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Summary Understanding (Ab)normal Behavior: Lessons from Clinical Psychology!

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Lecture 1
Learning objectives
1. Understanding the Definition of Normality and Models in Psychological Research
●​ Normality in psychology refers to behaviors or mental states that are typical,
expected, and culturally accepted within a given population.
●​ Determining what is “normal” often involves statistical, social, and functional
perspectives:
○​ Statistical normality: What falls within the average range (e.g., most people’s
IQs cluster around 100).
○​ Social/cultural normality: What aligns with societal norms and expectations.
○​ Functional normality: Whether a behavior helps or hinders an individual’s
ability to function in daily life.
●​ Models in psychological research are frameworks that help explain and predict
human behavior. They can be biological, cognitive, behavioral, psychodynamic, or
socio-cultural, among others. Each offers a different lens for defining and
understanding “normal” and “abnormal.”​

2. Determining Normal versus Abnormal Behavior
Psychologists and psychiatrists use several criteria to distinguish between normal and
abnormal:
●​ Deviance: Is the behavior statistically rare or socially unacceptable?
●​ Distress: Does it cause personal suffering or discomfort?
●​ Dysfunction: Does it interfere with daily functioning (work, relationships, self-care)?
●​ Danger: Does it pose a risk to self or others?​
Together, these are known as the “Four D’s” of abnormality.​
Diagnosis typically involves structured interviews, psychological testing, and
reference to classification systems such as the DSM-5-TR (Diagnostic and Statistical
Manual of Mental Disorders) or ICD-11 (International Classification of Diseases).​

3. History and Background of Diagnosing Mental Disorders
●​ Ancient and Medieval periods: Abnormal behavior was often attributed to spiritual or
supernatural causes (e.g., possession, witchcraft).
●​ 18th–19th centuries: The medical model began to dominate—mental illness viewed
as a disease of the brain or nervous system (e.g., Pinel’s moral treatment,
Kraepelin’s classification).
●​ 20th century: The rise of psychoanalysis (Freud), behaviorism (Watson, Skinner),
and humanism (Rogers, Maslow) expanded perspectives.
●​ Modern era: Diagnostic systems like the DSM evolved from psychoanalytic roots
(DSM-I, 1952) to empirically based, symptom-focused manuals (DSM-III onward).
●​ Current focus: evidence-based diagnosis, dimensional models, and
cultural/contextual understanding of mental health.​




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,4. Difference Between the Medical Model and the Network Model
●​ Medical Model:
○​ Views mental disorders as diseases with biological causes (e.g., genetics,
neurochemistry, brain structure).
○​ Emphasizes diagnosis and treatment—often through medication or other
biological interventions.
○​ Analogous to physical illness (e.g., depression = “chemical imbalance”).
●​ Network Model:
○​ Challenges the idea of a single underlying “disease.”
○​ Proposes that symptoms interact with each other directly (e.g., insomnia →
fatigue → poor concentration → hopelessness).
○​ Mental disorders emerge from complex networks of interacting symptoms,
rather than one central cause.
○​ Reflects a shift toward systems thinking and complexity science in
psychology.​

5. Applying Insights from Complexity Science to Modern Psychological Problems
●​ Complexity science studies how systems with many interacting parts (like the brain or
social networks) give rise to emergent behaviors.
●​ Applied to psychology, this means:
○​ Understanding mental disorders as dynamic systems that can shift between
stable and unstable states.
○​ Recognizing that small changes (stress, sleep loss) can have large effects
due to feedback loops.
○​ Promoting personalized and adaptive interventions—rather than
one-size-fits-all treatments.
○​ Using computational modeling, network analysis, and longitudinal data to
predict transitions into or out of mental disorders.​




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,Why clinical psychology if you’re not becoming a clinician?
●​ Many insights from clinical psychology and clinical practice are also useful in every
day life
●​ Skills to help deal with the complexity of the modern world
●​ Reducing stigma of mental health

Adolphe Quetelet was a Belgian mathematician, statistician, and sociologist who made
major contributions to the idea of statistical distributions in studying human characteristics.

Here’s what he said about distribution:
1.​ The “Average Man” (l’homme moyen)
Quetelet proposed that in any large group of people, most individual traits (like

➡️
height, weight, or intelligence) are distributed around an average value.
He called this concept the “average man”: not a real person, but a statistical ideal
representing the central tendency of a population.
2.​ Normal Distribution
He noticed that human characteristics often follow what we now call the normal
distribution (a bell-shaped curve).
That means:
●​ Most people are near the average.
●​ Fewer people are much higher or much lower than the average.
This was one of the first applications of probability and statistics to social science.​

Non-normal distribution
When researchers say mental health has a non-normal distribution, they mean the data
doesn’t form a neat bell curve.
Instead, it might be:
●​ Skewed (more people on one end than the other), or
●​ Bimodal (two peaks — for example, many people with very good mental health and
many with very poor, but fewer in between).

Antiquity
Mental patients were just like normal patients, but with a distorted biological homeostasis.

Hypocrate of Kos
Before Hippocrates, people often believed that diseases were punishments from the gods or

➡️
caused by supernatural forces.
Hippocrates changed that view — he taught that illness has natural causes and
should be treated using observation, logic, and diet, not superstition or magic.
The four humors theory
Hippocrates (and his followers) believed the body contained four fluids, or “humors”:
●​ Blood was produced in the liver.
●​ Phlegm was produced in the brain and lungs.
●​ Yellow bile was produced in the gallbladder.
●​ Black bile was produced in the spleen.
Health, they said, came from a balance of these humors. Disease happened when one
became dominant or deficient.



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, Middle ages
●​ Bad time to have mental health problems.
●​ Demonic possession, Witchcraft.
●​ Religious healings.
●​ Mental health as moral or spiritual failing.

Philip Pinel 1745–1826
●​ Start of psychiatry
●​ Moral treatment
●​ Unchaining of patients
●​ Psychological approach
●​ Classification of disorders
●​ Start of case studies by observation


Kraepelin (1856-1926) Freud (1856-1939)

●​ Focus on biological determinism ●​ Focus on psychodynamic
●​ Difference of causes between determinism
dementia praecox and manic ●​ Emphasis on unconscious
depression processes
●​ Emphasis longitudinal development ●​ Treatment by psychoanalysis
●​ Treatment within institutions


Modern Times: Neurasthenia
Neurastenia is a historical term for a condition characterized by chronic fatigue, weakness,
and a range of other physical and mental symptoms, such as headaches, dizziness, and
sleep problems.

➡️
●​ The name comes from the Greek words for "nerve" (𝑛𝑒𝑢𝑟) and "strength" (𝑠𝑡ℎ𝑒𝑛𝑜𝑠)
Though the term is rarely used clinically today, it was historically thought to be caused by
"nervous exhaustion" and is now understood to overlap with symptoms of depression,
anxiety, and chronic fatigue syndrome.

From neurasthenia to neurosis
As medical understanding evolved, neurasthenia began to be reclassified. Many of its
symptoms were absorbed into the broader, more encompassing category of neurosis.
●​ Not a physical cause, but a psychological one.
●​ Everybody has some latent vulnerability for neurosis.
●​ Individual and unobservable process.
●​ Psychodynamic treatment. (Freud)
Rise of Behaviorism - John B. Watson (1913)
●​ Focus: Observable behavior rather than inner thoughts or feelings.
●​ Main idea: Psychology should study what can be measured — behavior — not the
mind.
●​ Method: Laboratory experiments on learning and conditioning.
○​ Classical and operant conditioning.
●​ Goal: Predict and control behavior through reinforcement and punishment.




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