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Normality is a
behavior Behavior (American English) or behaviour (British English) is the range of actions of Individual, individuals, organisms, systems or Artificial intelligence, artificial entities in some environment. These systems can include other systems or or ...
that can be normal for an individual (intrapersonal normality) when it is consistent with the most common behavior for that person. Normal is also used to describe individual behavior that conforms to the most common behavior in society (known as
conformity Conformity or conformism is the act of matching attitudes, beliefs, and behaviors to social group, group norms, politics or being like-minded. Social norm, Norms are implicit, specific rules, guidance shared by a group of individuals, that guide t ...
). However, normal behavior is often only recognized in contrast to abnormality. In many cases normality is used to make moral judgements, such that normality is seen as good while abnormality is seen as bad, or conversely normality can be seen as boring and uninteresting. Someone being seen as normal or not normal can have social ramifications, such as being included, excluded or
stigmatized Stigma, originally referring to the visible marking of people considered inferior, has evolved to mean a negative perception or sense of disapproval that a society places on a group or individual based on certain characteristics such as their ...
by wider society.


Measuring

Many difficulties arise in measuring normal behaviors—biologists come across parallel issues when defining normality. One complication that arises regards whether 'normality' is used correctly in everyday language. People say "this heart is abnormal" if only a portion of it is not working correctly, yet it may be inaccurate to include the entirety of the heart under the description of 'abnormal'. There can be a difference between the normality of a body part's structure and its function. Similarly, a behavioral pattern may not conform to
social norm A social norm is a shared standard of acceptance, acceptable behavior by a group. Social norms can both be informal understandings that govern the behavior of members of a society, as well as be codified into wikt:rule, rules and laws. Social norma ...
s, but still be effective and non-problematic for that individual. Where there is a dichotomy between appearance and function of a behavior, it may be difficult to measure its normality. This is applicable when trying to diagnose a
pathology Pathology is the study of disease. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in the context of modern medical treatme ...
and is addressed in the ''
Diagnostic and Statistical Manual of Mental Disorders The ''Diagnostic and Statistical Manual of Mental Disorders'' (''DSM''; latest edition: ''DSM-5-TR'', published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a com ...
''.


Statistical normality

In general, 'normal' refers to a lack of significant deviation from the average. The word normal is used in a more narrow sense in
mathematics Mathematics is a field of study that discovers and organizes methods, Mathematical theory, theories and theorems that are developed and Mathematical proof, proved for the needs of empirical sciences and mathematics itself. There are many ar ...
, where a
normal distribution In probability theory and statistics, a normal distribution or Gaussian distribution is a type of continuous probability distribution for a real-valued random variable. The general form of its probability density function is f(x) = \frac ...
describes a population whose characteristics center around the average or the norm. When looking at a specific behavior, such as the frequency of lying, a researcher may use a
Gaussian Carl Friedrich Gauss (1777–1855) is the eponym of all of the topics listed below. There are over 100 topics all named after this German mathematician and scientist, all in the fields of mathematics, physics, and astronomy. The English eponymo ...
bell curve to plot all reactions, and a normal reaction would be within one
standard deviation In statistics, the standard deviation is a measure of the amount of variation of the values of a variable about its Expected value, mean. A low standard Deviation (statistics), deviation indicates that the values tend to be close to the mean ( ...
, or the most average 68.3%. However, this mathematical model only holds for one particular trait at a time, since, for example, the
probability Probability is a branch of mathematics and statistics concerning events and numerical descriptions of how likely they are to occur. The probability of an event is a number between 0 and 1; the larger the probability, the more likely an e ...
of a single individual being within one standard deviation for 36
independent variables A variable is considered dependent if it depends on (or is hypothesized to depend on) an independent variable. Dependent variables are studied under the supposition or demand that they depend, by some law or rule (e.g., by a mathematical function ...
would be one in a million. In
statistics Statistics (from German language, German: ', "description of a State (polity), state, a country") is the discipline that concerns the collection, organization, analysis, interpretation, and presentation of data. In applying statistics to a s ...
, ''normal'' is often arbitrarily considered anything that falls within about 1.96 standard deviations of the
mean A mean is a quantity representing the "center" of a collection of numbers and is intermediate to the extreme values of the set of numbers. There are several kinds of means (or "measures of central tendency") in mathematics, especially in statist ...
, i.e. the most average 95% (1.96). The probability of an individual being within 1.96 standard deviations for 269 independent variables is approximately one in a million. For only 59 independent variables, the probability is just under 5%. Under this definition of ''normal'', it is ''abnormal'' to be normal for 59 independent variables.


