(1994–2006)
Institution . | ECHR institutions . | Committee against Torture (CmAT) . |
---|---|---|
Legal nature | Court, judicial | Expert committee, quasi-judicial |
Treaty law | ECHR | CAT |
Mechanisms | Inter-state complaints, individual petitions | Self-reporting, inter-state complaints, individual communications, inquiries |
Procedure | Adversary | Expert review |
Outcome | Binding judgments | Non-binding decisions and observations |
Norm applications | Greek case, Ireland v. United Kingdom (1969–1978) | Israeli and US reviews (1994–2006) |
The ECHR institutions addressed allegations of torture in Greece and Northern Ireland in inter-state complaints between 1969 and 1978. CmAT dealt with allegations of torture against Israel and the United States in the self-reporting procedure between 1994 and 2006. The focus on these specific cases in the context of counterterrorism limits the jurisprudential terrain somewhat. 7 However, the comparison of judicial and quasi-judicial institutions provides explanatory insights into whether legally binding judgments in inter-state complaints differ from informal observations in expert reviews; whether the practices and outcomes of norm applications and lawmaking affect norm development in different or similar ways; and how this, in turn, affects recognition by states. Finally, the analysis of cases before and after the adoption of CAT in 1984—a watershed moment for the prohibition—adds a longitudinal perspective that puts into perspective the debates about norm erosion in the early 2000s.
The case studies trace the process leading from an alleged norm violation to a new legal instrument to identify the mechanisms at work between norm violation, application, and lawmaking (see Meegdenburg 2023 ). Each case study begins with a brief introduction to the institutional setting. The case studies then summarize the actions that triggered allegations of norm violations and analyze how international institutions conducted their fact-finding and determined and labeled deviance. Next, I turn to lawmaking efforts that shaped the torture prohibition to trace how norm violations procedurally and substantively influenced new formal and informal instruments. The case studies provide empirical evidence for the claim that the outcomes of norm applications are integrated into new legal instruments—either during the drafting process or in the instrument itself. The in-depth analysis is based on archival materials, the official travaux préparatoires , meeting minutes, expert interviews, participant observations at a CmAT session in 2016, and secondary literature.
Adopted in 1950 under the auspices of the Council of Europe (CoE), the ECHR established a tripartite architecture to oversee compliance with its norms—including the absolute and non-derogable torture prohibition ( Mavronicola 2021 , 16–17). The ECommHR was tasked with receiving applications, establishing facts, and reporting on norm violations. Initially, the CoE Committee of Ministers made the final decisions. Then, in 1959, the ECtHR was established to render legally binding decisions and order remedies in cases referred by States parties or ECommHR. Cases could be brought to the ECommHR—until its dissolution in 1998, a pre-trial chamber of the ECtHR that was also tasked with mediating friendly settlements—through individual and inter-state applications ( Bates 2010 , 120–24).
In April 1967, the infamous “Greek colonels” overthrew the democratic government, claiming to fight communism ( Bates 2010 , 264). Reports of torture soon began to circulate. In September 1967, Denmark, Norway, Sweden, and the Netherlands filed interstate complaints against Greece under the ECHR, which became known as the Greek case ( CoE 1972 , 5–6). In 1969, the ECommHR found Greece in violation of the ECHR torture prohibition. In 1971, as the Northern Ireland conflict escalated, the British were accused of torturing detainees with the “five techniques”: wall-standing, hooding, white noise, sleep, and food deprivation ( Rejali 2007 , 363). British inquiries into the torture allegations produced findings that refuted them and were ambivalent about their legality under international law ( Foley 2021 , 112–13). Ireland was dissatisfied and, in December 1971, filed an interstate complaint against the United Kingdom at the ECommHR ( Dickson 2010 , 61). In October 1975, Ireland declined the proposal for a friendly settlement ( Dickson 2010 , 35, n 67). The ECommHR issued its decision in 1976 followed by an ECtHR judgment of 1978, both of which found the United Kingdom in violation of ECHR Article 3 on torture and inhumane treatment but differed in their interpretation of torture.
The ECommHR used an adversarial procedure—hearing both applicant and respondent government representatives—to establish the facts of the case. In the Greek case , the commissioners received memoranda and countermemos from Scandinavian and Greek representatives, heard witnesses from both sides, and visited Greece ( Becket 1970 , 96–104). They collected information in a representative sample of 213 submissions. Based on this material, ECommHR found that Greece practiced falanga (beating on soles), electric shocks, beatings, mutilations, and various forms of sensory deprivation (see also Rejali 2007 , 276). In Ireland v. United Kingdom , the commissioners received oral and written submissions from the Irish and British governments and heard 100 witnesses speak to the allegations ( CoE 1977 , 522, 528). Striving to maintain a careful balance between the disputing parties, they heard witnesses produced and cross-examined by both sides. It found that the five techniques had indeed been used. As British commissions of inquiry had made similar assessments, the United Kingdom did not contest this finding. In both cases, fact-finding was based on written submissions, witnesses, and, in the Greek case , visits to places of detention. ECommHR validated the findings as credible facts in adversarial proceedings.
ECommHR then evaluated whether these facts constituted evidence of violating the torture prohibition. They began by interpreting the norm from scratch because key terms were not defined in European and international human rights law. The commissioners defined “torture” and “inhumane treatment” in the Greek case :
The notion of inhuman treatment covers at least such treatment as deliberately causes severe suffering, mental or physical, which, in the particular situation, is unjustifiable. The word ‘torture’ is often used to describe inhuman treatment, which has a purpose, such as the obtaining of information or confession, or the infliction of punishment, and is generally an aggravated form of inhuman treatment. ( CoE 1972 , 186).
This definition distinguishes torture— inhumane treatment that causes severe suffering—from inhumane treatment by its deliberateness and aggravation. In the Greek case , the ECommHR found evidence of an administrative practice: persistent acts of torture tolerated by the state ( CoE 1972 , 501). By thoroughly examining the torture allegations, it was able to “make a decision based on extensive evidence” ( Becket 1970 , 110). ECommHR established that the Greek practices crossed the threshold of torture and violated the country’s obligations under the ECHR. In Ireland v. United Kingdom , the commissioners based its interpretation on the Greek case . Addressing ambiguities in the Greek decision, it emphasized the non-derogable nature of the prohibition, which does not allow for exceptions even in cases of emergency ( CoE 1977 , 752). Based on two representative cases, they were convinced that the United Kingdom had used the five techniques to cause severe stress and suffering to obtain information—which constitutes ill-treatment and meets the threshold of torture ( CoE 1977 , 792–94). It found that the United Kingdom had violated Article 3 of the ECHR.
Ireland then referred the case to the ECtHR, which also found the United Kingdom in violation of the ECHR but differed in its interpretation of torture: A majority of judges found that the five techniques, while ill-treatment, did not amount to torture. The ECtHR ( 1978 , para. 167) held that torture is limited to “a special stigma to deliberate inhuman treatment causing very serious and cruel suffering.” The special stigma notion has no roots in human rights law and jurisprudence; it was “invented” by the ECtHR to reserve the concept of torture to “particularly brutal” practices that leave visible marks ( Farrell 2022 , 4). The ECtHR cited the recently adopted 1975 UNGA Declaration on Torture, which states that torture is “aggravated and deliberate” inhumane treatment. 8 Demonstrating the close links between norm violations and lawmaking (see below), the UNGA Declaration based its definition on the wording used in the Greek case , emphasizing the degree of suffering inflicted by each technique rather than its purpose .
The dissenting judges Franz Matscher and Dimitris Evrigenis took issue with the interpretation that reopened the uncontested ECommHR finding, arguing that modern torture also targets the psychological level, which should not be excluded from the ECHR definition ( ECtHR 1978 , 123–27; see also Mavronicola 2021 , 65). These different positions in Ireland v. United Kingdom illustrate how norm applications are open to negotiation, which is not without social, political, and legal interactions beyond the courtroom, as the ECtHR decision and the dissenting opinions—including the opposing views by the Irish and British judges—show. Deviance is not predetermined, and its meaning does not necessarily evolve progressively.
Greece and the United Kingdom reacted differently to the decisions. Greece denounced the ECHR and withdrew from the CoE before being expelled ( Becket 1970 , 107). The United Kingdom did not contest the ECommHR report. As Commissioner Jochen Frowein noted, British recognition was partly based on satisfaction with the procedures of the case. The United Kingdom delegation had been skeptical as to whether “this Commission of continental lawyers” could handle their case (quoted in Wolfrum and Deutsch 2009 , 23). Unsurprisingly, the United Kingdom accepted the ECtHR judgment, which acquitted it from the charge of torture. While the United Kingdom subsequently changed its discourse on torture ( Foley 2021 ), the ECtHR decision had permissive effects as evidenced by the United Kingdom’s use of the five techniques in the early 2000s ( Farrell 2022 , 11–13).
