is over
* Methodological and ethical considerations related to the research into prevalence rates
of disorders.
What is the serotonin hypothesis
According to this hypothesis, the cause of depression is low levels of serotonin in the brain. Low levels of serotonin make it more difficult for signals to be passed from one neuron to the next, slowing down the flow of brain activity. This results in the tell-tale signs of depression - such as low energy, lack of enjoyment of life, and feelings of sadness. The best treatment for depression, therefore, are antidepressant drugs, which work by raising the level of serotonin in the brain’s synapses. These drugs are known as SSRI’s. They work by inhibiting the reuptake of serotonin, causing more of the neurotransmitter to remain in the synapse
What is the The diathesis-stress model
The diathesis-stress model explains how genes and the environment interact to determine mental health. According to the model, some people have genes that predispose them to depression (diathesis). But not all of these people will become depressed. As long as life goes relatively smoothly, these people will be able to function normally. However, if stressful life events happen - perhaps a loved one dies suddenly, or the person goes through a difficult breakup or divorce - the combination of high levels of stress and genetic vulnerability will make depression more likely.
