Chapter 8: Abnormal Behaviors

Abnormal and Normal Behaviours

Since abnormal behaviours are often defined through the examples depicting divergence from social norms such as suicides, murders and sexual assault, they are considered identical to behavioural disorders or dangerous behaviours. Although some abnormal behaviour patterns are different from the usual and somewhat dangerous for society, some of them just prevent individuals from effectively dealing with the difficulties of life and bother only these individuals.

Scientifically speaking, there is no basic criterion to distinguish normal behaviours from abnormal ones. It is possible to examine abnormal behaviours under categorical and dimensional approaches while diagnosing mental illnesses. There is no clear-cut distinction between normality and abnormality while defining the weight of the individual.

The approaches regarding abnormal behaviour are based on two conflicting ideas. According to the first approach, obeying to norms of the society symbolizes normality and the divergence from these norms to abnormal. According to the other approach, obeying social rules to some extent is necessary for social life. The attitudes developed against these rules are harmful to the individual's self and society. However, the real normality criterion is not the approval of the society but the fact that whether the individual feels good or bad. The notion of "feeling good" includes not only to survive life but also to realize personal potentials and wishes

"Normality means being healthy. According to this traditional view of a normal, healthy person is the one who does not have any illnesses.

Normality refers to average values. This approach adapts mathematical principles that evaluate and measure normality rates. In other words, the majority group is evaluated as “normal” and the ones on the extreme points are considered “abnormal”. Normality is a process, and normal behaviour is a common product of a system interacting within itself. In other words, normality refers to the changes in an organism rather than defining a particular situation at a particular time. According to this approach, which deals with a human within a system mentality, normality functions thanks to biological, psychological and social changes and the continuity in time."

The Criteria Used While Defining Abnormal Behaviors

Divergence from the norms: Abnormal as a word means “away from the norm”. Any behaviour that diverges or differs from the acceptable norms of society is considered abnormal.

Personal Disorder: If the behaviour of an individual causes tension or stress, it is considered abnormal. Here, if behaviours or opinions of individuals disturb themselves, a treatment might be necessary. This approach deals with the individual according to his views rather than society. Since the same behaviour leads to different levels of satisfaction in different individuals, it is not possible to have a common view of personality disorder.

Divergence from the ideal: The behaviours below the lowest level necessary for psychological health are defined as abnormal. Societies account for abnormal behaviours generally within the framework of acquired and learned belief systems. The main weakness of this approach is the lack of a structure to reveal the differences between desired and undesired behaviours.

Defining and Describing the Main Theoretical Approaches of Abnormal

Psychological Approach

According to this approach, abnormal behaviours occur as a result of the interaction of the individual with his/her environment. Many factors such as an event deeply affecting the individual, too much stress and destructive family relationships can explain such behaviours. There are many different psychological approaches regarding this issue. While some of them focus on a single behaviour, others deal with abnormal behaviours as a whole.

While some take childhood life a criterion when defining abnormal behaviours, others take the present time as the criterion. Some approaches, on the other hand, suggest that behaviours are determined through external factors. At this point, there are four main approaches.

• Psychodynamic Approach
• Cognitive Behaviourist Approach
• Humanist-Existentialist approach
• Sociocultural Approach

Psychodynamic approach was developed by Sigmund Freud. He believed adult abnormality was caused by unresolved conflicts in early childhood. He said that abnormal behaviour arises from mental conflicts and drives that the person has been unable to resolve or coordinate with the realities of life and that therefore generate anxiety.

The behaviours of individuals are guided by the unconscious through sexuality and aggressiveness motives.

According to Freud, the behaviour is motivated by internal and psychological forces, and abnormality is caused by an imbalance in the internal forces that motivate the behaviour. He believed that mental illness arises from unresolved conscious conflicts which usually occur during early childhood. Freud suggested that forces within mind have different goals. These are id, ego and superego.

Id: id wants immediate gratification of its desires. The motivating forces for the id are the libido, which is the body's pleasure-seeking (sexual pleasure) force.

Ego: Ego is the rational part of the mind. Ego is concerned with behaving in a socially acceptable way.

Superego: Superego wants to live following ethical principles.