Sociology


Durkheim

In his ''
Rules of the Sociological Method ''The Rules of Sociological Method'' () is a book by Émile Durkheim, first published in 1895. It is recognized as being the direct result of Durkheim's own project of establishing sociology as a positivist social science. Durkheim is seen as on ...
'', French sociologist
Émile Durkheim David Émile Durkheim (; or ; 15 April 1858 – 15 November 1917) was a French Sociology, sociologist. Durkheim formally established the academic discipline of sociology and is commonly cited as one of the principal architects of modern soci ...
indicates that it is necessary for the sociological method to offer parameters in order to distinguish normality from
pathology Pathology is the study of disease. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in the context of modern medical treatme ...
or abnormality. He suggests that behaviors, or ''social facts'', which are present in the majority of cases are normal, and exceptions to that behavior indicate pathology. Durkheim's model of normality further explains that the most frequent or general behaviors, and thus the most normal behaviors, will persist through transition periods in society.
Crime In ordinary language, a crime is an unlawful act punishable by a State (polity), state or other authority. The term ''crime'' does not, in modern criminal law, have any simple and universally accepted definition,Farmer, Lindsay: "Crime, definiti ...
, for instance, should be considered normal because it exists in every society through every time period. There is a two-fold version of normality; behaviors considered normal on a societal level may still be considered pathological on an individual level. On the individual level, people who violate social norms, such as criminals, will invite a punishment from others in the society.


Social norms

An individual's behaviors are guided by what they perceive to be society's expectations and their peers' norms. People measure the appropriateness of their actions by how far away they are from those social norms. However, what is perceived as the norm may or may not actually be the most common behavior. In some cases of
pluralistic ignorance In social psychology, pluralistic ignorance (also known as a collective illusion) is a phenomenon in which people mistakenly believe that others predominantly hold an opinion different from their own. In this phenomenon, most people in a group ma ...
, most people wrongly believe the social norm is one thing, but in fact very few people hold that view. When people are made more aware of a social norm, particularly a ''descriptive'' norm (i.e., a norm describing what is done), their behavior changes to become closer to that norm. The power of these norms can be harnessed by social norms marketing, where the social norm is advertised to people in an attempt to stop extreme behavior, such as binge drinking. However, people at the other extreme (very little alcohol consumption) are equally likely to change their behavior to become closer to the norm, in this case by increasing alcohol consumption. Instead of using descriptive norms, more effective social norms marketing may use ''injunctive'' norms which, instead of describing the most common behavior, outline what is approved or disapproved of by society. When individuals become aware of the injunctive norm, only the extremes will change their behavior (by decreasing alcohol consumption) without the boomerang effect of under-indulgers increasing their drinking. The social norms that guide people are not always normal for everyone. Behaviors that are abnormal for most people may be considered normal for a
subgroup In group theory, a branch of mathematics, a subset of a group G is a subgroup of G if the members of that subset form a group with respect to the group operation in G. Formally, given a group (mathematics), group under a binary operation  ...
or
subculture A subculture is a group of people within a culture, cultural society that differentiates itself from the values of the conservative, standard or dominant culture to which it belongs, often maintaining some of its founding principles. Subcultures ...
. For example, normal college student behavior may be to party and drink alcohol, but for a subculture of religious students, normal behavior may be to go to church and pursue religious activities. Subcultures may actively reject "normal" behavior, instead replacing society norms with their own. What is viewed as normal can change dependent on both timeframe and environment. Normality can be viewed as "an endless process of man's self-creation and his reshaping of the world." Within this idea, it is possible to surmise that normality is not an all-encompassing term, but simply a relative term based around a current trend in time. With statistics, this is likened to the thought that if the data gathered provides a
mean A mean is a quantity representing the "center" of a collection of numbers and is intermediate to the extreme values of the set of numbers. There are several kinds of means (or "measures of central tendency") in mathematics, especially in statist ...
and
standard deviation In statistics, the standard deviation is a measure of the amount of variation of the values of a variable about its Expected value, mean. A low standard Deviation (statistics), deviation indicates that the values tend to be close to the mean ( ...
, over time these data that predict "normalness" start to predict or dictate it less and less since the social idea of normality is dynamic. This is shown in studies done on behavior in both
psychology Psychology is the scientific study of mind and behavior. Its subject matter includes the behavior of humans and nonhumans, both consciousness, conscious and Unconscious mind, unconscious phenomena, and mental processes such as thoughts, feel ...
and
sociology Sociology is the scientific study of human society that focuses on society, human social behavior, patterns of Interpersonal ties, social relationships, social interaction, and aspects of culture associated with everyday life. The term sociol ...
where behavior in
mating In biology, mating is the pairing of either opposite-sex or hermaphroditic organisms for the purposes of sexual reproduction. ''Fertilization'' is the fusion of two gametes. '' Copulation'' is the union of the sex organs of two sexually repr ...
rituals or religious rituals can change within a century in humans, showing that the "normal" way that these rituals are performed shifts and a new procedure becomes the normal one. Since normality shifts in time and environment, the mean and standard deviation are only useful for describing normality from the environment from which they are collected.


