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Defining abnormality  The history of psychological disorders Diagnosing and classifying psychological disorders Models of abnormality

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Deviance from the statistical norm Frequently occurring behaviour = normal Rare behaviour = abnormal  BUT  rare  ≠  presence of psychopathology always Who determines the cut-off point?

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Deviance from the social norm Person’s behaviour differs from society’s norms Should behaving differently = psychopathology? Assumes socially normal behaviour is adaptive Can be used as a means of social control

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Subjective Discomfort / Distress  Symptoms cause significant distress  Allows people to judge their need for treatment But  - What if a person’s behaviour is harmful but not distressing? What if a person’s behaviour causes distress to others but not to themselves?

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Maladaptive behaviour  Individual cannot function effectively in daily life Person may be a threat to self and/or others Could some symptoms be adaptive?

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Working definition  Used by psychologists to determine whether or not psychological functioning or behaviour is abnormal Psychological disorders – meet at least  two  of criteria below  Unusualness Deviance from the social norm Significant distress Maladaptive Danger to self or others

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Working definition – Major Depressive Disorder  Depressed mood  Loss of interest or pleasure in activities  >5% weight loss/gain or decrease/increase in appetite Insomnia or hypersomnia Psychomotor agitation or retardation  Fatigue or loss of energy Feelings of worthlessness or inappropriate guilt Diminished concentration or indecisiveness  Recurrent thoughts of death or suicide

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Demonic Possession  Symptoms of psychopathology result from being possessed by evil spirits  Sudden changes in behaviour or personality – person appears to be possessed or ‘taken over’ by someone or something else Treatment = exorcism

Trephination –  boring a hole into the skull to release the demons responsible for abnormal behaviour

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Witchcraft  Witches believed to have renounced God and voluntarily made a pact with the devil Massive persecution, mostly women Thousands accused of witchcraft and executed Persecuted for “abnormal” behaviour  Diagnostic tests designed to identify witches Means of social control

Water-float test –  if you floated you were in league with the devil

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Imbalance of body’s vital fluids Hippocrates (460-377 BC) – illnesses of the body and mind have natural causes (not demonic possession) The health of the body and mind depends upon the balance of the four humors / vital fluids Phlegm Black bile Yellow bile  Blood

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The Medical Model  General paresis  – psychological symptoms include personality changes, mood changes and dementia 1905  – discovered that general paresis had a physical cause (untreated syphilis) Lent support to the  Somatogenic Hypothesis  – biological impairments cause/explain psychological symptoms Gave rise to the medical model and psychiatry Psychological disorders can be diagnosed and treated

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Edition Publication Date Number   of Pages Number of  Diagnoses DSM-I 1952 132 128 DSM-II 1968 119 193 DSM-III 1980 494 228 DSM-III-R 1987 567 253 DSM-IV 1994 886 383 DSM-IV-TR 2000 943 383 DSM-5 2013 947 541

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http://psychiatryonline.org.ezproxy.uct.ac.za/

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Strengths of the DSM Create a common language for research and data sharing Understand the causes of psychopathology Develop effective treatment and prevention strategies Assess the effectiveness of treatments Organise services and support Financial compensation  Medical aid

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Limitations of the DSM Assumes that the disorders are universal Locates the disorder within the individual  Labelling people can be stigmatising and harmful Labelling people influences how they see themselves and how others see them Defines disorders as discrete entities (have it or you don’t)  High rates of comorbidity (79% meet the criteria for more than one disorder)

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Biological Genetic predisposition Neurotransmitters  Brain structure abnormalities

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Psychological Unconscious conflicts / repression Behaviourism (learning theories) Cognitions / thoughts  Personality traits

Psychological Disorders Lecture 1

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