LECTURE 13

ABNORMAL BEHAVIOUR

13.1 Introduction

Abnormal psychology is the scientific study of psychological disorders. These disorders affect the way
people feel, think, speak, and behave. The field of abnormal psychology is also known as
psychopathology.

Standards of normal and abnormal behaviour differ from society to society and change as social
conditions and customs change. For example, the practice of severely beating children to discipline
them was considered normal behaviour for many centuries. Today, many people consider such
behaviour abnormal and cruel.

Learning Activity:
How many mentally abnormal people are there in your neighbourhood or your local
market?

Studies in abnormal psychology are conducted mainly by clinical psychologists, psychiatrists and social
workers. These experts collect data by such means as personality and intelligence tests, experiments,
and case studies. One kind of case study, an idiographic study, describes the behaviour and thought
patterns of one person. Another type, called a Nomothetic study, examines the behaviour and thought
patterns common to many people who suffer the same disorder.

Psychiatrists are doctors specializing in the field of mental illness - they are medically trained and can
prescribe medicine while clinical psychologists are not medically trained and cannot prescribe
medicine. Clinical psychologists have a background in neuroscience and psychology.
 13.2 Learning Outcomes
At the end of this lecture, you should be able to:
• Define abnormality
• Describe the DSM classification system
• Discuss different mental disorders
• Distinguish between different therapeutic approaches to mental
disorders

13.3 Definition of Abnormality

Abnormality means anything that is not normal. This definition covers a wide range of abnormalities.
Clinical psychologists are interested in particular abnormalities. It is hard to define what we mean by
“abnormal” because:

• There is no absolute distinguishing line between normal and abnormal

• No single definition is enough to take into account all the different types of behaviour that might
be called abnormal
• There is no shared characteristic of all that we call abnormal - things that are abnormal can have
nothing at all in common.
There are several ways in which people have tried to define abnormality. Some of the approaches are
discussed below:

Statistical Deviation

Anything that happens infrequently can be defined as abnormal. What is normal is what usually
happens. This means that any behaviour that does not conform to established standards is abnormal.
For example, a child whose IQ is significantly low or high can be considered as abnormal. A single
figure can be used as a cut-off point. Any individual falling below the figure can be diagnosed as
abnormal.

Learning Activity:
Give examples of abnormal traits using the statistical deviation approach.
 Social Deviation
Deviation from social norms is another way of defining abnormality. For example, if a teacher who
has behaved normally starts to behave strangely (such as becoming obsessively religious) then he/she
can be referred to a psychiatrist. The problem with this definition is that, what may normal in one social
setting may be abnormal in another one. For example, gay marriage.

Learning Activity:

Give examples of behaviours that are considered normal in your community while in other
communities are considered abnormal.

Subjective Distress
If someone feels that they have a problem, and is so serious that it is disturbing their day-to-day living,
this can be used to diagnose abnormality. For example, if you are suffering from anxiety, then someone
can say the anxiety is unnecessary. The sufferer is in need of help. Thus, if the person suffering
psychologically or physically and is in need of help then he/she can be said to be abnormal.

Disability or Dysfunction
If a behaviour is causing a problem, it can be diagnosed as abnormal. If it were causing a dysfunction,
then treatment would be needed. The key feature is that the behaviour prevents normal functioning.
Abnormality as the Absence of Normality

If “normality” is defined, then abnormal means not fitting that definition. It is estimated that 20% of
people have a psychological disorder (Myers et al., 1984).

dh

Learning activity
Cite five examples of abnormality in your community

13.4 Approaches and Therapies of Abnormal Behaviours

Many different treatments and therapies are used to tackle mental problems, see figure 6. There
are many different paradigms in psychology. A paradigm is a set of basic assumptions about
how something is thought about, how data is gathered, and what influences there might be.
Paradigm in psychology is sometimes called an approach.

Causes of Psychological disorders

Theoretical Approach Focus
Cognitive Thinking process
Social approach Cultural factors, roles and norms
Cognitive developmental approach Maturational process
Learning approach Environment, Conditioning
Psychodynamic approach Inner forces
Physical approach Biology, genetics

The Medical/Biological Approach

Assumes that there is a disease to be treated. It includes aetiology – the study of what causes
the disease – as well as the underlying genetic and biochemical factors. It assumes that there is
an illness, comparable to a physical illness.
It looks at the disease and the disruption of biological functioning. For example, depression is
thought to arise sometimes from-problems in neural transmission, and anxiety disorder from a
problem in the autonomic nervous system.