The Greek case and Ireland v. United Kingdom are important instances of case-specific lawmaking that set precedents for the application of the torture prohibition and also shaped formal lawmaking in new international treaties. In the Greek case , the ECommHR articulated the first international definition of torture; it was also the first time that an international institution found a state in violation of the norm ( Bates 2010 , 266). Ireland v. United Kingdom was the first time that the ECtHR made such a decision ( Yildiz 2020 , 90). The special stigma notion has continued to shape its jurisprudence ( Farrell 2022 , 6–9). While the ECtHR 20 years later acknowledged that its concept of torture was open to change when it issued its first decision finding a state (France) guilty of torture ( Yildiz 2020 , 90), its unsystematic approach to Article 3 has been criticized for undermining its “capacity to guide” ( Mavronicola 2021 , 49–50). Even beyond the ECHR context, the decision had precedential effects: Decades later, Israel and the United States used the ECtHR’s narrow understanding of torture as a precedent to justify interrogation practices (see also below).
The decisions in the Greek case and Ireland v. United Kingdom also influenced lawmaking at the UN, where concerns about human rights in Chile inspired new efforts to combat torture ( Burgers and Danelius 1988 , 14–16). In 1975, the UNGA adopted the Declaration on Torture, which relied on the ECommHR decision in the Greek case to define torture ( Burgers and Danelius 1988 , 115). Article 1 of the Declaration restates the ECommHR definition from the Greek case and is based on its determination of deviance. As noted above, the ECtHR used the definition in the UN Declaration to justify its controversial conclusion that the five techniques did not constitute torture, thus demonstrating the close links between norm violations, applications, and lawmaking.
When the drafters of CAT sought to define torture, the main bone of contention was the second paragraph in the Declaration of 1975 and the notion of “aggravated” inhumane treatment ( Burgers and Danelius 1988 , 44). With the United States support, the United Kingdom pushed for language consistent with the ECtHR judgment that had acquitted them of torture ( Burgers and Danelius 1988 , 42–45, 73; Nowak, Birk, and Monina 2019 , 31–32, 43). The first Swedish draft of CAT included “aggravation” in the definition of torture ( Burgers and Danelius 1988 , 203). A revised version bracketed this subclause ( Burgers and Danelius 1988 , 208), which was omitted in the final text: CAT Article 1 defines torture as
any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity.
This definition echoes the Greek case but avoids the ambiguity about “aggravation” in the second sentence of the UN Declaration on Torture and its interpretation in Ireland v. United Kingdom . The drafters of CAT adopted ECommHR’s interpretation of torture in Ireland v. United Kingdom , which defined a different threshold for torture than the 1978 ECtHR decision, which the United Kingdom and the United States had unsuccessfully advocated in the CAT drafting process ( Nowak, Birk, and Monina 2019 , 44). Unlike the ECtHR decision, ECommHR considered the five techniques and similar interrogation techniques (including sensory deprivation) to be torture by placing greater emphasis on their purpose. This is also key to the multidimensional CAT definition, which went beyond the focus on the severity of suffering that the ECtHR had advocated in 1978 ( Nowak, Birk, and Monina 2019 , 45). 9 The torture definition in CAT translated this decision on norm violations against the United Kingdom into a general, formal instrument of international law. In terms of the norm’s applicatory scope, however, CAT obligations regarding torture in Article 2 and ill-treatment in Article 16 created space to exploit the vague distinction between torture and ill-treatment under CAT ( Nowak, Birk, and Monina 2019 , 443–46).
Norm violations by Greece and the United Kingdom and their determination as deviance by the ECHR institutions did not only shape law through case-specific decisions and precedents regarding the torture prohibition’s meaning. They were also essential for defining torture during the formal lawmaking process that led to CAT. While norm violations are crucial to norm development, the disputes over the “special stigma” of torture show that it can also stall or even go awry when institutions fail to unequivocally determine deviance.
CAT builds on the absolute and non-derogable torture prohibition in the International Covenant on Civil and Political Rights (ICCPR) and develops means to effectively implement this norm ( Burgers and Danelius 1988 , 1; Nowak, Birk, and Monina 2019 , 6–7). CmAT is an expert body of ten elected members that was established in 1989 under CAT. Its central monitoring mechanism—obligatory for all States parties—is the review of self-reports and NGO shadow reports in “constructive dialogues” with state delegations ( Creamer and Simmons 2019 , 1052). The professionally diverse composition of CmAT shapes its interactions with state delegations (see Reiners 2022 , 60). For example, longtime CmAT chair Jens Modvig’s medical background led him to ask different questions than the lawyers on the committee. The outcome of the review is observations and recommendations to improve the implementation of the norm. While non-binding and not always explicitly addressing norm violations ( Kelly 2009 , 793), even these informal documents raise “the political stakes of ignoring them” ( Creamer and Simmons 2020 , 17).
In the 1990s, Israel was criticized for interrogation practices, including shabeh , overwhelming restraint, stress positions (forced squatting, sitting, and standing), strenuous physical exercises, white noise, and beatings ( Rejali 2007 , 354–57). The methods were often intensified through sleep deprivation and shaking ( Rejali 2007 , 329, 337). In the early 2000s, the United States used similar techniques, including waterboarding, stress positions, sleep and food deprivation, white noise, beatings, and mock burials (US Senate 2014 , 32). The methods were accompanied by legal justifications. In Israel, the Landau Report of 1987 included guidelines for “moderate physical pressure”. In the United States, the 2002 Bybee Memorandum made the case for the legality of “enhanced interrogation techniques”. Both countries referred to the ECtHR judgment in Ireland v. United Kingdom to justify their methods ( Landau Commission 1987 , 69–70; Bybee [2002] 2005 , 197–98). This underscores the (unintended) precedential effects of this decision. As before CAT, there was growing uncertainty about the legality of certain interrogation practices. CmAT applied the torture prohibition in reviewing Israeli and US state reports. Despite the informal procedure, both countries dispatched high-level delegations to engage with CmAT (see also Schmidt and Sikkink 2019 , 108).
In contrast to the adversarial ECHR procedures, CmAT finds facts “indirectly” by having its experts review state reports and NGO “shadow reports” ( Viljoen 2004 , 59–61). The review is less formalized and relies heavily on secondary sources ( Kelly 2009 , 789). In the 1990s, Israel appeared before CmAT in 1994 and 1998 for its initial and second periodic reports, and in 1996, after submitting a special report requested by CmAT. It also used reports on the interrogation techniques by Amnesty International and Al-Haq , the Palestinian branch of the International Commission of Jurists ( CmAT 1994b , para. 239). In 2006, after submitting its initial report, the United States met with CmAT for the first time. In addition to the US report, CmAT reviewed over 3,000 pages of NGO reports. 10 It heard the Israeli and US positions and questioned the delegations. In meetings with the Israelis, CmAT experts referred to the findings of Amnesty International and Al-Haq, which they described as reputable sources ( CmAT 1994a , para. 11). By 1998, Peter Burns, the country rapporteur for Israel, was confident that CmAT had “full knowledge of the facts” about Israeli interrogation techniques like beatings, hooding, sleep deprivation, stress positions, and shaking ( CmAT 1998 , para. 13). The Landau Report and Israeli Supreme Court rulings provided additional information on interrogations using moderate physical pressure ( CmAT 1998 , paras. 22–24). With regard to the United States, CmAT used shadow reports by Amnesty International, Human Rights Watch and others as important points of reference ( CmAT 2006a , paras. 85, 97, and 102). CmAT members then inquired about the US position on water-boarding, sexual abuse, stress positions, and other techniques ( CmAT 2006a , paras. 82 and 97), pointing out that some were explicitly sanctioned in official US documents ( CmAT 2006b , para. 43).
CmAT assessed state and NGO reports on the relevant interrogation techniques. A review based on such documentation resembles an inquisitorial setting, with NGOs presenting evidence to the reviewing experts (on behalf of the plaintiffs as it were) to which the state under review reacts. Israel and the United States challenged that procedure by questioning the validity of NGO reports and demanding to respond to the allegations with their own information ( CmAT 1998 , para. 2). In contrast to the United Kingdom in the 1970s, neither Israel nor the United States was fully satisfied with this review-based fact-finding.
