Definitions of Abnormality

Behaviour is abnormal because it is statistically rare (i.e. uncommon).  It is based on the idea that behaviour is normally distributed and it is usually argued that people who are 2 standard deviations above or below the mean (i.e. in the extreme 2.145% of the population) are abnormal.

• Does not take into account the desirability of the behaviour. There are many desirable behaviours e.g. genius or low anxiety that are statistically infrequent but we would not want to call them abnormal as they are beneficial and do not require treatment. Other behaviours are statistically frequent but we would not necessarily want to class them as normal e.g. depression.  Also in Nazi Germany killing of the Jews was frequent however we would not wish to call it normal and refusal to kill abnormal.
• Inaccuracy of statistical data- this definition relies on having accurate statistical data for the population and there are many reasons why statistical data may be inaccurate.  Some have suggested gender bias is an issue and may be more a reflection of male & female socialisation than a true reflection of the frequency of a given disorder.  Females are more likely to consult their doctor about anxiety problems whereas males are more likely to bottle up their anxiety. Bennet believes that the socialisation of men has created masculine stereotypes that alienate men from seeking help.

• Cultural relativism - Definitions are based on a standard that is set by a particular population and the same standards may not apply to people of different cultures or ages i.e. the frequency of behaviours may be different for different cultures or ages.  Also the statistics may again reflect likelihood to seek medical help.  In China mental illness carries a great stigma and is only diagnosed when the behaviour is undisputedly psychotic.

Cultural Relativism: The view that behaviour cannot be judged properly unless it is viewed in the context of the culture in which it originates. Therefore behaviour should be judged relative to the specific culture and Western ideals should not be used to judge other cultures.   

A society has rules about what are acceptable behaviours, values & beliefs.  Behaviour is abnormal if it deviates from some notion of what the society considers proper or acceptable.  E.g. talking to oneself when walking down the street.

• The concept of social deviancy is related to moral standards that vary over time as a consequence of prevailing social attitudes.  E.g. until relatively recently in Britain it was not acceptable to have a child out of marriage and single women who did were locked up in psychiatric institutions.  Equally homosexuality was once considered a mental illness and was present on the DSM until 1973.
• Cultural relativism- Social standards vary from culture to culture and one society’s norms should not be used to define another culture as abnormal. There is a danger of an assumption that behaviours of White population are normal and used to diagnose ethnic minorities, who may deviate. This may explain why Afro-Caribbeans in the UK are 3x more likely to be diagnosed as schizophrenic.  When western standards are imposed on people from other cultures, many of their behaviours seem strange and abnormal.  In some countries people eat insects, practice sorcery and encourage sex play among children.  Whilst these behaviours seem abnormal to us, many people in the world would view as abnormal American behaviours such as birth control, having one spouse and bottle-feeding infants.

• Social control - A diagnosis of insanity in Russia has been used to detain political dissidents and in Japan it has been used to ensure a strong work ethic.  Szasz argues that abnormality is a socially constructed concept that allows people who are unusual to be labelled and thus treated differently from the others- often confined and persecuted. In the 19^th century women were frequently diagnosed with moral insanity. This was diagnosed when women who inherited money spent it on themselves rather than on male relatives. By being able to get women diagnosed with moral insanity (with the cooperation of male doctors) men were able to strictly control women in line with their own interests.

Behaviours that prevent people from coping with the demands of everyday life such as the ability to work, or have relationships or the motivation to care for themselves properly are considered abnormal. E.g. often people with severe OCD are housebound due to fear of contamination etc, anorexics eat so little they are in danger of starving to death.

One of the ways to assess this is the Global Assessment of Functioning Scale (GAF).  This is a scale from 0 -100.  100 is superior functioning in a wide range of activities where life’s problems never get out of hand.  10 is persistent danger of hurting self or others or persistent inability to maintain minimal personal hygiene or serious suicidal act with clear expectation of death.  60 is moderate symptoms e.g. occasional panic attacks OR moderate difficulty in social, occupational or school functioning e.g. few friends, conflicts with peers or co-workers.

• It involves making subjective value judgements about others as to what constitutes failure to function adequately. Who makes the judgement as to whether a person is not functioning adequately?  Schizophrenics often deny they have a problem as do people who have eating disorders.

• Many ‘normal’ people fail to cope with the demands of life at certain times e.g. after a bereavement or before a stressful exam.  In fact in these situations if a person does cope we may consider them abnormal.

• Cultural relativism – related to cultural ideas of how one’s life should be lived. Likely to result in different diagnoses when applied to people in different cultures, because the standard of one culture is being used to assess another. This may explain why lower-class and non-white patients are more often diagnosed with mental disorders – because their lifestyles are different from the dominant culture which may lead to a judgement of failing to function adequately.

Abnormal behaviour deviates from the ideal of how people should behave.  According to Jahoda (1958) ideal mental health consists of having:

• a positive attitude towards oneself;

• the opportunity to self-actualise (achieve one’s potential);

• the ability to resist stress;

• personal autonomy (not being too dependent on others);

• an accurate perception of reality;

• the ability to adapt to one’s environment

• The criteria are so demanding for ideal mental health that everyone would be considered abnormal to some extent e.g. very few people reach self-actualisation.
• Cultural relativism: The list of attributes has been criticised for being ethnocentric in that it describes individualistic cultures. In collectivist cultures personal autonomy is thought to be far from ideal and even unhealthy. Equally perceptions of reality are partly dependent on cultural and religious beliefs e.g. In Chippewa cultures, visions are seen as a great honour whereas in the West we see it as an inaccurate perception of reality and thus would diagnose mental illness.
• It has been suggested that an accurate perception of reality is not a characteristic of normal people. Taylor reports that depressed patients perceive the world more accurately than clinically normal people. It appears that ‘normal’ people need to create ‘positive illusions’ in order to protect themselves from reality. Depressed patients make much more accurate assessments of their place in the world.
• Perceptions of reality change with time with new knowledge e.g. once people believed that the world was flat and in fact the first individuals who challenged this were considered abnormal.