Sexual behavior

As another example, understandings of what is normal
sexual behavior Human sexual activity, human sexual practice or human sexual behaviour is the manner in which humans experience and express their sexuality. People engage in a variety of sexual acts, ranging from activities done alone (e.g., masturbation) t ...
varies greatly across time and place. In many countries, perceptions on
sexuality Human sexuality is the way people experience and express themselves sexually. This involves biological, psychological, physical, erotic, emotional, social, or spiritual feelings and behaviors. Because it is a broad term, which has varied ...
are largely becoming more liberal, especially views on the normality of
masturbation Masturbation is a form of autoeroticism in which a person Sexual stimulation, sexually stimulates their own Sex organ, genitals for sexual arousal or other sexual pleasure, usually to the point of orgasm. Stimulation may involve the use of han ...
and
homosexuality Homosexuality is romantic attraction, sexual attraction, or Human sexual activity, sexual behavior between people of the same sex or gender. As a sexual orientation, homosexuality is "an enduring pattern of emotional, romantic, and/or sexu ...
. Social understanding on normal sexual behavior also varies greatly country by country; countries can be divided into categories of how they approach sexual normality, as
conservative Conservatism is a cultural, social, and political philosophy and ideology that seeks to promote and preserve traditional institutions, customs, and values. The central tenets of conservatism may vary in relation to the culture and civiliza ...
, homosexual-permissive, or liberal. The
United States The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
, Ireland, and Poland have more conservative social understanding of sexuality among university students, while Scandinavian students consider a wider variety of sexual acts as normal. Although some attempts have been made to define sexual acts as ''normal'', ''abnormal'', or ''indeterminate'', these definitions are time-sensitive. Gayle Rubin's 1980s model of sexual 'normality' was comprehensive at the time but has since become outdated as society has liberalized.


Regulation

A disharmony exists between a virtual identity of the self and a real
social identity Identity is the set of qualities, beliefs, personality traits, appearance, or expressions that characterize a person or a group. Identity emerges during childhood as children start to comprehend their self-concept, and it remains a consistent ...
, whether it be in the form of a trait or attribute. If a person does not have this disharmony, then he or she is described as normal. A virtual identity can take many definitions, but in this case a virtual identity is the identity that persons mentally create that conforms to societal standards and norms, it may not represent how they actually are, but it represents what they believe is the typical "normal" person. A real social identity is the identity that persons actually have in their society or is perceived, by themselves or others, to have. If these two identities have differences between each other, there is said to be disharmony. Individuals may monitor and adapt their behavior in terms of others' expected perceptions of the individual, which is described by the social psychology theory of
self-presentation Impression management is a conscious or subconscious process in which people attempt to influence the perceptions of other people about a person, object or event by regulating and controlling information in social interaction.Sanaria, A. D. (2016) ...
. In this sense, normality exists based on societal norms, and whether someone is normal is entirely up to how he or she views him- or herself in contrast to how society views him or her. While trying to define and quantify normality is a good start, all definitions confront the problem of whether we are even describing an idea that even exists since there are so many different ways of viewing the concept.