CmAT then evaluated these facts, addressing the specific interrogations techniques and the prohibition’s applicatory scope. The findings on the interrogation techniques were key to CmAT’s evaluation of these facts as evidence of torture. The Israeli delegation was asked whether it considered the practices to be torture or ill-treatment, since it did not contest using “moderate physical pressure”. CmAT disagreed with Israel’s view that it was not torture. Bent Sørensen, the alternate rapporteur for Israel, applied the CAT definition of torture to shaking “inflicted intentionally by public officials with a view to obtaining information”. He concluded that “there was no doubt that those cases fell within the meaning of article 1 of the Convention” ( CmAT 1998 , para. 25). For him, it was primarily the purpose of the technique, not the intensity of pain, that made it torture. Similarly, CmAT rejected Israel’s reliance on Ireland v. United Kingdom to show that practices involving moderate physical pressure were not torture ( CmAT 1994a , para. 34; 1997b , para. 29). The US delegation was questioned about its interpretation of the CAT definition of torture and whether its enhanced interrogation constituted torture ( CmAT 2006a , paras. 18, 82, and 99). Nora Sveaass stated that
according to official documents of the United States, certain methods of interrogation being applied covered practices that the Committee defined as acts of torture, such as forced naked exposure, being required to remain in painful position, and the exploitation of phobias in the person being interrogated. ( CmAT 2006b , para. 43)
When Israel and the United States sought to exploit ambiguities in the non-derogable prohibition of torture, CmAT responded that CAT applies at all times and in all circumstances—rejecting arguments about its limited applicability in territory under de facto control or in occupied territory ( CmAT 2006a , paras. 14–15, 18–19, 1994a , para. 167, 1998 , para. 238).
Based on this assessment, CmAT concluded that Israeli and US interrogation techniques violated the torture prohibition. In 1997, CmAT stated that moderate physical pressure constitutes “breaches of article 16 and also constitute torture as defined in article 1 of the convention. This conclusion is particularly evident where such methods of interrogation are used in combination, which appears to be the standard case” ( CmAT 1997a , para. 5). Similarly, CmAT found that the United States had authorized interrogation techniques that “led to serious abuses of detainees” under CAT Articles 1 and 16. CmAT rejected the US interpretation of the torture prohibition and concluded that US interrogation techniques clearly violated CAT. In its concluding observations, CmAT called on the United States to
rescind any interrogation technique, including methods involving sexual humiliation, ‘waterboarding’, ‘short shackling’ and using dogs to induce fear, that constitutes torture or cruel, inhuman or degrading treatment or punishment, in all places of detention under its de facto effective control, in order to comply with its obligations under the Convention. ( CmAT 2006c , para. 24).
Even as informal decisions about deviance, CmAT’s concluding observations put the torture prohibition into effect. While the United States and Israel attempted to blur the distinction between “what the rules allow and forbid” with respect to torture ( Hurd 2017 , 125), CmAT established that the torture prohibition had been violated and exhibited US deviance for all to see (similarly, Creamer and Simmons 2019 , 1053).
Although Israel and the United States challenged the findings by questioning CmAT’s authority to adopt general conclusions and interpretations, both countries officially denounced their own interrogation techniques. CmAT helped bring “international law to bear on Israeli domestic actions” when the Israeli High Court of Justice ruled in 1999 that moderate physical pressure was illegal ( Grosso 2000 , 333). By decree, Israeli security agencies were ordered to comply with this judgment ( Barnes 2017 , 134). Yet its implementation remains controversial, which also shapes the ongoing exchange with CmAT ( CmAT 2019 , para. 30). The institutional determination of deviance by CmAT also provided an important counterweight to the US challenge, which received little international support ( Keating 2014 , 80–81; Schmidt and Sikkink 2019 , 109–12; Stimmer 2019 , 277). In one of its first decisions, the Obama administration rescinded the enhanced interrogation techniques. In 2014, the United States returned to CmAT for its second and third periodic reports, seeking to revoke the deviator label by accepting that enhanced interrogation constituted torture and assuring CmAT that it had ended all related methods ( CmAT 2014 , paras. 4–5).
The CmAT review process was not just important for the US case. As an example of informal, specific lawmaking it clarified “antitorture norms more generally and what normatively defines torture and cruel, inhumane, and degrading treatment” ( Creamer and Simmons 2019 , 1053). In rejecting the ECtHR decision, CmAT applied the ECommHR interpretation of the torture prohibition and rebuffed attempts to accommodate counterterrorism practices under the torture prohibition. This is important because some states emulated US arguments to justify torture ( Schmidt and Sikkink 2019 , 111). By determining and labeling deviance, CmAT helped push back on these challenges. These two norm applications also influenced more general lawmaking in CmAT’s second “general comment” on CAT ( CmAT 2008 ). 11
Human rights treaty bodies are created to monitor human rights norms and are not explicitly mandated to engage in lawmaking. However, drafting general comments helps them to develop norms relatively independently ( Reiners 2022 , 21). They use this informal instrument to enshrine their interpretation of human rights norms and to inform states of their obligations ( Creamer and Simmons 2020 , 33). CmAT was long reluctant to use general comments ( Nowak, Birk, and Monina 2019 , 528). The first was adopted in 1998, but several attempts to draft others were stifled. One of the reasons for this reluctance can be found in the professional background of CmAT members as international lawyers from a common law tradition have argued for maintaining a case-specific approach (e.g., CmAT 2002 , para. 73). Discussions about commenting on CAT Article 2 only took off in 2006 in the face of US norm violations and ongoing disputes with Israel ( Gaer 2008 , 195; Rodley 2008 , 354; for a detailed reconstruction of the drafting process, see Lesch and Reiners 2023 ).
Article 2 of CAT codifies state obligations regarding the universal territorial applicability and non-derogability of the norm. Building on the ICCPR, it is one of CAT’s core provisions ( Nowak, Birk, and Monina 2019 , 72–73). After Israel and the United States attempted to exploit the ambiguity of Article 16 with respect to ill-treatment, CmAT drafted General Comment No. 2 to counter their arguments in a general informal instrument, based on a letter that CmAT had circulated to all States parties to CAT in the wake of September 11, 2001 ( CmAT 2006d , para. 26, 2008 , para. 6, n1). In the drafting process, CmAT members cited Israeli arguments about moderate physical pressure as an attempt to blur the line between torture and ill-treatment ( CmAT 2006d , para. 23). CmAT clarified that the “obligation to prevent ill-treatment in practice overlaps and is largely congruent with the obligation to prevent torture”, including its non-derogability ( CmAT 2008 , para. 3). General Comment No. 2 builds on and reaffirms CmAT’s position on Israel and the United States, and distinguishes CAT from the ECtHR decision in Ireland v. United Kingdom by treating torture and ill-treatment as equally prohibited—and not “at the top end of a pyramid of pain and suffering” as implied by the 1978 ECtHR decision and subsequent Israeli and US interpretations ( Rodley 2008 , 356–57).
General Comment No. 2 also addresses CAT’s territorial scope and non-derogability. It further specifies that the torture prohibition applies in the context of “any threat of terrorist acts or violent crime as well as armed conflict, international or non-international” ( CmAT 2008 , para. 5). During the drafting process, CmAT members explicitly referred to the dialogue with the United States to clarify that terrorism could not justify an exception ( CmAT 2006d , para. 28). General Comment No. 2 states that CAT applies to all territories under the de jure and de facto control of States parties ( CmAT 2008 , para. 7). CmAT’s determination of deviance in Israeli and US self-reports helped to reinforce the norm by underlining that torture and ill-treatment are prohibited under international law in all circumstances and in all territories under the legal and effective control of States parties. This rejects arguments that implicitly seek exceptions for counterterrorism, in (secret) detention facilities, and in occupied territories.
General Comment No. 2 critically developed the torture prohibition and became a central point of reference in CmAT’s practice. 12 The legally amorphous nature of general comments means that, perhaps more than other lawmaking mechanisms, they depend on recognition ( Reiners 2022 , 32–33). Many States parties supported CmAT during the drafting process ( CmAT 2007 , para. 4). The UNGA included General Comment No. 2 in its 2008 resolution on the torture prohibition to emphasize its absoluteness and non-derogability—a sign of broad support by states. 13 The US State Department, however, has issued a detailed critique of General Comment No. 2, aimed primarily at denying it any legal effects ( US State Department 2008 ). Yet human rights courts cite General Comment No. 2, 14 which underlines that this informal lawmaking has been recognized as part of international human rights law (see also McCall-Smith 2016 , 34–45). By establishing that Israeli and U.S. interrogation techniques violated the torture prohibition, CmAT has significantly reinforced the norm, which also shaped informal lawmaking in General Comment No. 2.
Norm violations are a driving force behind the development of international norms. In this article, I have demonstrated how international institutions determine deviance and engage in lawmaking. In the two case studies, norm violations influenced formal and informal lawmaking through norm applications by institutions ranging from courts to expert committees—even despite powerful challenges to the norm.