Behaviour Genetics involves study of genes and how genes account for differences in
behaviour. Some disorders may come from a genetic predisposition.
Biochemistry: the assumption is that abnormal behaviour can stem from problems in
neurotransmitter activity.

Biological Approaches to Treatment

Treatment will have a biological basis if it is thought that abnormal behaviour is caused by
either a genetic predisposition or a biochemical imbalance. Altering bodily functioning may
correct the problem or alleviate the symptoms. Drugs can be administered to alter the
neurotransmitter balance or to mimic a neurotransmitter that is deficient. A good example is
administering Diazepam (Valium) to reduce tension in anxiety disorders or using other drugs
such as lithium to treat bipolar disorder.

The Psychodynamic/Psychoanalytic Approach

Figure 25: Sigmund Freud
According Sigmund Freud, problems come from unconscious conflicts and forces. Defence
mechanisms are used (unconsciously) to allow the individual to avoid facing up to their
unconscious conflicts.
Mental illness occurs when the energy used in maintaining defence mechanisms is giving an
individual problems. The main method of treatment is to release the unconscious conflicts,
getting behind the defence mechanism, and making thoughts and memories conscious. The
idea is that when they have come to conscious awareness there will be no problem because the
individual will learn more open ways of working through their problems and coming to terms
with them, and as a result will have freed themselves. Treatment is by psychoanalysis that
includes transference and counter transference. Transference is where the person undergoing
treatment (the analysand) transfers their feelings on to the therapist; counter transference is
where the therapist may transfer feelings on to be analysed.

The Behavioural Approach

Assumptions
• Learning comes from surroundings and environment.
• Experiences shape a person’s behaviour, attitudes and beliefs.
• Mental illness can be understood in terms of a person’s learning and experiences.
• Treatment of mental illness is about changing the person’s behaviour, that is re-learning
new ways of acting.
• Mental health problems are maladaptive behaviours accruing as a result of
inappropriate learning experiences.
• If behaviour is changed, mental health will improve.
• Behaviour can be changed through behaviour modification and behaviour therapy.
The Cognitive Approach
Assumes that mental problems come from inappropriate attributions, beliefs, and bad
thoughts or maladaptive thinking.
Cognitive- Behavioural Therapy
Cognitive-behavioural therapy involves the use of cognitive restructuring to change the
way the person thinks about life

Rational–Emotive Behaviour Therapy

According to Ellis (1962) irrational beliefs cause maladaptive behaviour. People have
mistaken assumptions and, therefore, put pressure on themselves to achieve things they cannot
achieve. For example, a woman might think everyone must like her, or a man might think he
must always be perfect. Rational-emotive behaviour therapy aims to get people to think more
rationally. For example, to admit that they can make mistakes.

Cognitive Therapy
Beck (1967) put forward a form of cognitive therapy, emphasizing how people distort their
experience. For example, someone who is depressed is likely to remember or notice only the
bad things that happen in a day, and to ignore or discount the positive ones. Beck developed a
form of therapy that aimed at encouraging people to change the way they see themselves and
the way they interpret what happens to them. Thus, cognitive therapy is concerned with the
attributions and explanations that people use to explain what is happening to them.

The Humanistic Approach (Carl Rogers and Abraham Maslow)

Focuses on personal growth, and not so much on mental disorder. Mental disorder occurs when
personal growth is interrupted or stopped for some reason. The humanistic paradigm:

• Emphasise free will.

• See the most important part of someone’s world as being their own view of it.
• Focus on an individual’s strength, and not their weaknesses.
• Encourage personal growth rather than relieving distress.
For the humanists:
• Human nature is basically good.
• Everyone has a need to self-actualise, that is, to realise his or her full potential, or strive to
do so.
• Mental problems arise when the striving to self-actualisation becomes blocked in some
way.
Humanistic therapies have generally been regarded as more appropriate for people with
neurotic or anxiety disorders than for those with psychotic problems such as schizophrenia.

