Abnormal Psychology is a division of psychology that studies people who are "abnormal" or "atypical" compared to the members of a given society. 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?
Hence to understand Abnormality, one needs to understand normalcy.
ABNORMALITY= Deviation from Norms.
In case of physical illness, the boundary lines between normality and pathology can be clearly delineated. For psychology, there is no 'ideal man/ woman' as a base of comparison. The concept of abnormality has gone through many changes: possession to evil, biological differences, and a combination of biological and psychosocial factors.
A combination of 4 Approaches have been used to understand Abnormal Behaviour:
Though a truly satisfying definition of Abnormality remains elusive (Lilenfield and Landfield, 2008; Stein et al.,2010).
According to Comer (2006) the 4D's are:
1. Statistical Deviance/Infrequency: A person is normal means that the person does not deviate much from the average in a particular trait.
Statistical infrequency is used explicitly in diagnosing intellectual impairment. 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?
Also, many rare behaviours 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.
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.
Limitation: However, this definition fails to distinguish between desirable and undesirable behaviour. 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.
2. Personal Distress/Suffering: If people suffer psychologically we’re inclined to consider this as indicative of abnormality. For example, depression, anxiety, guilt, suicide etc.
Strength: Typically easy to observe if someone is facing a difficulty. Often prompts others to seek psychological treatment.
Limitation: Distress not necessary for abnormality (absence of distress can also be an abnormality). Lack of personal distress in cases of mania, ASPD, hallucination of dead mother that makes him happy. Thus, suffering is neither a sufficient nor necessary for abnormality.
3. Dysfunction/ Maladaptiveness: Most psychologists maintain the best criterion for determining normality of a behaviour is whether or not it fosters the well-being of the (a) individual and ultimately of the (b) group he/she belongs to. Well-being of the Individual. E.g. a person with claustrophobia may leave a job that requires him to take an elevator for the 25th floor. (occupational maladjustment). Well-being of the Group the Individual belongs to example A contract killer and con-artist are earning at the cost of someone else’s well-being, even though they might be well-adjusted.
Limitation: A “well-adjusted” individual may not be using his potentialities.
4. Social Norm Violation/ Social Discomfort: When someone causes others discomfort by his/her behaviour. E.g. complete stranger hugging a person in public. Behaviour is abnormal if and only if the society labels it as such. 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.
E.g. Voice pitch and volume, touching, direction of gaze and acceptable subjects for discussion have all been found to vary between cultures.
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.
Also, 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.
E.g. 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.
5. Danger to self and others: Someone who is dangerous to self and others is considered abnormal. E.g. someone who expresses suicidal or homicidal intent.
Limitation: Dangerousness cannot be the sole feature of abnormality. Conversely, not all people with mental disorders are dangerous. In people with mental disorder, dangerousness is an exception (Corrigan & Watson, 2005).
6. Irrationalty and Unexpectedness: Not all distress/disability is considered abnormal. Is considered abnormal when it is UNEXPECTED and IRRATIONAL response to an environmental stressor. A person would like to wash his/her hands every time he has an obsessive thought that makes him/her feel dirty(Irrational).
Limitation: People could have personal reasons which may seem irrational/unexpected for us.
7. Medical Disorder: Determinant of a medial disorder is that for which biological causes exist. E.g. Down’s syndrome, phenylketonuria, hydrocephaly, microcephaly, etc. It implies health is absence of disease.
Following are the characteristics we consider necessary to mental health.
Jahoda (1958) defined six criteria by which mental health could be measured:
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. E.g. 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.
The BIOLOGICAL 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 of PSYCHODYNAMIC MODEL 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, E.g:
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.
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 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 behaviour. 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.
BEHAVIORAL MODEL emphasises 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 behaviour 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).
SOCIO-CULTURAL helps to understand Abnormal Behavior in terms of external environmental events and family systems perspective. Individual personality development reflects the larger society- its institutions, norms, values, ideas as well as the immediate groups. When social roles are conflicting unclear, difficult to achieve healthy personality development is impaired. Low SES, unemployment, prejudice, discrimination, violence, homelessness, social change and uncertainty have been related to a number of mental disorders. Eating disorders and depression more common in women. Why?
Is there a sharp dividing line between Normality and Abnormality?
No element/feature/criterion of abnormality is sufficient in itself to determine/define abnormal behaviour. Abnormality may be thought of as a cluster of symptoms sharing some features such as maladaptation, deviation, from norms, personal distress etc.
However, a sharp dividing line as is the case with medical diseases, does not exist for mental disorders. As our understanding of mental disorder evolves, so will DSM/ICD and so will the definition of mental disorder.
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