Cognitive-Behaviourist Approach

Behaviourist approach argues that abnormal behaviours occur because of learned behaviours like all other behaviours. It assumes that, unlike classical conditioning and operant conditioning, abnormal behaviours are shaped by the effects of internal processes such as expectations and a wish to see the results of the things done.

From the cognitive and behavioural approaches, mental disorders are learned, maladaptive habits of thinking and acting that have been acquired through the person’s interaction with the environment.

“The cognitive approach assumes that a person’s thoughts are responsible for their behaviour. The approach deals with how information is processed in the brain and the impact of this on behaviour.

In this approach, people’s thoughts and beliefs are central to abnormal behaviour. The basic assumptions of cognitive approach are:

• Maladaptive behaviour is caused by faulty and irrational cognitions.
• It is the way you think about a problem, rather than the problem itself that causes mental disorders.
• Individuals can overcome mental disorders by learning to use more appropriate cognitions

There are four different concepts regarding human cognition and these are:

• Cognitive structures: how an individual organizes information; for example, do they see a spider as just another daily object that they need to live with or do they see that spider as an object of fear?
• Cognitive content: whether a person thinks negatively or positively about certain situations
• Cognitive processes: how individuals then process this information and operate on it and whether they do so in a rational or irrational way
• Cognitive products: this refers to the conclusion that the individual will draw from the processed information

Humanist-Existentialist Approach

According to this approach, individuals are born with a tendency to behave ideally in terms of psychological development, growth and healthy balance. This tendency is called self-realization. In this approach, the individual consistently expresses his wishes and needs according to his own psychological development needs. Such an expression pattern is sometimes observed as aggressiveness, sometimes as sexuality and sometimes as a wish to be independent. Employing limitations while meeting some demands of a child may lead to his denial of basic needs and lead to emotional depression since the child does not know what he wants.

Sociocultural Approach

"The sociocultural approach assumes that people's behaviour both normal and abnormal is shaped by the kind of family group, society, and culture in which they live. According to this view, the kinds of relationships that evolve with others may support abnormal behaviours and even cause them to occur. The kinds of stresses and conflicts people experience as part of their daily interactions with others in their environment can promote and maintain abnormal behaviour.”

Biological Approach

This approach explains abnormal behaviours through faulty processes due to genetic factors or organic function disorders in the nervous system and glands. The reason for this disorder might be a virus or microbe, organic deficiencies from birth or head trauma. Whatever the problem is, this model has three assumptions:

• The patient suffers from physical or emotional pain due to an illness.
• It is possible to diagnose this illness by identifying certain symptoms
• Each illness has a unique and certain reason

Classification of Abnormal Behaviours

"Despite the difficulty of defining and classifying abnormal behaviours into diagnosis categories, American Psychiatry Association (APA) has developed a system to classify behaviour disorders. Available in “Diagnosal and Statistical Handbook of Mental Disorders”, this system was published by American Psychiatry, Association (APA) (DSM-I) in 1952 for the first time. The most recent version (DSM IV) was published in 1994. DSM-IV presents comprehensive and relatively precise definitions for more than 200 separate diagnostic categories. By following the criteria present in the system, diagnosticians can provide a clear description of the specific problems an individual experiencing.

Anxiety-Related Disorders

They are a group of mental illnesses and the distress which can keep you from carrying on with your life normally. Anxiety is overwhelming and hard to control. Primary anxiety-related diagnosis includes generalized anxiety disorder, panic disorder, social phobia and obsessive-compulsive disorder.

Generalized Anxiety Disorder: Generalized anxiety disorder is characterized by excessive, exaggerated anxiety and worries about everyday life events with no obvious reasons to worry.

The individual under the effect of general anxiety suffers from both physical and psychological symptoms. Physical symptoms can be listed as follows:

• Muscle Tension-Shivering and failure of relaxation in muscles since they are very tense
• Hyperactivity of the autonomous system leading to sweating, tachycardia, dizziness, trembling, nausea, headache

Psychological symptoms of general anxiety can be listed as follows:

• The normal behaviour of the individual displays a sort of distortion. The individual always feels upset and has some hostile ideas about others. The wish to hide anxiety affects his/her daily life, preventing him/her from having a normal life.
• The individual displays irrational and meaningless behaviours. Sometimes, he/ she has irrational fears such as repeating a behaviour many times or being afraid of getting on a bus.
• Even though it is depressing, those suffering from general anxiety disorder do not break their ties with reality. They do not live in a world of fantasy.

