Defining Mental Health and Psychopathology
The difference between mental health and mental disorder has never been clearly stated (Qualls,
1999) . Most scholars avoid the issue entirely or try simply to say what mental health or psychopathology is not. How to tell the difference between normal or abnormal behavior is hard to define precisely, because expectations and standards for behavior change over time, over situations, and across age groups (Zarit & Zarit, 2006). Thus what is considered mental health depends on the circumstances under consideration. Researchers and practitioners still refer to Birren and Renner’s (1980) argument that mentally healthy people have the following characteristics: a positive attitude toward self, an accurate perception of reality, a mastery of the environment, autonomy, personality balance, and growth and self-actualization.
One could argue that to the extent these characteristics are absent, mental disorder or psychopathology becomes more likely. In that case, we would consider behaviors that are harmful to oneself or others, lower one’s well-being, and are perceived as distressing, disrupting, abnormal, or maladaptive. Although this approach is used frequently with younger or middle-aged adults, it presents problems when applied to older adults
360 CHAPTER 10 (Zarit & Zarit, 2006). Some behaviors that would be considered abnormal under this definition may actually be adaptive under some circumstances for many older people (such as isolation, passivity, or aggressiveness). Consequently, an approach to defining abnormal behavior that emphasizes considering behaviors in isolation and from the perspective of younger or middle-aged adults is inadequate for defining abnormal behaviors in older adults. For example, because of physical, financial, social, health, or other reasons, some older adults do not have the opportunity to master their environment. Depression or hostility may be an appropriate and justified response to such limitations. Moreover, such responses may help them deal with their situation more effectively and adaptively. Figure 10.1 compares some common forms of mental disorder as a function of age.
The important point in differentiating normal from abnormal behavior (or mental health from psychopathology) is that behaviors must be interpreted in context. In other words, we must consider what else is happening and how the behavior fits the situation in addition to such factors as age and other personal characteristics.