Psychology and Mental Health Volume II Group Therapy—Type A Behavior Pattern potx

Psychology
and
Mental Health
This Page Intentionally Left Blank
Psychology
and
Mental Health
Volume I
Abnormality — Grief and Guilt
edited by
Jaclyn Rodriguez, Ph.D.
Occidental College
project editor
Tracy Irons-Georges
SALEM PRESS, INC.
Pasadena, California Hackensack, New Jersey
MAGILL’S
CHOICE
Copyright © 2001, by Salem Press, Inc.
All rights in this book are reserved. No part of this work may be used or
reproduced in any manner whatsoever or transmitted in any form or by any
means, electronic or mechanical, including photocopy, recording, or any
information storage and retrieval system, without written permission from the
copyright owner except in the case of brief quotations embodied in critical
articles and reviews. For information address the publisher, Salem Press, Inc.,
P.O. Box 50062, Pasadena, California 91115.
Most of the essays in Magill’s Choice: Psychology and Mental Health
originally appeared in Magill’s Survey of Social Science: Psychology, 1993,
edited by Dr. Frank N. Magill and Jaclyn Rodriguez; some of them were
updated for Magill’s Choice: Psychology Basics, 1998. The remainder of the

essays were taken from Magill’s Medical Guide: Revised Edition 1998. All
bibliographies have been updated, and some formats have been changed.
∞ The paper used in these volumes conforms to the American National
Standard for Permanence ofPaper for Printed Library Materials, Z39.48-1992
(R1997).
Library of Congress Cataloging-in-Publication Data
Psychology and mental health / edited by Jaclyn Rodriguez ; project editor
Tracy Irons-Georges.
p. cm. — (Magill’s choice)
Includes bibliographical references and index.
ISBN 0-89356-066-9 (set : alk. paper). — ISBN 0-89356-167-7 (vol. 1 :
alk. paper). — ISBN 0-89356-068-5 (vol. 2 : alk. paper)
1. Psychology, Pathological—Encyclopedias. 2. Mental illness— Encyclo-
pedias.3.Mentalhealth—Encyclopedias.I.Rodriguez,Jaclyn. II. Irons-Georges,
Tracy. III. Series.
RC437 P795 2001
616.89’003—dc21
00-046312
First Printing
printed in the united states of america
Table of Contents
Publisher’s Note . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
Contributor List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Abnormality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Abnormality: Behavioral Models . . . . . . . . . . . . . . . . . . . . . . . . 8
Abnormality: Biomedical Models . . . . . . . . . . . . . . . . . . . . . . . 14
Abnormality: Cognitive Models . . . . . . . . . . . . . . . . . . . . . . . . 22
Abnormality: Family Models . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Abnormality: Humanistic-Existential Models . . . . . . . . . . . . . . . . . 35
Abnormality: Legal Models . . . . . . . . . . . . . . . . . . . . . . . . . . 43

Abnormality: Psychodynamic Models . . . . . . . . . . . . . . . . . . . . . 49
Abnormality: Sociocultural Models . . . . . . . . . . . . . . . . . . . . . . 56
Addictive Personality and Behaviors . . . . . . . . . . . . . . . . . . . . . . 63
Aggression: Definitions and Theoretical Explanations . . . . . . . . . . . . 71
Aggression: Reduction and Control . . . . . . . . . . . . . . . . . . . . . . 79
Agoraphobia and Panic Disorders . . . . . . . . . . . . . . . . . . . . . . . 84
Alcoholism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Alzheimer’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
Amnesia, Fugue, and Multiple Personality . . . . . . . . . . . . . . . . . . . 106
Analytical Psychotherapy . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
Anorexia Nervosa and Bulimia Nervosa . . . . . . . . . . . . . . . . . . . . 118
Antisocial Personality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
Anxiety Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
Aphasias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139
Attention-Deficit Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . 146
Autism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152
Aversion, Implosion, and Systematic Desensitization Therapies . . . . . . 158
Bed-Wetting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166
Behavioral Assessment and Personality Rating Scales . . . . . . . . . . . . 172
Behavioral Family Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
Biofeedback and Relaxation . . . . . . . . . . . . . . . . . . . . . . . . . . 186
Borderline, Histrionic, and Narcissistic Personalities . . . . . . . . . . . . . 192
Brain Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199
Child Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205
Child and Adolescent Psychiatry . . . . . . . . . . . . . . . . . . . . . . . . 212
Codependent Personality . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216
Cognitive Behavior Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . 222
Cognitive Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230
Community Psychology . . . . . . . . . . . . . . . . . . . . . . . . . . . . 236
Couples Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243