Panic Disorder: A disturbingly intense experience of fear or terror despite the lack of rational reason is called panic disorder. The individuals with panic disorder, which is a different type of anxiety disorder and is accompanied by frequent panic attacks, can think that there might be a disaster and therefore feel chest pain.

Common symptoms associated with a panic attack include:

• Racing heartbeat or palpitations
• Shortness of breath
• Feeling like you are choking
• Dizziness (vertigo)
• Light-headedness
• Nausea
• Sweating or chills
• Shaking or trembling
• Changes in mental state, including a feeling of derealisation (feeling of unreality) or depersonalization (being detached from oneself)
• Numbness or tingling in your hands or feet
• Chest pain or tightness
• Fear that you might die

Phobic Disorder: Phobic patients seldom ruminate about their fears, nor do they show ritualistic compulsive behaviour. And the two disorders are evoked by different stimuli. Dirt, germs, and harm to others – common obsessive-compulsive preoccupations – seldom cause major problems for phobic individuals.”

Social Phobia: Social phobia can be observed in some people as the fear of speaking in front of people. Social phobias may simply be extreme forms of shyness For example, fears of public speaking, fears of eating alone and meeting new people, avoid situations in which others might evaluate them.

Obsessive-Compulsive Disorder: The individuals having this psychological illness develop habits that they repeat quite often but are not able to control them easily. These weird habits, which seem to be harmless, emerge to help individuals to control and regulate their intense and complex feelings. When these repeated actions and ideas become a source of anxiety and unhappiness, the normal life of the individual starts to go wrong.

The most common obsessions are as follows:

• Fear of being infected with contagious diseases and microbes; for example, not shaking hands with other people and developing a fear of being infected with an illness
• Forgetting to turn off the cooker, leaving the hot iron on clothes while ironing them and forgetting to lock the door.
• Agoraphobics who are afraid of going to big shopping centres, crowded shops and open markets avoid not only crowded places but also other places that are difficult to leave immediately in case of emergencies, such as lifts or tunnels.
• Unwanted forbidden or taboo thoughts involving sex, religion and harm. Aggressive thoughts towards others or self.
• Being obsessed with order and cleanliness at home, dusting every day all parts of the house and feeling anxiety and discomfort when some parts of the house are dirty.
• Being afraid of harm. For instance, always being afraid of someone’s giving harm to his/her child.

Obsession The involuntary ideas that individuals cannot control are called obsession.

Compulsion Ritual behaviours repeated continuously by individuals are called compulsion.

Classification of Psychological Disorders

Somatoform Disorder: Even if there is not a specific reason, there might be somatoform disorders caused by anxiety. Emotional determinants are effective in the emergence of physical illnesses. Since the ways to discharge these undesired emotions are not available in this type of disorders, tension extends to internal organs. The unconscious plays an important role in this process.

Somatoform disorders Psychological difficulties that take on physical form.

Such individuals also complain about physical illnesses despite the lack of any symptoms. Although they do not have any physical illnesses, physical reactions accompanying emotions are displayed exaggeratedly. Among the common somatoform are:

• Hypochondriasis
• Conversion hysteria
• Hypochondriasis
• Psychogenic pain

Hypochondriasis: Hypochondriasis refers to the situation when an individual is too much interested in his/her body functions and develops irrational beliefs about disorders or illnesses affecting the functions of his/her internal organs.

Hypochondriasis: Unlike hypochondriasis, those having this problem are reluctant to see a doctor despite the presence of the symptoms of an illness. The individual rejects the treatment because of the following reasons: thinking that nothing will happen to him/her; the wish to retain self-consciousness about being strong and to avoid the anxiety caused by the possibility of illness.

Conversion Hysteria: The individuals having such a disorder may suffer from functional inadequacies in sense organs although there are no physiological or neurological reasons.

