How do we define abnormality? A major issue to be faced by those who study and treat abnormal behaviour lies in the question ‘when does behaviour come abnormal’? There is no separating normal behaviour and abnormal behaviour:- Psychopathology is a scientific study of mental disorders, the immediate problem this shows is what constitutes a mental disorder and should this be regarded as ‘mental illness’. Mental disorders are treated mainly by psychiatrist doctors who specialize in the study and treatment of mental abnormality describing the disorders by DSM- IV and ICD10 later on.
One of the most difficult tasks for those working within the field of abnormal psychology is to define abnormality. Definitions of what constitutes abnormal behaviour have changed dramatically through history. Any behaviour that seemed outside an individuals control was thought to be the product of supernatural forces, for example exorcism was one of them. The definition of abnormality itself remains a judgement; abnormality is described in several ways.
Applying abnormality to psychology is very complex, what is normal? Whose normal? For what age? For what culture? Some would classify or argue that what is ‘good’ as normal and what is ‘bad’ as abnormal. Definition brings up many of the same questions. There are many more ways of showing a more objective reference point. One way of defining abnormality is statistical infrequency; such statistics inform us about things such as what age is most typical for women (and men) to have their fist baby, the average shoe size for 10 year old children, how many people read certain magazines or daily newspapers etc.
Those who stray from the average on the statistical infrequency diagram are then considered abnormal. This definition has its problems it does not recognize valuable derivations such as a genius neither does it recognize a maladaptive behaviour like smoking and drinking, nonetheless this method is both objective and scientific. In some situations it is appropriate to use a statistical criterion to define abnormality for example mental retardation is defined in terms of the normal distribution using the concept of standard deviation to establish a cut-off point for abnormality.
A very simple idea that can be used to classify abnormal behaviour is personal distress, basically if a person is content with their life then they are of no concern to the mental health field, However if a person’s thoughts or behaviours are causing them personal discomfort or unhappiness, then they will be considered abnormal. Defining the ‘norm’ for any group of people is something that is usual, regular or typical. If the table can define what is most common then it can define what is not common i.e. abnormal. For example it is not the ‘norm’ when you have your first baby when you’re over 40 and less than 20.
DSM-IV Psychiatric diagnoses are categorized by the diagnostic and statistical manual of mental disorders 4th edition better known as DSM-IV. This covers all mental health disorders for both children and adults. It assesses five dimensions listed on next page. “Axis 1 – clinical syndromes” This lists all the mental health disorders for example depression, schizophrenia, social phobia etc “Axis II – developmental disorders and personality disorders” Developmental disorders include autism and mental retardation which are first evident in childhood Personality disorders are clinical syndromes which have more long lasting symptoms; they include paranoid, antisocial and borderline personality disorders.
“Axis III – physical and medical conditions” Lists any medical conditions that could affect a person’s mental state and hence would be relevant to understanding and treating a disorder. “Axis IV- psychosocial problems” These are problems that might affect the diagnosis, treatment and prognosis of a diagnosed disorder, for example a person may have experience a stressful event such as divorce or loss of a loved one. “Axis V – level of functioning” On this the clinician provides a rating of the person’s psychological, social and occupational functioning.
Major categories in ICD-10 “Symptomatic mental disorders- dementia in Alzheimer’s disease; organic amnestic syndrome; personality and behavioural disorders due to brain disease, damage and dysfunction.” “Mental and behavioural disorders due to psychoactive substance use- substances include alcohol, cannabinoids, cocaine, and hallucinogens.” “Schizophrenia and delusional disorders- schizophrenia (paranoid, hebephrenic, catatonic, undifferentiated, residual”) “Mood (affective) disorders- manic episodes including hypomania, bipolar affective disorder, depressive episode, recurrent depressive disorder, persistent mood.” “Neurotic stress related- phobic anxiety disorders, social phobias, anxiety disorders (including panic disorders), obsessive compulsive order, and reaction to severe stress.”
“Behavioural syndrome- eating disorders including anorexia and bulimia, sleep disorders including sleep walking and night terrors, sexual dysfunction including lack or loss of sexual desire.” “Disorders of adult personality and behaviour- specific personality disorders (including paranoid, schizoid, dissocial, emotionally unstable”) “Mental retardation- mental retardation which is mild severe or profound” “Disorders of psychological development- specific disorders of speech or language, reading, spelling, arithmetic and scholastic skills. Pervasive developmental disorder including (childhood autism, atypical autism and Rett’s syndrome”)
Behavioural and emotional disorders- mixed disorders of conduct and emotion The range of behaviours listed above has been classified abnormal. Some abnormal behaviours are acute, resulting from certain stressful events whereas others are severe and lifelong. Some abnormal behaviours result from disease, others are through faulty learning experiences. Each person’s behaviour and emotional problems are unique; no two individuals behave in exactly the same way or share the same life experiences.
Labeling induces us to overlook the unique features of each case and to expect the person to conform to the classification. Label for maladaptive behaviour is not an explanation of that behaviour; the classification does not say how the behaviour originated or what maintains the behaviour. How ever, enough similarities exist for mental health professionals to classify cases into categories.