2. Defining Abnormality
Sometimes, we all have thoughts that upset us, experience feelings
we’d rather not have, and act in ways that are self-defeating or
detrimental to others.
We may find ourselves in situations in which we can’t think, feel or behave
as others would—e.g. we can’t let go of a failed relationship.
Our thoughts, feelings, or behaviors may be interfering with our
functioning in daily life— e.g. we become afraid to walk alone in dark.
We may become upset over a situation that others don’t find distressing
— e.g. getting an average grade on an exam.
We may be acting in ways that are dangerous to ourselves or others —
e.g. driving a car when intoxicated.
3. Defining Abnormality
A common belief: Behaviors, thoughts, or feelings can be
viewed as abnormal if they are symptoms of a mental illness
An individual “has schizophrenia” (characterized by unreal
perceptions and severely irrational thinking)
This implies -> a disease process,
much like hypertension or diabetes,
is present.
imply - >he or she has a disease that should
show up on some sort of biological test, just as
hypertension shows up when a person’s blood
pressure is taken.
4. Defining Abnormality
To date, however, no biological test is available to
diagnose any of the types of abnormality.
This is not just because we do not yet have the right biological tests.
Mental health experts view mental disorders as collections
of problems in thinking or cognition, in emotional
responding or regulation, and in social behavior.
It is likely: biological factors are associated with these problems in
thinking, feeling, and behaving
It is unlikely: a singular disease process underlies the symptoms we call
schizophrenia
5. Cultural Norms
A man driving a nail through his hand
A woman refusing to eat for several days
A man barking like a dog and crawling on the floor on his hands and knees
A woman building a shrine to her dead husband in her living room and
leaving food and gifts for him at the altar
Cultural relativism is the view that there are no universal
standards or rules for labeling a behavior abnormal; instead,
behaviors can be labeled abnormal only relative to cultural
norms (Snowden & Yamada, 2005).
7. Cultural Norms
A woman refusing to eat for several days
Fasting during Ramadan means abstinence from all food or drink,
including water and chewing gum, from dawn to sunset.
8. Cultural Norms
A man barking like a dog and crawling on the floor on his hands and knees
Among the Yoruba of Africa, traditional healers act like dogs during healing rituals
9. Cultural Norms
A woman building a shrine to her dead husband in her living room and
leaving food and gifts for him at the altar
10. Cultural Relativism
Cultural relativism is the view that there are no universal
standards or rules for labeling a behavior abnormal; instead,
behaviors can be labeled abnormal only relative to cultural norms
It honors the norms and
traditions of different
cultures, rather than imposing
the standards of one culture
on judgments of abnormality.
Throughout history, societies have labeled
individuals and groups abnormal in order
to justify controlling or silencing them.
Drapetomania
a supposed mental illness that,
in 1851, is the cause of enslaved
Africans fleeing captivity.
11. The Influcence of
Culture & Gender
First, culture and gender can
influence the ways people express
symptoms.
Second, culture and gender can influence people’s willingness to admit to
certain types of behaviors or feelings (Snowden & Yamada, 2005).
Third, culture and gender can influence
the types of treatments deemed
acceptable or helpful for people
exhibiting abnormal behaviors.
12. Historical Perspectives on
Abnormality
The biological theories have viewed
abnormal behavior as similar to physical
diseases, caused by the breakdown of
systems in the body. The appropriate
cure is the restoration of bodily health.
The psychological theories have
viewed abnormal behavior as a
result of traumas, such as
bereavement, or of chronic stress.
The supernatural theories have viewed
abnormal behavior as a result of divine
intervention, curses, demonic
possession, and personal sin. To rid the
person of the perceived affliction,
religious rituals, exorcisms, confessions,
and atonement have been prescribed.
trephination, the
operation of drilling a
hole on one’s skull
13. The Four Ds of Abnormality
Dysfunction, Distress, Deviance, and Dangerousness
Behaviors, thoughts, and feelings are dysfunctional
when they interfere with the person’s ability to function
in daily life, to hold a job, or to form close relationships.
