Defining Disordered Behavior

The boy, who was born with two extra chromosomes, was a happy baby who was somewhat slow in walking and did not speak until age four. In nursery school he was easily victimized by other children. Throughout childhood he was fearful, had a low attention span and tolerance for frustration, and did not want to attend school. By adolescence he was acting antisocial: he set fires and stole. He also displayed some bizarre behaviors, such as putting on many layers of clothing and smearing his mother’s clothes with catsup and mayonnaise.

Karen was a nine-year-old girl with a history of refusal to eat solid foods. Six weeks previously, she had choked on a piece of popcorn, with coughing and gagging. From that time on, she had refused to eat any solid foods and had lost about fifteen pounds. She had also developed multiple fears concerning choking. She would not brush her teeth for fear a bristle would come out and she would choke. She slept propped on pillows for fear a loose tooth would come out while she was asleep and that she would choke and suffocate. She was afraid to go to sleep and requested to sleep with her mother because of her fears. She also had frequent nightmares and vivid dreams of choking.

Joe, who is eight years old, has a history of multiple problems. They include chronic hyperactivity, destructive behavior, short attention span, difficulty following verbal directions, low frustration tolerance, impulsiveness, poor interpersonal relationships, fighting, lying, stealing, disobedience, running away from school, and setting fires. His parents had discounted the importance of these behaviors, preferring to believe that little boys should be allowed to express themselves. Joe had been recommended for special education placement in the first grade, but his parents had refused the recommendation. His behavior worsened in the second and third grades, and after Joe exposed himself to female peers, the school forced further evaluation.

There is no concise and simple way to define and identify disordered functioning. Behavioral repertoires come in endless varieties. Illustrations above provide actual examples of some kinds of problem behaviors observed in youngsters. We will examine many more then, and also see that behavioral disorders are evaluated and treated from several perspectives.
Frequently problem behavior is viewed as abnormal. Ab means away or from, while normal refers to the average or standard. Thus, abnormal simply means something that deviates from the average. However, common usage also assumes that deviation is harmful in some way to the organism. Furthermore, an often-made assumption is that the deviation is pathological. Pathological or behavioral problems are therefore often referred to as psychopathology. Unfortunately, the term abnormal and psychopathology are often associated with the idea that problem behavior is caused by disease or other biological factors.
We make no such assumption here, since the cause of problem behavior are complex, include psychosocial factors, and most often cannot be traced directly to biological factors.
Judgments are always required to determine whether or not behavior is abnormal. We must establish some behavior standard and decide whether the behavior of interest does or does not meet the standard in quality or quantity. Of course, dramatic differences are easy to identify. Most of us would agree that individuals who cannot learn to speak or to feed and dresses themselves are “abnormal”. Less dramatic instances are harder to judge. Individuals may display behaviors that are quite common or only slightly deviant—and yet appear maladaptive. In these instances parents, teachers, other adults, and occasionally children themselves rely on numerous criteria to make the judgment that something is wrong.
Socio cultural norms
The role of socio cultural norms, perhaps the broadest criterion for judging behavior, was tellingly discussed many years ago by the anthropologist Ruth Benedict. After studying widely diverse cultures, Benedict proposed that each society select certain behaviors that are value to it and socializes its members to act accordingly. Individuals who do not display these behaviors, for whatever reasons, are considered deviant by the society. Deviance is always related to cultural norms. Benedict note that, for example, that suspiciousness typically exhibited in one Melanisian culture would be considered pathological in our society. The Melanesian would not leave their cooking pots for fear of the food being poisoned by others. Further, Melanesians who displayed the helpfulness, kindness, and cheerfulness that viewed as positive in our society were considered abnormal in their culture.
Cultural norms are applied to the children as well as adult, and may broadly influence expectations, judgments, and beliefs about the behavior of youth. Youngsters in the United States, for example, are expected to show less self-control and deference to adults compared to children in some parts of the world. We would be relatively more likely, then, to express concern about the over-controlled, passive child. Similarly, in the technological advanced societies that value certain intellectual skills special concern would be voiced about the child who does not measure up to these standards of intellectual development.
A study by Weisz et al (1988) showed that culture might influence the degree to which childhood problems are considered serious. Parent and teacher in US and Thailand read descriptions of child problems and then answered question about them. Thai adults were less worried than the US adults. This finding appears consistent with the teachings of Thai Buddhism—for example, that every condition changes and that behavior does not reflect enduring personality.
In another study Weisz and his colleagues (1995) found that teachers in Thailand reported more conduct problems in students than teachers in the US, while trained observers reported just the opposite. The researchers suggested that Thai teachers may hold more demanding behavioral standards.
Culture can also influence how problem behaviors are explained. For example, forty North African and Middle Eastern mothers living in Israel were interviewed about their retarded children (Stahl, 1991). Almost half gave magic-religious cause for the condition. They believe in Fate, demons entering the body, an evil eye, prenatal fear in the mother, and punishment from God. They relied on treatments accordingly: burning the child’s hand to drive out the demons, burning a piece of cloth belonging to the person who cast the evil eye. Prayer, or help from a rabbi. All of this is consistent with the cultural beliefs of their native countries.
In the society as heterogeneous as that of the US, sub cultural norms are also found. Consider, for example, a study that compared two group of New York City families: well-educated, middle class families, and Puerto Rican families living in low income housing (Korn and Gannon, 1983). For their five year old children, the middle class families reported two and a half times as many problems as the low income, less well educated families. This was probably because the families set different standards and the middle class families were more psychological oriented. The kind of problems reported also different in the two kinds of families and they seemed related to sub cultural value and child management. For example, many more middle-class than lower-class families set a standard bedtime and did not allow their children to take a bottle to bed with them. They also reported more sleep problems. Puerto Rican families placed high value on “good” behavior, disciplined their children more severely, and reported more discipline problems.
Sociocultural norms are tied to specific variables. One of these is the social setting energetic running may be quite acceptable on the playground, but would create havoc in the classroom or a dental office. And singing aloud might well be tolerated at home, but rarely allowed in the library. Individuals are expected to act in certain ways in certain situations—in short, to meet situational norms.
Sociocultural norms are also specified recording to gender. In most societies males are expected to be relatively more aggressive, dominant, active, and adventurous. Females to be more passive, dependent, quite, and sensitive ((Bem, 1985, Bergen and Williams, 1991). These sex stereotypes strongly guide judgments about normality. We would probably be less inclined to worry about the hypersensitive, shy girls and the excessively dominant boy than about their opposite-sex counterparts.
Finally, it must be noted that sociocultural norms may change over time, due to broad societal changes or changes in ideas about mental health. For example, in the 1800s childhood disturbance could be attributed to “masturbatory insanity,” but that label no longer exists (Rie, 1997). And nail biting, once seen as sign of degeneration, is considered quite harmless today (Kanner, 1960, cited by Anthony, 1970).

