Definitions of abnormality

What is statistical infrequency?

• According to the statistical definition any relatively usual behaviour or characteristic can be thought of as ‘normal’, and any behaviour that is unusual is ‘abnormal’. This is what is meant by statistical infrequency. The statistical approach comes into its own when we are dealing with characteristics that can be reliably measure, like intelligence. We know that, in any human characteristic, most people’s scores will cluster around the average, and that the further we go above or below that average, the fewer people will attain that score. This is called the normal distribution.

Give 1 strength of statistical infrequency

• A strength of the statistical definition is its usefulness. Statistical Infrequency is used in clinical practice, both as part of formal diagnosis and as a way to assess the severity of an individual’s symptoms. For example, a diagnosis of intellectual disability disorder requires an IQ below 70 (bottom 2%). An example of statistical infrequency used in an assessment tool is Beck depression inventory (BDI). A score of 30+ (top 5% of respondents) is widely interpreted as indicating severe depression. This shows that the value of the statistical infrequency criterion is useful in diagnostic and assessment procedures.

Give 1 limitation of statistical infrequency

• A weakness of statistical definition is not all infrequent behaviours are abnormal- some rare behaviours and characteristics are desirable rather than being undesirable. For example, having a high IQ is just as statistically rare as having an IQ below 70 yet a high IQ is seen as a desirable characteristic and therefore doesn’t require treatment like a low IQ score would. Similarly, we would not think of someone with a very low depression score on the BDI as abnormal. These examples show that being unusual or at one end of ta psychological spectrum does not necessarily make someone abnormal. This means that although statistical infrequency can form part of assessment and diagnostic procedures, it is never sufficient as the sole basis for defining abnormality.

What is deviation from social norms?

• concerns behaviour that is different from the accepted standards of behaviour in a community or society. Groups of people (hence ‘social’) choose to define behaviour as abnormal on the basis that it offends their sense of what is ‘acceptable’ or the norm. We are making a collective judgement as a society about what is right.

• Norms are specific to the culture we are in- social norms may be different for each generation and every culture, so there are relatively few behaviours that would be considered universally abnormal on the basis that they breach social norms. For example, homosexuality continues to be viewed as abnormal in some cultures and was considered abnormal in our society in the past.

Give 1 strength of deviation from social norms

• One strength of deviation from social norms is its usefulness. Deviation from social norms is used in clinical practice. For example, the key defining characteristic of APD is the failure to conform to culturally normal ethical behaviour. These signs of the disorder are all deviations from social norms. Such norms also plays a part in the diagnosis of schizotypal personality disorder, where the term ‘strange’ is used to characterise the thinking, behaviour and appearance of people with the disorder. This shows that deviation from social norms criterion has value in psychiatry.

Give 1 limitation of deviation from social norms

• A problem with using deviations from social norms to define behaviour as abnormal is that social norms vary tremendously from one generation to another and from one community to another. This means, for example, that a person from one cultural group may label someone from another culture as behaving abnormally according to their standards rather than the standards of the person behaving that way. For example, hearing voices is socially acceptable in some cultures but would be seen as a sign of mental abnormality in the UK. This creates problems for people from one culture living within another culture group.

What is failure to function?

• Occurs when someone is unable to cope with ordinary demands of day-to-day living. We might decide that someone is not functioning adequately when they are unable to maintain basic standards of nutrition and hygiene. We might also consider that they are no longer functioning adequately if they cannot hold down a job or maintain relationships with people around them.

Rosenham and Seligman (89) proposed some additional signs that can be used to determine when someone is not coping. These include: When a person no longer conforms to standard interpersonal rules, for example maintaining eye contact, When a person experiences severe personal distress, When a person’s behaviour becomes irrational or dangerous to themselves or others.

• One of the criteria for diagnosis of intellectual disability disorder is having a very low IQ (a statistical infrequency). However, a diagnosis would not be made on this basis only – an individual must also be failing to function adequately before a diagnosis would be given

Give 1 strength of failure to function

• One strength is this definition represents a sensible threshold for when people need professional help. Most of us have symptoms of mental disorder to some degree at some time. In fact, according to the mental health charity MIND, around 25% of people in the UK will experience a mental health problem in any given year. However, many people press on in the face of fairly severe symptoms. It tends to be at the point that we cease to function adequately that people seek professional help or are noticed and referred to help by others. This criterion means that treatment and services can be targeted to those who need them the most.

Give 1 limitation of failure to function

• One limitation of failure to function is that it is easy to label non-standard lifestyle choices as abnormal. In practice it can be very hard to say when someone is really failing to function and when they have simply chosen to deviate from social norms. We might think that not having a job or a permanent address is a sign of failure to function adequately. But then what do we say about people with alternative lifestyles who choose not to have those things? Similarly, those who practice extreme sports could be accused of behaving in a maladaptive way. If we treat these behaviours as ‘failures’ of adequate functioning, we risk limiting personal freedom and discriminating against minority groups.

What is deviation from ideal mental health?

• occurs when someone does not meet a set of criteria for good mental health. Marie Jahoda (1958) suggested that we are in good mental health if we meet the following criteria:

We have no symptoms or distress

We self-actualise (reach our full potential)

We can cope with stress

We have a realistic view of the world

We have good self-esteem and lack guilt

We are independent of other people

• We can successfully work, love and enjoy our leisure Inevitably there is some overlap between what we might call deviation from ideal mental health and what we might call failure to function adequately. So, we can think of someone’s inability to keep a job as either a failure to cope with the pressures of work or as a deviation from the ideal of successfully working.

Give 1 strength of deviation from ideal mental health

• A strength of deviation from ideal mental health is that it is very comprehensive. It covers a broad range of criteria for mental health, in fact it probably covers most of the reasons someone would seek help from mental health services or be referred for help. This in turn means that an individual’s mental health can be discussed meaningfully with a range of professionals who might take different theoretical views e.g. a medically trained psychiatrist might focus on symptoms whereas a humanistic counsellor might be more interested in self-actualisation. This means that ideal mental health provides a checklist against which we can assess ourselves and other and discuss psychological issues with a range of professionals.

Give 1 limitation of deviation from ideal mental health

• Very few of us attain all Jahoda’s criteria for mental health, and probably none of us achieve all of them at the same time or keep them up for very long. Therefore, this approach would see pretty much all of us as abnormal. On the positive side it makes it clear to people the ways in which they could benefit from seeking treatment to improve their mental health. However, deviation from ideal mental health is of no value in thinking about who might benefit from treatment against their will.