Lecture 1
      
                                     DEFINITIONS
      
      
      Lecture outline
      
      I.  Introduction
      II. Definitions of abnormality
           A. Statistical deviation
           B. Social norm violation
           C. Maladaptive behavior
           D. Personal distress
           E. Deviation from an ideal
           F. Medical disorder
      III.Problems with the definitions
      IV. Conclusions
      
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      I. Introduction
           What do we mean when we talk about abnormal behavior?  The
      definition of abnormality has gone through many dramatic changes through
      history: Demons, gods, and magic; bodily fluids and wandering uteruses;
      astral influences; physical illness; etc.  (Chapter 2 of your book looks
      at many of these early theories).
           How we conceptualize the nature and cause of abnormal behavior has
      important implications for 1) how we conceptualize treatment, the
      clinician's role, and the client's role; and 2) what we see in research
      and treatment, and perhaps more importantly what we don't see.          
                eg: "possession" definition logically leads to trephining.     
                   "Bodily fluids" definition logically leads to bleeding.     
                   If you see witches, you won't see social causes such as     
                  oppression.
      
      II. Definitions of Abnormality
           Today there are various definitions that are used by psychologists
      and people in general for defining abnormal behavior (Bootzin &
      Acocella, 1984; Carson, Butcher & Coleman, 1988; Sarason & Sarason,
      1984; Weckowicz, 1984).  These definitions are not necessarily mutually
      exclusive.
      
           A. Statistical deviation: The defining characteristic is uncommon
           behavior - a significant deviation from the average/majority.  Many
           human characteristics are normally distributed.  Handout 1-1
      illustrates a normal distribution.  Basically, we're talking about
      a nice symmetrical bell-shaped curve along which we can rank
      people:  more people fall around the average; the farther away you
      get from the average, the fewer the people.  Example:  Height is a
      human characteristic.  Most people fall around the average height
      of 5'8" (I just made this value up, I don't know if it is in fact
      the average human height).   In this example, height can be said to
      be normally distributed.  
           Characteristics falling beyond a particular distance from the
      average values are sometimes seen as abnormal.  This distance is
      defined in terms of "standard deviation units" - these are values
      that tell the scientist how many people fall beyond the average. 
      For example:  The percentage of people 1 standard deviation greater
      than the average is about 34% (see Handout 1-1).  A convention
      selected (arbitrarily) by scientists is to see people falling
      beyond 2 standard deviations as abnormal (95.4% falls within the 2
      sd boundaries).  This is perhaps the most straight forward
      definition:  collect data, calculate averages and sd's.
      
           Eg: Intelligence - there is a normal distribution of IQ
      scores.  Those whose scores are 2 sd's below the mean of 100 are,
      by this definition mentally retarded (ie: abnormal).  See Handout
      1-2.
      
      B. Social norm violation: Breaking social "rules".  Most of our
      behavior is shaped by norms - cultural expectations about the right
      and wrong way to do things.
           
      Examples of norms: proper dress, how/what to eat, behavior on the
      first date, eye contact with strangers, student/instructor
      behavior, in fact, all aspects of our lives.
      
      Someone who frequently violates these unwritten rules is seen as
      abnormal.  This is a very powerful and persuasive definition.  It
      is seemingly common-sense.  Norms are so deeply ingrained they seem
      absolute.
      
      C. Maladaptive behavior:  Two aspects to this: 1) Maladaptive to
      one's self - inability to reach goals, to adapt to the demands of
      life, and 2) maladaptive to society - interferes, disrupts social
      group functioning.
      
      Eg: John, a 38 male, drinks every day to the point of losing
      consciousness.  He is argumentative with his family and friends,
      and has gotten into frequent fights at work.  Last week he swore at
      his boss, and as a result has been fired.  John does not seem to
      have any motivation to find further employment.  Nevertheless, he
      spends what little money he has in savings on alcohol and
      unnecessary items such as candy, video tapes, and what ever else he
      might want at the moment.  John often dwells on how worthless he
      thinks he is, but also on how others do not treat him properly. 
      When not aggressive, he is frequently depressed.
      
      This is a "practical" definition: it identifies those unable to
      cope.  It is also a "flexible" definition: it takes into account an
      individual's context, recognizing that maladaptive is a relative
      term - it depends on the person's life circumstances (Sarason and
      Sarason, 1984).
           
