ABNORMAL BEHAVIOR AND ITS DIAGNOSES

What is Abnormal Behavior?

You have probably heard the term "abnormal behavior" before. You probably think of it is as any
type of human behavior that seems weird or strange.

However, when you hear the term abnormal behavior in a psychological context, it refers to
something more specific. In psychology, abnormal behavior refers to four general criteria. They
are maladaptive behavior, personal distress, statistical rarity, and violation of social norms.

Maladaptive Behavior

The first behavior that psychologists think of as abnormal is maladaptive. Maladaptive behavior
is behavior that will likely lead to harm either to the person who is exhibiting it or to someone
else. The harm of which we are speaking might be physical. Punching someone in the face is
undoubtedly going to be classified as maladaptive. Cutting yourself intentionally would be
another example.

Personal Distress

Personal distress is where you are engaging in abnormal behavior, and the reason for it is some
type of difficulty that you are experiencing. One of the common examples of this is obsessive-
compulsive disorder. This is where you are experiencing a great deal of anxiety, and it's leading
to your engaging in behaviors that are meant to make you feel better. Your distress might be
acute, or it might be chronic.

Statistical Rarity

Statistical rarity refers to someone who is atypical in some way, and because of that, they are
engaging in behavior that is considered to be abnormal. For instance, if you have a
developmental disorder or an extremely low IQ, then you are deemed to be a statistical rarity.

However, there are also some people who can be considered statistical rarities, and what is
different about them probably would not be considered impairment. For instance, individuals
who have extremely high IQs are also statistical rarities. Someone like Albert Einstein would be
considered to be one, so according to these strict definitions, he would be thought of as
abnormal, despite the negative connotation that usually accompanies the word.

Violation of Social Norms

The fourth abnormal behavior is a violation of social norms. It is easy to identify someone who is
engaging in these behaviors. A man who removes all of his clothing and goes running down the
street will be seen as abnormal. However, a three-year-old child who does the same thing will
not. In this way, you can see how a person's age has just as much to do with what's considered a
social norm violation as the activity itself.

CLINICAL DIAGNOSIS AND CLASSIFICATION SYSTEMS

To begin any type of treatment, the client/patient must be clearly diagnosed with a mental
disorder. Clinical diagnosis is the process of using assessment data to determine if the pattern of
symptoms the person presents with is consistent with the diagnostic criteria for a specific mental
disorder set forth in an established classification system such as the DSM-5 or ICD-10.

Any diagnosis should have clinical utility, meaning it aids the mental health professional in
determining the prognosis, the treatment plan, and possible outcomes of treatment (APA, 2013).
Receiving a diagnosis does not necessarily mean the person requires treatment. This decision is
made based upon how severe the symptoms are, the level of distress caused by the symptoms,
symptom salience such as expressing suicidal ideation, risks and benefits of treatment, disability,
and other factors (APA, 2013). Likewise, a patient may not meet full criteria for a diagnosis but
require treatment nonetheless.

Symptoms that cluster together on a regular basis are called a syndrome. If they also follow the
same, predictable course, we say that they are characteristic of a specific disorder. Classification
systems for mental disorders provide mental health professionals with an agreed upon list of
disorders falling in distinct categories for which there are clear descriptions and criteria for
making a diagnosis.
Distinct is the key word here. People experiencing delusions, hallucinations, disorganized
speech, catatonia, and/or negative symptoms are different from people presenting with a primary
clinical deficit in cognitive functioning that is not developmental in nature but has been acquired
(i.e. they have shown a decline in cognitive functioning over time). The former would likely be
diagnosed with a schizophrenia spectrum disorder while the latter likely has a neurocognitive
disorder (NCD). The latter can be further distinguished from neurodevelopmental disorders
which manifest early in development and involve developmental deficits that cause impairments
in social, academic, or occupational functioning (APA, 2013). These three disorder groups or
categories can be clearly distinguished from one another. Classification systems also permit the
gathering of statistics for the purpose of determining incidence and prevalence rates, they
facilitate research on the etiology and treatment of disorders, and they conform to the
requirements of insurance companies for the payment of claims.

The most widely used classification system in the United States is the Diagnostic and Statistical
Manual of Mental Disorders currently in its 5th edition and produced by the American
Psychiatric Association (APA, 2013). Alternatively, the World Health Organization (WHO)
produces the International Statistical Classification of Diseases and Related Health
Problems (ICD) currently in its 10th edition with an 11th edition expected to be published
in 2018.

Elements of a Diagnosis in DSM

The DSM 5 states that the following make up the key elements of a diagnosis (APA, 2013):

 Diagnostic Criteria and Descriptors

 Subtypes and Specifiers
 Principle Diagnosis
 Provisional Diagnosis

THE ICD-10

In 1893, the International Statistical Institute adopted the International List of Causes of Death
which was the first edition of the ICD. The World Health Organization was entrusted with the
development of the ICD in 1948 and published the 6th version (ICD-6), which was the first
version to include mental disorders. The ICD-10 was endorsed in May 1990 by the 43rd World
Health Assembly. The WHO states:

ICD is the foundation for the identification of health trends and statistics globally, and the
international standard for reporting diseases and health conditions. It is the diagnostic
classification standard for all clinical and research purposes. ICD defines the universe of
diseases, disorders, injuries and other related health conditions, listed in a comprehensive,
hierarchical fashion that allows for:

 easy storage, retrieval and analysis of health information for evidence-based decision-
making;
 sharing and comparing health information between hospitals, regions, settings, and
countries;
 and data comparisons in the same location across different time periods.
REFERENCE:

1. Durand, V., & Barlow, D. (2016). Essentials of Abnormal Psychology. Boston, MA:
Cengage Learning.
2. "Normal vs. Abnormal Behavior: A Continuum". First Responder's Guide to Abnormal
Psychology. Springer, Boston, MA. 2007. pp. 13–18