Psychogenic Pain: Psychogenic pain is similar to conversion hysteria; the difference being the presence of acute pain or ache in a part of the body rather than function loss. This pain has no physiological or neurological reasons. This pain or ache can be a tool to avoid anxiety and receive attention from the people around.

Dissociative Disorders: As the name implies, the dissociative disorders have in common some type of dissociation or separation in consciousness or identity. Dissociative disorders involve problems with memory, identity, emotion, perception, behaviour and sense of self.

Dissociative disorders give harm to the unity of an individual. The individual evades his/her personality by reducing stress and anxiety when such disorders are concerned. There are three main types of dissociative disorders:

• Dissociative amnesia,
• Dissociative fugue
• Multiple personalities

Dissociative Amnesia: “Dissociative amnesia (loss of memory) is about the sudden loss of important information (knowledge) due to stressful and traumatic incidents although the capacity to learn new information is not deteriorated. Such a memory loss cannot be considered a simple forgetfulness problem.

Dissociative amnesia A dissociative disorder in which the person cannot remember personal information.

Dissociative Fugue: Dissociative fugue A symptom that sometimes accompanies dissociative amnesia where the person travels to a new location.

Multiple Personality: In this type of illness, one individual displays different personalities and identities.

The patient controls the personality, attitudes and behaviours he/she has at that moment as if the other identity does not exist. When he/she switches to the second identity, the real one is often not remembered. Real personality is not aware of the other, and the switch from one identity to the other is often sudden and each identity has its characteristics. When both of them are applied psychological tests, they give the same results.

Schizophrenia: Serious psychological problems are called psychosis and they are often treated in hospital environments. Psychosis is categorized as functional and organic psychosis. If no brain damage or disorder such as schizophrenia or psychotic emotional disorders exists, it is called functional psychosis. If there are brain damage, brain tumour or failures in the brain’s functions, it is called organic psychosis.

Functional Psychosis If no brain damage or disorder such as schizophrenia or psychotic emotional disorders exists, it is called functional psychosis.

Delusions: False ideas, like everyone around him/her spying on him. Paranoid schizophrenia is characterized by elaborate hallucinations and delusions, especially delusions of persecutions and delusions of grandeur. They can generally take care of themselves well enough to get through the activities of the day.

Hallucinations: Tasting, feeling, seeing, smelling that does not exist. Hearing imaginary sounds and voices. The voices may speak nonsense, or they may direct the person to do something.

Disorganized behaviour: This can range from having problems with routine behaviours like hygiene or choosing appropriate clothing for the weather, to unprovoked outburst, to impulsive and uninhibited actions.

Disordered thinking and speech: Changing from one topic to another. Persons may also make up their own words or sounds. Even those people with schizophrenia who have normal or above-average intelligence are impaired on tasks requiring selective attention or executive functions.

There are negative symptoms, that are lost from the person’s personality:

• Social withdrawal
• Lack of drive or initiative
• Emotional disturbance
• Lack of interest

Types of Schizophrenia: Simple schizophrenia: This illness progresses very slowly. After the puberty period, the individual starts to lose interest in people around him/her, and academic success gets lower. He/she does not care about his/her friends or family. He/she is not interested in the opposite sex and has concentration problems.

Paranoid Schizophrenia: Feeling superior and bullying are the characteristics of paranoid schizophrenia. They always suspect that others bully them and talk behind them or deceive them.

Catatonic Schizophrenia: Since body movement functions are lost due to this illness, the individual does not change his/her body position – motionless like a sculpture- for hours or even days. In catatonic freezing, eyes stare blankly, faces are meaningless and individuals do not react to pain-giving stimulants and threats.

Hebephrenic schizophrenia: The most characteristic symptoms of hebephrenic schizophrenia are as follows: childish talk, giggling, disconnected talk, gestures and mimics, self-talking, crying jags following reasonless laughter, too much interest in faeces and urine, smearing faeces on clothes or walls, showing sexual organs with no feeling of shame, tantrums and bad temper.