Client-Centred Therapy
Assumes that healthy people are innately good, effective and can become aware of their
behaviour as goal directed and self-directive.
therapists should create a situation where the individual can become healthy.
To do so people need to become effective, aware of their behaviour, and able to direct their
own goals. The therapist has three core qualities:
• Genuineness, which means no façade: the therapist must act normally and honestly.
• Unconditional Positive Regard, which means there are no conditions attached by the
therapist to the client, in terms of how the therapist sees him/her. This can be achieved
by:
o Suspending all critical judgement concerning the client.
o Encouraging clients to express themselves freely.
o Identifying and calling clients by their names and remembering the details
shared with them earlier.
o Speaking in modulated warm tones.
o Concentrating on both verbal and non-verbal messages in order to understand
the person.
o Creating a conducive atmosphere, which will promote the client’s self-worth.
o Communicating to the clients your faith and confidence in their ability to solve
their own problems.
o Being courteous (Kenya Institute of Education, 2003).
• Accurate
• empathetic understanding. This means being able to see through the eyes of the client
and share in their feelings.
• When empathizing the therapist should not:
 o Get to the empathetic trap whereby he/she forgets that the client is the focus of
the therapy e.g., by saying, I know how you feel, that happened to me as well.
o Deny the client his feelings by saying, many people have had that problem, you
will soon settle down.
o Show lack of understanding. Ability to empathize is what makes therapy
different from a conversation. This enables the client to explore himself and
understand the problem at a deeper level (Kenya Institute of Education, 2003).

Psychotherapy
Psychotherapy covers all treatments involving psychological techniques, such as talking,
listening and exploring thinking.
The fact that someone pays attention to the individual is what helps rather than the therapy
itself.
This is like a placebo effect, where someone is given a sugar pill instead of the drug they think
they are taking, but they still improve, presumably because of psychological reasons. The
warmth, trust and encouragement do have a lasting effect, and this is more than a simple
placebo effect. Although some clients may improve with psychotherapy, others may
deteriorate.

Learning Activity:

1. Explain how patients of mental illness were treated in your communities in the past.
2. How are mental patients treated today in the country?

13.5 Specific Mental Disorders

Anxiety Disorders
They are classified as neuroses. These are mental disorders where there is dysfunction. The
dysfunction takes the form of an exaggeration of certain behaviours or symptoms which occur
normally in just about everyone. The person is still in touch with reality, and knows that they
have a problem.

Anxiety disorders are closely associated with stress. Anxiety is comparable with fear which is
a response to something specific. Anxiety is more general unease. It is non-specific. Some
anxiety is normal-up to a point. It becomes a problem when it interferes with the person’s
normal everyday functioning. Symptoms of anxiety disorders include; tension, nervousness,
sweating, heart palpitations, dizziness, trembling and concentration problems.

Anxiety disorders and symptoms

• Generalized anxiety disorder. Excessive anxiety that occurs on most days for a period
of months. The anxiety usually centres on issues like work and school. Symptoms
include fatigue, difficulty in concentrating, muscle tension and sleep disorders.
• Simple or specific phobia. This is persistent, excessive, unreasonable fear about an
object.
• Social phobia. Anxiety in response to social situations
• Panic attack, is a feeling of overwhelming fear that occurs suddenly and unexpectedly.
Symptoms include; sweating, fear of losing control, trembling, shaking and shortness
of breath.
• Agoraphobia – fear of being in open places, or places where escape is difficult. It often
includes fear of the fear itself.
• Obsessive-compulsive disorder (OCD). Obsessions are recurrent, persistent,
inappropriate thoughts, and compulsions are repetitive acts the person feels obliged to
perform.
• Post-traumatic stress (PTSD)-persistent experiencing of a traumatic event. Symptoms
include sleep disturbances, difficult in concentrating and an exaggerated startle
response