      D. Personal distress: Put simply, if the person is content with
      his/her life, then s/he is of no concern to the mental health
      field.  If, on the other hand, the person is distressed (depressed,
      anxious, etc), then those behaviors and thoughts that the person is
      unhappy about are abnormal behaviors and thoughts.  
      
      E. Deviation from an ideal:  This perspective requires
      specification of what the "ideal" personality is.  Falling short of
      this specified ideal is an indication of mental illness.  (Certain
      Psychological theories attempt this specification, especially the
      humanistic and existential orientations).  Thus a person may be
      seen as "abnormal" even if they seem to be functioning alright. 
      Indeed, from this perspective, we are all striving for some ideal
      (personal or cultural), and many of us will never reach it.  We all
      at some point deviate from or fall short of the ideal.  So, in this
      sense, we are all abnormal to a certain degree, at least until we
      reach (if ever) the ideal (whatever that may be).
      
      F. Medical disorder: Abnormality exists when there is a physical
      disease.  Abnormal behavior is a symptom of a physical disorder. 
      This is a biogenic definition.  The person is qualitatively
      different from the unafflicted (Weckowicz, 1984).  For example: 
      Alzheimer's Disease - The major cause is atrophy of certain regions
      of the brain, typically occurring during the forties or fifties. 
      The individual suffers from difficulties in concentration, leading
      to absent-mindedness, irritability and even delusions.  Memory
      continues to deteriorate; and death usually occurs 10-12 years
      after onset of symptoms.
      
      No one definition is the "correct" or the "best" definition.  To a
      certain extent each one captures a different aspect of the meaning of
      abnormality.  When we talk about Abnormality, or when we study it, or
      treat those suffering from it, we inevitably invoke one or more of these
      definitions, either explicitly of implicitly -either we're aware of the
      definition(s) we're using or we're not.  But we do use some definition. 
      All of you have some definition in your heads about what psychological
      abnormality is, whether or not you could clearly state it.  In any
      event, it is important, especially as scientists, that we make as
      explicit as possible the definition(s) we use, and acknowledge any
      limitations.  To operate implicitly hinders our ability to develop as a
      science - our awareness is limited because as long as our definitions
      are implicit, they remain unchallengeable, we ignore alternatives, we
      don't "stretch" ourselves. And each definitional stance can certainly be
      challenged...
      
      III. Problems with the definitions of abnormality
      There are exceptions with each stance, or in other words "counter-
      examples".  Identifying counter-examples is a useful exercise: it allows
      you to uncover a definition's logical flaws.
      
      A. Statistical deviation: This definition would mean a genius
      should be termed abnormal.  Reliance on means and deviations
      implicitly sets up the identity "average person" = "ideal person". 
      Is the average the ideal?  Are deviations from the average a sign
      of abnormality?  In many respects, think how boring life would be
      if we were all "average" - all basically the same - no dramatic
      differences.  Indeed, many of the wonderful advances made in our
      history (be it in art, science, culture...) resulted from people
      who took chances and tried new ways of doing things - people who
      deviated from what was the average way of doing things.  Deviations
      can lead to flexibility and progress (cf. Dobzansky, 1962 for a
      discussion of genetic theory and the importance of variability for
      survival).
      
      B. Social norm violation:  
           a) Social reformers, protestors, etc.  This definition would
      require that we label all social reformers as abnormal, people like
      Susan B. Anthony, a feminist leader.  She wanted social rules
      changed - she rejected the norms of society.
           b) Cultural relativism.  As natural and absolute the norms of
      our society seem to us, Sociology and Anthropology have taught us
      that there is in fact nothing absolute about them.  What's abnormal
      (read "norm violating") in one society may be perfectly normal
      ("norm consistent") in another.  The raw behavior hasn't changed,
      but the society has.
           eg: Sex and Temperament in New Guinea tribes - research by
           Margaret Mead (1963):  Three tribes, each with very different
           norms.
               1. Arapesh: Both males and females are mild, parental, and
                  nurturing.
               2. Mundugumar: Males and females are fierce, oppressive    
                 and cannibalistic.
               3. Tchumbuli: Males are catty, wear curls and pretty       
                 clothes, love to go shopping.  Females are energetic,    
                managerial, unadorned.
      