v
Dementia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
Depression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 258
Diagnosis and Classification . . . . . . . . . . . . . . . . . . . . . . . . . . 267
Divorce and Separation: Adult Issues . . . . . . . . . . . . . . . . . . . . . 274
Divorce and Separation: Children’s Issues . . . . . . . . . . . . . . . . . . . 281
Domestic Violence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288
Down Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 298
Dyslexia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305
Eating Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311
Electroconvulsive Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . 319
Forgetting and Forgetfulness . . . . . . . . . . . . . . . . . . . . . . . . . . 325
Geriatric Psychiatry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 331
Gestalt Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 335
Grief and Guilt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 341
Category List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 351
Psychology and Mental Health
vi
Publisher’s Note
From the earliest history, humans have sought explanations for seemingly
abnormal thoughts and actions. Some behaviors were attributed to possession by
gods or demons, others to an imbalance of theoretical “humors” in the body. It was
not until modern times, with the advent of the science of psychology, that the
influence of physical disease, genetic makeup, and emotional or psychological
trauma on mental health has been identified. Psychology and Mental Health
examines this field as it continues to unravel the origins of mental illness and
psychological disorders and the means to prevent or alleviate their symptoms.
Of the 107 essays in this work, 83 first appeared in Magill’s Survey of Social
Science: Psychology (1993); 16 of them were updated and reprinted in Psychology
Basics (1998). The other 24 essays were published in Magill’s Medical Guide,

Revised Edition 1998. All bibliographies havebeen updated with the latest editions
and most recent scholarship in the field.
Many of the entries in Psychology and Mental Health consider psychopatholo-
gies. Some of these conditions can pose a serious threat to the safety and function-
ality of the patient, such as schizophrenia, Alzheimer’s disease, anorexia nervosa,
or autism. Other psychic-emotional and learning disorders have a lesser but still
significant impact on a patient’s mental health and emotional condition, such as
depression, dyslexia, sibling rivalry, or sexual dysfunction. A number of entries
discuss various treatment options, from electroconvulsive therapy and lobotomy to
play therapy and psychoanalysis.
All entries begin with the standard information “Type of psychology” and
“Fields of study.” A brief definition of the topic follows. Next comes a list of
“Principal terms” with concise definitions. Entries on mental illness or lesser
psychological impairments have a section “Causes and Symptoms,” which defines
the condition and describes its origins and possible manifestations in patients, and
a section “Treatment and Therapy,” which explores the various treatments avail-
able to alleviate symptoms or effect a cure. More general entries feature the
sections “Overview” and “Applications.” The last section of all entries is “Perspec-
tive and Prospects,” which places the topic in a larger context within psychology.
For example, an entry on a psychopathology may cover the earliest known inves-
tigation into that condition, the evolution of its treatment over time, and promising
areas of research for a greater understanding of its causes and cure. Every entry
ends with a “Bibliography” of sources to consult for further study and a list of
cross-references to related articles within Psychology and Mental Health. All
essays are signed by the author.
At the end of volume 2 is a list of entries by category: abnormality, anxiety
disorders, childhood and adolescent disorders, depression, developmental issues,
diagnosis, emotional disorders, learning disorders, organic disorders, personality
disorders, schizophrenias, sexual disorders, sleep disorders, stress, substance
abuse, and treatment. A comprehensive subject Index of people and concepts

concludes the volume.
vii
The contributors to this work are academicians from psychology, medicine, and
other disciplines in the life sciences; their names and affiliations are listed in the
front matter to volume 1. We thank them for sharing their expertise with general
readers. The charts of possible symptoms and signs that appear in some entries
were taken from National Mental Health Association factsheet from 1996 and
1997.
Psychology and Mental Health
viii
Contributor List
Norman Abeles
Michigan State University
Steven C. Abell
Loyola University of Chicago
Bruce Ambuel
Medical College of Wisconsin
Stephen M. Auerbach
Virginia Commonwealth University
Bruce E. Bailey
Stephen F. Austin University
Iona C. Baldridge
Lubbock Christian University
Donald G. Beal
Eastern Kentucky University
Alan J. Beauchamp
Northern Michigan University
Brett L. Beck
Bloomsbury University
Paul F. Bell