Schizophrenia
Schizophrenia is classified under psychosis. Psychoses are mental disorders where the
individual is not in touch with reality. Schizophrenia is a specific sort of psychosis,
characterized by thought, language and behaviour disturbances. There is more than one type
of schizophrenia. Blenler (1911) introduced the term “schizophrenia” split (schism) of the
mind (phrenos). It implies splitting of cognition from emotion.
Table 20
Schizophrenic disorders and symptoms
Disorders Symptoms
Affective disturbances apathy, lack of pleasure, inappropriate feelings and
emotions
Perceptual disturbances heightened sensations, hallucinations
Behavioural disturbances peculiar mannerisms, facial expressions, reduced
movements, inappropriate social behaviours, lack of
motivation
Disturbances of language and thought Loose association of ideas, lack of coherence,
conceptual difficulties with thinking, poor speech, etc
Source: Brain (2002)
Different people with schizophrenia present different symptoms. Patients do not recognize
that they are ill or that what they are doing is wrong and therefore they cannot communicate
their feelings. Speech is disorganized. Five different kinds of schizophrenia have been
identified: Paranoid, Catatonic, Disorganised, Undifferentiated or simple, and Residual
schizophrenia.
Paranoid
• Preoccupation with one or more delusions or frequent auditory hallucinations
• Absence of prominent schizophrenic symptoms such as disorganised speech or
behaviour, catatonic behaviour, or flat or inappropriate affect.
Catatonic
• Immobility (including waxy flexibility or stupor)
• Excessive motor activity (seemingly purposeless)
• Extreme negativism (resistance, rigidity of posture) or mutism
• Posturing (peculiar voluntary movements, bizarre positions)
• Repetition of speech sounds.
Disorganized
• Disorganized speech and behaviour
• Flat or inappropriate affect
Undifferentiated
• Meets criteria for schizophrenia but does not meet criteria for catatonic, paranoid or
disorganized sub-types.
Residual
• No longer active symptoms of schizophrenia, and does not meet criteria for any sub-type.
• Continuing evidence of disturbance indicated by two or more symptoms of schizophrenia
in mild forms.
Mood Disorders
These are disorders of feeling, also known as affective disorders. There are two main types of
affective disorders.
• Unipolar depression
• Bipolar depression
Unipolar depression is where the person has one consistent, recurrent state-generally that of
being depressed.
Bipolar disorder is where the person experiences more than one emotional state as part of
their problem. For example, they are sometimes manic and sometimes depressed. Bipolar
means having two extremes, or “poles” so manic depression is two-sided and known as bipolar,
whereas straightforward depression is one-sided, and known as unipolar.
Depression involves resistant negative moods, depleted energy, the altering of sleep habits, and
altered motivation and behaviours. Depression becomes a problem when it leads to
dysfunctional behaviour and persists. Major depressive disorders include:
• Psychotic depression, where there is departure from reality
• Melancholic depression, where there are several physical symptoms
• Seasonal affective disorder, where depression occur because of persistent
environmental conditions such as cold weather.

Learning Activity:
Differentiate between anxiety disorders, schizophrenia and mood disorders.

Eating Disorders
There are two main types of eating disorder: Anorexia nervosa and bulimia nervosa that
generally start before adulthood. In rare occasions, adults develop eating disorders for the first
time.
Anorexia nervosa is an illness that stems from an intense fear of becoming fat, and a distorted
body image. Symptoms include:
 • Dramatic weight loss
• Obsessions and neuroses
• A need for personal control
• Depression
• Low oestrogen levels
• Negative attitudes towards sexual activity

Anorexics see themselves as fat, and refuse to maintain their normal body weight. Anorexia
nervosa is more common in females than in males. It is a serious mental problem that in
extreme cases can cause death (Brain, 2002). The most likely age for the onset is between 14
and 18 years.

Bulimia nervosa is characterized by binge eating, where there is little control over how much
is taken in. Typically, these binges will be followed by self-induced vomiting, fasting, vigorous
exercise, or excessive use of laxatives as the bulimic person tries to prevent weight gain by
getting rid of the calories. It is common among young people. For bulimia to be diagnosed as
a disorder in need of treatment, the general criteria operated by clinicians is that there should
have been at least two binges (eating sprees) a week, over a period of three months.

Anorexia and bulimia seem to be related and about half of those with anorexia show some sign
of bulimia, as they often use bingeing and purging techniques rather than simple fasting.
Bulimia occurs more in women than in men and the average age for onset is 18 years.
13.6 Summary
• Abnormal behaviour is one that:
• Deviates from the social norm
o Happens infrequently
o Causes a problem to the individual
• For proper treatment of mental disorders, diagnosis is necessary
• Anxiety disorders are disorders in which there is no dysfunction
• Schizophrenia is a mental disorder in which the individual is not in touch with reality.
• Mood disorders involve disordered feelings and other affective disorders. There are two
main types, bipolar and unipolar.
• Two eating disorders are anorexia nervosa and bulimia nervosa.
• Anorexia nervosa is a condition in which a person becomes so obsessed with weight control
that she starves herself to death (note that it affects mainly females).
• Bulimia nervosa is an eating disorder that involves periodic bingeing, alternated with
purging to avoid gaining weight.

? Self-Assessment Questions
1. Differentiate between a clinical psychologist and a psychiatrist
2. Discuss the term abnormality
3. List mental disorders as identified in the DSM IV
4. Briefly explain the following mental disorders:
(i) Anxiety
(ii) Schizophrenia
(iii) Mood disorders
(iv) Eating disorders