UNIT ONEExamples and Definitions of Abnormal BehaviorWhat is Psychopathology?In PracticeDiffering ViewpointsDominance of Categories (History)Why “Psychopathology & Problems in Living?”What is Mental Illness?Slide 9Slide 10Slide 11Slide 12Mental Disorder vs. Abnormal BehaviorSlide 14Slide 15Slide 16DSM-5 Definition of Mental DisorderSlide 18Slide 19The Role of CultureSlide 21Slide 22Cultural Relativity (Etic vs Emic)Slide 24Important Points about Mental Illness across CulturesSlide 26Four Ds of AbnormalitySlide 28How often does Abnormal Behavior Occur? (more definitions)IncidencePrevalenceQuestionSlide 33Slide 34Slide 35Summary of Epidemiological Findings (adults)Summary of Epidemiological Findings (children)Summary of Epidemiological Findings (race)Summary of Epidemiological Findings (gender)AssignmentsUNIT ONEExamples and Definitions of Abnormal BehaviorDefining abnormal behavior, mental illness/disorderDSM 5 definition of mental disorderThe role of cultureEpidemiologyExamples and Definitions of Abnormal BehaviorWhat is Psychopathology?It depends…In PracticeClinicians in practice traditionally:AssessDiagnoseInterventionThis Course:Multiple ViewpointsDiffering ViewpointsProblems in Living (Sullivan, Szasz)Harmful Dysfunction (Wakefield)4D’s (DSM)PsychopathologyBiopsychosocialDominance of Categories (History)History of DSMMedical ModelDisorder CategoriesReliability/ValidityStigmaCurrent tension: dimensional vs. categorical viewpointWhy “Psychopathology & Problems in Living?”Course used to be called “abnormal psychology”Many courses at other Universities still called “Abnormal Psychology” (required course)Presumptive?Too narrow?What is “abnormal”?There is no consensusLeaning towards “dimensional” viewpointWhat is Mental Illness?Mental illness is a natural concept in which the boundaries we define that separate category members from non category members are fuzzy NORMAL ABNORMAL NORMAL ABNORMAL Hard to cut nature at its jointsWhat is Mental Illness?Some examples are more clear - blue jayOthers are less clear – ostrich Therefore, disagreement regarding whether certain behavioral patterns constitute disorders NORMAL ABNORMAL NORMAL ABNORMALWhat is Mental Illness?Why is it so hard to define mental illness relative to other illnesses/disorders?No laboratory tests that can be used to definitively confirm the presence of psychopathology because the processes that are responsible for mental disorders have not yet been discoveredOngoing debate about what the definition of mental illness is…What is Mental Illness?Thomas Szasz (1960): myth of mental illnessMental illness just a convenient label for behavior that either society or the individual in question finds unwanted or unpleasantAbnormal behavior is a social phenomenon and may be a perfectly normal response to an abnormal environmentWhat is Mental Illness?Thomas Szasz: myth of mental illnessIndividuals who have mental illness don’t suffer from illnesses, but rather from problems in living•What are benefits and drawbacks of identifying and labeling mental disorders?Mental Disorder vs. Abnormal BehaviorMental illness is a social construction i.e. does not exist in nature.  Our choice of definition implies a value judgmentImportant to consider situational context as welle.g. is it abnormal to water one’s lawn?What is Mental Illness? Jerome Wakefield (1992, 2010): harmful dysfunctionA condition is a mental disorder only if:it results from failure of some internal mechanism to perform its natural functionit causes harm to the person as judged by standards of that person’s cultureWhat is Mental Illness?15Jerome Wakefield: harmful dysfunction Recognizes that not every type of dysfunction leads to a disorder But what are the natural functions and dysfunctions of the body?  Can harm be treated as dichotomous variable? NOT HARMFULNOT HARMFULHARMFULHARMFULNOT HARMFUL HARMFUL NOT HARMFUL HARMFULMental Disorder vs. Abnormal BehaviorSymptoms thoughts, feelings, and behaviors that indicate a mental disorderSyndromea group of signs and symptoms that tend to co-occur and are assumed to have a common etiology or causeAdditional ConsiderationsdurationImpairmentSituation / contextDSM-5 Definition of Mental DisorderDefinition of mental disorder used by APA. (Diagnostic and Statistical Manual of Mental Disorders) incorporates many of the factors just discussed.current distress (anxiety or depression)disability (impairment in functioning)significantly increased risk in suffering, death, pain, disability, or important loss of freedomDivide disorders into categoriesDSM-5 Definition of Mental DisorderEXCLU SIONSDoes not include:culturally sanctioned response to event (like grieving over loss)deviant behavior (actions of political, religious, sexual minorities)conflicts between individual and society (trying to express individuality)Mental Disorder vs. Abnormal Behavior19Mental Disorder Abnormal BehaviorThe Role of Culture Important to recognize that all definitions are culturally embeddedCulture: shared values, beliefs, and practices of a group of peopleThe Role of Culture Culture has a profound influence regarding what is considered abnormal and normal behavior “Only dysfunctions that are socially disvalued are disorders” (Wakefield, 1992) Is it possible to eliminate social values from a definition of abnormal behavior?The Role of Culture Zeitgeist = “spirit of the times”Drapetomania (out)Homosexuality (out)Pathological gambling (in)Cultural influences on prevalenceCulture is NOT static. It will continue to influence the prevalence of a disorderCultural Relativity (Etic vs Emic)Etic perspective (outsider)Emphasis on universals among human beings from a position outside the culture of interestWho decides what is abnormal?Historically, it has been Western social scientists imposing their standards of normalityNow, we are