Abnormal behavior is an interesting subject. It is interesting because behavior that is considered normal or abnormal is defined by the culture of a particular place. As cultures vary, so does behavior that is considered abnormal. Behavior which aligns with what society expects is considered normal. On the other hand, behavior which is contrary to social expectation is said to be abnormal. This is a sociological perspective. Abnormal behavior is not only socially unacceptable, it also distresses the individual. The person is unable to function and attain goals like others. Furthermore, abnormal behavior has been studied by various scholars in different fields of endeavor- each field has its approach in explaining the concept to abnormal behavior. Abnormal behavior is disturbing to other members of society- it is socially unacceptable. The distress which abnormal behavior causes often results from self defeatist and distorted thoughts. This paper explores abnormal behavior by examining two theoretical approaches in the study and treatment of abnormal behavior. Furthermore, it discusses a few issues involved in abnormal behavior. The concluding segments of the paper explain the V axes diagnosis system.
0.2 Two theories of abnormal behavior
There are many models of abnormal behavior. However, in this paper only two of these models are discussed in detail, yet it is important to gloss over the others to put this paper in proper context. Some models of abnormal behavior include: statistical model; physiological or biological model; sociological theory; psychoanalytic theory; and the learning model. The statistical model measures standard deviation from what is considered as normal. In the physiological or biological model, abnormal behavior is linked to a disease. For example if someone has a runny nose (which is abnormal), the person has a cold which is caused by a virus. Furthermore, in this model, certain abnormal behaviors are called mental illnesses when they satisfy certain conditions. According to sociological theory, mental disorder is a myth because it is only a label given to people whose behavior differs from what is accepted in society. According to the sociological theory if this label is taken away there will be no disorder. The psychoanalytic theory holds that abnormal behavior is caused by conflicts between an individual’s identity, their ego and the super ego.
The Cognitive theory of abnormal behavior
According to cognitive theories of abnormal behavior the thoughts of individuals are essential in explaining abnormal behavior. Fraser (2009, p.1) writes that cognitive theories of abnormal behavior hold that abnormal behavior originates from maladaptive thoughts and beliefs which have taken root in the individual. These thoughts and beliefs originate due to some experiences which the individual has passed through. Over time, the experiences of the individual are transformed into thoughts and when these thoughts persist, they become the reinforced as beliefs in the mind of individuals. The cognitive theory explains causal attributions. Nothing just happens. There are factors that necessitate these events and these factors can be personality or situational. Furthermore, the theory states that some people have control over their environment while others do not have such control.
For people who do not have control over their environments this can lead to learned helplessness. The theory also examines the various dysfunctional assumptions which people make about life. While some thoughts and assumptions are healthy, others are dysfunctional. All these go a long way in determining their behavior and when these assumptions are negative and unhealthy, they manifest in abnormal behavior. Cognitive theories of abnormal behavior recommend that treatment of abnormal behavior should be focused upon identifying the dysfunctional thoughts that are the cause of the abnormal behavior. When these are identified they can be resolved by challenging their existence. By so doing the individual can overcome the various symptoms of abnormal behavior.
The psychoanalytic theory was propounded by Sigmund Freud and it holds that a lot about human behavior is rooted in the sub conscious- the manifest behavior of human beings that is manifest is only a tip of the iceberg. According to Freud a lot of answers can be found when the subconscious is explored and analyzed. This theoretical approach states that the human personality is made up of three major components namely: the identity, the ego and super ego. According to the theory, defense mechanisms are the minds way of keeping primitive emotions in control. In this theory, treatment for abnormal behavior is made up of talk therapy in order to resolve the many conflicts that are in the subconscious of patient. When these conflicts are unraveled, it is a significant step in finding a solution to abnormal behavior.
0.3 Issues in the study of abnormal behaviors
Certain criteria need to exist for any type of behavior to be considered abnormal. However, it is important to note that the following attributes that are identified below may not all be found in one single individual who exhibits abnormal behavior. They might have only one or a combination of the traits which are described below. In the first place abnormal behavior is unusual. It is not often the norm- it is different from what is expected and common place. By extension, abnormal behavior violates social norms. Since it is unusual it is not accepted in the community. Thus people from that community find it strange and are not willing to accept it. At this point it is important to point out that normality is culturally defined. Port (1996) upholds this statement in a study on abnormal behavior and cultural differences between Hispanics and Asians. Behavior that is considered normal in some parts of the world is considered abnormal in others. One very contemporary example is the acceptance of gay people in most western countries. In developing countries of Africa like Nigeria, gay people are thought to be abnormal. Pentecostal church and traditional worshipers in these places often hold that gay people are possessed by evil spirits and that need to be cast out or that they have curses operating in their lives. However, in the west, many communities have come to terms with same sex sexual preferences expressed by other people.