Effects of labeling

When people do not conform to the normal standard, they are often labelled as sick, disabled, abnormal, or unusual, which can lead to
marginalization Social exclusion or social marginalisation is the social disadvantage and relegation to the fringe of society. It is a term that has been used widely in Europe and was first used in France in the late 20th century. In the EU context, the Euro ...
or
stigmatization Stigma, originally referring to the visible marking of people considered inferior, has evolved to mean a negative perception or sense of disapproval that a society places on a group or individual based on certain characteristics such as their ...
. Most people want to be normal and strive to be perceived as such, so that they can relate to society at large. Without having things in common with the general population, people may feel isolated among society. The abnormal person feels like they have less in common with the normal population, and others have difficulty relating to things that they have not experienced themselves. Additionally, abnormality may make others uncomfortable, further separating the abnormally labelled individual. Since being normal is generally considered an ideal, there is often pressure from external sources to conform to normality, as well as pressure from people's intrinsic desire to feel included. For example, families and the medical community will try to help
disabled Disability is the experience of any condition that makes it more difficult for a person to do certain activities or have equitable access within a given society. Disabilities may be cognitive, developmental, intellectual, mental, physica ...
people live a normal life. However, the pressure to appear normal, while actually having some deviation, creates a conflict—sometimes someone will appear normal, while actually experiencing the world differently or struggling. When abnormality makes society feel uncomfortable, it is the exceptional person themselves who will laugh it off to relieve social tension. A disabled person is given normal freedoms, but may not be able to show negative emotions. Lastly, society's rejection of deviance and the pressure to normalize may cause shame in some individuals. Abnormalities may not be included in an individual's sense of identity, especially if they are unwelcome abnormalities. When an individual's abnormality is labelled as a
pathology Pathology is the study of disease. The word ''pathology'' also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in the context of modern medical treatme ...
, it is possible for that person to take on both elements of the
sick role Sick role is a term used in medical sociology regarding sickness and the rights and obligations of the affected. It is a concept created by American sociologist Talcott Parsons Talcott Parsons (December 13, 1902 – May 8, 1979) was an Ameri ...
or the stigmatization that follows some illnesses. Mental illness, in particular, is largely misunderstood by the population and often overwhelms others' impression of the patient.


Intrapersonal normality

Most definitions of normality consider interpersonal normality, the comparison between many different individual's behaviors to distinguish normality from abnormality. Intrapersonal normality looks at what is normal behavior for one particular person (consistency within a person) and would be expected to vary person-to-person. A mathematical model of normality could still be used for intrapersonal normality, by taking a sample of many different occurrences of behavior from one person over time. Also like interpersonal normality, ''intra''personal normality may change over time, due to changes in the individual as they age and due to changes in society (since society's view of normality influences individual peoples' behavior). It is most comfortable for people to engage in behavior which conforms to their own personal habitual norms. When things go wrong, people are more likely to attribute the negative outcome on any abnormal behavior leading up to the mishap. After a
car crash A traffic collision, also known as a motor vehicle collision, or car crash, occurs when a vehicle collides with another vehicle, pedestrian, animal, road debris, or other moving or stationary obstruction, such as a tree, pole or building. T ...
, people may say "if only I didn't leave work early," blaming the crash on their actions which were not normal. This
counterfactual thinking Counterfactual thinking is a concept in psychology that involves the human tendency to create possible alternatives to life events that have already occurred; something that is contrary to what actually happened. Counterfactual thinking is, as it ...
particularly associates abnormal behavior with negative outcomes.


Behavioral normality

In
medicine Medicine is the science and Praxis (process), practice of caring for patients, managing the Medical diagnosis, diagnosis, prognosis, Preventive medicine, prevention, therapy, treatment, Palliative care, palliation of their injury or disease, ...
, behavioral normality pertains to a patient's mental condition aligning with that of a model,
health Health has a variety of definitions, which have been used for different purposes over time. In general, it refers to physical and emotional well-being, especially that associated with normal functioning of the human body, absent of disease, p ...
y patient. A person without any
mental illness A mental disorder, also referred to as a mental illness, a mental health condition, or a psychiatric disability, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. A mental disorder is ...
is considered a normal patient, whereas a person with a mental disability or illness is viewed as abnormal. These normals and abnormals in the context of
mental health Mental health is often mistakenly equated with the absence of mental illness. However, mental health refers to a person's overall emotional, psychological, and social well-being. It influences how individuals think, feel, and behave, and how t ...
subsequently create negative stigmatic perceptions towards individuals with mental illness. According to the Brain & Behavior Research Foundation, "an estimated 26.2 percent of Americans ages 18 and older—about 1 in 4 adults—suffer from one or more of (several) disorders in a given year." Though the population of American individuals living with mental illness is not as small of a minority as commonly perceived, it is considered abnormal nonetheless, therefore the subject of discrimination and abuse such as violent therapies, punishments, or labeling for life by the normal, healthy majority. The
CDC The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency under the Department of Health and Human Services (HHS), and is headquartered in Atlanta, ...
reported that "cluster of negative attitudes and beliefs motivate the general public to fear, reject, avoid, and discriminate against people with mental illnesses." In continuum, the resources available to those who suffer from such illness are limited, and government support is constantly being cut from programs that help individuals living with mental illness live more comfortable, accommodative, happier lives.