Once the ECHR institutions had defined torture and determined Greek and British interrogation techniques as “torture”, these violations shaped CAT. However, the ECtHR precedent in Ireland v. United Kingdom continued to influence contestations of the torture prohibition. Although institutionally very different, CmAT advanced norm development by reviewing Israeli and US interrogation techniques and establishing that they deviated from the prohibition. Then, in General Comment No. 2, CmAT took on the role of a lawmaker. It reaffirmed the non-derogability of the torture prohibition in light of Israeli and US deviance and ruled out arguments based on the “bad precedent” of Ireland v. United Kingdom . Norm-applying institutions—even without formal authority—can engage in lawmaking when their pronouncements are judicially or politically recognized. CmAT’s General Comment No. 2 is part of a series of successful lawmaking efforts by several treaty bodies ( Reiners 2022 , 116). More research is needed on whether and how general comments have been driven by norm violations. This should also extend beyond human rights to study the link between norm violations and other informal lawmaking efforts by compliance panels, commissions of inquiry, peer-review mechanisms, and NGO reporting.
The case studies also shed light on how the design of different institutions affects the way states perceive them and react to their judgments, adding to research on compliance with decisions of expert bodies and courts. More research is needed to identify conditions under which states accept or reject labels of deviance from international institutions. This should link insights on contestation patterns and stigma management with the practice of norm-applying institutions. Although both the Greek and British delegations acknowledged the adversarial procedures—similar to common law court proceedings—only the United Kingdom accepted the verdict. On the other hand, Israel and the United States contested the procedures and decisions by CmAT, whose members review evidence based on self-reports and shadow reports by NGOs—closer to proceedings in a civil law tradition. British recognition of the ECHR’s adversary procedures and Israeli and US critiques of the practice of expert review suggest that states are more likely to recognize proceedings in which they are closely involved. Such research could also add another layer to scholarship on the backlash against international institutions.
Beyond human rights, future studies should examine the informal and confidential approach by the International Committee of the Red Cross to monitoring compliance in armed conflicts and analyze how norm violations have influenced formal and informal lawmaking efforts to improve, for example, the protection of civilians in the Additional Protocols to the Geneva Conventions or the recent Dublin Declaration ( Kinsella and Mantilla 2020 ). In trade law, scholars should study how, for example, disputes over intellectual property rights violations have influenced lawmaking in the 1994 Agreement on Trade-Related Intellectual Property Rights and the 2001 Doha Declaration. These disputes continue to shape debates about the limits of intellectual property rights with regard to compulsory licensing of medicines in health crises ( Sell and Prakash 2004 , 157–58). Finally, future research should study how institutions that are unable or unwilling to determine deviance affect norm development. This can be seen in the blockade of the WTO Appellate Body ( Kucik and Puig 2022 ) and the silence of the UN Security Council regarding interventions against non-state actors ( O'Connell, Tams, and Tladi 2019 ). Studying norm violations and international institutions in these and other cases will provide better explanations for the puzzle of why norms remain robust and develop despite—or even because—of their violation.
European Treaty Series, No. 5.
UN Treaty Series, no. 24841, vol. 1465 at 85.
ECommHR functioned as a pre-trial chamber of the ECtHR ( Bates 2010 , 120). It was dismantled in the 1998 reform.
For a recent international law approach to study the link between norm violations and the international legal order, see Marxsen (2021 ).
Stimmer and Wisken (2019 , 521–22) include behavioral contestation that not necessarily violates norms.
Next to norm violations, technological and societal changes, emerging issues, social pressure on states, and agenda setting by transnational coalitions also influence lawmaking ( Keck and Sikkink 1998 ; Sandholtz 2007 ; Rosert 2019 ; Kinsella and Mantilla 2020 ; Reiners 2022 ).
For comprehensive assessments of ECHR jurisprudence, see Yildiz (2020 , 2023 ) and Mavronicola (2021 ); for an inter-institutional perspective, see Davidson (2022 ).
UNGA Resolution 3452 (XXX), Article 1(2).
Recent ECtHR jurisprudence frequently cites CAT, emphasizing “purpose” as a definitional criterion ( Mavronicola 2021 , 74–75).
Interview with CmAT member, May 2016.
It was also important to frame domestic violence as torture ( Davidson 2022 , 214–18).
UNGA Resolution 63/166, para. 26.
The ECtHR cited General Comment No. 2 in five decisions: 67258/13, 36391/02, 25703/11, 26828/06, and 41261/17; https://hudoc.echr.coe.int (accessed December 2, 2022).
Max Lesch is a Postdoctoral Researcher at the Peace Research Institute Frankfurt (PRIF). His research interests include norm contestation and deviance in human rights and peace and security law, as well as international practice theories, fact-finding missions, and (in)formal lawmaking.
Author’s note: This paper has benefited greatly from discussions with Rebecca Adler-Nissen, Antonio Arcudi, Nicole Deitelhoff, Klaus Dingwerth, Jennifer Erickson, Frank Gadinger, Nele Kortendiek, Stefan Kroll, Christian Marxsen, Galia Press-Barnathan, Elvira Rosert, Philip Wallmeier, and Lisbeth Zimmermann. I would like to thank the editors of International Studies Quarterly and the three anonymous reviewers for their constructive feedback and helpful comments on earlier versions of this article.
Abbott Kenneth W. , Keohane Robert O. , Moravcsik Andrew , Slaughter Anne-Marie , Snidal Duncan . 2000 . “ The Concept of Legalization .” International Organization . 54 ( 3 ): 401 – 19 .
Google Scholar
Adler-Nissen Rebecca . 2014 . “ Stigma Management in International Relations: Transgressive Identities, Norms, and Order in International Society .” International Organization . 68 ( 1 ): 143 – 76 .
Alter Karen J . 2014 . The New Terrain of International Law: Courts, Politics, Rights . Princeton, NJ : Princeton University Press .
Google Preview
Alter Karen J. , Hafner-Burton Emilie M. , Helfer Laurence R . 2019 . “ Theorizing the Judicialization of International Relations .” International Studies Quarterly . 63 ( 3 ): 449 – 63 .
Barnes Jamal . 2017 . A Genealogy of the Torture Taboo . London : Routledge .
Barnett Michael N. , Finnemore Martha . 2004 . Rules for the World: International Organizations in Global Politics . Ithaca : Cornell University Press .
Bates Ed . 2010 . The Evolution of the European Convention on Human Rights: From Its Inception to the Creation of a Permanent Court of Human Rights . Oxford : Oxford University Press .
Becket James . 1970 . “ The Greek Case Before the European Human Rights Commission .” Human Rights . 1 ( 1 ): 91 – 117 .
Birdsall Andrea . 2016 . “ But We Don’t Call It ‘Torture’! Norm Contestation During the US ‘War on Terror’ .” International Politics . 53 ( 2 ): 176 – 97 .
Brunnée Jutta , Toope Stephen J . 2010 . Legitimacy and Legality in International Law: An Interactional Account . Cambridge : Cambridge University Press .
Burgers J. Herman , Danelius Hans . 1988 . The United Nations Convention Against Torture: A Handbook on the Convention Against Torture and Other Cruel and Inhuman or Degrading Treatment . Dordrecht : Nijhoff .
Bybee Jay S . [2002] 2005 . “ Memorandum for Alberto R. Gonzales Counsel to the President: August 1, 2002 .” In The Torture Papers: Road to Abu Ghraib , edited by Greenberg Karen J. , Dratel Joshua L. , 172 – 217 .. Cambridge : Cambridge University Press .
Çali Başak , Costello Cathryn , Cunningham Stewart . 2020 . " Hard Protection through Soft Courts? Non-Refoulement before the United Nations Treaty Bodies ." German Law Journal . 21 ( 3 ): 355 – 84 .
Carraro Valentina . 2019 . “ Promoting Compliance with Human Rights: The Performance of the United Nations’ Universal Periodic Review and Treaty Bodies .” International Studies Quarterly . 63 ( 4 ): 1079 – 93 .
Caserta Salvatore , Madsen Mikael Rask . 2022 . “ The Situated and Bounded Rationality of International Courts: A Structuralist Approach to International Adjudicative Practices .” Leiden Journal of International Law . 35 ( 4 ): 931 – 43 .
CmAT . 1994a . UN Doc. CAT/C/SR.183 .
CmAT . 1994b . UN Doc. A/49/44, Supp. 44 .
CmAT . 1997a . UN Doc. CAT/C/SR.297/Add.1 .
CmAT . 1997b . UN Doc. CAT/C/SR.295 .
CmAT . 1998 . UN Doc. CAT/C/SR.336 .
CmAT . 2002 . UN Doc. CAT/C/SR.532 .
CmAT . 2006a . UN Doc. CAT/C/SR.703 .
CmAT . 2006b . UN Doc. CAT/C/SR.706 .
CmAT . 2006c . UN Doc. CAT/C/USA/CO/2 .
CmAT . 2006d . UN Doc. CAT/C/SR.752 .
CmAT . 2007 . UN Doc. CAT/C/SR.782 .
CmAT . 2008 . UN Doc. CAT/C/GC/2 .
CmAT . 2014 . UN Doc. CAT/C/SR.1264 .
CmAT . 2019 . UN Doc. CAT/C/ISR/QPR/6 .
CoE . 1972 . Yearbook of the European Convention on Human Rights 1969: The Greek Case . The Hague : Martinus Nijhoff .
