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VANDERBILT HON 182 - What is Normal

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What is Normal?OverviewHow do you define normal?Have you ever…Questions for the ClassThree Approaches:Medical PerspectivesSlide 8Medical Perspectives: PhrenologyPsychological PerspectivesSlide 11DSM IV and ADHDADHD and RitalinSlide 14Social PerspectivesSlide 16Social Perspectives: DrapetomaniaPanic Disorder and PTSDSlide 19Slide 20MedicalizationConsequences of LabelingSlide 23WHAT IS NORMAL? Michael Putman and Dan OhngemachOverviewSurveyOverview of 3 ways to define “normal”The effects of abnormalHow do you define normal? Definition VotesViolation of Social NormsStatistical DefinitionsPersonal DistressBehavioral Impairment Faulty Perceptions Biological Abnormalities The “Natural” state of thingsHave you ever… Action VotesTalked to yourselfScored in the top 98% on a standardized test (ACT, SAT, PSAT, GMAT, MCAT, etc) Gone skydiving, driven over 80mphUsed “retarded” derisively Been excessively nervous or saddened for a long period of timeBeen scared of something that others aren’t (spiders, roller coasters, flying, etc) Knocked on wood, avoided stepping on cracks, not opened umbrella insideQuestions for the ClassDo you consider yourself normal? Thoughts on why one was chosen over anotherDid anyone come out “normal?”Three Approaches:Medical Perspectives try to diagnose and correct for biological abnormalities that result in disorder.Psychological Perspectives attempt to determine how thought and behavior are affected in a disorder.Social Perspectives put disordered behavior in the context of societal beliefs and values.Medical PerspectivesDisorders result from structural or chemical brain anomalies. Nature, not nurture.Example: Third Interstitial Nucleus of the Hypothalamus is thought to be of variable size, correlated to one’s sexual orientation (larger in heterosexual men than in homosexual men, oppositefor women).Major Problems:no “exact standard” thatapplies to everyone;diagnosis relieson psychologicalmethods.Medical PerspectivesTreatment can involve surgical or pharmaceutical methods.Antidepressant drugs are common- e.g. SSRI’s (Lexapro, Prozac, etc.).These drugs work to correct chemical (neurotransmitter) imbalances in the brain.Criticism: using psychopharmacological drugs creates an unhealthy dependence.2Medical Perspectives: Phrenology In 1800 Franz Gall mapped out the brain into 27 “organs”Each contained discrete human facultyClaimed that talents and abilities could be inferred from the shape of the skull Defined “normal” skullNazi’s claimed Jews had abnormal shapes 1930’s: used to show superiority of Tutsis over HutusPsychological PerspectivesDisorders result from painful experiences. Nurture, not nature.Example: Many child molesters are often thought to be subconsciously seeking power over children as a result of their own histories of sexual abuse.Major Problems: biological abnormalities often exist “behind the scenes;” normal behavior can be relative from person to person.Psychological PerspectivesDSM IV- Diagnostic and Statistical Manual of Mental Disorders, version 4.All recognized mental disorders are described, and guidelines for diagnosis are outlined.Examples: Panic Disorder, Nicotine Dependence, Trichotillomania, Dependent Personality Disorder, PicaDSM IV and ADHD1) Six or more of the following symptoms ofJinattentionJhave persisted for at least six months to a degree that is maladaptive and inconsistent with the developmental level:Inattentionoften fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activitiesoften has difficulty sustaining attention in tasks or play activitiesoften does not seem to listen when spoken to directlyoften does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behaviour or failure of comprehension)often has difficulty organizing tasks and activitiesoften avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)often loses things necessary for tasks or activites at school or at home (e.g. toys, pencils, books, assignments)is often easily distracted by extraneous stimuliif often forgetful in daily activitiesADHD and Ritalin Graph at left shows increased prescription of Ritalin Positives We have identified a treatment for a disease Many kids benefit from thisNegatives Overprescribing Growth of dependenceResearch shows therapy is just as good over long termQuestions for the ClassHow accurate do you suppose our standards are after seeing the list here? How effective do you think clinical psychology is for treating disorders like these? Do you feel that over prescription constitutes a serious issue? What can we do about it?Social PerspectivesDisorders deviate from accepted social norms.Example: in kindergarten, you don’t share your snack/blocks/the teacher’s attention with others.Major Problems: society doesn’t always discriminate between “harmful” and “weird,” (e.g., the difference between trouble sharing and picking your nose).Social Perspectives“Diagnosis” often equates “normal” with “ordinary.”A strong emphasis is placed on conformity- different means abnormal.Treatment involves positive reinforcement (e.g. by parents/teachers/friends)“Treatment” can sometimes mean bullying, ostracizing, or peer pressure- generally thought to be negative influences in today’s society.Social Perspectives: Drapetomania “Normal” behavior of a slave was servitude 1851: Samuel Cartwright describes the “disorder”Mental disorder “The disease that causes Negros to run away” Believes that slavery is both natural and spiritual Combated by a mix of kind treatment and total subserviencePanic Disorder and PTSDPanic Disorder and PTSDMedical Perspective- imbalance of serotonin levels in brain cause abnormal thoughts of fear and impending doom. Treated with an SSRI.Psychological Perspective- a traumatic event led to inappropriate response behaviors being learned. Treated with psychotherapy and “calming down” techniques (e.g. deep breathing).Social Perspective- person has an irrational fear of driving in cars. Treated with encouragement and empathy.Questions for the ClassWhich approach do


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