Neuronal and synaptic normality

Hebbian
associative learning Learning is the process of acquiring new understanding, knowledge, behaviors, skills, values, attitudes, and preferences. The ability to learn is possessed by humans, non-human animals, and some machines; there is also evidence for some kin ...
and memory maintenance depends on synaptic normalization mechanisms to prevent synaptic runaway. ''Synaptic runaway'' describes overcrowding of
dendritic Dendrite derives from the Greek word "dendron" meaning ( "tree-like"), and may refer to: Biology *Dendrite, a branched projection of a neuron *Dendrite (non-neuronal), branching projections of certain skin cells and immune cells Physical *Dendri ...
associations, which reduce sensory or behavioral acuteness proportional to the level of synaptic runaway. Synaptic/neuronal normalization refers to synaptic competition, where the prosper of one
synapse In the nervous system, a synapse is a structure that allows a neuron (or nerve cell) to pass an electrical or chemical signal to another neuron or a target effector cell. Synapses can be classified as either chemical or electrical, depending o ...
may weakening the efficacy of other nearby surrounding synapses with redundant
neurotransmission Neurotransmission (Latin: ''transmissio'' "passage, crossing" from ''transmittere'' "send, let through") is the process by which signaling molecules called neurotransmitters are released by the axon terminal of a neuron (the presynaptic neuron ...
. Animal dendritic density greatly increases throughout waking hours despite intrinsic normalization mechanisms as described as above. The growth rate of synaptic density is not sustained in a cumulative fashion. Without a pruning state, the signal to noise ratio of CNS mechanism would not be able to operate with maximum effectiveness, and learning would be detrimental to animal survival. Neuronal and synaptic normalization mechanisms must operate so positive association feedback loops to not become rampant while constantly processing new environmental information. Some researchers speculate that the slow
oscillation Oscillation is the repetitive or periodic variation, typically in time, of some measure about a central value (often a point of equilibrium) or between two or more different states. Familiar examples of oscillation include a swinging pendulum ...
( nREM) cycles of animal sleep constitute an essential 're-normalization' phase. The re-normalization occurs from cortical large
amplitude The amplitude of a periodic variable is a measure of its change in a single period (such as time or spatial period). The amplitude of a non-periodic signal is its magnitude compared with a reference value. There are various definitions of am ...
brain rhythm, in the low delta range (0.5–2  Hz), synaptically downscaling the associations from the wakeful learning state. Only the strongest associations survive the pruning from this phase. This allows retention of salient information coding from the previous day, but also allows more cortical space and energy distribution to continue effective learning subsequently after a slow-wave oscillation episode of sleep. Also, organisms tend to have a normal biological developmental pathway as a central nervous system ages and/or learns. Deviations for a species' normal development frequently will result in behavior dysfunction, or death, of that organism.


