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Abnormal Psychology
byBy Saul McLeod
published 2008, updated 2014
Abnormal psychology is a division of
psychology that studies people who are "abnormal" or "atypical"
compared to the members of a given society.
There is evidence that some
psychological disorders are more common than was previously thought.
Depending on how data are gathered
and how diagnoses are made, as many as 27% of some population groups may be
suffering from depression at any one time (NIMH, 2001; data for older adults).
The
definition of the word abnormal is simple enough but applying this to
psychology poses a complex problem: what is normal? Whose norm? For what age?
For what culture?
The concept of abnormality is
imprecise and difficult to define. Examples of abnormality can take many
different forms and involve different features, so that, what at first sight
seem quite reasonable definitions, turns out to be quite problematical.
There are several different ways in
which it is possible to define ‘abnormal’ as opposed to our ideas of what is
‘normal’.
Statistical
Infrequency
Under this definition of
abnormality, a person's trait, thinking or behavior is classified as abnormal
if it is rare or statistically unusual. With this definition it is
necessary to be clear about how rare a trait or behavior needs to be before we
class it as abnormal
For instance one may say that an
individual who has an IQ below or above the average level of IQ in society is
abnormal.
However this definition obviously
has limitations, it fails to recognize the desirability of the particular
behavior.
Going back to the example, someone
who has an IQ level above the normal average wouldn't necessarily be seen as
abnormal, rather on the contrary they would be highly regarded for their
intelligence.
This definition also implies that
the presence of abnormal behavior in people should be rare or statistically
unusual, which is not the case. Instead, any specific abnormal behavior
may be unusual, but it is not unusual for people to exhibit some form of
prolonged abnormal behavior at some point in their lives.
Strength: The statistical approach helps to address what is meant by
normal in a statistical context. It helps us make cut – off points in terms of
diagnosis.
Limitations: However, this definition fails to distinguish between
desirable and undesirable behavior. For example, obesity is a statistically
normal but not associated with healthy or desirable. Conversely high IQ is
statistically abnormal, but may well be regarded as highly desirable.
Many rare behaviors or
characteristics (e.g. left handedness) have no bearing on normality or
abnormality. Some characteristics are regarded as abnormal even though
they are quite frequent. Depression may affect 27% of elderly people
(NIMH, 2001). This would make it common but that does not mean it isn’t a
problem
The decision of where to start the
"abnormal" classification is arbitrary. Who decides what is
statistically rare and how do they decide? For example, if an IQ of 70 is the
cut-off point, how can we justify saying someone with 69 is abnormal, and
someone with 70 normal ?
Violation
of Social Norms
Every culture has certain standards
for acceptable behaviour, or socially acceptable norms. Norms are expected ways
of behaving in a society according to the majority and those members of a
society who do not think and behave like everyone else break these norms so are
often defined as abnormal.
Under this definition, a person's
thinking or behavior is classified as abnormal if it violates the (unwritten)
rules about what is expected or acceptable behavior in a particular social
group. Their behavior may be incomprehensible to others or make others feel
threatened or uncomfortable.
Social behavior varies markedly when
different cultures are compared. For example, it is common in Southern Europe
to stand much closer to strangers than in the UK. Voice pitch and volume,
touching, direction of gaze and acceptable subjects for discussion have all
been found to vary between cultures.
With this definition, it is
necessary to consider: (i) The degree to which a norm is violated, the
importance of that norm and the value attached by the social group to different
sorts of violation. (ii) E.g. is the violation rude, eccentric, abnormal or criminal?
Limitations: The most obvious problem with defining abnormality using
social norms is that there is no universal agreement over social norms. Social
norms are culturally specific - they can differ significantly from one
generation to the next and between different ethnic, regional and
socio-economic groups. In some societies, such as the Zulu for example,
hallucinations and screaming in the street are regarded as normal behavior.
Social norms also exist within a
time frame, and therefore change over time. Behavior that was once seen
as abnormal may, given time, become acceptable and vice versa. For
example drink driving was once considered acceptable but is now seen as
socially unacceptable whereas homosexuality has gone the other way. Until
1980 homosexuality was considered a psychological disorder by the World Health
Organization (WHO) but today is considered acceptable.
Social norms can also depend on the
situation or context we find ourselves in. Is it normal to eat parts of a dead
body? In 1972 a rugby team who survived a plane crash in the snow-capped Andes
of South America found themselves without food and in sub-freezing temperatures
for 72 days. In order to survive they ate the bodies of those who had died in
the crash.
Failure
to Function Adequately
Under this definition, a person is
considered abnormal if they are unable to cope with the demands of everyday
life. They may be unable to perform the behaviors necessary for
day-to-day living e.g. self-care, hold down a job, interact meaningfully with
others, make themselves understood etc.
Rosenhan& Seligman (1989)
suggest the following characteristics that define failure to function
adequately:
o
Suffering
oMaladaptiveness
(danger to self)
o
Vividness & unconventionality (stands out)
o
Unpredictably & loss of control
o
Irrationality/incomprehensibility
o Causes
observer discomfort
o Violates
moral/social standards
One limitation of this
definition is that apparently abnormal behavior may actually be helpful,
function and adaptive for the individual. For example, a person who has
the obsessive-compulsive disorder of hand-washing may find that the behavior
makes him cheerful, happy and better able to cope with his day.
Many people engage in behavior that
is maladaptive/harmful or threatening to self, but we don’t class them as
abnormal
Ø
Adrenaline sports
Ø
Smoking, drinking alcohol
Ø
Skipping classes
Deviation
from Ideal Mental Health
Under this definition, rather than
defining what is abnormal, we define what is normal/ideal and anything that
deviates from this is regarded as abnormal. This requires us to decide on
the characteristics we consider necessary to mental health.
