1. ABNORMAL PSYCHOLOGY
What does it really mean to be “normal” and “abnormal”? The whole idea of normality is incredibly subjective and fluid. Definitions of “normal” can differ depending on factors such as culture, group identity, individual beliefs, and life experiences. As a society changes, so do its concepts of normality and abnormality. Things many people considered abnormal 50 years ago are no longer looked at that way today. In this unit, we will explore various definitions of abnormal behavior and how these definitions have changed over time.

2. Mental Health Statistics
450 million world wide are in need of psychological assistance
57 million Americans
2 million “in-patient” in psychiatric units
2.4 million group home residents
15% utilize treatments for psychological disorders
According to Myers (2005) the prevalence of psychological disorders is higher than one might think:
Roughly 2 million people in the US are in-patients in psychiatric units. These people are essentially under lock and key because they have the most serious disturbances.
Over 2.4 million people in the US are residents in group homes. Group homes are shared living spaces that provide patients with assistance to potentially transition back in to the community. Residents of group homes typically are able to come and go, but they are under supervision of a staff that provides support.
Roughly 15% of American utilize services for treatment of a psychological disorder. This number represents people who either use medication to treat a disorder (Xanax for anxiety) or are under the treatment of a psychotherapist. This number is probably a low estimate, as some have speculated that many homeless people should- but do not – receive some psychological assistance.
Over 400 million people worldwide are in need of some form of psychological assistance.
Attempted Suicides
Overall, there may be between 8 and 25 attempted suicides for every suicide death; the ratio is higher in women and youth and lower in men and the elderly.2 Risk factors for attempted suicide in adults include depression, alcohol abuse, cocaine use, and separation or divorce.7,8 Risk factors for attempted suicide in youth include depression, alcohol or other drug use disorder, physical or sexual abuse, and disruptive behavior.8,9 As with people who die by suicide, many people who make serious suicide attempts have co-occurring mental or substance abuse disorders. The majority of suicide attempts are expressions of extreme distress and not just harmless bids for attention. A suicidal person should not be left alone and needs immediate mental health treatment. 2

3. Psychological Classification
A Medical Model
Assumption that mental illness can be described in the same manner as any physical illness.
For years, psychologists tried to devise a logical and useful method for classifying emotional disorders. Today, all of the major classification schemes have accepted a medical model, making the assumption that mental illness can be described in the same manner as any physical illness.

4. Is Mr. Thompson Abnormal?
The city of San Diego evicted 54 year old Richard Thompson and all his belongings from his home. His belongings included shirts, pants, dozens of shoes, several bibles, a cooler, a tool chest, lawn chairs, a barbecue grill, tin plates, bird-cages, two pet rats, and his self fashioned bed. For the previous 9 months Thompson had lived happily and without any problems in a downtown storm drain (sewer). Because the city does not allow people to live in storm drains, Thompson was evicted from his underground storm-drain home and forbidden to return. Although Thompson later lived in several care centers and mental hospitals, he much preferred the privacy and comfort of the sewer. (Grimaldi, 1986)
Is Thompson’s living in the sewer abnormal?
Have kids discuss.
On what basis do they determine Thompson is abnormal/normal…then discuss how abnormality is defined. 6

5. Deviant - changes w/ culture and time Distressful
D-D-D
efining Abnormality
Deviant - changes w/ culture and time
Distressful
Dysfunctional - (key) interfering with work and leisure
Mental health workers label behavior psychologically disordered when they judge it to be
Deviant, Distressful and Dysfunctional.
Deviance is part of what it takes to define psychological disorders
Standards for deviant behavior vary by culture, context, time
(nude beaches, mass killings, wearing earings, homesexuality)
More than JUST DEVIANCE-they may be maladaptive
DEVIANT behavior must also cause distress.
Unjustifiable: Doesn’t make sense to the average person. Feeling depressed when your family first moves away from all your friends is not seen as irrational, while prolonged depression due to virtually any situation is.
Maladaptive (harmful) to the individual. For instance, someone who has agoraphobia, fear open spaces, and is thus unable to leave his or her home experiences something maladaptive and disturbing.
Atypical: Not shared by many members of the population. In the US, having visions is atypical, while in some other cultures it occurs more commonly.
Disturbing: Zoophilia, being aroused by animals, for example, disturbs others.
People may be diagnosed with a psychological disorder even if they are not experiencing all, or even most, of the above symptoms. Another important point is that the term insane, often used by laypeople to describe psychological disorders in general, is not a medical term. Rather, insanity is a legal term. The reason behind the legal definition of insanity is to differentiate between those people who can be held entirely responsible for their crimes (the sane) and those people who, because of a psychological disorder, cannot be held fully responsible for their actions. When defendants plead not guilty by reason of insanity they are asking that the court acquit them due to psychological factors. 7