Developmental Criteria
Age is always of consideration in judging behavior, but it is especially crucial with youth because they change rapidly. Assessment of behavior requires developmental norms. The typical rates and sequences of the growth of skills, knowledge, and social-emotional behavior serve as developmental standards to evaluate the possibility that something is wrong. “Adults would be mistaken to worry about the one-year-old who is not yet walking, because many children of this age do not walk. However, if the same child is unable to sit without support, concern would be appropriate, because virtually all babies can sit up before their first birthdays.
It is not only failure to initially display developmental age norms that identifies psychopathology. Children sometimes “act their age” but then fail to progress. Temper tantrums might not be labeled a problem in three-year-old but would likely be seen as problematic if they persisted into the twelfth year. Children may also achieve age norms and then regress.
Several other normative factors may be considered. Behavior that meets age norms may still be judged disturbed if it occurs too frequently or infrequently, is too intense or insufficiently intense, or endures over too long or too short a period of time. It is not unusual for a child to display fear, for example, but fearfulness may be a problem if it occurs in an excessive number of situations, is extremely intense, and does not weaken over time. Concern might also be expressed for the child whose reactions change, such as when a friendly, outgoing girl turns shy and solitary. Adults are rightly concerned too when a child displays several questionable behaviors or seems troubled by several things.
More rarely, some youth exhibit behaviors that appear qualitatively different from the norm, that is, are not at all seen in normal youngsters. For example, most children become socially responsive to their caretakers soon after birth, but children diagnosed as autistic display atypical unresponsive behaviors
The Role of Others
Finally, the feelings and beliefs of others in the immediate environment play a role in identifying problem behaviors. The labeling of a problem is likely to occur when others are disturbed, for example, when a sibling complains of being physically attacked or when a teacher is worried about a child’s social withdrawal. Because childhood disorders are often identified by adults, adult attitudes, sensitivity, tolerance, and ability to cope are bound to influence how children are perceived and treated.
In fact, several research studies show the influence of various factors on parental identification of children’s problems and referral to clinics (McMahon and Forehand, 1988). For example, there is limited evidence that first born and only children are move readily identified as having problems than are other children (Jensen et al., 1990). Parental characteristics may also play a role. One study distinguished two group of children referred to a clinic for acting-out problems (Rickard et al., 1981). Group 1 showed more actual acting-out behaviors than nonclinic children. Group 2 did not. What further differentiated the groups was parental depression. The parental of group 1 children were not depressed, while those of group 2 children exhibited depression. Thus, it appears that parental depression, rather than children’s actual behavior, may have led to clinic referral for group 2 children. Yet another investigation indicated that parents who abused their children tended to overestimate problem behaviors emitted by the offspring (Reid, Kavanagh, and Baldwin, 1987)
In summary, then, we can see that defining, identifying, and conceptualizing behavioral or psychological disorders is a complex matter that depends on many factors. Disordered behavior is not simply an entity carried around in a person. It can be thought of as a judgment about behavior, based on society’s values, beliefs about how youth develop, and the social context.

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