CoE . 1977 . Yearbook of the European Convention on Human Rights 1976 . The Hague : Martinus Nijhoff .
Creamer Cosette D. , Simmons Beth A . 2019 . “ Do Self-Reporting Regimes Matter? Evidence from the Convention Against Torture .” International Studies Quarterly . 63 ( 4 ): 1051 – 64 .
Creamer Cosette D. , Simmons Beth A . 2020 . “ The Proof Is in the Process: Self-Reporting Under International Human Rights Treaties .” American Journal of International Law . 114 ( 1 ): 1 – 50 .
Davidson Natalie R . 2022 . “ Everyday Lawmaking in International Human Rights Law: Insights from the Inclusion of Domestic Violence in the Prohibition of Torture .” Law & Social Inquiry . 47 ( 1 ): 205 – 35 .
Deitelhoff Nicole , Zimmermann Lisbeth . 2019 . “ Norms Under Challenge: Unpacking the Dynamics of Norm Robustness .” Journal of Global Security Studies . 4 ( 1 ): 2 – 17 .
Deitelhoff Nicole , Zimmermann Lisbeth . 2020 . “ Things We Lost in the Fire: How Different Types of Contestation Affect the Robustness of International Norms .” International Studies Review . 22 ( 1 ): 51 – 76 .
Devaney James Gerard . 2016 . Fact-Finding Before the International Court of Justice . Cambridge : Cambridge University Press .
Dickson Brice . 2010 . The European Convention on Human Rights and the Conflict in Northern Ireland . Oxford : Oxford University Press .
Durkheim Émile . 1969 . The Division of Labor in Society . New York : Free Press .
Durkheim Émile . 1982 . The Rules of the Sociological Method . New York : Free Press .
ECtHR . 1978 . Ireland v. United Kingdom: Judgement on the Merits . no. 5310/71 .
Eilstrup-Sangiovanni Mette , Sharman J.C . 2022 . Vigilantes Beyond Borders: NGOs as Enforcers of International Law . Princeton, NJ : Princeton University Press .
Erikson Kai T . 1962 . “ Notes on the Sociology of Deviance .” Social Problems . 9 ( 4 ): 307 – 14 .
Evers Miles M . 2017 . “ On Transgression .” International Studies Quarterly . 61 ( 4 ): 786 – 94 .
Farrell Michelle . 2022 . “ The Marks of Civilisation: The Special Stigma of Torture .” Human Rights Law Review . 22 ( 1 ): 1 – 26 .
Fikfak Veronika . 2022 . “ Against Settlement Before the European Court of Human Rights .” International Journal of Constitutional Law . 20 ( 3 ): 942 – 75 .
Finnemore Martha , Sikkink Kathryn . 1998 . “ International Norm Dynamics and Political Change .” International Organization . 52 ( 4 ): 887 – 917 .
Finnemore Martha , Toope Stephen J . 2001 . “ Alternatives to ‘Legalization’: Richer Views of Law and Politics .” International Organization . 55 ( 3 ): 743 – 58 .
Foley Frank . 2021 . “ The (De)Legitimation of Torture: Rhetoric, Shaming and Narrative Contestation in Two British Cases .” European Journal of International Relations . 27 ( 1 ): 102 – 26 .
Gaer Felice D . 2008 . “ Opening Remarks: General Comment No. 2 .” New York City Law Review . 11 ( 2 ): 187 – 200 .
Grosso Catherine M . 2000 . “ International Law in the Domestic Arena: The Case of Torture in Israel .” The Iowa Law Review . 86 ( 1 ): 305 – 37 .
Hafner-Burton Emilie M . 2008 . “ Sticks and Stones: Naming and Shaming the Human Rights Enforcement Problem .” International Organization . 62 ( 4 ): 689 – 716 .
Hathaway Oona A. , Shapiro Scott J . 2011 . “ Outcasting: Enforcement in Domestic and International Law .” Yale Law Journal . 121 ( 2 ): 252 – 349 .
Hillebrecht Courtney . 2014 . Domestic Politics and International Human Rights Tribunals: The Problem of Compliance . Cambridge : Cambridge University Press .
Hirsch Moshe . 2015 . Invitation to the Sociology of International Law . Oxford : Oxford University Press .
Hurd Ian . 2017 . How to Do Things with International Law . Princeton, NJ : Princeton University Press .
Jurkovich Michelle . 2020 . “ What Isn’t a Norm? Redefining the Conceptual Boundaries of ‘Norms’ in the Human Rights Literature .” International Studies Review . 22 ( 3 ): 693 – 711 .
Keating Vincent C . 2014 . US Human Rights Conduct and International Legitimacy: The Constrained Hegemony of George W. Bush . New York : Palgrave Macmillan .
Keating Vincent C . 2022 . “ Membership Has Its Privileges: Targeted Killing Norms and the Firewall of International Society .” International Studies Quarterly . 66 ( 3 ): 1 – 12 .
Keck Margaret E. , Sikkink Kathryn . 1998 . Activists Beyond Borders: Advocacy Networks in International Politics . Ithaca : Cornell University Press .
Kelly Tobias . 2009 . “ The UN Committee Against Torture: Human Rights Monitoring and the Legal Recognition of Cruelty .” Human Rights Quarterly . 31 ( 3 ): 777 – 800 .
Kinsella Helen M. , Mantilla Giovanni . 2020 . “ Contestation Before Compliance: History, Politics, and Power in International Humanitarian Law .” International Studies Quarterly . 64 ( 3 ): 649 – 56 .
Kratochwil Friedrich , Ruggie John Gerard . 1986 . “ International Organization: A State of the Art on an Art of the State .” International Organization . 40 ( 4 ): 753 – 75 .
Kratochwil Friedrich . 1989 . Rules, Norms, and Decisions: On the Conditions of Practical and Legal Reasoning in International Relations and Domestic Affairs . Cambridge : Cambridge University Press .
Krisch Nico . 2014 . “ The Decay of Consent: International Law in an Age of Global Public Goods .” American Journal of International Law . 108 ( 1 ): 1 – 40 .
Kucik Jeffrey , Puig Sergio . 2022 . “ Do International Dispute Bodies Overreach? Reassessing World Trade Organization Dispute Ruling .” International Studies Quarterly . 66 ( 4 ): 1 – 8 .
Kutz Christopher . 2014 . “ How Norms Die: Torture and Assassination in American Security Policy .” Ethics & International Affairs . 28 ( 4 ): 425 – 49 .
Landau Commission . 1987 . “ Commission of Inquiry into the Methods of Interrogation of the General Security Service Regarding Hostile Terrorist Activity .” Report, Part One. Jerusalem: State of Israel. English Translation Provided by the Government Press Office. 10.1017/S2045381723000023 1 – 24 .
Lebovic James H. , Voeten Erik . 2006 . “ The Politics of Shame: The Condemnation of Country Human Rights Practices in the UNCHR .” International Studies Quarterly . 50 ( 4 ): 861 – 88 .
Lesch Max , Marxsen Christian . 2023 . “ Norm Contestation in the Law Against War: Towards an Interdisciplinary Analytical Framework .” Heidelberg Journal of International Law . 83 ( 1 ): 11 – 38 .
Lesch Max , Reiners Nina . 2023 . “ Informal Human Rights Lawmaking: How Treaty Bodies Use ‘General Comments’ to Develop International Law .” Global Constitutionalism . doi: 10.1017/S2045381723000023 , 1 – 24 .
Lesch Max , Zimmermann Lisbeth . 2023 . “ There Is Life in the Old Dog yet: Assessing the Strength of the International Torture Prohibition .” In Tracing Value Change in the International Legal Order: Perspectives from Legal and Political Science , edited by Krieger Heike , Liese Andrea , 100 – 117 .. Oxford : Oxford University Press .
Lesch Max . 2021 . “ Multiplicity, Hybridity and Normativity: Disputes About the UN Convention Against Corruption in Germany .” International Relations . 35 ( 4 ): 613 – 33 .
Liese Andrea . 2009 . “ Exceptional Necessity: How Liberal Democracies Contest the Prohibition of Torture and Ill-Treatment When Countering Terrorism .” Journal of International Law and International Relations . 5 ( 1 ): 17 – 47 .
Lupu Yonatan , Voeten Erik . 2012 . “ Precedent in International Courts: A Network Analysis of Case Citations by the European Court of Human Rights .” British Journal of Political Science . 42 ( 2 ): 413 – 39 .
Marxsen Christian . 2021 . Völkerrechtsordnung und Völkerrechtsbruch: Theorie und Praxis der Illegalität im Ius Contra Bellum . Tübingen : Mohr Siebeck .
Mavronicola Natasa . 2021 . Torture, Inhumanity and Degradation Under Article 3 of the ECHR: Absolute Rights and Absolute Wrongs . Oxford : Hart .