The Medical Center, Beaver,
Pennsylvania
Christiane Brems
University of Alaska
Louis A. Cancellaro, M.D.
Veteran Affairs Medical Center,
Mountain Home, Tennessee
Rebecca M. Chesire
University of Hawaii—Manoa
Richard G. Cormack
Independent Scholar
Arlene R. Courtney
Western Oregon State College
Thomas E. DeWolfe
Hampton-Sydney College
Ted Eilders
American Psychological Association
Russell Eisenman
McNeese State University
Mary C. Fields
Collin County Community College
Robin Franck
Southwestern College
Alan K. Gibson
Southern California College
Virginia L. Goetsch
West Virginia University
Dolye R. Goff
Lee College
L. Kevin Hamberger

Medical College of Wisconsin
Ronald C. Hamdy, M.D.
James H. Quillen College of Medicine
Peter M. Hartmann, M.D.
York Hospital, Pennsylvania
James Taylor Henderson
Wingate College
Katherine H. Houp
Midway College
Larry Hudgins, M.D.
Veteran Affairs Medical Center,
Mountain Home, Tennessee
Mark E. Johnson
University of Alaska, Anchorage
Jonathan Kahane
Springfield College
William B. King
Edison Community College
Terry Knapp
University of Nevada, Las Vegas
Kevin T. Larkin
West Virginia University
ix
Joseph C. LaVoie
University of Nebraska at Omaha
Scott O. Lilienfeld
State University of New York at
Albany
Deborah R. McDonald
New Mexico State University

Linda E. Meashey
Pennsylvania State University,
Harrisburg
Laurence Miller
Western Washington University
Paul Moglia
St. Joseph’s Hospital and Medical
Center, Paterson, New Jersey
John Panos Najarian
William Paterson University
John W. Nichols
Tulsa Junior College
Shirley A. Albertson Ownes
Southern California College
Oliver Oyama
Duke/Fayetteville Area Health
Education Center
Linda J. Palm
Edison Community College
Keith Krom Parker
Western Montana College of the
University of Montana
Carol Moore Pfaffly
Fort Collins Family Medical Center
Vicky Phares
University of Connecticut
Nancy A. Piotrowski
University of California, Berkeley
Layne A. Prest
University of Nebraska Medical

Center
Judith Primavera
Fairfield University
R. Christopher Qualls
Emory and Henry College
Paul August Rentz
South Dakota State University
Ronald G. Ribble
University of Texas at San Antonio
Cheryl A. Rickabaugh
University of Redlands
Denise S. St. Cyr
New Hampshire Technical College
Elliott P. Schuman
Long Island University
Susan J. Shapiro
Indiana University East
Michael F. Shaughnessy
Eastern New Mexico University
Sanford S. Singer
University of Dayton
Genevieve Slomski
Independent Scholar
Gerald Sperrazzo
University of San Diego
Stephanie Stein
Central Washington University
Leland C. Swenson
Loyola Marymount University
Richard G. Tedeschi

University of North Carolina at
Charlotte
Gerald T. Terlep
Bon Secours Hospital System
Leslie V. Tischauser
Prairie State College
James T. Trent
Middle Tennessee State University
Lois Veltum
University of North Dakota
Scott R. Vrana
Purdue University
Psychology and Mental Health
x
Elaine F. Walker
Emory University
Ann L. Weber
University of North Carolina at
Asheville
Edward R. Whitson
State University of New York, College
at Genesco
Mark A. Williams
University of Mississippi
Russell Williams
University of Arkansas for Medical
Sciences
Bradley R. A. Wilson
University of Cincinnati
Gregory L. Wilson

Washington State University
Karen Wolford
State University of New York, College
at Oswego
Frederic Wynn
County College of Morris
Contributor List
xi
This Page Intentionally Left Blank
Psychology
and
Mental Health
This Page Intentionally Left Blank
Psychology
and
Mental Health
Volume II
Group Therapy — Type A
Behavior Pattern
Index
edited by
Jaclyn Rodriguez, Ph.D.
Occidental College
project editor
Tracy Irons-Georges
SALEM PRESS, INC.
Pasadena, California Hackensack, New Jersey
MAGILL’S
CHOICE

