Behavior in Context A Practical Approach
456 IS THIS PERSON ABNORMAL? Whether unusual individuals are labeled “abnormal” and perhaps given treatment for psychological disorders depends on a number of factors, including how abnormality is deﬁned by the culture in which they live, who is most directly affected by their behavior, and how much distress they suffer or cause. Chapter 12 Psychological Disorders not. But statistical infrequency alone is a poor criterion for abnormality, because any rare quality or characteristic, including creative genius or world-class athletic ability, would be considered abnormal. Further, because this deﬁnition implies that conformity with the majority is normal, equating rarity with abnormality may result in the oppression of nonconformists who express unusual or unpopular views or ideas. Finally, just how rare must a behavior be in order to call it “abnormal”? The dividing line is not easy to locate. Another possible criterion for abnormality is the violation of social norms—the cultural rules that tell us how we should and shouldn’t behave in various situations, especially in relation to others. According to this norm violation criterion, when people behave in ways that are unusual enough or disturbing enough to violate social norms, they may be described as abnormal. However, norm violation alone is an inadequate measure of abnormality. For one thing, some norm violations are better characterized as eccentric or illegal than as abnormal. People who seldom bathe or who stand too close during conversation violate social norms, but are they abnormal or merely annoying? Further, whose norms are we talking about? Social norms vary across cultures, subcultures, and historical eras, so certain behaviors that qualify as abnormal in one part of the world might be perfectly acceptable elsewhere (Giosan, Glovsky, & Haslam, 2001; Phelan et al., 2000). Abnormality can also be described in terms of personal suffering. In fact, experiencing distress is the criterion that people often use in deciding that their psychological problems are severe enough to require treatment. But personal suffering alone is not an adequate criterion for abnormality. For one thing, it does not take into account the fact that people are sometimes distressed about characteristics (such as being gay or lesbian) that are not mental disorders. Second, some people display serious psychological disorders but experience little or no distress. Those who sexually abuse children, for example, create far more distress in victims and their families than they suffer themselves. Behavior in Context: A Practical Approach impaired functioning Difﬁculty in fulﬁlling appropriate and expected social roles. biopsychosocial model Explaining mental disorders as the combined result of biological, psychological, and sociocultural factors. Obviously, no single criterion fully deﬁnes abnormality. So mental health practitioners and researchers tend to adopt a practical approach that combines aspects of all the criteria we’ve discussed. They consider the content of behavior (that is, what the person does), the sociocultural context in which the person’s behavior occurs, and the consequences of the behavior for that person and for others. This practical approach pays special attention to whether a person’s thoughts, behavior, or emotions cause impaired functioning—that is, difﬁculty in fulﬁlling appropriate and expected roles in family, social, and work-related situations (U.S. Surgeon General, 1999; Wakeﬁeld, 1999). What is “appropriate” and “expected” depends on age, gender, culture, and the particular situation and historical era in which people live. For example, a short attention span is considered normal in a two-year-old but inappropriate and problematic in an adult. In some countries, expressing certain emotions is considered more appropriate for women than for men. So kisses, tears, and long embraces are common when women in the U.S. greet each other after a long absence; men tend to simply shake hands or hug brieﬂy. And because of cultural differences, hearing a dead relative’s voice calling from the afterlife would be more acceptable in certain American Indian tribes than among, say, the families of suburban Toronto. Situational factors are important as well. Falling to the ﬂoor and “speaking in tongues” is considered appropriate, and even desirable, during the worship services of some religious groups; but the same behavior would be seen as inappropriate, and possibly a sign of disorder, in a college classroom. Finally, judgments about behavior are shaped by changes in social trends and cultural values. For example, the American Psychiatric Association once listed homosexuality as a mental disorder but dropped this category from its ofﬁcial list of disorders in 1973. In taking this step, it was responding to changing views of sexual orientation prompted in part by the political and educational efforts of gay and lesbian rights groups.