           Each of these culture is different from the other.  By which
      culture's standards do we judge a behavior to be abnormal?
      
      In addition, even in a single society such as the U.S., there are a
      myriad of subcultures.  Add to this the fact that norms change
      through the years so that what's normative in one generation, may
      not be in another.  We are left with a single society where there
      are no clear norms that apply across all individuals.    This
      definitional stance implies that normality is the same as
      conformity to the mainstream, when in fact there are many streams. 
      The term abnormality thus loses any firm referent.
      
      C. Maladaptive behavior:  This position ignores the possibility
      that there may be abnormal situations.  That is, perhaps there are
      situations in which it would be abnormal to adapt.  Eg: Germans who
      were unable to adapt to Nazi Germany (Bootzin & Acocella, 1984); A
      woman unable to cope with a husband who abuses her.  The risk here
      is that we will end up "blaming the victim" (Ryan, 1976).
      
      D. Personal distress:  To say that abnormal behavior is behavior
      that causes a person distress/discomfort is to say that it is
      normal if there is no discomfort.  Thus, it logically follows that
      someone like Charles Manson, a mass murderer, is normal: he feels
      no guilt or discomfort about the killings he is responsible for. 
      Similarly, a psychotic patient who hears voices from his dead
      mother that make him happy.  
      
      Conversely, distress may not always be a bad thing.  Indeed,
      perhaps people who can easily express their fear, depression, or
      other forms of distress end up better dealing with their problems. 
      Or some types of distress may actually be very useful:  anxiety,
      for example, can signal you that danger is afoot and that you
      better prepare for it!  
      
      It seems clear that the definition of abnormality must go beyond
      the limited confines of "distress" and "discomfort", at least in
      certain situations.
      
      E. Deviation from an ideal:  Whose ideal?  The ideal for the
      individual? the species? the culture? god? (Weckowicz, 1984).  What
      if the ideal is unrealistic or unobtainable?
      
      Ideals, like social norms, are relative across groups and across
      time, so all the problems discussed above apply here as well. 
      Here's an extreme example of the time-relative nature of ideals:
      Pythagoras founded a religion with its own clearly defined ideals,
      which included: don't pick up what has fallen, don't break bread,
      don't walk on highways, and abstain from beans (Russell, 1945)!
      
      F. Medical disorder:  
           a) Historically, some hoped that biological causes would be
      found for all psychological problems.  But as we will see, there is
      a growing body of evidence that certain abnormal behaviors cannot
      be fully explained without looking at the psychology of the
      problem.  Eg: Conversion hysteria (symptoms such as paralysis,
      blindness, deafness, which have no physical causes) results from a
      person's attempt to unconsciously cope with strong unwanted
      emotions such as anxiety.  
           b) Implies "health" = absence of disease.  According to the
      World Health Organization, "health" = "a state of complete
      physical, mental and social well being and not merely the absence
      of disease and infirmity" (Zubin, 1961, emphasis added).  In other
      words:  The absence of X doesn't necessarily mean the presence of
      Y.
      
      IV. Conclusions
           Using a definition is unavoidable and it is necessary.  But
      choosing one is inherently unscientific - a value judgment in the final
      moment.  When we choose a definition, we do so in part based on feeling,
      emotion, convenience, custom, appeal, ethics.  There is an inherent
      nonscientific arbitrariness in this choice.  The potential result is
      that psychologist Y and psychologist X could be talking about very
      different things when using the word "abnormal"  Confusion and
      controversy ensues, especially if the definitions remain implicit.  
           However, as a science, we ideally make our definitions explicit and
      then attempt to clarify and modify these definitions through
      scientific/methodological rigor, with an eye always open to the
      exception and alternative explanations. 
           It remains a philosophical debate whether the uncertainty of our
      definition of "abnormality" is surmountable or is an inherent fuzziness
      of the field.
           Finally, the definition we use in this course is multifaceted -
      using aspects of each definitional stance.  Their individual
      shortcomings and mutual incompatibilities will create tensions in our
      discussions that we can use to explore some of the important issues in
      the study of psychopathology.