Clinical normality

Applying normality clinically depends on the field and situation a practitioner is in. In the broadest sense, ''clinical normality'' is the idea of uniformity of physical and psychological functioning across individuals.
Psychiatric Psychiatry is the medical specialty devoted to the diagnosis, treatment, and prevention of deleterious mental conditions. These include matters related to cognition, perceptions, mood, emotion, and behavior. Initial psychiatric assessment of ...
normality, in a broad sense, states that
psychopathology Psychopathology is the study of mental illness. It includes the signs and symptoms of all mental disorders. The field includes Abnormal psychology, abnormal cognition, maladaptive behavior, and experiences which differ according to social norms ...
are disorders that are deviations from normality. Normality, and abnormality, can be characterized statistically. Related to the previous definition, ''statistical normality'' is usually defined it in terms of a normal distribution curve, with the so-called 'normal zone' commonly accounting for 95.45% of all the data. The remaining 4.55% will lie split outside of two
standard deviations In statistics, the standard deviation is a measure of the amount of variation of the values of a variable about its mean. A low standard deviation indicates that the values tend to be close to the mean (also called the expected value) of the ...
from the
mean A mean is a quantity representing the "center" of a collection of numbers and is intermediate to the extreme values of the set of numbers. There are several kinds of means (or "measures of central tendency") in mathematics, especially in statist ...
. Thus any variable case that lies outside of two deviations from the mean would be considered ''abnormal''. However, the critical value of such statistical judgments may be subjectively altered to a less conservative estimate. It is in fact normal for a population to have a proportion of abnormals. The presence of abnormals is important because it is necessary to define what 'normal' is, as normality is a relative concept. So at a
group A group is a number of persons or things that are located, gathered, or classed together. Groups of people * Cultural group, a group whose members share the same cultural identity * Ethnic group, a group whose members share the same ethnic iden ...
, or macro,
level of analysis Level of analysis is used in the social sciences to point to the location, size, or scale of a research target. It is distinct from unit of observation in that the former refers to a more or less integrated set of relationships while the latter re ...
, abnormalities are normal given a
demographic Demography () is the statistics, statistical study of human populations: their size, composition (e.g., ethnic group, age), and how they change through the interplay of fertility (births), mortality (deaths), and migration. Demographic analy ...
survey; while at an individual level, abnormal individuals are seen as being deviant in some way that needs to be corrected. Statistical normality is important in determining demographic pathologies. When a variable rate, such as
virus A virus is a submicroscopic infectious agent that replicates only inside the living Cell (biology), cells of an organism. Viruses infect all life forms, from animals and plants to microorganisms, including bacteria and archaea. Viruses are ...
spread within a human population, exceeds its normal infection rate, then preventative or emergency measures can be introduced. However, it is often impractical to apply statistical normality to diagnose individuals. Symptom normality is the current, and assumed most effective, way to assess patient pathology.


DSM

''Normality'', as a relative concept, is intrinsically involved with contextual elements. As a result, clinical disorder classification has particular challenges in discretely diagnosing 'normal' constitutions from true disorders. The ''
Diagnostic and Statistical Manual of Mental Disorders The ''Diagnostic and Statistical Manual of Mental Disorders'' (''DSM''; latest edition: ''DSM-5-TR'', published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a com ...
'' (DSM) is the psychiatric profession's official classification manual of
mental disorders A mental disorder, also referred to as a mental illness, a mental health condition, or a psychiatric disability, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. A mental disorder is ...
since its first published version (DSM-I) by the
American Psychological Association The American Psychological Association (APA) is the main professional organization of psychologists in the United States, and the largest psychological association in the world. It has over 170,000 members, including scientists, educators, clin ...
in 1952. As the DSM evolved into its current version (DSM-V) in late 2013, there have been numerous conflicts in proposed classification between
mental illness A mental disorder, also referred to as a mental illness, a mental health condition, or a psychiatric disability, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. A mental disorder is ...
and normal mentality. In his book ''Saving Normal'',
Allen Frances Allen J. Frances (born 2 October 1942) is an American psychiatrist. He is currently Professor and Chairman Emeritus of the Department of Psychiatry and Behavioral Sciences at Duke University School of Medicine. He is best known for serving as ch ...
, who chaired the
task force A task force (TF) is a unit or formation established to work on a single defined task or activity. Originally introduced by the United States Navy, the term has now caught on for general usage and is a standard part of NATO terminology. Many ...
for content in the DSM-IV and DSM-IV-TR, wrote a scathing indictment of the pressures incumbent on the definition of "normal" relative to psychological constructs and mental illness. Most of this difficulty stems from the DSM's ambiguity of natural contextual
stressor A stressor is a chemical or biological agent, environmental condition, external stimulus or an event seen as causing stress to an organism. Psychologically speaking, a stressor can be events or environments that individuals might consider dema ...
reactions versus individual dysfunction. There are some key progressions along the DSM history that have attempted to integrate some aspects of normality into proper diagnosis classification. As a diagnostic manual for classification of abnormalities, all DSMs have been biased towards classifying symptoms as disorders by emphasizing symptomatic singularity. The result is an encompassing misdiagnosis of possible normal
symptom Signs and symptoms are diagnostic indications of an illness, injury, or condition. Signs are objective and externally observable; symptoms are a person's reported subjective experiences. A sign for example may be a higher or lower temperature ...
s, appropriate as contextually derived.


