Statistical Infrequency

Real-life application - A strength of the statistical definition is that it has a real-life application in the diagnosis of intellectual disability disorder. There is therefore a place for statistical infrequency in thinking about what are normal and abnormal behaviours and characteristics. Actually all assessment of patients with mental disorders includes some kind of measurement of how severe their symptoms are as compared to statistical norms (as distinct from social norms). Statistical infrequency is thus a useful part of clinical assessment.

Unusual characteristics can be positive - IQ scores over 130 are just as unusual as those below 70, but we wouldn’t think of super-intelligence as an undesirable characteristic that needs treatment. Just because very few people display certain behaviours does make the behaviour statistically abnormal (i.e. it is not ‘normal’) but doesn’t mean it requires treatment to return to normal. This is a serious limitation to the concept of statistical infrequency and means that it would never be used alone to make a diagnosis.

Not everyone benefits from a label - Another problem with statistical infrequency is that, where someone is living a happy fulfilled life, there is no benefit to them being labelled as abnormal regardless of how unusual they are. So someone with a very low IQ but who was not distressed, quite capable of working, etc., would simply not need a diagnosis of intellectual disability. If that person was ‘labelled’ as abnormal this might have a negative effect on the way others view them and the way they view themselves.

Deviation from Social Norm

Not a sole explanation - A strength of the deviation from social norms definition is that it has a real-life application in the diagnosis of antisocial personality disorder. There is therefore a place for deviation from social norms in thinking about what is normal and abnormal. However, even in this case there are other factors to consider, for example the distress to other people resulting from antisocial personality disorder (the failure to function definition, which is explained on the next spread). So in practice, deviation from social norms is never the sole reason for defining abnormality.

Culture relativism - Another problem with using deviation from social norms to de ne 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.

Can lead to human rights abuses - Too much reliance on deviation from social norms to understand abnormality can also lead to systematic abuse of human rights. Looking at the historical examples of deviation from social norms in the table on the right, it is pretty clear that these diagnoses were really there to maintain control over minority ethnic groups and women. The classifications appear ridiculous nowadays – but only because our social norms have changed. More radical psychologists suggest that some of our modern categories of mental disorder are really abuses of people’s rights to be different.

Failure to Function Adequately

Patient’s perspective - A strength of failure to function adequately is that it does attempt to include the subjective experience of the individual. It may not be an entirely satisfactory approach because it is difficult to assess distress, but at least this definition acknowledges that the experience of the patient (and/or others) is important. In this sense the failure to function adequately definition captures the experience of many of the people who need help. This suggests that failure to function adequately is a useful criterion for assessing abnormality.

Is it simply a deviation from social norms? - In practice it can be hard to say when someone is really failing to function and when they are just deviating from social norms. See, for example, the table on the right. 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 practise extreme sports could be accused of behaving in a maladaptive way, whilst those with religious or supernatural beliefs could be seen as irrational. If we treat these behaviours as ‘failures’ of adequate functioning, we risk limiting personal freedom and discriminating against minority groups.

Subjective judgements - When deciding whether someone is failing to function adequately, someone has to judge whether a patient is distressed or distressing. Some patients may say they are distressed but may be judged as not suffering. There are methods for making such judgments as objective as possible, including checklists such as Global Assessment of Functioning Scale. However, the principle remains that someone (e.g. a psychiatrist) has the right to make this judgement.

Deviation from Ideal Mental Health

It is a comprehensive definition - 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. The sheer range of factors discussed in relation to Jahoda’s ideal mental health make it a good tool for thinking about mental health.

Cultural relativism - Some of the ideas in Jahoda’s classification of ideal mental health are specific to Western European and North American cultures (we say they are culture-bound).For example, the emphasis on personal achievement in the concept of self actualisation would be considered self-indulgent in much of the world because the emphasis is so much on the individual rather than the family or community. Similarly, much of the world would see independence from other people as a bad thing. Such traits are typical of individualist cultures.