McCall-Smith Kasey L . 2016 . “ Interpreting International Human Rights Standards: Treaty Body General Comments as a Chisel or a Hammer .” In Tracing the Roles of Soft Law in Human Rights , edited by Lagoutte Stéphanie , Gammeltoft-Hansen Thomas , Cerone John , 27 – 46 .. Oxford : Oxford University Press .
McKeown Ryder . 2009 . “ Norm Regress: US Revisionism and the Slow Death of the Torture Norm .” International Relations . 23 ( 1 ): 5 – 25 .
Meegdenburg Hilde van . 2023 . “ Process Tracing: An Analyticist Approach .” In Routledge Handbook of Foreign Policy Analysis Methods , edited by Mello Patrick A. , Ostermann Falk , 405 – 20 .. London : Routledge .
Möllers Christoph . 2020 . The Possibility of Norms: Social Practice Beyond Morals and Causes . Oxford : Oxford University Press .
Nowak Manfred , Birk Moritz , Monina Giuliana . 2019 . The United Nations Convention Against Torture and Its Optional Protocol: A Commentary . Oxford : Oxford University Press .
O'Connell Mary Ellen , Tams Christian J. , Tladi Dire . 2019 . Self-Defence Against Non-State Actors . Volume 1 : Max Planck Trialogues on the Law of Peace and War edited by Christian Marxsen and Anne Peters . Cambridge : Cambridge University Press .
Panke Diana , Petersohn Ulrich . 2012 . “ Why International Norms Disappear Sometimes .” European Journal of International Relations . 18 ( 4 ): 719 – 42 .
Parry John T . 2010 . Understanding Torture: Law, Violence, and Political Identity . Ann Arbor : University of Michigan Press .
Pauwelyn Joost , Wessel Ramses A. , Wouters Jan , eds. 2013 . Informal International Lawmaking . Oxford : Oxford University Press .
Percy Sarah V. , Sandholtz Wayne . 2022 . “ Why Norms Rarely Die .” European Journal of International Relations . 28 ( 4 ): 934 – 54 .
Pratt Simon Frankel . 2020 . “ From Norms to Normative Configurations: A Pragmatist and Relational Approach to Theorising Normativity in IR .” International Theory . 12 ( 1 ): 59 – 82 .
Putnam Tonya L . 2020 . “ Mingling and Strategic Augmentation of International Legal Obligations .” International Organization . 74 ( 1 ): 31 – 64 .
Reiners Nina . 2022 . Transnational Lawmaking Coalitions for Human Rights . Cambridge : Cambridge University Press .
Rejali Darius . 2007 . Torture and Democracy . Princeton, NJ : Princeton University Press .
Rodley Nigel S . 2008 . “ Reflections on Committee Against Torture General Comment No. 2 .” New York City Law Review . 11 ( 2 ): 353 – 58 .
Rogers Charles B. , 2020 . The Origins of Informality: Why the Legal Foundations of Global Governance Are Shifting, and Why It Matters . Oxford : Oxford University Press .
Rosert Elvira , Sauer Frank . 2021 . “ How (Not) To Stop the Killer Robots: A Comparative Analysis of Humanitarian Disarmament Campaign Strategies .” Contemporary Security Policy . 42 ( 1 ): 4 – 29 .
Rosert Elvira . 2019 . “ Norm Emergence as Agenda Diffusion: Failure and Success in the Regulation of Cluster Munitions .” European Journal of International Relations . 25 ( 4 ): 1103 – 31 .
Saha Aniruddha . 2022 . “ Nuclear Stigma and Deviance in Global Governance: A New Research Agenda .” International Studies Quarterly . 66 ( 3 ): 1 – 12 .
Sandholtz Wayne . 2007 . Prohibiting Plunder: How Norms Change . Oxford : Oxford University Press .
Schmidt Averell , Sikkink Kathryn . 2019 . “ Breaking the Ban? The Heterogeneous Impact of US Contestation of the Torture Norm .” Journal of Global Security Studies . 4 ( 1 ): 105 – 22 .
Sell Susan K. , Prakash Aseem . 2004 . “ Using Ideas Strategically: The Contest Between Business and NGO Networks in Intellectual Property Rights .” International Studies Quarterly . 48 ( 1 ): 143 – 75 .
Smetana Michal , Onderco Michal . 2019 . “ Bringing the Outsiders in: An Interactionist Perspective on Deviance and Normative Change in International Politics .” Cambridge Review of International Affairs . 3 ( 3 ): 1 – 21 .
Soley Ximena , Steininger Silvia . 2018 . “ Parting Ways or Lashing Back? Withdrawals, Backlash and the Inter-American Court of Human Rights .” International Journal of Law in Context . 14 ( 2 ): 237 – 57 .
Sparks Thomas . 2023 . Self-Determination in the International Legal System: Whose Claim to What Right? . Hart : Oxford .
Staden Andreas von . 2018 . Strategies of Compliance with the European Court of Human Rights: Rational Choice Within Normative Constraints . Pennsylvania : University of Pennsylvania Press .
Stappert Nora . 2020 . “ Practice Theory and Change in International Law: Theorizing the Development of Legal Meaning Through the Interpretive Practices of International Criminal Courts .” International Theory . 12 ( 1 ): 33 – 58 .
Stiansen Øyvind , Voeten Erik . 2020 . “ Backlash and Judicial Restraint: Evidence from the European Court of Human Rights .” International Studies Quarterly . 64 ( 4 ): 770 – 84 .
Stimmer Anette , Wisken Lea . 2019 . “ The Dynamics of Dissent: When Actions Are Louder Than Words .” International Affairs . 95 ( 3 ): 515 – 33 .
Stimmer Anette . 2019 . “ Beyond Internalization: Alternate Endings of the Norm Life Cycle .” International Studies Quarterly . 63 ( 2 ): 270 – 80 .
Ullmann Andreas J. , Staden Andreas von . 2023 . “ A Room Full of ‘Views': Introducing a New Dataset to Explore Compliance with the Decisions of the UN Human Rights Treaty Bodies’ Individual Complaints Procedures .” Journal of Conflict Resolution , doi: 10.1177/00220027231160460 , 1 – 28 ..
US Senate . 2014 . “ Report of the Senate Select Committee on Intelligence of the Central Intelligence Agency’s Detention and Interrogation Program .” Senate Report , Washington, DC .
US State Department . 2008 . “ Observations by the United States of America on Committee Against Torture General Comment No. 2.” . Accessed December 2, 2022 . https://2009-2017.state.gov/documents/organization/138853.pdf .
Venzke Ingo . 2012 . How Interpretation Makes International Law: On Semantic Change and Normative Twists . Oxford : Oxford University Press .
Verdier Pierre-Hugues , Voeten Erik . 2015 . “ How Does Customary International Law Change? . The Case of State Immunity .” International Studies Quarterly . 59 ( 2 ): 209 – 22 .
Viljoen Frans . 2004 . “ Fact-Finding by UN Human Rights Complaints Bodies: Analysis and Suggested Reforms .” Max Planck Yearbook of United Nations Law Online . 8 ( 1 ): 49 – 100 .
Wiener Antje . 2018 . Contestation and Constitution of Norms in Global International Relations . Cambridge : Cambridge University Press .
Winston Carla . 2018 . “ Norm Structure, Diffusion, and Evolution: A Conceptual Approach .” European Journal of International Relations . 24 ( 3 ): 638 – 61 .
Wolfrum Rüdiger , Deutsch Ulrike . 2009 . The European Court of Human Rights Overwhelmed by Applications: Problems and Possible Solutions . Heidelberg : Springer .
Wunderlich Carmen . 2020 . Rogue States as Norm Entrepreneurs: Black Sheep or Sheep in Wolves’ Clothing? . Cham : Springer .
Yildiz Ezgi . 2020 . “ A Court with Many Faces: Judicial Characters and Modes of Norm Development in the European Court of Human Rights .” European Journal of International Law . 31 ( 1 ): 73 – 99 .
Yildiz Ezgi . 2023 . Between Forbearance and Audacity: The European Court of Human Rights and the Norm Against Torture . Cambridge : Cambridge University Press .
Zangl Bernhard . 2008 . “ Judicialization Matters! A Comparison of Dispute Settlement Under GATT and the WTO .” International Studies Quarterly . 52 ( 4 ): 825 – 54 .
Zarakol Ayşe . 2014 . “ What Made the Modern World Hang Together: Socialisation or Stigmatisation? ” International Theory . 6 ( 2 ): 311 – 32 .
Zimmermann Lisbeth , Deitelhoff Nicole , Lesch Max , Arcudi Antonio , Peez Anton . 2023 . International Norm Disputes: The Link Between Contestation and Norm Robustness . Oxford : Oxford University Press .
Zvobgo Kelebogile , Graham Benjamin A. T . 2020 . “ The World Bank as an Enforcer of Human Rights .” Journal of Human Rights . 19 ( 4 ): 425 – 48 .