DSM-II

The second edition of the DSM could not be effectively applied because of its vague descriptive nature.
Psychodynamic Psychodynamics, also known as psychodynamic psychology, in its broadest sense, is an approach to psychology that emphasizes systematic study of the psychological forces underlying human behavior, feelings, and emotions and how they might relate t ...
etiology Etiology (; alternatively spelled aetiology or ætiology) is the study of causation or origination. The word is derived from the Greek word ''()'', meaning "giving a reason for" (). More completely, etiology is the study of the causes, origins ...
was a strong theme in classifying mental illnesses. The applied definitions became
idiosyncratic An idiosyncrasy is a unique feature of something. The term is often used to express peculiarity. Etymology The term "idiosyncrasy" originates from Greek ', "a peculiar temperament, habit of body" (from ', "one's own", ', "with" and ', "blend ...
, stressing individual unconscious roots. This made applying the DSM unreliable across
psychiatrists A psychiatrist is a physician who specializes in psychiatry. Psychiatrists are physicians who evaluate patients to determine whether their symptoms are the result of a physical illness, a combination of physical and mental ailments or strictly ...
. No distinction between abnormal to normal was established. Evidence of the classification ambiguity were punctuated by the
Rosenhan experiment The Rosenhan experiment or Thud experiment was an experiment regarding the validity of psychiatric diagnosis. For the experiment, participants submitted themselves for evaluation at various psychiatric institutions and feigned hallucinations in or ...
of 1972. This experiment demonstrated that the
methodology In its most common sense, methodology is the study of research methods. However, the term can also refer to the methods themselves or to the philosophical discussion of associated background assumptions. A method is a structured procedure for bri ...
of psychiatric diagnosis could not effectively distinguish normal from disordered mentalities. DSM-II labelled 'excessive' behavioral and emotional response as an index of abnormal mental wellness to diagnose some particular disorders. 'Excessiveness' of a reaction implied alternative normal behavior which would have to include a situational factor in evaluation. As an example, a year of intense grief from the death of a spouse may be a normal appropriate response. To have intense
grief Grief is the response to the loss of something deemed important, particularly to the death of a person to whom or animal to which a Human bonding, bond or affection was formed. Although conventionally focused on the emotional response to loss, ...
for twenty years would be indicative of a mental disorder. As well, to grieve intensely over the loss of a sock would also not be considered normal responsiveness and indicate a mental disorder. The consideration of proportionality to stimuli was a perceived strength in psychiatric diagnosis for the DSM-II. Another characteristic of the DSM-II systemization was that it classified
homosexuality Homosexuality is romantic attraction, sexual attraction, or Human sexual activity, sexual behavior between people of the same sex or gender. As a sexual orientation, homosexuality is "an enduring pattern of emotional, romantic, and/or sexu ...
as a mental disorder. Thus, homosexuality was psychiatrically defined as a pathological deviation from "normal" sexual development. In the 7th printing of the DSM-II, "homosexuality" was replaced with "sexual orientation disturbance." The intent was to have a label that applied only to homosexual individuals who were bothered by their sexual orientation. In this manner homosexuality would not be viewed as an atypical mental disorder; only if it was distressing would it be classified as a mental illness. However, the DSM-II did not state that homosexuality was normal, either, and a diagnosis of distress related to one's sexual orientation was retained in all editions of the DSM until the DSM-5 in 2013, under different names.


DSM-III

DSM-III was a best attempt to credit
psychiatry Psychiatry is the medical specialty devoted to the diagnosis, treatment, and prevention of deleterious mental disorder, mental conditions. These include matters related to cognition, perceptions, Mood (psychology), mood, emotion, and behavior. ...
as a
scientific discipline The branches of science, also referred to as sciences, scientific fields or scientific disciplines, are commonly divided into three major groups: * Formal sciences: the study of formal systems, such as those under the branches of logic and mat ...
from the opprobrium resulting from DSM-II. A reduction in the
psychodynamic Psychodynamics, also known as psychodynamic psychology, in its broadest sense, is an approach to psychology that emphasizes systematic study of the psychological forces underlying human behavior, feelings, and emotions and how they might relate t ...
etiologies of DSM-II spilled over into a reduction symptom etiology altogether. Thus, DSM-III was a specific set of definitions for mental illnesses, and entities more suited to diagnostic psychiatry, but which annexed response proportionality as a classification factor. The product was that all symptoms, whether normal proportional response or inappropriate pathological tendencies, could both be treated as potential signs of mental illness.


