Welcome to Coursera's Abnormal Psychology series. My name is Jennifer D'Andrea. I'm a clinical psychologist located in Middletown, Connecticut. I'm the director of Wesleyan University's Counseling and Psychological Services, and I teach in Wesleyan's Master of Arts in Liberal Studies Program. I'm glad you will be joining me in this introduction to abnormal psychology course. Before we jump into the course content, I'd like to say a few things about the structure and purpose of this course. This course will introduce you to several facets of the major domains of abnormal psychology. The first module is made up of introductory material and considers such issues as definition of abnormality, clinical assessment, diagnosis, and classification, and the major models of understanding psychological abnormality. In modules 2 through 5, we will cover central dimensions of abnormal psychology. These include: mood disorders, anxiety disorders, stress and trauma related disorders, and schizophrenia spectrum disorders. The lectures in modules 2 through five follow the same progression. Introduction, major disorders, predominant models, treatment interventions, and sociocultural multicultural considerations. This course is not designed to assist you with assessing, diagnosing, or treating your own psychological struggles, nor is it designed to prepare you to act as psychotherapists for distressed individuals in your personal lives. However, the course is designed to assist you with becoming more comfortable identifying emotional or psychological distress in another person, approaching another person to initiate a caring conversation, projecting a warm, empathic compassionate presence, and connecting another person to assistance if necessary toward this goal. Each module, 1 through 5, concludes with an additional lecture in the foundations of empathy lecture series. By the conclusion of the course, you will possess an introductory level understanding of the ideology, symptomatology, epidemiology, intervention strategies, and relevant contextual factors of four broad experiences of psychopathology. You will also possess a fundamental understanding of the indicators a family member, friend, or colleague may be experiencing distress, as well as the comfort level required for initiating an empathic, compassionate conversation with a person of concern. Now, let's get into the course. This is module 1, introduction. In the first lecture of the course, we will consider the question, what is abnormal? How do we determine what is abnormal and what is not? How do we understand what causes psychological abnormality? How does our understanding of the causes of psychological abnormality impact the way it is treated? These are the questions and issues I will address in this module. The first question we must ask is this, what is abnormal? While the question itself is simple, the answer is not. There is no one definition of psychological abnormality that fits all people for all disorders in all situations. For this reason, the designation of abnormal is often the subject of debate and disagreement. This will be an important point for you to keep in mind as you move through the lectures contained in this course. The disorders we will discuss in upcoming modules are not always as clear as they appear. When we talk about defining abnormality, we consider four components that are often referred to as the four Ds. They are: deviance, distress, dysfunction, and danger. Let's take a few minutes to consider each one in turn. First, let's consider deviance. Deviance is defined as a departure from the norm, from usual or accepted standards. When considering psychological abnormality, we're talking about a significant difference from what is generally considered to be normal or typical psychological functioning. Who decides what's considered normal? It's important to realize that the rules for what is considered normal are determined by a particular society, a place, time, and cultural context. What is considered to be a deviation in one context may be considered normative in another. For example, in a community that values cooperation and compassion, aggressive behavior may be considered deviant. On the other hand, in a community that values competition and individual achievement, that same aggressive behavior may be considered normative and even admirable. Another important point to consider is that an individual specific circumstances impact whether they are experiencing psychological abnormality. For example, in the immediate aftermath of experiencing a traumatic events such as an earthquake, it is normative for a person to experience terrible nightmares of the event. However, if the person is still experiencing terrifying nightmares months or even years after the event, we may consider that to be a deviation from the norm. Deviation alone does not determine psychological abnormality. There are people who run up 86 flights of stairs to the top of the Empire State Building in New York City every year. While this is most definitely a deviation from the norm, it's not an indication of psychological abnormality. Next, let's consider distress. A feeling of being distressed, upset, frightened, uncomfortable, worried by feelings, thoughts or behaviors is often present as well. For example, a person may feel an overwhelming need to go back into their home multiple times before they leave for work each day in order to make sure they did not leave the stove on. Each time they get into their car to leave for work, they become overwhelmed by the certainty the stove is on and their house will burn down, so they go back again to check it. This pattern of worry and checking behavior likely causes the person intense distress. They know their stove is not on, they know they checked it before leaving the house the first time, they try to stop themselves from checking behavior but they can't. It is likely the person feels very upset, frustrated, and worried about themselves, as well as what may happen to their job. Must distress be present in order for someone to be experiencing psychological abnormality? The answer is no. Sometimes the behavior or inner experience that is abnormal does not cause distress. For example, someone in the early stages of mania, which we'll talk about in the next module, feels full of positive energy and ideas. In fact, they feel the opposite of distress, they feel wonderful. In spite of feeling wonderful however, we would say they are experiencing psychological abnormality. Next, let's talk about dysfunction. We define dysfunction as an inability or an impaired ability to function in daily life and carry out the tasks and activities that must be completed each day. We think about impaired ability to perform at work or school, care for children, maintain a household, and attend to relationships. We also think about behavior that could cause legal problems such as shoplifting. Is dysfunction always present when there's psychological abnormality? While it's possible that a person experiencing mild psychological abnormality may function very well in some or even most areas of their lives, in the vast majority of cases we do see dysfunction in one or more areas of a person's life even if the dysfunction is not outwardly apparent. Finally, let's take a look at the concept of dangerousness. It's important to state that dangerousness need not be present for psychological abnormality to occur. In fact, in many and perhaps most cases there's no dangerousness present at all. Nonetheless, this component is present at times, and when it is present it's very important to consider. Sometimes a person's thoughts and feelings and/or their behavior create a situation in which there is danger present, possibly danger to the person or to the people around this person, or both the person and others. For example, someone who is experiencing severe depression, which we'll talk about in the next module, may be considering ending their own life, this would constitute dangerousness to self. On the other hand, a person who is experiencing psychosis, which we'll discuss in Module 5, may believe they have magical powers that allow them to drive their car at night without using their headlights. This belief and the behavior that follows it create a very dangerous situation for both the individual as well as others who are on the road at the same time as they are. How do we put the four Ds together? Must all four be present in order for someone to be experiencing psychological abnormality? As we've already discussed, the answer is no. We can make a case that by its very definition, abnormality requires deviation from an accepted norm of behavior or psychological functioning. We need to be careful however, because the identification of something as deviant varies quite a bit from context to context. What about distress, dysfunction, dangerousness? Must any of them or any combination of them be present in order to label something as psychologically abnormal? The answer is no. This makes labeling or diagnosing behavior, thoughts or feelings as abnormal very tricky. It needs to be done on a case by case basis and it needs to include a thorough understanding of an individual's life circumstances: who they are, when and where they are living, and what has been happening to them in their lives. As we move through the next four modules and consider different forms of psychological disorders, remember the importance of the four Ds. Remember, every person and situation is different. That's it for Module 1, Lecture 1.