People who behave abnormally often have a very poor perception of reality. They find it difficult to accept and deal with the prevailing status quo In other words they are living in a dream world- a fantasy and an illusion that is very different from reality. There is often distress within people who exhibit abnormal behavior. They are not comfortable with themselves. There are many issues that are not resolved within their personality. Other people who behave abnormally are maladapted, thus they have impaired functioning. Maladaptive thoughts may lead to abnormal behavior. Often people loose the ability to think straight. This can be due to some experiences which they have been through. They end up thinking in a different many and these thoughts are put into action. Inadvertently, this results in abnormal behavior because the individual acts out their thoughts. In this case a solution to this problem will be to address these thoughts and resolve the confusion that has been created- straighten things out.
Above all, some individuals who behave abnormally are dangerous and should not be around normal people in certain conditions. These people have a poor perception of reality, thus they may not realize that what they are doing can be dangerous. In this light it is up to normal people around to make a balanced judgment and avert disaster. Abnormal behavior is caused by a number of factors which are diverse (genetic, biological, physiological, spiritual, psychological, etc). These causes of abnormal behavior are an important aspect of study. Many causes have been attributed to origin of abnormal behavior. This forms a basis for the many theories which seek to explain abnormal behavior.
0.4 V axes diagnosis
The V axes diagnosis refers to the system of diagnosis that is used in the mental health system to arrive at an accurate and objective evaluation of a patient. The V axes diagnosis is often undertaken by a qualified physician. When the V axes diagnosis is undertaken to its completion it gives a picture of the patient- it tells the story of the patient. Accurate diagnosis is important in treating patients in the mental health system. When health personnel use the V axes diagnosis system, they are on the way to accurate diagnosis and the solution of the health problem which faces the patient. The V axes diagnosis system is descriptive and enables health professionals from various theoretical persuasions to use the system in order to explain what is wrong with the patient. The diagnosis is comprehensive and systematically evaluates the patient. A number of factors are used in analyzing the patient. These factors are as follows: different mental disorders; the overall medical state of the patient; psychological problems; social problems; environmental problems; and the functioning of the patient. The five different axes of the V axes diagnosis system are listed and explained below.
The first axis is “Psychiatric diagnosis.” On this Axis I all psychiatric diagnosis are listed. However, it is important to note that personality disorders and mental retardation are left out on this axis but listed on axis II. Personality disorders and mental retardation are left out on axis I because these conditions may be overlooked in favor of other elaborate conditions that may overshadow its presence. The two conditions are placed on axis II so that there can be a detailed examination of the presence of these conditions. Some patients have more than one diagnosis. When this happens, the primary diagnosis is stated and the subsequent ones.
Axis II focuses on “Developmental diagnoses and diagnoses first diagnosed in infancy or childhood.” On this axis, the diagnoses recorded include personality disorders and mental retardation. These conditions are placed on this axis in order to examine patients in a detailed manner so as to ascertain the presence or otherwise of these conditions. Axis II is also used to take into account prominent maladaptive personality features as well as defence mechanisms. People often use defence mechanisms when they feel that they are placed in a tight spot and they need to wriggle out. In some cases, when it is not the intention of anyone to place them in a tight spot these maladapted individuals continue to use defence mechanisms. Over time it becomes part of them. In a way their thoughts (cognitions have led them to this condition.
On axis II it is difficult to make the diagnosis stated above (namely: prominent maladaptive personality features and defence mechanisms) Diagnosis is often achieved in the end after several visits to the physician. It takes a detailed process but in the end the physician is able to identify the problem.
Diagnosis on axis II is usually postponed if a patient is still suffering from any of the conditions listed on axis I. For example, a patient who has been diagnosed with schizophrenia or depression on axis I cannot be examined on axis II and said to have a personality disorder. In the light, of the patient’s condition, diagnosis on axis II is postponed to a more opportune time. This depends on the peculiar condition at hand.
