Macatangay, John Harvey M.
BSHRM-PSY12/306H Prof. Camacho
Abnormality, in the vivid sense of something deviating from the normal or differing from the typical
(such as an aberration), is a subjectively defined behavioral characteristic, assigned to those with rare or
dysfunctional conditions. Defining who is normal or abnormal is a contentious issue in abnormal
psychology.
One criterion for "abnormality" that may appear to apply in the case of abnormal behavior is
statistical infrequency. This has an obvious flaw — the extremely intelligent, are just as abnormal as
their opposites. Therefore, individual abnormal behaviors are considered to be statistically unusual
as well as undesirable. The presence of some form of abnormal behavior is not unusual. About one
quarter of people in the United States, for example, are believed to meet criteria for a mental
disorder in any given year 1. Mental disorders, by definition, involve unusual or statistically abnormal
behaviors.
A more discerning criterion is distress. A person who is displaying a great deal of depression,
anxiety, unhappiness, etc. would be thought of as exhibiting abnormal behavior because their own
behavior distresses them. Unfortunately, many people are not aware of their own mental state, and
while they may benefit from help, they feel no compulsion to receive it.
Another criterion is morality. This presents many difficulties, because it would be impossible to
agree on a single set of morals for the purposes of diagnosis.
One criterion commonly referenced is maladaptivity. If a person is behaving in ways counter-
productive to their own well-being, it is considered maladaptive. Although more tenable than the
above criteria, it does have some shortcomings. For example, moral behavior
including dissent and abstinence may be considered maladaptive to some.
Another criterion that has been suggested is that abnormal behavior violates the standards of
society. When people do not follow the conventional social and moral rules of their society, the
behavior is considered abnormal. However, the magnitude of the violation and how commonly it is
violated by others must be taken into consideration.
Another element of abnormality is that abnormal behavior will cause social discomfort to those
who witness such behavior.
The standard criteria in psychology and psychiatry is that of mental illness or mental disorder.
Determination of abnormality is based uponmedical diagnosis. This is often criticized for removing
control from the 'patient', and being easily manipulated by political or social goals.
Statistical Infrequency: In this definition of abnormality behaviors which are seen as statistically
rare are said to be abnormal. For instance, one may say that an individual of above or below average
IQ is abnormal. This definition, however, fails to recognize the desirability of the particular
incidence. This definition also implies that the presence of abnormal behavior in people should be
rare or statistically unusual, which is not the case. Instead, any specific abnormal behavior may be
unusual, but it is not unusual for people to exhibit some form of prolonged abnormal behavior at
some point in their lives.
Deviation from Social Norms defines the departure or deviation of an individual, from society's
unwritten rules (norms). For example if one was to witness a man jumping around, nude, on the
streets, the man would be perceived as abnormal, as he has broken society's norms about wearing
clothing, not to mention one's self dignity. There are also a number of criteria for one to examine
before reaching a judgment as to whether someone has deviated from society's norms. The first of
these criterion being culture; what may be seen as normal in one culture, may be seen as abnormal
in another. The second criterion being the situation & context one is placed in; for example, going to
the toilet is a normal human act, but going in the middle of a supermarket would be seen as highly
abnormal, i.e., defecating or urinating in public is illegal as a misdemeanor act of indecent public
conduct. The third criterion is age; a child at the age of three could get away with taking off its
clothing in public, but not a man at the age of twenty. The fourth criterion is gender: a male
responding with behavior normally reacted to as female, and vice versa, is retaliated against, not
just corrected. The fifth criterion is historical context; standards of normal behavior change in some
societies, sometimes very rapidly.
FF: The Failure to Function Adequately definition of abnormality defines whether or not a
behavior is abnormal if it is counter-productive to the individual. The main problem with this
definition however is that psychologists cannot agree on the boundaries that define what is
'functioning' and what is 'adequately', as some behaviors that can cause 'failure to function' are not
seen as bad i.e. firemen risking their lives to save people in a blazing fire.
DIM: Deviation from Ideal Mental health defines abnormality by determining if the behavior
the individual is displaying is affecting their mental well-being. As with the Failure to Function
definition, the boundaries that stipulate what 'ideal mental health' is are not properly defined, and
the bigger problem with the definition is that all individuals will at some point in their life deviate
from ideal mental health, but it does not mean they are abnormal; i.e., someone who has lost a
relative will be distressed, but would not be defined as abnormal for showing that particular
behavior. On the contrary, there are some indications that some people require assistance to grieve
properly.