DSM-IV

DSM-IV The ''Diagnostic and Statistical Manual of Mental Disorders'' (''DSM''; latest edition: ''DSM-5-TR'', published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a com ...
explicitly distinguishes mental disorders and non-disordered conditions. A non-disordered condition results from, and is perpetuated by, social stressors. Included in DSM-IV's classification is that a mental disorder "must not be merely an expectable and culturally sanctioned response to a particular event, for example, the death of a loved one. Whatever its original cause, it must currently be considered a manifestation of a behavioral, psychological, or biological dysfunction in the individual" (
American Psychiatric Association The American Psychiatric Association (APA) is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the largest psychiatric organization in the world. It has more than 39,200 members who are in ...
2000:xxxi) This had supposedly injected normality consideration back into the DSM, from its removal from DSM-II. However, it has been speculated that DSM-IV still does not escape the problems DSM-III faced, where psychiatric diagnoses still include symptoms of expectable responses to stressful circumstances to be signs of disorders, along with symptoms that are individual dysfunctions. The example set by DSM-III, for principally symptom-based disorder classification, has been integrated as the norm of mental diagnostic practice.


DSM-5

The
DSM-5 The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the '' Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiat ...
was released in the second half of 2013. It has significant differences from DSM IV-TR, including the removal of the multi-axial classifications and reconfiguring the Asperger's/ autistic spectrum classifications.


Criticisms of diagnostics

Since the advent of DSM-III, the subsequent editions of the DSM have all included a heavy symptom based pathology diagnosis system. Although there have been some attempts to incorporate environmental factors into mental and behavioral diagnostics, many practitioners and scientists believe that the most recent DSM's are misused. The symptom bias makes diagnosing quick and easier allowing for practitioners to increase their clientele because symptoms can be easier to classify and deal with than dealing with life or event histories which have evoked what may be a temporary and normal mental state in reaction to a patient's environmental circumstances. The easy-to-use manual not only has increased the perceived need for more mental health care, stimulating funding for mental health care facilities, but also has had a global impact on marketing strategies. Many pharmaceutical commercial ads list symptoms such as fatigue, depression, or anxiety. However, such symptoms are not necessarily abnormal, and are appropriate responses to such occurrences as the loss of a loved one. The targets of such ads in such cases do not need medication and can naturally overcome their grief, but with such an advertising strategy pharmaceutical companies can greatly expand their marketing.


See also

*
Abnormality (behavior) In psychology, abnormality (also dysfunctional behavior, maladaptive behavior, or deviant behavior) is a behavioral characteristic assigned to those with conditions that are regarded as dysfunctional. Behavior is considered to be abnormal when i ...
*
Attitude change Attitude change is when a person or group changes their views, values, or beliefs about a particular topic, issue, or object. This can happen as a result of new information, experiences, or influence from others. Attitudes are associated beliefs ...
*
Deviance (sociology) Deviance or the sociology of deviance explores the actions or behaviors that violate social norms across formally enacted rules (e.g., crime) as well as informal violations of social norms (e.g., rejecting folkways and mores). Although deviance ...
*
Eccentricity (behavior) Eccentricity (also called quirkiness) is an unusual or odd behavior on the part of an individual. This behavior would typically be perceived as unusual or unnecessary, without being demonstrably maladaptive. Eccentricity is contrasted with n ...
*
Social norm A social norm is a shared standard of acceptance, acceptable behavior by a group. Social norms can both be informal understandings that govern the behavior of members of a society, as well as be codified into wikt:rule, rules and laws. Social norma ...
*
Masking (behavior) In psychology and sociology, masking, also known as social camouflaging, is a defensive behavior in which an individual conceals their natural personality or behavior in response to social pressure, abuse, or harassment. Masking can be strongly i ...


References

{{Reflist, 2


External links

* Lochrie, Karma
Desiring Foucault
' Journal of Medieval and Early Modern Studies – Volume 27, Number 1, Winter 1997, pp. 3–16 *
Is It Normal?
' A community question and answer forum based specifically around surveys to determine the normality of various behaviors or thoughts Human behavior Social constructionism Behavioural sciences Stereotypes