Social, personality and abnormal psychology session 5: normal vs. abnormal states of mind
Mental disorders: Incidence Rates
The Adult Psychiatric Morbidity Survey (2007: see also Office for National Statistics
Psychiatric Morbidity (UK) report, 1993, 2001):
1 in 4 people over 16 years old admitted to a diagnosable mental health problem in
2007.
1 in 20 people over 16 years old admitted to having attempted suicide at some point
in their lives.
Mixed anxiety & depression most common mental disorder in Britain: 9% of people
meeting criteria for diagnosis in 2007.
Mental disorders aren’t all that ‘abnormal’!
Nature Editorial (2010): “In Britain, the public donates £500 million (US$800 million)
each year to charities for cancer research. For mental-health research, the figure is a
few million, and most of that is for work on neurodegenerative diseases such as
Alzheimer’s, rather than for earlier-onset conditions that can undermine people’s
entire lives, such as depressive disorders…. The stigma of psychiatric disorders is
misplaced, their burdens on society are significantly greater than more publicized
diseases in developed and developing nations alike,…” (p.9)
Greco-Roman Approaches to Mental Illness
Hippocrates (460-377 B.C.) - suggested that mental illness may have natural causes,
rather than supernatural.
suggested that mental illness is caused by internal physical problems, rather than
trouble with bad spirits.
four fluids that flow through the body (yellow bile, black bile, blood and phlegm),
and an imbalance between these ‘humours’ leads to physical brain pathology.
e.g. an excess of black bile causes depression/melancholia.
Abnormal Psychology: Through the Ages 1
Emperor Marcus Aurelius (161-180 A.D.): also a Stoic philosopher. To cope with the
stresses of running the Roman Empire at a difficult time, he kept a notebook just for
himself of positive thoughts and ideas, later collected under the title ‘Meditations’:
“Dwell on the beauty of life. Watch the stars, and see yourself running with
them.”/“Everything we hear is an opinion, not a fact. Everything we see is a
perspective, not the truth.”/“Accept the things to which fate binds you, and love the
people with whom fate brings you together, but do so with all your heart.”
Abnormal Psychology: Through the Ages 2
Marcus Aurelius (161-180 A.D.): Many ideas in ‘Meditations’ and Stoicism now seen
as anticipating cognitive therapy, e.g. “If you are distressed by anything external, the
pain is not due to the thing itself, but to your estimate of it; and this you have the
power to revoke at any moment.”/“Very little is needed to make a happy life; it is all
within yourself in your way of thinking.”
Marcus Aurelius is seen as the last of the ‘Five Good Emperors’, and possibly marks
the high watermark for the Roman Empire.
Defining Mental ’Disorders’
1. Statistical infrequency: Abnormal behaviour often infrequent e.g. hallucinations in
schizophrenia. However, infrequent need not equate with abnormal - we all have
our idiosyncrasies.
, 2. Violation of social norms: but what is seen as abnormal in one culture may not be
abnormal in another: so it’s not just about you, it’s about you vs. the world you find
yourself in, re. wingsuits now vs. a century ago.
3. Personal Distress: Personal distress may occur, but may not be abnormal
(mourning), and a lack of distress does not necessarily = normal, e.g. antisocial
personality disorder.
4. Disability: Some issues e.g. substance abuse or agoraphobia defined in part by
levels of occupational or social disability. However, not all mental issues are
necessarily disabling, e.g. bulimia.
6. Harmful Dysfunction (Wakefield, 1992): ‘harmful’ somewhat subjective value
judgement that relates to points above, while ‘dysfunction’ intended to be a more
objective, scientific component – assuming you can define a mental ‘dysfunction’
objectively and scientifically that is (hint: you often can’t - yet).
Diagnostic and Statistical Manual of Mental Disorders
DSM first published in 1952 by the American Psychiatric Association, described 106
disorders: mental disorders classified/’pigeonholed’ cf. Linnaeus (1707-1778) - “the
father of modern taxonomy.”
DSM-5 published in 2013:
Approximately 400 disorders, somewhat more ‘dimensional’ approach than
previously, so disorders tend to be seen as continuums, e.g. anxiety. each disorder is
described in terms of verifiable symptoms, i.e. relatively objective and observable
criteria.
Criticisms: British Psychological Society (2011):
too many criteria based on social norms / cultural dependence with symptoms that
rely on subjective judgements. psychiatric diagnoses are still plagued by problems of
reliability, validity, prognostic value, and co-morbidity. disorders categorised as “not
otherwise specified” run at a huge 30% of all disorders. Some categories still
incredibly wide ranging, e.g. anxiety disorders, from generalised anxiety to 100’s of
specific phobias and agoraphobia to panic attacks and selective mutism; or
Obsessive-Compulsive Disorders, from OCD to hoarding disorder to body dysmorphic
disorder.
Criticisms: Cultural dependence:
In the 19th century, a mental disorder called ‘drapetomania’ was attributed to slaves
in the US by prominent doctor and psychologist Dr. Samuel A. Cartwright, described
as an obsessive desire for freedom and “...an irrestrainable propensity to run away”
[it] “...is as much a disease of the mind as any other species of mental alienation, and
much more curable, as a general rule.” Said cure was straightforward - amputation
of the toes.
DSM-II published in 1968: classified same-sex sexual orientation as a mental
disorder. Revised somewhat in 1970’s, but not removed entirely until DSM-IV’s
publication in 1994. Obesity still not a Feeding and Eating Disorder in DSM5, much
debate before publication.
Mental illness
These Stone Age skulls show trepanation: holes have been drilled into the skulls. It
has been suggested that this technique was used to alleviate mental disorder,
perhaps by “releasing evil spirits” (e.g. Selling, 1940).