Anxiety Disorder
Anxiety disorders are blanket terms covering several different forms of abnormal and
pathological fear and anxiety which only came under the aegis of psychiatry at the very end of the 19th
century. Gelder, Mayou & Geddes (2005) explains that anxiety disorders are classified in two groups:
continuous symptoms and episodic symptoms. Current psychiatric diagnostic criteria recognize a wide
variety of anxiety disorders. Recent surveys have found that as many as 18% of Americans may be
affected by one or more of them.The term anxiety covers four aspects of experiences an individual may
have: mental apprehension, physical tension, physical symptoms and dissociative anxiety (symptoms
associated with hyperventillation). Anxiety disorder is divided into generalized anxiety, phobic, and
panic disorders; each has its own characteristics and symptoms and they require different treatment
(Gelder et al 2005). The emotions present in anxiety disorders range from simple nervousness to bouts
of terror (Barker 2003).
Generalized anxiety disorder
Generalized anxiety disorder (GAD) is a common chronic disorder characterized by long-lasting anxiety
that is not focused on any one object or situation. Those suffering from generalized anxiety experience
non-specific persistent fear and worry and become overly concerned with everyday matters.
Generalized anxiety disorder is the most common anxiety disorder to affect older adults. [4] Anxiety can
be a symptom of a medical or substance abuse problem, and medical professionals must be aware of
this. A diagnosis of GAD is made when a person has been excessively worried about an everyday
problem for six months or more. A person may find they have problems making daily decisions and
remembering commitments as a result of lack of concentration/preoccupation with worry. Appearance
looks strained; skin is pale with increased sweating from the hands, feet and axillae. May be tearful
which can suggest depression. Before a diagnosis of anxiety disorder is made, nurses and physicians
must rule out drug-induced anxiety and medical causes.
Panic disorder
In panic disorder, a person suffers from brief attacks of intense terror and apprehension, often marked
by trembling, shaking, confusion, dizziness, nausea, difficulty breathing. These panic attacks, defined by
the APA as fear or discomfort that abruptly arises and peaks in less than ten minutes, can last for several
hours and can be triggered by stress, fear, or even exercise; the specific cause is not always apparent.
In addition to recurrent unexpected panic attacks, a diagnosis of panic disorder requires that said attacks
have chronic consequences: either worry over the attacks' potential implications, persistent fear of
future attacks, or significant changes in behavior related to the attacks. Accordingly, those suffering from
panic disorder experience symptoms even outside specific panic episodes. Often, normal changes in
heartbeat are noticed by a panic sufferer, leading them to think something is wrong with their heart or
they are about to have another panic attack. In some cases, a heightened awareness (hypervigilance) of
body functioning occurs during panic attacks, wherein any perceived physiological change is interpreted
as a possible life-threatening illness (i.e., extreme hypochondriasis). However, with the correct
professional help 70%–90% of those suffering from panic disorder are helped in 6–8 weeks.
Panic disorder with agoraphobia
A person experiences an unexpected panic attack, and then has substantial anxiety over the possibility
of having another attack. The person fears and avoids whatever situation might induce a panic attack.
The person may never or rarely leave their home to prevent a panic attack they believe to be
inescapable, extreme terror.
Phobias
The single largest category of anxiety disorder is that of phobic disorders, which includes all cases in
which fear and anxiety is triggered by a specific stimulus or situation. Between 5% and 12% of the
population worldwide suffer from phobic disorders. Sufferers typically anticipate terrifying
consequences from encountering the object of their fear, which can be anything from an animal to a
location to a bodily fluid to a particular situation. Sufferers understand that their fear is not proportional
to the actual potential danger but still are overwhelmed by the fear.
Agoraphobia
Agoraphobia is the specific anxiety about being in a place or situation where escape is difficult or
embarrassing or where help may be unavailable. Agoraphobia is strongly linked with panic disorder and
is often precipitated by the fear of having a panic attack. A common manifestation involves needing to
be in constant view of a door or other escape route. In addition to the fears themselves, the
termagoraphobia is often used to refer to avoidance behaviors that sufferers often develop. For
example, following a panic attack while driving, someone suffering from agoraphobia may develop
anxiety over driving and will therefore avoid driving. These avoidance behaviors can often have serious
consequences; in severe cases, one can be confined to one's home.