Axis III deals with “Physical diseases.” On this axis, all physical diseases are listed. All physical diseases are listed irrespective of whether these diseases have any relationship to mental disease (psychiatric disorders) or not. The general medical condition of the patient is important because it is an important consideration in managing the patient’s mental condition. Furthermore, it is important to state that the general medical condition of the patient is can be related to the mental disorder. In some cases the patient’s medical condition is directly responsible for the aggravation and deterioration of the patient’s mental state.
When a physiological condition is directly responsible for the mental disorder in a patient, this should be diagnosed on axis I. Furthermore, the particular medical condition should be recorded on both axis I and axis III. Hypothyroidism is often a direct cause of depression. When a patient presents with this conditions, it is diagnosed on axis I as a mood disorder (hypothyroidism triggers depression) and on axis III the hypothyroidism is recorded.
On the other hand a physiological condition may not be directly responsible for the mental disorder in the patient. When this happens, it is important to investigate the effect of the drugs which are used to treat the physiological condition on the mental disorder. Although the physiological condition does not set off the mental disorder, the drugs used in treating the physiological condition may worsen the mental disorder. In other words, the pharmacotherapy of the physiological condition adversely affects the mental disorder and vice versa. It can also work the other way round.
On axis IV, “Psychological stress factors affecting the patient” are examined. Devos (1989) writes that certain psychiatric and physiological symptoms appear in individuals when they are placed under stressful conditions. On this axis, various stress factors affecting the patient (both past and present) are examined. Also, the stress factors which are present at the time of evaluating the patient are also addressed. Stress factors in the patient’s past may date back to childhood. Stress often results from psychological and environmental problems. These are as follows: negative experiences in life; difficulties and inadequacies in the environment; stress originating from the family; stress at work; stress among peers; deficient financial and social support; and inadequate personal resources.
Axis V addresses the “Global functioning of the patient.” Axis V evaluates whether the patient is able to cope with their present condition. If the patient is unable to cope with their present situation in life, it might be necessary to admit the patient into hospital. Hospital admission is necessary for patients who need care and cannot be left on their own. Information gathered on axis V is necessary in predicting outcomes i.e. what will happen in future.
The level of a patient’s functioning is assessing using the Global Assessment of Functioning (GAF) scale. The GAF scale quantifies the patient’s level of functioning. The GAF scale rates the psychological, social and occupational functioning of the patient. According to Endicott, Spitzer, Fleiss and Cohen (1976, pp. 766-771) the GAF scale is graduated as follows: 1-10; 11-20, 21-30; 31-40; 41-50; 51-60; 61-70; 71-80; 81-90; 91-100. The lower end of the scale (1-10) indicates that the patient danger of hurting self or others. At this point they are suicidal and unable to maintain personal hygiene. On the upper end of the scale, the patient has superior functioning and life’s problems never seem to get out of hand.
Abnormal behavior is a wide field of study which lends itself to many theoretical approaches. Each of these approaches is relevant because they address specific issues involved in abnormal behavior. Insisting on one theoretical approach will be wrong and a narrow attempt at understanding such a complex subject as abnormal behavior. Also, there are many causes of abnormal behavior. Mental disorder is an extreme aspect of abnormal behavior. The treatment of mental disorder needs careful analysis and the use of thorough approaches such as the V axes diagnosis system. At the end of treatment of mental disorders, it is important to assess the patient using GAF scale to know whether the patient is fit to be released into society or retained in hospital for more treatment.
DeVos, Boyer (1989) Symbolic Analysis: Cross-Culturally Berkley: University of California Press, Berkley.
Endicott, J., Spitze, R. L., Fleiss, J. L., Cohen, J. (1976) “The Global Assessment Scale: A Procedure for Measuring Overall Severity of Psychiatric Disturbance.” Archives of General Psychiatry Vol. 33
Fraser, Kalip (2009) “Cognitive theory of abnormal behavior” Retreived 27th May 2009 from http://dogsbody.psych.mun.ca/3650/a4.pdf
Luborsky, L (1962) “Clinician’s Judgments of Mental Health.” Archives of General Psychiatry Vol. 7 p. 407 – 417
Port, Patricia (1996) “Cross cultural perspectives of abnormal behavior and treatment” an unpublished research presented to the Paradise Valley Community College, Phoenix Arizona
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