For example, thinking that is out of touch with reality
(for example, believing you are demon and should be
punished) makes it difficult to function in everyday life
and so is considered dysfunctional.
14. The Four Ds of Abnormality
Behaviors and feelings that cause distress to the
individual or to others around him or her are also likely
to be considered abnormal. Many of the problems cause
individuals tremendous emotional and even physical
pain; in other cases, the person diagnosed with a
disorder is not in distress but causes others distress, for
example, through chronic lying, stealing or violence.
15. The Four Ds of Abnormality
Highly deviant behaviors, such as hearing voices
when no one else is around, lead to judgments of
abnormality. What is deviant is influenced by cultural
norms, of course.
Finally, some behaviors and feelings are of potential
harm to the individual, such as suicidal gestures, or to
others, such as excessive aggression. Such dangerous
behaviors and feelings are often seen as abnormal.
16. Challenge
In the year between her 18th and 19th birthdays, Jennifer, who is
1.67m, dropped from a weight of 57kg to 45kg. The weight loss began
when Jennifer had an extended case of the flu and lost 4kg. Friends
complimented her on being thinner, and Jennifer decided to lose more
weight. She cut her intake of food to about 1,200 calories, avoiding carbs
as much as possible, and began running a few miles every day.
Sometimes she is so hungry she has trouble concentrating on her
schoolwork. Jennifer values her new lean look so much, however, that
she is terrified of gaining the weight back. Indeed, she’d like to lose a few
more pounds so she could fit into a size 2.
Consider the following description:
Do you find Jennifer’s behaviors abnormal? How would you
rate their level of dysfunction, distress, deviance, and danger?
19. What Are We Talking About
When We Talk About Assessing & Diagnosing
Abnormality?
Important concepts
Modern tools of assessment
How they are used both to diagnose
psychological symptoms and to help us
understand and treat psychological
problems
Modern systems of diagnosing
psychological problems
20. Important Terms
Assessment is the process of gathering information about
people’s symptoms and the possible causes of these symptoms.
A diagnosis is a label for a set of symptoms that often
occur together.
Types of information: info about current symptoms and ways of
coping with stress, recent events and physical condition, drug and
alcohol use, personal and family history of psychological disorders,
cognitive functioning, and sociocultural background, etc.
The information gathered in an assessment is used to
determine the appropriate diagnosis for a person’s problems.
21. Assessment Tools
Validity refers to the accuracy of a measure (whether the
results really do represent what they are supposed to measure).
Reliability refers to the consistency of a measure (whether
the results can be reproduced under the same conditions).
Reliability implies consistency: if you take the ACT five
times, you should get roughly the same results every time.
A test is valid if it measures what it’s supposed to. The ACT is
valid (and reliable) because it measures what a student
learned in high school.
How do we know if a test is a good one?
23. Modern Tools of Assessment
Structured clinical interviews
What does the clinician access?
- The person’s general functioning
Appearance and behavior
Thought processes, including how
coherently and quickly he or she speaks
Mood & affect
Intellectual functioning
Whether the individual seems appropriately
oriented to place, time, & person
24. Modern Tools of Assessment
Symptom questionnaires
One of the most common questionnaires used to assess symptoms
of depression is the Beck Depression Inventory, or BDI.
21 items
Each of which describes four levels of a given symptom of depression
Ranging from feeling “I do not feel unhappy” to “I am so
unhappy that I can’t stand it.”
25. Modern Tools of Assessment
Personality inventories
Behavioral observation
Self-monitoring
Brain-imaging techniques such as CT, PET, SPECT, and MRI scans
26. Problems & Biases
Resistance to Providing Information
Sometimes, the person does not want to be assessed or treated.
For example, when a teenager is forced to see a psychologist
because of parental concern about his behavior.
Evaluating Children
27. Problems & Biases
Evaluating Individuals Across Cultures
The person may not speak your language or may speak it only partially
Symptoms can be both underdiagnosed and overdiagnosed
Cultural biases can arise when everyone supposedly is speaking the
same language but has a unique cultural background.