Mood Disorder: These disorders, which occur due to the increase of emotional disorders in the category of psychosis, vary according to the mental health of the individual and they should not be mistaken with boredom we all experience. They are temporary and do not follow a specific pattern. Any individual suffering from emotional disorders experiences emotional depression and emotional excitement. Avoiding these feelings are not under his/her control. He/she can not keep up with normal working life and is not in harmony with his/her surroundings due to the effects of these feelings. These periods generally last six months either by following manic or depressive patterns. Emotional disorders are observed in the forms of:

Depressions: The individual has the feelings of insignificance, guilt and disparity.

Bipolar disorders: The individual experiences both depression and excitement.

Personality Disorders: Personality disorders are characterized by dysfunctional self-functioning and interpersonal functioning, as well as long-term maladaptive personality traits (e.g. Hostility, emotional instability, eccentricity, impulsivity).

The common personality disorders are:

• Antisocial
• Narcissistic personality disorder.

Antisocial Personality: "People with antisocial personalities are often impulsive, and they cannot withstand frustration. They can be extremely manipulative"

These individuals have a personality structure that is not in harmony with social expectations and realities. No laws or rules can stop these individuals, who act on their own rules. Since they always seek for excitement or action, they get bored very easily. If the following behaviour patterns are observed in an individual, he might be said to have anti-social personality structure.

• Not caring about the safety of himself, his acquaintances or other people
• Disregarding social behaviours and constantly carrying out actions that might lead to his arrestment
• Displaying dishonest behaviours such as telling lies constantly, using different nicknames and deceiving others for personal benefits or just for pleasure
• Displaying sudden behaviours without considering the consequences, not making any plans for future
• Bad temper or tendency to be involved in fights and attacks
• Blaming himself for failing to do a task or managing his budget unwisely
• Being indifferent and trying to prove his innocence and not feeling remorse despite the conduct of a harm-giving behaviour such as theft or physical damage

Narcissistic Personality: “Narcissistic personality disorder is characterized by a preoccupation with oneself. People with narcissistic personality disorder believe they are superior or special. They have the following symptoms:

• Exaggerate own importance
• He/or she is preoccupied with fantasies of success, power, beauty, intelligence
• Requires constant attention and admiration from others
• Has unreasonable expectations of favourable treatment
• Takes advantage of others to reach his or her own goals
• Disregards the feelings of others, lacks empathy
• Is often envious of others or believes other people are envious of him or her
• Shows arrogant behaviours and attitudes.

Psychosexual Disorders: Sensitive, careful and responsible sexual experiences are the most important steps towards being a mature adult. Sexual experiences may cause conflicts in the individual due to sexual taboos, so these conflicts may trigger sexual disorders in some individuals. Psychologists generally examine sexual disorders in three categories. The first category involves disorders that need to be treated such as loss of sexual desire and importance.

Psychologists generally examine sexual disorders in three categories. The first category involves disorders that need to be treated such as loss of sexual desire and importance. Those committing exhibitionism crimes enjoy this action when people are scared or get shocked. In other words, the real aim is not assaulting the opposite sex. The psychodynamic approach explains exhibitionism as a reaction to internal conflicts while other approaches suggest that it is a way for males lacking the self confidence to prove themselves. Another sexual disorder called "rape" rarely occurs as a result of an uncontrolled sudden drive. This action is often pre-planned by the individual. The reasons for rape can be listed as follows:

• Hatred for the opposite sex
• Wish to prove oneself
• A wrong belief that the victim wants this action or encourages it to happen
• Regarding the other sex as an object.

Substance Abuse: The problems due to addiction to alcohol, heroin and cocaine and related problems are among abnormal behaviours. Painkillers and sedatives used to reduce stress level also belong to that group. Drug addiction is defined as the overdose of any drugs. The most common and addictive substances are alcohol, amphetamine, cocaine, heroin and marihuana.

The following five common characteristics have been identified in individuals drinking alcohol:

• An immature personality structure displaying self-centred behaviours and having difficulties in establishing genuine emotional relationships with people
• Suffering from constant depression and feeling disparity, loneliness and worthlessness
• Being highly dependent on people around him
• Developing hostility for other people
• Not being mature in terms of sexuality.