Defining Normality

and Abnormality
Mariam M. Estrabo, Ed D, RPm
CASE STUDY

Matt is a 42-year-old construction worker. He has been married for 20

years, has two nearly grown children, served four years in the military and
has been employed at the same construction company since he left
military service. He is described as steady and reliable. Yet, there is one
thing that doesn’t seem quite right; he carries small brass bells with him
wherever he goes. He has carried these bells since he was a child and will
tell people that they are for luck. The reality is that Matt carries them to
keep evil spirits away.

He stopped telling people his real reason for carrying bells

because people were less understanding than if he just
said he carried them for luck.
CASE STUDY

Matt’s beliefs do not interfere in his life, he has never been

treated for a mental illness, and he doesn’t appear to use
them to control anything else in his life. His behaviour has
made him the butt of jokes. He has been called harsh names;
he has been physically and mentally abused by others and yet
he continues to carry his bells. Time has taught him to hide
them in his clothing and he has taken to sewing them in
the seams of his shirts and trousers.

How would you describe Matt’s behaviour?

Is Matt mentally ill?
 Problems in defining normality and abnormality

Ritual Homosexuality of the Sambia

The Sambia (pseudonym) are a tribe of
mountain-dwelling, hunting and
horticultural people who inhabit the
fringes of the Eastern Highlands Province
of Papua New Guinea. well known for
their acts of “ritualized homosexuality”
and semen ingestion practices with
pubescent boys.
Problems in defining normality and abnormality
Female Genital Mutilation
the partial or total cutting away of the
external female genitalia as one element of
a rite of passage preparing young girls for
womanhood and marriage
DEFINING ABNORMALITY
• Statistical Infrequency:
Deviation from the average
DEFINING ABNORMALITY
• Deviation from the Optimal:
Failure to function adequately
DEFINING ABNORMALITY
• Behaviour that does not conform to
social expectations or demands
DEFINING ABNORMALITY
• Presence of pronounced psychological
suffering or distress
DEFINING ABNORMALITY
• peculiar thoughts and behavior
DEFINING ABNORMALITY
• maladaptive behavior
DEFINING ABNORMALITY
• Unusual sensory and
perceptual experiences
DEFINING ABNORMALITY
• bodily symptoms involving
appetite, sleep and energy levels
DEFINING ABNORMALITY
• disturbed emotional state
DEFINING ABNORMALITY
• harm to self or other people
THE 3 D’s of Abnormal Behavior

Distress

Disability

Deviance
clinical observations or symptoms should co-occur
DEFINING NORMALITY
DEFINING ABNORMALITY
• self-knowledge
DEFINING ABNORMALITY
• Ability to exercise voluntary
control over behavior
DEFINING ABNORMALITY
• Self-esteem and acceptance
DEFINING ABNORMALITY
• Ability to form and maintain
affectionate relationships
DEFINING ABNORMALITY
• Productivity
 Abnormal Behavior …

is a behavior that is personally

distressful or personally disabling or is
culturally deviant that other individuals judge
the behavior to be inappropriate or
maladaptive.
(HOLMES)
Some Qualifying Terms in Referring to
Mental Disorders

Acute. Used to described disorders of relatively

short duration.

Chronic. Refers to longstanding and often

permanent disorders
Some Qualifying Terms in Referring to
Mental Disorders

Mild, Moderate, Severe

Terms relating to varying points on a
dimension of severity or seriousness
Some Qualifying Terms in Referring to
Mental Disorders

Episodic and Recurrent

Used to described unstable disorder patterns
that tend to come and go
 The Evolution of DSM (Diagnostic &
DSM I (1952)
Statistical Manual of Mental Disorders)

DSM II (1968)

DSM III (1980)

DSM III-R (1987)

DSM IV (1994)

DSM IV-TR (1994) DSM V (2013)