Mental disorders: Incidence Rates
The Adult Psychiatric Morbidity Survey (2007: see also Office for National Statistics
Psychiatric Morbidity (UK) report, 1993, 2001):
1 in 4 people over 16 years old admitted to a diagnosable mental health problem in
2007.
1 in 20 people over 16 years old admitted to having attempted suicide at some point
in their lives.
Mixed anxiety & depression most common mental disorder in Britain: 9% of people
meeting criteria for diagnosis in 2007.
Mental disorders aren’t all that ‘abnormal’!
Nature Editorial (2010): “In Britain, the public donates £500 million (US$800 million)
each year to charities for cancer research. For mental-health research, the figure is a
few million, and most of that is for work on neurodegenerative diseases such as
Alzheimer’s, rather than for earlier-onset conditions that can undermine people’s
entire lives, such as depressive disorders…. The stigma of psychiatric disorders is
misplaced, their burdens on society are significantly greater than more publicized
diseases in developed and developing nations alike,…” (p.9)
Greco-Roman Approaches to Mental Illness
Hippocrates (460-377 B.C.) - suggested that mental illness may have natural causes,
rather than supernatural.
suggested that mental illness is caused by internal physical problems, rather than
trouble with bad spirits.
four fluids that flow through the body (yellow bile, black bile, blood and phlegm),
and an imbalance between these ‘humours’ leads to physical brain pathology.
e.g. an excess of black bile causes depression/melancholia.
Abnormal Psychology: Through the Ages 1
Emperor Marcus Aurelius (161-180 A.D.): also a Stoic philosopher. To cope with the
stresses of running the Roman Empire at a difficult time, he kept a notebook just for
himself of positive thoughts and ideas, later collected under the title ‘Meditations’:
“Dwell on the beauty of life. Watch the stars, and see yourself running with
them.”/“Everything we hear is an opinion, not a fact. Everything we see is a
perspective, not the truth.”/“Accept the things to which fate binds you, and love the
people with whom fate brings you together, but do so with all your heart.”
Abnormal Psychology: Through the Ages 2
Marcus Aurelius (161-180 A.D.): Many ideas in ‘Meditations’ and Stoicism now seen
as anticipating cognitive therapy, e.g. “If you are distressed by anything external, the
pain is not due to the thing itself, but to your estimate of it; and this you have the
power to revoke at any moment.”/“Very little is needed to make a happy life; it is all
within yourself in your way of thinking.”
Marcus Aurelius is seen as the last of the ‘Five Good Emperors’, and possibly marks
the high watermark for the Roman Empire.
Defining Mental ’Disorders’
1. Statistical infrequency: Abnormal behaviour often infrequent e.g. hallucinations in
schizophrenia. However, infrequent need not equate with abnormal - we all have
our idiosyncrasies.
, 2. Violation of social norms: but what is seen as abnormal in one culture may not be
abnormal in another: so it’s not just about you, it’s about you vs. the world you find
yourself in, re. wingsuits now vs. a century ago.
3. Personal Distress: Personal distress may occur, but may not be abnormal
(mourning), and a lack of distress does not necessarily = normal, e.g. antisocial
personality disorder.
4. Disability: Some issues e.g. substance abuse or agoraphobia defined in part by
levels of occupational or social disability. However, not all mental issues are
necessarily disabling, e.g. bulimia.
6. Harmful Dysfunction (Wakefield, 1992): ‘harmful’ somewhat subjective value
judgement that relates to points above, while ‘dysfunction’ intended to be a more
objective, scientific component – assuming you can define a mental ‘dysfunction’
objectively and scientifically that is (hint: you often can’t - yet).
Diagnostic and Statistical Manual of Mental Disorders
DSM first published in 1952 by the American Psychiatric Association, described 106
disorders: mental disorders classified/’pigeonholed’ cf. Linnaeus (1707-1778) - “the
father of modern taxonomy.”
DSM-5 published in 2013:
Approximately 400 disorders, somewhat more ‘dimensional’ approach than
previously, so disorders tend to be seen as continuums, e.g. anxiety. each disorder is
described in terms of verifiable symptoms, i.e. relatively objective and observable
criteria.
Criticisms: British Psychological Society (2011):
too many criteria based on social norms / cultural dependence with symptoms that
rely on subjective judgements. psychiatric diagnoses are still plagued by problems of
reliability, validity, prognostic value, and co-morbidity. disorders categorised as “not
otherwise specified” run at a huge 30% of all disorders. Some categories still
incredibly wide ranging, e.g. anxiety disorders, from generalised anxiety to 100’s of
specific phobias and agoraphobia to panic attacks and selective mutism; or
Obsessive-Compulsive Disorders, from OCD to hoarding disorder to body dysmorphic
disorder.
Criticisms: Cultural dependence:
In the 19th century, a mental disorder called ‘drapetomania’ was attributed to slaves
in the US by prominent doctor and psychologist Dr. Samuel A. Cartwright, described
as an obsessive desire for freedom and “...an irrestrainable propensity to run away”
[it] “...is as much a disease of the mind as any other species of mental alienation, and
much more curable, as a general rule.” Said cure was straightforward - amputation
of the toes.
DSM-II published in 1968: classified same-sex sexual orientation as a mental
disorder. Revised somewhat in 1970’s, but not removed entirely until DSM-IV’s
publication in 1994. Obesity still not a Feeding and Eating Disorder in DSM5, much
debate before publication.
Mental illness
These Stone Age skulls show trepanation: holes have been drilled into the skulls. It
has been suggested that this technique was used to alleviate mental disorder,
perhaps by “releasing evil spirits” (e.g. Selling, 1940).
