Psychological Abnormality
Psychological Abnormality
There have been many attempts to define psychological abnormality. One of these is the Failure to Function Adequately that defines abnormality in the sense that every human being should be able to achieve some sense of personal well-being and make some contribution to a larger social group. Any individual who fails to function adequately in this respect is seen as 'abnormal'.
According to Sue et al (1994), there are two ways by which people fail to function adequately being the practical and clinical criteria. Buss (1966) and Miller & Morley (1986) suggests that a failure to function adequately occurs when personal distress or discomfit which takes the form of intense anxiety and depression, loss of appetite etc. But we cannot use personal distress criteria to define abnormality since it is normal or an appropriate response in particular circumstances. For example, depression as a response to the death of a loved one, it is only when it persists after a long period of time or the source has been removed or most persons have adjusted to it/them, that it becomes abnormal. Also some forms of mental disorders are not necessarily accompanied by personal distress. Example; dissocial personality disorder which involves repeated acts of violence and crime without experiencing guilt or remorse and substance related disorders like excessive use of alcohol may be vigorously denied by the user.
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Another factor is when psychological states may be distressing to others. For example a person who tries to assassinate the Prime Minister might not experience any personal distress but however the fact that such a person is a threat to others establish a failure to function adequately. If such is the case, then when can we say that one is being abnormal or merely being non-conformist? Such a case is the incident on the 11th of September 2001 in New York in which some people bombed the World Trade Centre by flying planes into them. Where can we then draw a fine line between those who are abnormal or non-conformists? Gross (1995) concluded that such a criteria is a 'double-edged sword' because in some cases it can be seen as a 'blessing' in the sense that one persons distress as a result of other peoples behaviour can be a life-saver. But in other cases it can be a curse, example, when a father expresses distress over his son's homosexuality whereas the son feels perfectly comfortable with it.
Another criterion is maladaptive ness. When ones behaviour prevents one from efficiently satisfying social and occupational roles, it is seen as being maladaptive. An example is some mental disorders like substance-related disorders who are defined in terms of how the (ab)use of the substance (eg. Alcohol) produces social and occupational difficulties, such as marital problems and poor work performance. Davison and Neale (1994) suggested unexpected behaviour as another criterion. This involves reacting to a
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situation or event in ways that could not be predicted or reasonably expected from what is known about human behaviour. If a person behaves in a way
that is 'out of proportion to the situation', then the person is failing to function adequately. For example, a person who reacts to the banishment of a favourite football team by attempting to commit suicide. But then Davison and Neale (1994) only viewed unexpected behaviour as that which involves an over reaction. However a behaviour which is out of all proportion can equally refer to an under ...
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situation or event in ways that could not be predicted or reasonably expected from what is known about human behaviour. If a person behaves in a way
that is 'out of proportion to the situation', then the person is failing to function adequately. For example, a person who reacts to the banishment of a favourite football team by attempting to commit suicide. But then Davison and Neale (1994) only viewed unexpected behaviour as that which involves an over reaction. However a behaviour which is out of all proportion can equally refer to an under reaction as well. One last criterion is when one acts bizarrely, because unless it is really evident that the Martians in association with the MI5 are trying to gain information from someone, it will be very difficult to deny that anyone who makes such claims is behaving bizarrely and hence is failing to function adequately. However there are certain behaviours, which generally would be considered bizarre, but having occurred under conditions and contexts such that the perpetrators could justify them in terms of survival, political or religious meanings (Houston et al 1991). An example is dressing up in clothes of the opposite sex, which may, depending on the context, be entertaining for others and profitable for the person engaging in such behaviour.
Overall, such an approach avoids labelling which poses problems to the individual who has been labelled long after the cause has been removed. It also avoids enforced detaining in mental institutions against the will of the
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individual. This approach leaves the choice of seeking help entirely up to the individual.
Yet another attempt to define abnormality is the Deviation from Statistical Norms that defines abnormality by anything which deviates from the norm or average. An example is when an average height of adults is 5'8"; we would probably describe someone who is 7' or 3' as being 'abnormally' tall or short respectively.
There are so many loopholes in this approach because
It does not take into account the desirability of a behaviour or characteristic. Some behaviour that is both statistically infrequent and probably undesirable but produces a positive outcome is not considered as abnormal. An example is Mozart who at the age of three performed his own concerto; another is Balamurali Ambati, who is a child prodigy by graduating in biology at the age of 13 and a doctor at 17.
There are people involved in a range of undesirable behaviours in all cultures. For example, polygamy in some cultures is undesirable to other westbound cultures. Hassett and White (1989) stated that "Americans are involved in a wide variety of socially undesirable behaviour patterns from mild depression to child abuse, (and) if it were possible to add up all the numbers, it would
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become clear that as many as one out of every two people would fall into at least one of these categories" (Gross & McIlveen 1998, p 563)
It could be a reflection of male and female socialization than a true reflection of the real differences between males and females for any given mental
disorder. This is according to the statistical values in relation to gender issues. (Bennett 1995)
One research study into the causes of anorexia nervosa suggests that it may be genetic. According to Strober & Katz (1987), there is a trend in which the disorder runs in families, with first- and second-degree relatives of anorectic individuals being significantly more likely to develop the disorder compared to first- and second-degree relatives of a control group of non-anorectics. Twin studies have also been used to find out the role that genetic factors play. Askevold & Heiberg (1979) reported a 50% concordance rate for monozygotics (MZ) brought up in the same environment. Holland et al (1984) also found a 55% concordance rate for MZ twins and 7% for dizygotic (DZ) twins. But Treasure & Holland (1991) suggest that if genes play a role, then it is likely to be very small. Wade et al (1998), who studied both genetic and
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environmental risk factors in 325 female twins, found out that environmental factors greatly influence shaping women's attitudes towards weight, shape, eating and food but little evidence of a genetic component. This does not support a genetic cause of anorexia as behaviour may be learned from other family members as they also share the same environmental factors.