Social anxiety disorder
Social anxiety disorder (SAD; also known as social phobia) describes an intense fear and avoidance of
negative public scrutiny, public embarrassment, humiliation, or social interaction. This fear can be
specific to particular social situations (such as public speaking) or, more typically, is experienced in most
(or all) social interactions. Social anxiety often manifests specific physical symptoms, including blushing,
sweating, and difficulty speaking. Like with all phobic disorders, those suffering from social anxiety often
will attempt to avoid the source of their anxiety; in the case of social anxiety this is particularly
problematic, and in severe cases can lead to complete social isolation.
Obsessive–compulsive disorder
Obsessive–compulsive disorder (OCD) is a type of anxiety disorder primarily characterized by
repetitive obsessions (distressing, persistent, and intrusive thoughts or images) and compulsions (urges
to perform specific acts or rituals). It affects roughly around 3% of the population worldwide. The OCD
thought pattern may be likened to superstitions insofar as it involves a belief in a causative relationship
where, in reality, one does not exist. Often the process is entirely illogical; for example, the compulsion
of walking in a certain pattern may be employed to alleviate the obsession of impending harm. And in
many cases, the compulsion is entirely inexplicable, simply an urge to complete a ritual triggered by
nervousness.
In a slight minority of cases, sufferers of OCD may only experience obsessions, with no overt
compulsions; a much smaller number of sufferers experience only compulsions.
Post-traumatic stress disorder
Post-traumatic stress disorder (PTSD) is an anxiety disorder which results from a traumatic experience.
Post-traumatic stress can result from an extreme situation, such as combat, natural disaster,
rape, hostage situations, more serious kinds of child abuse, or even a serious accident. It can also result
from long term (chronic) exposure to a severe stressor, for example soldiers who endure individual
battles but cannot cope with continuous combat. Common symptoms
include hypervigilance, flashbacks, avoidant behaviors, anxiety, anger and depression. There are a
number of treatments which form the basis of the care plan for those suffering with PTSD. Such
treatments include cognitive behavioral therapy (CBT), psychotherapy and support from family and
friends. These are all examples of treatments used to help people suffering from PTSD.
Separation anxiety
Separation anxiety disorder (SepAD) is the feeling of excessive and inappropriate levels of anxiety over
being separated from a person or place. Separation anxiety is a normal part of development in babies or
children, and it is only when this feeling is excessive or inappropriate that it can be considered a
disorder. Separation anxiety disorder affects roughly 7% of adults and 4% of children, but the childhood
cases tend to be more severe, in some instances even a brief separation can produce panic.
Childhood anxiety disorders
Children as well as adults experience feelings of anxiousness, worry and fear when facing different
situations, especially those involving a new experience. However, if anxiety is no longer temporary and
begins to interfere with the child's normal functioning or do harm to their learning, the problem may be
more than just an ordinary anxiousness and fear common to the age.
Mood disorder - is the term designating a group of diagnoses in the Diagnostic and Statistical Manual of
Mental Disorders (DSM IV TR) classification system where a disturbance in the person's mood is
hypothesized to be the main underlying feature. The classification is known as mood (affective)
disorders in ICD 10.
English psychiatrist Henry Maudsley proposed an overarching category of affective disorder.The term
was then replaced by mood disorder, as the latter term refers to the underlying or longitudinal
emotional state,whereas the former refers to the external expression observed by others.
Two groups of mood disorders are broadly recognized; the division is based on whether the person has
ever had a manic or hypomanicepisode. Thus, there are depressive disorders, of which the best known
and most researched is major depressive disorder (MDD)commonly called clinical depression or major
depression, and bipolar disorder (BD), formerly known as manic depression and characterized by
intermittent episodes of mania or hypomania, usually interlaced with depressive episodes.
Personality disorders - formerly referred to as character disorders, are a class of personalitytypes and
behaviors that the American Psychiatric Association (APA) defines as "an enduring pattern of inner
experience and behavior that deviates markedly from the expectations of theculture of the individual
who exhibits it".