30. The Social-Psychological
Dangers of Diagnosis
a classic study of the effects of diagnoses by David Rosenhan (1973)
Once a diagnosis is given, people tend to see it as real rather than
as a judgment.
had themselves admitted to 12 mental hospitals by reporting hearing
voices saying the words “empty”, “hollow”, and “thud”.
All 8 were admitted to the hospitals, 7 w/ a diagnosis of schizophrenia
19 days, no one was detected as normal
“It is clear that we cannot distinguish the
sane from the insane in psychiatric
hospitals. The hospital itself imposes a
special environment in which the
meanings of behavior can be easily
misunderstood.” - Rosenhan (1973)
33. What Are the Treatments?
Psychological treatment, in which people interact with a clinician
in order to use the environment to change their brain and behavior
Biological treatment, in which the brain is treated directly with
drugs, surgery, or some other direct intervention.
In some cases, both psychological and biological treatments are
applied.
Two broad types:
36. Behavior Therapy: Changing
Maladaptive Behavior Patterns
Behavior therapy assumes that disordered behavior is learned
and that symptom relief is achieved through changing overt,
maladaptive behaviors into more constructive behaviors.
Behaviorists rejected theories that were based on
“invisible” mental properties that were difficult to
test and impossible to observe directly.
37. Examples of Behavior
Therapy Techniques in Action
How would you change a 3-yearold boy’s
habit of throwing tantrums at the grocery
store? Did the child get candy to “shut him
up”? The study of operant conditioning
shows that behavior can be influenced by its
consequences (the reinforcing or punishing
events that follow). Adjusting these ->
change the behavior.
Making the consequences less reinforcing
(no candy!) and more punishing (a period of
time-out facing the wall in the grocery store)
could eliminate the problem behavior.
Eliminating Unwanted Behaviors
38. Examples of Behavior
Therapy Techniques in Action
How might you get an individual with schizophrenia to engage in
activities of daily living? How would you get a cocaine addict to stop
using drugs?
Promoting Desired Behaviors
Token economy: giving clients “tokens” for desired behaviors, which they
can later trade for rewards. For instance, in the case of cocaine dependence,
the desired behavior is not using cocaine.
Programs that reward non-use with vouchers that can be exchanged for
rewards such as money, bus passes, clothes -> significantly reduce cocaine
use and associated psychological problems (Petry, Alessi, & Rash, 2013).
Similar systems -> promote desired behaviors in classrooms, the
workplace, and commercial advertising (e.g., airline and credit card
rewards programs).
39. Cognitive Therapy:
Changing Distorted Though
Cognitive therapy focuses on helping a client identify and
correct any distorted thinking about self, others, or the world.
Being bite by a dog -> Cognitive theorists emphasize the
interpretation of the event.
Not be the event itself that caused the fear, but rather the
individual’s beliefs and assumptions about the event and the
feared stimulus. Cognitive theorists might focus on a
person’s new or strengthened belief that dogs are dangerous.
41. Cognitive Behavioral
Therapy(CBT): Blending Approaches
A blend of cognitive and behavioral therapeutic strategies,
often referred to as cognitive behavioral therapy (CBT).
This technique acknowledges
that there may be behaviors that
people cannot control through
rational thought, but also that
there are ways of helping people
think more rationally when
thought does play a role.
BT or CT, which one is more effective?
42. Cognitive Behavioral
Therapy(CBT): Blending Approaches
CBT is problem focused -> it is undertaken for specific problems
(e.g., reducing the frequency of panic attacks or returning to work
after a bout of depression),
CBT is action oriented -> the therapist tries to assist the client in
selecting specific strategies to help address those problems.
The client is expected to do things, such as engage in exposure
exercises, practice behavior change skills or use a diary to monitor
relevant symptoms (e.g., the severity of depressed mood, panic
attack symptoms).
43. One of the CBT techniques:
The ABC Model of Journaling
44. What did the therapist do
that is helpful? (Hint: you
can refer to the worksheet)
Summarize the girl’s concerns.
What major questions did the
therapist ask?
Activity: a Real-Life Case