Month: | Total Views: |
---|---|
June 2023 | 647 |
July 2023 | 357 |
August 2023 | 245 |
September 2023 | 219 |
October 2023 | 268 |
November 2023 | 340 |
December 2023 | 226 |
January 2024 | 235 |
February 2024 | 271 |
March 2024 | 217 |
April 2024 | 219 |
May 2024 | 235 |
June 2024 | 127 |
Citing articles via.
Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide
Sign In or Create an Account
This PDF is available to Subscribers Only
For full access to this pdf, sign in to an existing account, or purchase an annual subscription.
Learning objectives.
By the end of this section, you should be able to:
Why does deviance occur? How does it affect a society? Since the early days of sociology, scholars have developed theories that attempt to explain what deviance and crime mean to society. These theories can be grouped according to the three major sociological paradigms: functionalism, symbolic interactionism, and conflict theory.
Sociologists who follow the functionalist approach are concerned with the way the different elements of a society contribute to the whole. They view deviance as a key component of a functioning society. Strain theory and social disorganization theory represent two functionalist perspectives on deviance in society.
Émile Durkheim believed that deviance is a necessary part of a successful society. One way deviance is functional, he argued, is that it challenges people’s present views (1893). For instance, when Black students across the United States participated in sit-ins during the civil rights movement, they challenged society’s notions of segregation. Moreover, Durkheim noted, when deviance is punished, it reaffirms currently held social norms, which also contributes to society (1893). Seeing a student given detention for skipping class reminds other high schoolers that playing hooky isn’t allowed and that they, too, could get detention.
Durkheim’s point regarding the impact of punishing deviance speaks to his arguments about law. Durkheim saw laws as an expression of the “collective conscience,” which are the beliefs, morals, and attitudes of a society. “A crime is a crime because we condemn it,” he said (1893). He discussed the impact of societal size and complexity as contributors to the collective conscience and the development of justice systems and punishments. For example, in large, industrialized societies that were largely bound together by the interdependence of work (the division of labor), punishments for deviance were generally less severe. In smaller, more homogeneous societies, deviance might be punished more severely.
Sociologist Robert Merton agreed that deviance is an inherent part of a functioning society, but he expanded on Durkheim’s ideas by developing strain theory , which notes that access to socially acceptable goals plays a part in determining whether a person conforms or deviates. From birth, we’re encouraged to achieve the “American Dream” of financial success. A person who attends business school, receives an MBA, and goes on to make a million-dollar income as CEO of a company is said to be a success. However, not everyone in our society stands on equal footing. That MBA-turned-CEO may have grown up in the best school district and had means to hire tutors. Another person may grow up in a neighborhood with lower-quality schools, and may not be able to pay for extra help. A person may have the socially acceptable goal of financial success but lack a socially acceptable way to reach that goal. According to Merton’s theory, an entrepreneur who can’t afford to launch their own company may be tempted to embezzle from their employer for start-up funds.
Merton defined five ways people respond to this gap between having a socially accepted goal and having no socially accepted way to pursue it.
Developed by researchers at the University of Chicago in the 1920s and 1930s, social disorganization theory asserts that crime is most likely to occur in communities with weak social ties and the absence of social control. An individual who grows up in a poor neighborhood with high rates of drug use, violence, teenage delinquency, and deprived parenting is more likely to become engaged in crime than an individual from a wealthy neighborhood with a good school system and families who are involved positively in the community.
Social disorganization theory points to broad social factors as the cause of deviance. A person isn’t born as someone who will commit crimes but becomes one over time, often based on factors in their social environment. Robert Sampson and Byron Groves (1989) found that poverty and family disruption in given localities had a strong positive correlation with social disorganization. They also determined that social disorganization was, in turn, associated with high rates of crime and delinquency—or deviance. Recent studies Sampson conducted with Lydia Bean (2006) revealed similar findings. High rates of poverty and single-parent homes correlated with high rates of juvenile violence. Research into social disorganization theory can greatly influence public policy. For instance, studies have found that children from disadvantaged communities who attend preschool programs that teach basic social skills are significantly less likely to engage in criminal activity. (Lally 1987)
Conflict theory looks to social and economic factors as the causes of crime and deviance. Unlike functionalists, conflict theorists don’t see these factors as positive functions of society. They see them as evidence of inequality in the system. They also challenge social disorganization theory and control theory and argue that both ignore racial and socioeconomic issues and oversimplify social trends (Akers 1991). Conflict theorists also look for answers to the correlation of gender and race with wealth and crime.
Conflict theory was greatly influenced by the work of German philosopher, economist, and social scientist Karl Marx. Marx believed that the general population was divided into two groups. He labeled the wealthy, who controlled the means of production and business, the bourgeois. He labeled the workers who depended on the bourgeois for employment and survival the proletariat. Marx believed that the bourgeois centralized their power and influence through government, laws, and other authority agencies in order to maintain and expand their positions of power in society. Though Marx spoke little of deviance, his ideas created the foundation for conflict theorists who study the intersection of deviance and crime with wealth and power.
In his book The Power Elite (1956), sociologist C. Wright Mills described the existence of what he dubbed the power elite , a small group of wealthy and influential people at the top of society who hold the power and resources. Wealthy executives, politicians, celebrities, and military leaders often have access to national and international power, and in some cases, their decisions affect everyone in society. Because of this, the rules of society are stacked in favor of a privileged few who manipulate them to stay on top. It is these people who decide what is criminal and what is not, and the effects are often felt most by those who have little power. Mills’ theories explain why celebrities can commit crimes and suffer little or no legal retribution. For example, USA Today maintains a database of NFL players accused and convicted of crimes. 51 NFL players had been convicted of committing domestic violence between the years 2000 and 2019. They have been sentenced to a collective 49 days in jail, and most of those sentences were deferred or otherwise reduced. In most cases, suspensions and fines levied by the NFL or individual teams were more severe than the justice system's (Schrotenboer 2020 and clickitticket.com 2019).
While crime is often associated with the underprivileged, crimes committed by the wealthy and powerful remain an under-punished and costly problem within society. The FBI reported that victims of burglary, larceny, and motor vehicle theft lost a total of $15.3 billion dollars in 2009 (FB1 2010). In comparison, when former advisor and financier Bernie Madoff was arrested in 2008, the U.S. Securities and Exchange Commission reported that the estimated losses of his financial Ponzi scheme fraud were close to $50 billion (SEC 2009).
This imbalance based on class power is also found within U.S. criminal law. In the 1980s, the use of crack cocaine (a less expensive but powerful drug) quickly became an epidemic that swept the country’s poorest urban communities. Its pricier counterpart, cocaine, was associated with upscale users and was a drug of choice for the wealthy. The legal implications of being caught by authorities with crack versus cocaine were starkly different. In 1986, federal law mandated that being caught in possession of 50 grams of crack was punishable by a ten-year prison sentence. An equivalent prison sentence for cocaine possession, however, required possession of 5,000 grams. In other words, the sentencing disparity was 1 to 100 (New York Times Editorial Staff 2011). This inequality in the severity of punishment for crack versus cocaine paralleled the unequal social class of respective users. A conflict theorist would note that those in society who hold the power are also the ones who make the laws concerning crime. In doing so, they make laws that will benefit them, while the powerless classes who lack the resources to make such decisions suffer the consequences. Throughout the 1980s and early 1990s, states passed numerous laws increasing penalties, especially for repeat offenders. The U.S. government passed an even more significant law, the Violent Crime Control and Law Enforcement Act of 1994 (known as the 1994 Crime Bill), which further increased penalties, funded prisons, and incentivized law enforcement agencies to further pursue drug offenders. One outcome of these policies was the mass incarceration of Black and Hispanic people, which led to a cycle of poverty and reduced social mobility. The crack-cocaine punishment disparity remained until 2010, when President Obama signed the Fair Sentencing Act, which decreased the disparity to 1 to 18 (The Sentencing Project 2010).
Symbolic interactionism is a theoretical approach that can be used to explain how societies and/or social groups come to view behaviors as deviant or conventional.
Although all of us violate norms from time to time, few people would consider themselves deviant. Those who do, however, have often been labeled “deviant” by society and have gradually come to believe it themselves. Labeling theory examines the ascribing of a deviant behavior to another person by members of society. Thus, what is considered deviant is determined not so much by the behaviors themselves or the people who commit them, but by the reactions of others to these behaviors. As a result, what is considered deviant changes over time and can vary significantly across cultures.
Sociologist Edwin Lemert expanded on the concepts of labeling theory and identified two types of deviance that affect identity formation. Primary deviance is a violation of norms that does not result in any long-term effects on the individual’s self-image or interactions with others. Speeding is a deviant act, but receiving a speeding ticket generally does not make others view you as a bad person, nor does it alter your own self-concept. Individuals who engage in primary deviance still maintain a feeling of belonging in society and are likely to continue to conform to norms in the future.
