Tuesday, December 26, 2017

abuse an example of concept creep

psychological inquiry


The main contention of this article is that in recent
decades the meanings of several of psychology’s key
concepts have changed in a systematic way. I argue
that those changes have targeted particular kinds of
concept and moved in a particular direction. Specifi-
cally, it is psychology’s negative concepts—those
that refer to undesirable, harmful, or pathological
aspects of human experience and behavior—that had

meaning changes, and these changes have consis-
tently expanded those meanings. The concepts in

question continue to refer to the phenomena they
denoted at an earlier time, but they now also refer to

a horizontally and vertically enlarged range of addi-
tional phenomena. This semantic inflation is not

widely appreciated by psychologists. When it has
been noted it has been discussed in relation to a single
concept, and the general pattern has been missed. In
the body of the article I illustrate the “concept creep”
hypothesis by reviewing changes in six concepts
drawn from the provinces of developmental, clinical,

and social psychology: abuse, bullying, trauma, men-
tal disorder, addiction, and prejudice.

After presenting these six case studies, I examine

the causes and implications of the changes they illus-
trate. I argue that a good explanation of concept creep

must account for why the changes are specific to neg-
ative concepts and why they involve expansion rather

than contraction. It should also encompass both verti-
cal and horizontal expansion and account for the con-
sistency of the effect across diverse concepts rather

than explaining each change on its own terms.
Explanations that invoke technological, social, and
cultural developments are entertained, as are some
that implicate psychology as a discipline.
I then discuss the wider consequences of concept
creep. As Hacking argued, changes in human kind
concepts alter social reality, looping back into how
people understand themselves and one another and
bringing new kinds of people into existence through
what he called “dynamic nominalism” (Hacking,
1986). I am at pains not to present concept creep as
unambiguously desirable or undesirable, or to write it
off as arbitrary or unwarranted. Conceptual revision
is to be expected in view of changing scientific and

social realities, and it may be appropriately respon-
sive to those changes. Although many critics have

held psychological concepts responsible for damag-
ing cultural trends—such as supposed cultures of

fear, therapy, and victimhood—the conceptual shifts

I present have some positive implications. Neverthe-
less, they also have potentially damaging ramifica-
tions for society and for psychology that cannot be

ignored.

Case Study 1: Abuse

The concept of abuse has grown in prominence
within psychology and related fields, largely through
the growing awareness that maltreatment of children
and adults, and its implications for mental health, has
been underestimated in the past. This underestimation
goes back at least as far as Freud’s abandonment of
the seduction theory of hysteria. Decades of research
have established the disturbing high prevalence of


their
causal role in a variety of mental disorders.
Hacking (1991) has written at length about the
shifting understandings of abuse and the relevance of
looping effects to those shifts. He documented the
malleability of ideas of child abuse and how these
were shaped by cultural trends, legal institutions, and
social movements such as feminism and children’s

rights activism. However, his historical study primar-
ily addresses changes in professional and popular rep-
resentations of abuse from the 19th century through

to the 1970s and does not focus specifically on psy-
chology. My emphasis here is on more recent changes

in the definition of abuse within that field.

Classic psychological investigations of abuse rec-
ognized two forms, physical and sexual. Physical

abuse involved the intentional infliction of bodily
harm, whereas sexual abuse involved inappropriate

sexual contact, including penetrative sex or nonpene-
trative molestation. Childhood exposure to these

forms of abuse was found to increase vulnerability to
adult psychopathology, relationship difficulties, and
physical ill health.
Three changes to the conceptualization of abuse
that have occurred within the psychological literature

over recent decades represent clear cases of horizon-
tal expansion. First, “emotional abuse” (Thompson &

Kaplan, 1996)—sometimes labeled “psychological
abuse”—was introduced as a new abuse subtype. It
refers to forms of maltreatment that need not involve
bodily contact, unlike physical and sexual abuse, but
includes verbal aggression and other behavior that is
domineering, intimidating, threatening, rejecting,
degrading, possessive, inconsistent, or emotionally
unresponsive. This form of abuse was commonly
studied within intimate domestic relationships. This
new focus on behavior exchanged between adults
represents a second horizontal extension of the abuse
concept from its traditional focus on the behavior of
adults toward children.
A third horizontal extension of the abuse concept
is its incorporation of neglect. Neglect implies a lack
of appropriate care and concern, as when negligent
parents fail to tend to their children’s basic needs for

food, shelter, clothing, physical contact, and affec-
tion. In the early literature on child maltreatment,

neglect and abuse were traditionally considered sepa-
rately—the field’s flagship journal, which com-
menced publication in 1976, was entitled Child

Abuse and Neglect—but increasingly neglect has
been understood as a form of abuse. Cicchetti and

Barnett’s (1991) taxonomy of child abuse, for exam-
ple, considers physical neglect as one of its subtypes.

Similarly, Goldsmith and Freyd (2005) considered
emotional neglect, or “emotional unavailability,” to
be a form of emotional abuse.

Emotional abuse and neglect-as-abuse are ideas

that represent horizontal extensions of the abuse con-
cept. The former extends abuse into the realm of non-
physical harm, where damage is done indirectly

through language or social interaction. The latter

extends the abuse concept by including acts of omis-
sion. Whereas physical and sexual forms of abuse

represent the commission of undesirable acts toward

a victim, neglect involves the failure to commit desir-
able acts. Neglect, like physical or sexual abuse, can

be an act in the sense of being deliberate, but it differs
from these prototypes of abuse by referring to
inaction.
The inclusion of emotional abuse and neglect

within a broadened concept of abuse may also repre-
sent a vertical expansion of that concept. Emotional

abuse encompasses some forms of interpersonal mal-
treatment that are more diffuse and ambiguous than

those that fall within the realms of physical and

sexual abuse, which, because they require bodily con-
tact, are intrinsically more tangible. Determining

what counts as emotional abuse may have a larger

element of subjectivity. Whether a particular interac-
tion represents humiliation or teasing, possessiveness

or protectiveness, and aggressiveness or assertiveness
may be uncertain and the parties involved may have

very different perceptions. If deciding whether emo-
tional abuse has occurred depends on the self-identi-
fied victim’s perception, abuse can be invoked as a

description that might seem innocuous from an inde-
pendent observer’s standpoint. This reliance on

highly subjective impressions is a feature of some
methods of assessing abuse, as in the following item
from a popular self-report measure: “As a child, did
you feel unwanted or emotionally neglected?”
A similar vertical expansion of the abuse concept

can result when it incorporates neglect. Because crite-
ria for judging omissions (i.e., what was not done that

should have been) tend to be less concrete than those
for judging commissions (i.e., what was done that
should not have been), the boundary of neglect is
indistinct. As a consequence, the concept of neglect
can become overinclusive, identifying behavior as
negligent that is substantially milder or more subtle
than other forms of abuse. This is not to deny that
some forms of neglect are profoundly damaging,

merely to argue that the concept’s boundaries are suf-
ficiently vague and elastic to encompass forms that

are not severe.

This brief discussion of abuse reveals that the con-
cept’s meaning has undergone significant inflation,

horizontal and vertical. Its message is well captured
by Furedi (2006), who noted a “continuous expansion
of the range of human experiences which can be

labelled as abusive,” such that “neglect and unin-
tended insult become equated with physical violence

and incorporated into an all-purpose generic category
” (p. 86).

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