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WHAT IS NORMAL? Michael Putman and Dan Ohngemach Overview Survey Overview of 3 ways to define “normal” The effects of abnormal How do you define normal? Definition Violation of Social Norms Statistical Definitions Personal Distress Behavioral Impairment Faulty Perceptions Biological Abnormalities The “Natural” state of things Votes Have you ever… Action Talked to yourself Scored in the top 98% on a standardized test (ACT, SAT, PSAT, GMAT, MCAT, etc) Gone skydiving, driven over 80mph Used “retarded” derisively Been excessively nervous or saddened for a long period of time Been scared of something that others aren’t (spiders, roller coasters, flying, etc) Knocked on wood, avoided stepping on cracks, not opened umbrella inside Votes Questions 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, opposite for women). Major Problems: no “exact standard” that applies to everyone; diagnosis relies on psychological methods. 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. Medical 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 Hutus 2 Psychological 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, Pica DSM IV and ADHD 1) Six or more of the following symptoms of inattention have 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 activities ADHD 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 term Questions 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 subservience Panic Disorder and PTSD Panic 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 you think was the most valid? Would a combination/which combinations would be more effective? Medicalization Medicalization is a process by which previously unregulated or “normal” conditions become labeled abnormal Positive angle Greater knowledge creates new disorders Negative angle Creation of diseases that for the purpose of profits Irresponsible advertising, pharma, etc. Quick Video Clip Consequences of Labeling Positive Closure Peace from a diagnosis Placebo effect of drug therapy Negative Stigma Psychological Divisions turmoil Questions for the Class Do you think our current definitions of normal are useful? Could we be abnormalizing “normal” things? Should apotemnophilia be considered a real disorder? If so, should we amputate?