Copyright © 2001, by Salem Press, Inc.
All rights in this book are reserved. No part of this work may be used or
reproduced in any manner whatsoever or transmitted in any form or by any
means, electronic or mechanical, including photocopy, recording, or any
information storage and retrieval system, without written permission from the
copyright owner except in the case of brief quotations embodied in critical
articles and reviews. For information address the publisher, Salem Press, Inc.,
P.O. Box 50062, Pasadena, California 91115.
Most of the essays in Magill’s Choice: Psychology and Mental Health
originally appeared in Magill’s Survey of Social Science: Psychology, 1993,
edited by Dr. Frank N. Magill and Jaclyn Rodriguez; some of them were
updated for Magill’s Choice: Psychology Basics, 1998. The remainder of the
essays were taken from Magill’s Medical Guide: Revised Edition 1998. All
bibliographies have been updated, and some formats have been changed.
∞ The paper used in these volumes conforms to the American National
Standard for Permanence of Paper for Printed Library Materials, Z39.48-1992
(R1997).
Library of Congress Cataloging-in-Publication Data
Psychology and mental health / edited by Jaclyn Rodriguez ; project editor
Tracy Irons-Georges.
p. cm. — (Magill’s choice)
Includes bibliographical references and index.
ISBN 0-89356-066-9 (set : alk. paper). — ISBN 0-89356-167-7 (vol. 1 :
alk. paper). — ISBN 0-89356-068-5 (vol. 2 : alk. paper)
1. Psychology, Pathological—Encyclopedias. 2. Mental illness— Encyclo-
pedias.3.Mentalhealth—Encyclopedias.I.Rodriguez,Jaclyn. II. Irons-Georges,
Tracy. III. Series.
RC437 P795 2001
616.89’003—dc21
00-046312

First Printing
printed in the united states of america

Table of Contents
Group Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 355
Hypochondriasis, Conversion, Somatization, and Somatoform Pain . . . . 360
Identity Crises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 368
Insomnia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 375
Jealousy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 381
Juvenile Delinquency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 386
Learning Disabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 393
Lobotomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 402
Madness: Historical Concepts . . . . . . . . . . . . . . . . . . . . . . . . . 408
Manic-Depressive Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . 417
Memory Loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 426
Mental Health Practitioners . . . . . . . . . . . . . . . . . . . . . . . . . . 429
Mental Retardation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 435
Midlife Crises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 443
Modeling Therapies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 449
Music, Dance, and Theater Therapy . . . . . . . . . . . . . . . . . . . . . . 455
Neurosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 461
Obsessive-Compulsive Disorder . . . . . . . . . . . . . . . . . . . . . . . . 465
Operant Conditioning Therapies . . . . . . . . . . . . . . . . . . . . . . . . 473
Paranoia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 480
Person-Centered Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 484
Personality: Psychophysiological Measures . . . . . . . . . . . . . . . . . . 491
Phobias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 498
Play Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 502
Post-traumatic Stress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 508
Projective Personality Traits . . . . . . . . . . . . . . . . . . . . . . . . . . 515

Psychiatry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 521
Psychoactive Drug Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . 525
Psychoanalysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 531
Psychosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 538
Psychosomatic Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . 541
Psychosurgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 548
Psychotherapy: Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . 554
Psychotherapy: Effectiveness . . . . . . . . . . . . . . . . . . . . . . . . . . 561
xix
Psychotherapy: Goals and Techniques . . . . . . . . . . . . . . . . . . . . . 568
Psychotherapy: Historical Approaches to Treatment . . . . . . . . . . . . . 574
Rational-Emotive Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . 581
Reality Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 588
Schizophrenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 594
Schizophrenia: High-Risk Children . . . . . . . . . . . . . . . . . . . . . . 601
Seasonal Affective Disorder . . . . . . . . . . . . . . . . . . . . . . . . . . 607
Sexual Dysfunction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 614
Sexual Variants and Paraphilias . . . . . . . . . . . . . . . . . . . . . . . . 621
Sibling Rivalry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 627
Sleep Apnea Syndromes and Narcolepsy . . . . . . . . . . . . . . . . . . . 635
Strategic Family Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . 641
Stress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 648
Stress: Behavioral and Psychological Responses . . . . . . . . . . . . . . . 654
Stress: Coping Strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . 661
Stress: Physiological Responses . . . . . . . . . . . . . . . . . . . . . . . . 666
Stress: Prediction and Control . . . . . . . . . . . . . . . . . . . . . . . . . 673
Substance Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 679
Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 685
Teenage Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 693
Transactional Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 699