These behavioral patterns in personality disorders are typically associated with severe disturbances in
the behavioral tendencies of an individual, usually involving several areas of the personality, and are
nearly always associated with considerable personal and social disruption. Additionally, personality
disorders are inflexible and pervasive across many situations, due in large part to the fact that such
behavior is ego-syntonic (i.e. the patterns are consistent with the ego integrity of the individual) and are,
therefore, perceived to be appropriate by that individual. This behavior can result in the client adopting
maladaptive coping skills, which may lead to personal problems that induce extreme anxiety, distress
and depression in clients.[4]
The onset of these patterns of behavior can typically be traced back to late adolescence and the
beginning of adulthood and, in rarer instances, childhood. [1] It is therefore unlikely that a diagnosis of
personality disorder will be appropriate before the age of 16 or 17 years. General diagnostic guidelines
applying to all personality disorders are presented below; supplementary descriptions are provided with
each of the subtypes.
Diagnosis of personality disorders can be very subjective; however, inflexible and pervasive behavioral
patterns often cause serious personal and social difficulties, as well as a general functional impairment.
Rigid and ongoing patterns of feeling, thinking and behavior are said to be caused by underlying belief
systems and these systems are referred to as fixed fantasies or "dysfunctional schemata" (Cognitive
modules).
Schizophrenia - (pronounced /ˌskɪtsɵˈfrɛniə/ or /ˌskɪtsɵˈfriːniə/) is a mental disordercharacterized by a
disintegration of thought processes and of emotional responsiveness. [1] It most commonly manifests as
auditory hallucinations, paranoid or bizarre delusions, ordisorganized speech and thinking, and it is
accompanied by significant social or occupational dysfunction. The onset of symptoms typically occurs in
young adulthood, with a global lifetime prevalence of about 0.3–0.7%. [2] Diagnosis is based on observed
behavior and the patient's reported experiences.
Genetics, early environment, neurobiology, and psychological and social processes appear to be
important contributory factors; some recreational and prescription drugs appear to cause or worsen
symptoms.
Historical Background of the Treatment of Psychological Disorder
References to mental disorders in early Egyptian, Indian, Greek, and Roman writings show that the
physicians and philosophers who contemplated problems of human behaviour regarded mental
illnesses as a reflection of the displeasure of the gods or as evidence of demoniac possession. Only a
few realized that individuals with mental illnesses should be treated humanely rather than exorcised,
punished, or banished. Certain Greek medical writers, however, notably Hippocrates (flourished 400 BC),
regarded mental disorders as diseases to be understood in terms of disturbed physiology.
Techniques in Psychotherapy
Behavior Therapy
Behavior therapy focuses on changing the unwanted and self-defeating behavior patterns of the
individual through conditioning. In essence, this technique involves the removal of undesirable
habits and replacing that behavior with more satisfying and rewarding behavior. Behavior
therapy can help an individual to modify the stress response or overcome a crippling phobia.
Cognitive Therapy
Cognitive therapy looks at the underlying thought patterns and core beliefs behind unwanted
feelings and emotions. The basic idea is that our thoughts about a situation are what create our
emotions regarding that situation, and often our thoughts are based on irrational or troublesome
core beliefs that we might not even be consciously aware of. An example would be a
perfectionist who is suffering anxiety because of all the pressure that they put on themselves.
Cognitive therapy can help this person see that they are too rigid in their thinking and that it is
irrational to expect to be perfect at all times.
Cognitive-Behavioral Therapy
Cognitive-Behavioral therapy (CBT) is a combination of the above techniques, and this is the
most popular therapy for dealing with depression and anxiety. The idea here is to simultaneously
modify thoughts and behaviors to help the individual not only get beyond the negative core
beliefs that are holding them back but also change the behavior patterns they have developed in
response to those thought patterns. It is often our troublesome behavior that first brings us to
therapy, and then, once the therapist has somewhat modified the behavior, the patient is in the
position to work on changing the negative thoughts that create the unwanted behavior in the
first place.
Gestalt
Gestalt therapy is based on the philosophy of existentialism and phenomenology; basically, it is
essential to understand who we are in relation to all the things around us, and we must study
and observe what is going on in the present moment in order to truly know ourselves. The
saying, “Man is not an island unto himself,” would describe the Gestalt view of human
understanding. Everything is interrelated, and one cannot understand themselves without
simultaneously understanding the world around them at this time.
Interpersonal Therapy
With interpersonal therapy, or IPT, the focus is on improving relationship skills such as
communication and improving the supporting relationships in the depressed or anxious person’s
life. By learning how to deal with loved ones in a more productive and less combative way, the
individual can improve these relationships and reduce conflicts that might be contributing to
their feelings of depression or anxiety.