Research studies also associate a biochemical imbalance as a cause. It has been suggested that a malfunction of the hypothalamus leads to the disorder. Kaplan & Woodside (1987) showed that when nonadrenaline is active on parts of the hypothalamus, non-humans eat a lot and rather prefer carbohydrates. Any condition that increases serotonin would decrease eating. Jimerson et al (1997) performed clinical tests comparing the amount of serotonin function in patients who are anorexic and in healthy control groups and found significant difference which concluded that impaired serotonergic responsiveness may contribute to the onset, recurrence or persistence of abnormal eating pattern in people with anorexic. But Kaye et al (1993) pointed out that it was difficult to differentiate whether hypothalamus malfunction and changes in neurotransmitter levels are causes, effects of it or merely a correlation (link between them).
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The psychodynamic theory proposes that this is an unconscious effort by a young woman or girl to remain young or pre-pubescent. This is an outcome of reliability on parents so much that some girls are afraid to become sexually mature and independent. Since this disorder is associated with amenorrhoea (cessation of menstruation) and psychodynamic theorists see this as helping the anorectic to avoid growing up and taking up adult responsibilities. Obviously we have to gain a certain level of body fat to achieve puberty and
proof suggests that anorexic patients will eat but only if they do not gain weight.
Another account suggests that the disorder prevents a girl from gaining her sexuality. The loss of body weight prevents the onset of puberty signs, eg, rounding of hips and breasts and so the body assumes a 'tom-boy' appearance. This might be a way of preventing the issue of sexuality in general and the idea of pregnancy in particular, since anorexic females associate oral fixation with pregnancy. (Bruch 1979)
Yet another psychodynamic account proposes that it is an attempt by adolescents to identify themselves from their parents. They argue that parents of anorectics are prone to be overbearing and the disorder is a reflection of their attempt to prove or exert their individuality. Bemis (1978) proved that anorectics are 'good girls'; perfectionists who exceed in school
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work and are extremely well behaved and co-operative. He argued that this makes them feel that they have no choice of their own and are rather being controlled by the desires and demands of others and the only way of proving their individuality is the assumption of control over what belongs to ones self - the body. Therefore thinness and starvation are signs of self-control and independence.
Though one will see the truth in above psychodynamic accounts there are at least two observations, which disapproves them. First of all is how the prospect of avoiding pregnancy applies to only females and offers no
explanation for male anorectics. Secondly, there is no explanation for the occurrence of this disorder after the onset of puberty.
The behavioural model explains anorexia nervosa as a phobia (i.e. fear of) the possibility of weight gain. Crisp (1967) suggested that anorexia might be more appropriately known as 'weight phobia' and this is assumed to be the outcome of the role of social norms. Classical conditioning includes the layperson's view that suggests anorexia as 'slimming that got out of hand' and that it goes on to become a 'habit' and just like any other habits it is through a stimulus-response mechanism. When a person accomplishes a diet plan and achieves the weight loss, they gain admiration for either their
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determination or new, slimmer appearance from others. They then associate being slim with feeling good about them.
Operant conditioning comes about when admiration from others urges the person to continue dieting. Also starvation may serve as a reward in the gain of attention from parents and even as effectuations in the punishment of parents. According to Petkova (1997) 'cultural idealisation' of slimmer women (eg supermodels) may be a cause of the weight phobia and these pressures have become so much that normal eating in America at the least is characterised by dieting (Polivy & Herman 1985).
Some occupations, which require slimness as an essential, such as ballet dancing, gymnastics and modelling. A study by Garner et al (1987) showed that in a group of 11- to 14-year old ballet students, 25% developed anorexia over a two-year period which supported Garfinkel & Garner (1982) deductions that there is a lot of pressure on women in such occupations to be thin and the incidence of anorexia to be higher as compared to the population in general.
However, not all ballet dancers, gymnasts, models and so on that diet to become slim develop eating disorders according to Copper (1995). Another mind-boggling observation that is exceedingly difficult to explain is the occurrence of anorexia in blind people. Since a 'distorted body image' is one of the characteristics of anorexia. Yager et al (1986) describes a case of a 28-year-old woman who has been blind from the age of two and became anorexic at age 21. Touyz et al (1988) also reported a similar case in a
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woman blinded at birth. Although either teams could not offer a satisfactory explanation, they all agreed that blindness from early childhood or birth does not exclude anorexia's development and people do not have to perceive themselves before they desire a slimmer physique.
Reference
Askevold & Heiberg 1979
Bemus 1978
Bruch 1979
Bennett 1995
Buss 1966
Cooper 1995
Crisp 1967
Davison & Neale 1994
Garner et al 1987
Garfinkel & Garner 1982
Gross 1995
Hassett & White 1989
Holland et al 1991
Houston et al 1991
Jimerson et al 1992
Kaplan & Woodside 1987
Kaye et al 1993
Miller & Neale 1994
Petkova 1997
Polivy & Herman 1985
Strober & Katz 1987
Sue et al 1994
Treasure & Holland 1991
Touyz et al 1988
Wade et al 1997
Yager et al 1986
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