Type A Behavior Pattern . . . . . . . . . . . . . . . . . . . . . . . . . . . . 706
Category List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 715
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 719
Psychology and Mental Health
xx
Psychology
and
Mental Health
This Page Intentionally Left Blank
Abnormality
Abnormality
Type of psychology: Psychopathology
Fields of study: Models of abnormality
Abnormality means behavior, thinking processes, or feelings deemed undesirable
and therefore subject to control or change. Differing points of view about theoreti-
cal orientation, tolerance for deviance, where to draw the line between normal and
abnormal, and the use of labeling lead to differences in the criteria used for
definitions. Important criteria include subjective discomfort, disability or ineffi-
ciency, and deviance, especially bizarre or reality-distorting deviance.
Principal terms
behavioral view: a perspective that emphasizes understanding a person in terms
of his or her objectively measured behavior; normal, in this view, is functioning
well
deviancy: the quality of having a condition or engaging in behavior that is
different from the typical in a social group and is considered undesirable
distortions of reality: beliefs that distort universally accepted assumptions
such as those about time, space, cause and effect, or life and death; delusions
medical model: a view in which abnormality consists of a number of diseases
which originate in bodily functions, especially in the brain, and have defined
symptoms, treatments, and outcomes

phenomenological view: a perspective that emphasizes understanding a person
from his or her own viewpoint; normal, in this view, is feeling satisfied with
oneself
psychodynamic view: a perspective that emphasizes understanding a person in
terms of how he or she copes with unconscious feelings and conflicts; normal,
in this view, is understanding and controlling the feelings and conflicts
statistical definition: a definition of abnormality as a condition that is different
from the average or mean of the characteristic or trait
Overview
Abnormality is a term applied to behaviors, thinking processes, or feelings that are
viewed by the individual and/or by society as undesirable and requiring control or
change, and viewed as deficits which may or may not have a clear etiology but
which should be compensated for by the individual and society. Psychologists or
other mental health professionals are enlisted to test and/or interview individuals
to determine whether a condition is abnormal, and to facilitate change or advise in
delineating compensation. There are three typical standards, or criteria, that are
used by mental health professionals to decide whether the condition is abnormal:
discomfort, disability, and deviance.
The first two of these criteria have some similarity to the general indicators of a
physical disease. Just as physical disease may be marked by pain, the major
1
symptom that brings most private patients to a psychotherapist is a chronic
psychological pain or discomfort. Just as a physical impairment, such as a broken
leg, usually leads to problems in daily living, so the second condition that defines
abnormality is some sort of difficulty in functioning, a disability or impairment.
Both discomfort and disability are often evaluated by one’s personal standards.
One is feeling discomfort because of problems one knows best oneself, or one is
inefficient compared to what one expects of oneself.
The third major criterion for abnormality, deviance, is based not on personal
standards but on the standards of society. Deviance is behavior that is undesirably

different from social expectations; such behavior is most likely to be considered
psychologically abnormal if it is unpredictable, bizarre, or dangerous.
Each of these three major criteria that collectively define psychological abnor-
mality can range greatly in quality and degree, and each summarizes a large
number of symptoms and conditions. Any deviancy or discomfort is more likely to
be defined as abnormal if disability or impairment in function is present. The
impairment can be judged based on the typical performance of others, or it can be
judged based upon the individual’s own potential or subjective expectation. The
impairment may sometimes be based on a physical condition such as retardation
or brain injury. Even if the condition itself cannot be changed, a psychologist can
help determine the degree of the problem and help facilitate useful compensations.
Although one can catalog the suggested criteria for abnormality, there are broad
theoretical disagreements about which of these criteria should be emphasized in
practice. For example, there are phenomenologists who argue that problems do not
exist unless they are perceived by the individual and reflected in personal distress.
There are behaviorists who argue equally vehemently that only overt behavior
should be treated. Such theoretical differences are a primary reason for differences
in definitions.
A second core issue is the quantitative one, the question of how much deviance,
bizarreness, inefficiency, or distress constitutes “abnormality.” Many of those who
use the medical model assume a dichotomy between those who have a specific
mental disease and the vast majority of normals who are disease free. An alterna-
tive view is that the dimensions defining illness are continuous ones ranging from
abnormality through mere adequacy to equally rare degrees of supernormality.
Defining categories of deviancy as “abnormal” presents the particularly thorny
problem of the relativity of cultural standards. The actions society considers
deviant seem limited to particular cultures at particular times. For example, in
Victorian times, young women who had children out of wedlock were sometimes
committed to hospitals for the “morally insane.” Such deviant actions of one
generation may later be ignored or even approved by society. A common solution

to this dilemma is to distinguish deviancies requiring correction and treatment
from others. Deviancies that are dangerous, harmful to others, or accompanied by
personal distress are examples of the former.
A final issue pertains to the value placed on the defining process itself. Accord-
ing to the medical model, the definition of abnormality is all-important, central to
understanding the cause of the disease and to planning treatment. Any disease
Abnormality Psychology and Mental Health
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