Jahoda (1958) defined six criteria
by which mental health could be measured:
o Positive
view of the self
o Capability
for growth and development
o Autonomy
and independence
o Accurate
perception of reality
o Positive
friendships and relationships
o
Environmental mastery – able to meet the varying demands of day-to-day
situations
According to this approach, the more
of these criteria are satisfied, the healthier the individual is.
Limitation: It is practically impossible for any individual to achieve
all of the ideal characteristics all of the time. For example, a person
might not be the ‘master of his environment’ but be happy with his
situation. The absence of this criterion of ideal mental health hardly indicates he is suffering from a mental disorder.
Ethnocentric: Most definitions of psychological abnormality are devised
by white, middle class men. It has been suggested that this may lead to
disproportionate numbers of people from certain groups being diagnosed as
"abnormal."
For example, in the UK, depression
is more commonly identified in women, and black people are more likely than
their white counterparts to be diagnosed with schizophrenia. Similarly, working
class people are more likely to be diagnosed with a mental illness than those
from non manual backgrounds.
Perspectives
in Abnormal Psychology
Behaviorists
believe that our actions are determined largely by the experiences we have in
life, rather than by underlying pathology of unconscious forces. Abnormality is
therefore seen as the development of behavior patterns that are considered
maladaptive (i.e. harmful) for the individual.
Behaviorism states that all behavior
(including abnormal) is learned from the environment (nurture), and that all
behavior that has been learnt can also be ‘unlearnt’ (which is how abnormal
behavior is treated).
The emphasis of the behavioral
approach is on the environment and how abnormal behavior is acquired, through classical conditioning, operant conditioning and social learning.
Classical conditioning has been said
to account for the development of phobias.
The feared object (e.g. spider or rat) is associated with a fear or anxiety
sometime in the past. The conditioned stimulus subsequently evokes a powerful
fear response characterized by avoidance of the feared object and the emotion
of fear whenever the object is encountered.
Learning environments can reinforce
(re: operant conditioning) problematic behaviors. E.g. an individual may be
rewarded for being having panic attacks by receiving attention from family and
friends – this would lead to the behavior being reinforced and increasing in
later life.
Our society can also provide deviant
maladaptive models that children identify with and imitate (re: social learning
theory).
The cognitive approach
assumes that a person’s thoughts are responsible for their behaviour. The model
deals with how information is processed in the brain and the impact of this on
behaviour.
The basic assumptions are:
- Maladaptive behaviour is caused by faulty and
irrational cognitions.
- It is the way you think about a problem, rather than
the problem itself that causes mental disorders.
- Individuals can overcome mental disorders by learning
to use more appropriate cognitions.
The individual is an active processor of information. How a person, perceives, anticipates and evaluates events
rather than the events themselves, which will have an impact on behavior. This
is generally believed to be an automatic process, in other words we do not
really think about it.
In people with psychological
problems these thought processes tend to be negative and the cognitions (i.e.
attributions, cognitive errors) made will be inaccurate:
These cognitions cause distortions
in the way we see things; Ellis suggested it is through irrational thinking, while Beck
proposed the cognitive triad.
The medical model
of psychopathology believes that disorders have an organic or physical cause.
The focus of this approach is on genetics, neurotransmitters, neurophysiology,
neuroanatomy, biochemistry etc.
For example, in terms of
biochemistry – the dopamine hypothesis argues that elevated levels of dopamine
are related to symptoms of schizophrenia.
The approach argues that mental
disorders are related to the physical structure and functioning of the brain.
For example, differences in brain
structure (abnormalities in the frontal and pre-frontal cortex, enlarged
ventricles) have been identified in people with schizophrenia.
The main assumptions include Freud’s
belief that abnormality came from the psychological causes rather than the
physical causes, that unresolved conflicts between the id, ego and superego
can all contribute to abnormality, for example:
- Weak ego: Well- adjusted people have a strong ego that
is able to cope with the demands of both the id and the superego by
allowing each to express itself at appropriate times. If, however, the ego
is weakened, then either the id or the superego, whichever is stronger,
may dominate the personality.
- Unchecked id impulses: If id impulses are unchecked
they may be expressed in self-destructive and immoral behaviour. This may
lead to disorders such as conduct disorders in childhood and psychopathic
[dangerously abnormal] behaviour in adulthood.
- Too powerful superego: A superego that is too powerful,
and therefore too harsh and inflexible in its moral values, will restrict
the id to such an extent that the person will be deprived of even socially
acceptable pleasures. According to Freud this would create neurosis, which
could be expressed in the symptoms of anxiety disorders, such as phobias
and obsessions.
Freud also believed that early childhood experiences and unconscious motivation were responsible for disorders.
An
Alternative View: Mental illness is a Social Construction
Since the 1960’s it has been argued
by anti-psychiatrists that the entire notion of abnormality or mental disorder
is merely a social construction used by society. Notable anti-psychiatrists
were Michel Foucault, R.D. Laing, Thomas Szasz and Franco Basaglia. Some
observations made are;
- Mental illness is a social construct created by
doctors. An illness must be an objectively demonstrable biological
pathology, but psychiatric disorders are not.
- The criteria for mental illness is vague, subjective
and open to misinterpretation criteria.
- The medical profession uses various labels eg.
depressed, schizophrenic to exclude those whose behaviour fails to conform
to society’s norms.
- Labels and consequently treatment can be used as a form
of social control and represent an abuse of power.
- Diagnosis raises issues of medical and ethical
integrity because of financial and professional links with pharmaceutical
companies and insurance companies.
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