6. Modern Perspectives of Psychological Disorders
Biological
(evolution, individual genes, brain structures and chemistry)
Bio-psycho-social Model
Eclectic
Psychological
(stress, trauma, learned helplessness, mood-related, perceptions and memories)
This eclectic contemporary model assumes that biological, psychological, and sociocultural factors interact to produce psychological disorders.
Today’s psychologists contend that ALL behavior, whether called normal or disordered, arises from the interaction of nature and nurture.
Some major disorders such as depression and schizophrenia are universal, while other disorders are culture-bound. Different cultures have different sources of stress. Bulimia, Susto-fear of black magic.
Therapists who subscribe to this view may recommend drugs as well as behavioral and cognitive therapies.
Sociocultural
(roles, expectations, definition of normality and disorder 8

8. What are the advantages/disadvantages of psychological disorder labels?

9. Labeling Psychological Disorders
Labels may stigmatize individuals.
Labels can alter perceptions (videotaped interviews) and lead to self fulfilling prophecies.
Communication with healthcare professionals
and establishing therapy.
4. To be able to receive Health Care/Prescriptions

10. David Rosenhan: Pseudo-Patient Experiment
Investigated reliability of psychiatric diagnoses
Eight healthy people entered psychiatric hospitals complaining of hearing strange voices
Once admitted to the hospital, they behaved normally and claimed that the voices had disappeared
David Rosenhan’s 1972 study, published under the title “On Being Sane in Insane Places,” investigated the reliability of psychiatric diagnoses and, more broadly, tested the credibility of the profession of psychiatry. He selected eight healthy people (three women and five men) to pose as psychiatric patients. When they presented themselves at psychiatric hospitals, they claimed to be hearing voices that said things like “empty,” “hollow,” and “thud.” They also lied about their real names and occupations. All eight pseudo-patients were admitted, and seven were diagnosed as schizophrenic, since people with schizophrenia often hear voices that don’t really exist. Once admitted, the pseudo-patients behaved normally and claimed to no longer hear voices.
Despite their normal behavior and claim that they felt fine, hospital staff still treated the pseudo-patients as mentally ill. Staff members noted that the pseudo-patients exhibited significant numbers of “ill” behaviors and kept them hospitalized for an average of 19 days before releasing them. In the discharge reports, the staff claimed that the psuedo-patients had “schizophrenia in remission” rather than characterizing them as completely healthy.
In Rosenhan’s next experiment, he hypothesized that hospital staff, when warned to expect pseudo-patients, would incorrectly label genuine patients as pseudo-patients. He told the staff at a prestigious psychiatric hospital that sometime during the next three months, he would be sending them one or more pseudo-patients whom the staff should try to identify. After the three-month period, the hospital staff had identified 41 patients as “impostors” (pseudo-patients) and were suspicious of an additional 42; during that time a total of 193 patients had come to the hospital. In fact, Rosenhan had tricked the hospital and had sent no pseudo-patients at all. Thus, the staff had incorrectly identified genuine patients as frauds.

11. Rosenhan: Implications
Psychiatrists disputed the results
Prompted changes in psychiatric diagnosis
The DSM-V
Primary and secondary features
Describe criteria of disorders (reliability)
Common language for communication and study
Rosenhan’s two famous studies proved very controversial. Many psychiatrists argued against the validity of these experiments, saying that if a patient fakes symptoms psychiatrists shouldn’t be blamed for misdiagnosing him or her. Still, these studies prompted psychiatrists to make some changes in the way they diagnosed mental illness. For example, subsequent updates to diagnostic procedure eventually resulted in the creation of the Diagnostic and Statistical Manual of Mental Disorders Text Revision (DSM-IV-TR), the manual used by most mental health professionals today.