One person’s abnormal is another person’s normal

Differentiating the nuances of normalcy from psychopathology has plagued psychologists since the early days of clinical diagnosis.

Operational and diagnostic definitions of “normal” and “abnormal” behavior must consider contextual variables — both at the individual and cultural level. Comer (2004) suggests assessing abnormality along the dimensions of deviance, distress, dysfunction and danger (the four D’s). While this does further delineate the concept, each of these dimensions also varies in interpretation with regard to context, particularly circumstantial and cultural perspectives. In considering both the normal and abnormal characteristics of the four D’s, the same behavior could be categorized as either functional or dysfunctional, depending on the specific circumstances — i.e., the individual’s comparative level of functioning and the context (macro and micro) of the behavior.

From a broader perspective, consideration of behavior as abnormal must also be assessed relative to the values, beliefs and practices of the larger culture. Lopez and Guarnaccia (2000), along with other researchers, emphasize this need to attend to “the cultural specificity of mental illness and mental health” (p. 575). Behavior that can appear abnormal when assessed from one perceptual set may make perfect sense in relation to another conglomeration of values and beliefs.

Deviance — Comer (2004) defines deviant behavior, thought and emotion in terms of the violation of the norms of psychological functioning. These norms can vary significantly among cultures. Normality should be assessed with regard to functioning in context as well as compared to the level of functionality prior to the stressor episode.

Distress — Comer (2004) further defines abnormality in terms of the subjective experience of distress and personal suffering. Although in certain circumstances this aspect is neither necessary nor sufficient to constitute abnormality, it is a facet of human experience that considers individual differences in resilience and perception. While individuals naturally differ in response to stressful events along a continuum of distress intensity, experiences at either extreme (i.e., too much or too little subjective distress) may indicate an abnormal reaction. For example, if an individual’s fear of and/or preoccupation with a situation (real or perceived) is so intense as to render them unable to get out of bed and perform regular tasks of daily living despite a desire to do so, then the distress is at an incapacitating and comparatively abnormal level.

Danger — In contrast to the subjective experience of distress, abnormality is often assessed with regard to an objective evaluation of the probability of posing a threat of harm to oneself or others (Comer, 2004). Depending on the scenario, this could manifest in such behaviors as not eating, not taking necessary medication or conversely over- or self — medicating without a doctor’s supervision. Additionally, violent or suspicious and defensive behavior could pose a threat of harm to others.

Beyond individual differences and context, the various psychological perspectives offer differing views of mental illness explain behavior — both normal and abnormal.

Biological — Theorists adhering to the biological model will assess abnormality in terms of a malfunctioning of the brain and its related processes. The etiology of abnormal behavior from this perspective will be attributed to dysfunction or imbalances in the anatomical structures or chemical reactions within the brain and related neurological structures. For example, the symptoms of anxiety and depression would be explained by this model as possibly resulting from malfunction of specific areas in the brain, such as those that are related to mood and emotion (i.e., hippocampus), or by an imbalance in the neurotransmitters related to anxiety (GABA) or depression (serotonin, norepinephrine).

Freudian — Freudian psychologists would describe the same anxious and depressed behavior as a product of underlying, unconscious internal unresolved conflict. Experiences from the individual’s past would be paramount in explaining the current psychological problems. Extensive analysis would be necessary to determine the specific nature of underlying conflicts as manifested in the defense mechanisms and developmental fixations that drive the abnormal behavior.

Behavioral — In contrast to the aforementioned internal focus of the Freudian perspective, the behavioral model concentrates solely upon the behaviors of individuals as learned responses to their environment. Assessing the individual’s abnormal behavior from a behaviorist perspective would consist of analyzing their determinants based on the principles of classical conditioning, operant conditioning and/or modeling. The individual’s dysfunction would be viewed as learned responses to the external stimuli experienced.

Cognitive — The cognitive model views abnormal behavior as a dysfunction in the processes of thinking, reasoning and problem solving. Repeated patterns of illogical thinking, negative perceptions and inaccurate assumptions result in skewed views of the self and the world. These inaccurate thought habits are applied to new experiences, causing emotional difficulties and behavioral problems.

Humanistic — The humanistic orientation considers abnormality as a byproduct of a distorted view of the self and one’s experiences caused by the imposition of conditions of worth (as opposed to unconditional positive regard) against which the individual feels inadequate. Abnormal behavior is considered a defense against internalized critical judgments and feelings of self-doubt and ineffectiveness.

Sociocultural — The sociocultural model emphasizes the role of the broader external environment in influencing the thoughts and behaviors of individuals. An analysis of abnormal behavior from this perspective includes a thorough assessment of the various social contexts within which an individual operates (i.e., family, culture, social networks). Disturbances in the dynamics of interactions in these contexts can lead to abnormal and inappropriate reactions from the individual.

The possible manifestations of abnormal behavior in any scenario are numerous and varied. However, each one must be carefully evaluated in both a personal and cultural context using the lens of an appropriate theoretical perspective in order to arrive at a relevant and accurate conclusion and a helpful diagnosis.

References

Comer, R. J. (2004). Abnormal psychology (5th ed.). New York, NY: Worth Publishers

Lopez, S. R. & Guarnaccia, P. J. J. (2000). Cultural psychopathology: Uncovering the social world of mental illness. Annual Review of Psychology.