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.