Sometimes, in more extreme cases, primary deviance can morph into secondary deviance. Secondary deviance occurs when a person’s self-concept and behavior begin to change after his or her actions are labeled as deviant by members of society. The person may begin to take on and fulfill the role of a “deviant” as an act of rebellion against the society that has labeled that individual as such. For example, consider a high school student who often cuts class and gets into fights. The student is reprimanded frequently by teachers and school staff, and soon enough, develops a reputation as a “troublemaker.” As a result, the student starts acting out even more and breaking more rules; the student has adopted the “troublemaker” label and embraced this deviant identity. Secondary deviance can be so strong that it bestows a master status on an individual. A master status is a label that describes the chief characteristic of an individual. Some people see themselves primarily as doctors, artists, or grandfathers. Others see themselves as beggars, convicts, or addicts.
How do people deal with the labels they are given? This was the subject of a study done by Sykes and Matza (1957). They studied teenage boys who had been labeled as juvenile delinquents to see how they either embraced or denied these labels. Have you ever used any of these techniques?
Let’s take a scenario and apply all five techniques to explain how they are used. A young person is working for a retail store as a cashier. Their cash drawer has been coming up short for a few days. When the boss confronts the employee, they are labeled as a thief for the suspicion of stealing. How does the employee deal with this label?
The Denial of Responsibility: When someone doesn’t take responsibility for their actions or blames others. They may use this technique and say that it was their boss’s fault because they don’t get paid enough to make rent or because they’re getting a divorce. They are rejecting the label by denying responsibility for the action.
The Denial of Injury: Sometimes people will look at a situation in terms of what effect it has on others. If the employee uses this technique they may say, “What’s the big deal? Nobody got hurt. Your insurance will take care of it.” The person doesn’t see their actions as a big deal because nobody “got hurt.”
The Denial of the Victim: If there is no victim there’s no crime. In this technique the person sees their actions as justified or that the victim deserved it. Our employee may look at their situation and say, “I’ve worked here for years without a raise. I was owed that money and if you won’t give it to me I’ll get it my own way.”
The Condemnation of the Condemners: The employee might “turn it around on” the boss by blaming them. They may say something like, “You don’t know my life, you have no reason to judge me.” This is taking the focus off of their actions and putting the onus on the accuser to, essentially, prove the person is living up to the label, which also shifts the narrative away from the deviant behavior.
Appeal to a Higher Authority: The final technique that may be used is to claim that the actions were for a higher purpose. The employee may tell the boss that they stole the money because their mom is sick and needs medicine or something like that. They are justifying their actions by making it seem as though the purpose for the behavior is a greater “good” than the action is “bad.” (Sykes & Matza, 1957)
The right to vote.
Before she lost her job as an administrative assistant, Leola Strickland postdated and mailed a handful of checks for amounts ranging from $90 to $500. By the time she was able to find a new job, the checks had bounced, and she was convicted of fraud under Mississippi law. Strickland pleaded guilty to a felony charge and repaid her debts; in return, she was spared from serving prison time.
Strickland appeared in court in 2001. More than ten years later, she is still feeling the sting of her sentencing. Why? Because Mississippi is one of twelve states in the United States that bans convicted felons from voting (ProCon 2011).
To Strickland, who said she had always voted, the news came as a great shock. She isn’t alone. Some 5.3 million people in the United States are currently barred from voting because of felony convictions (ProCon 2009). These individuals include inmates, parolees, probationers, and even people who have never been jailed, such as Leola Strickland.
Under the Fourteenth Amendment, states are allowed to deny voting privileges to individuals who have participated in “rebellion or other crime” (Krajick 2004). Although there are no federally mandated laws on the matter, most states practice at least one form of felony disenfranchisement .
Is it fair to prevent citizens from participating in such an important process? Proponents of disfranchisement laws argue that felons have a debt to pay to society. Being stripped of their right to vote is part of the punishment for criminal deeds. Such proponents point out that voting isn’t the only instance in which ex-felons are denied rights; state laws also ban released criminals from holding public office, obtaining professional licenses, and sometimes even inheriting property (Lott and Jones 2008).
Opponents of felony disfranchisement in the United States argue that voting is a basic human right and should be available to all citizens regardless of past deeds. Many point out that felony disfranchisement has its roots in the 1800s, when it was used primarily to block Black citizens from voting. These laws disproportionately target poor minority members, denying them a chance to participate in a system that, as a social conflict theorist would point out, is already constructed to their disadvantage (Holding 2006). Those who cite labeling theory worry that denying deviants the right to vote will only further encourage deviant behavior. If ex-criminals are disenfranchised from voting, are they being disenfranchised from society?
In the early 1900s, sociologist Edwin Sutherland sought to understand how deviant behavior developed among people. Since criminology was a young field, he drew on other aspects of sociology including social interactions and group learning (Laub 2006). His conclusions established differential association theory , which suggested that individuals learn deviant behavior from those close to them who provide models of and opportunities for deviance. According to Sutherland, deviance is less a personal choice and more a result of differential socialization processes. For example, a young person whose friends are sexually active is more likely to view sexual activity as acceptable. Sutherland developed a series of propositions to explain how deviance is learned. In proposition five, for example, he discussed how people begin to accept and participate in a behavior after learning whether it is viewed as “favorable” by those around them. In proposition six, Sutherland expressed the ways that exposure to more “definitions” favoring the deviant behavior than those opposing it may eventually lead a person to partake in deviance (Sutherland 1960), applying almost a quantitative element to the learning of certain behaviors. In the example above, a young person may find sexual activity more acceptable once a certain number of their friends become sexually active, not after only one does so.
Sutherland’s theory may explain why crime is multigenerational. A longitudinal study beginning in the 1960s found that the best predictor of antisocial and criminal behavior in children was whether their parents had been convicted of a crime (Todd and Jury 1996). Children who were younger than ten years old when their parents were convicted were more likely than other children to engage in spousal abuse and criminal behavior by their early thirties. Even when taking socioeconomic factors such as dangerous neighborhoods, poor school systems, and overcrowded housing into consideration, researchers found that parents were the main influence on the behavior of their offspring (Todd and Jury 1996).
Continuing with an examination of large social factors, control theory states that social control is directly affected by the strength of social bonds and that deviance results from a feeling of disconnection from society. Individuals who believe they are a part of society are less likely to commit crimes against it.
Travis Hirschi (1969) identified four types of social bonds that connect people to society:
Strain Theory | Robert Merton | A lack of ways to reach socially accepted goals by accepted methods |
Social Disorganization Theory | University of Chicago researchers | Weak social ties and a lack of social control; society has lost the ability to enforce norms with some groups |
Unequal System | Karl Marx | Inequalities in wealth and power that arise from the economic system |
Power Elite | C. Wright Mills | Ability of those in power to define deviance in ways that maintain the status quo |
Labeling Theory | Edwin Lemert | The reactions of others, particularly those in power who are able to determine labels |
Differential Association Theory | Edwin Sutherland | Learning and modeling deviant behavior seen in other people close to the individual |
Control Theory | Travis Hirschi | Feelings of disconnection from society |
As an Amazon Associate we earn from qualifying purchases.
This book may not be used in the training of large language models or otherwise be ingested into large language models or generative AI offerings without OpenStax's permission.
Want to cite, share, or modify this book? This book uses the Creative Commons Attribution License and you must attribute OpenStax.
Access for free at https://openstax.org/books/introduction-sociology-3e/pages/1-introduction
© Jan 18, 2024 OpenStax. Textbook content produced by OpenStax is licensed under a Creative Commons Attribution License . The OpenStax name, OpenStax logo, OpenStax book covers, OpenStax CNX name, and OpenStax CNX logo are not subject to the Creative Commons license and may not be reproduced without the prior and express written consent of Rice University.
The intersection between ‘the audit society’ and public sector corruption and fraud: – a literature review and future research agenda, monetization of politics and public procurement in ghana, the dis-embedded arbitrator: releasing arbitration from corruption-shaped environments in the wake of the odebrecht arbitral ordeal in peru, how the colonial legacy frames state audit institutions in benin that fail to curb corruption.
The labyrinth of corruption in the construction industry: a system dynamics model based on 40 years of research, accounting for crime in the us: race, class and the spectacle of fear, the corruption of project governance through normalization of deviance, organized decoupling of management control systems: an exploratory study of traders’ unethical behavior, anticorruption practices in construction projects: looking through two theoretical lenses, 43 references, illusions of control the extension of new public management through corporate governance regulation, re‐theorizing change: institutional experimentation and the struggle for domination in the field of public accounting, accounting and networks of corruption, the construction of the risky individual and vigilant organization: a genealogy of the fraud triangle, fear and risk in the audit process, identity narratives under threat: a study of former members of arthur andersen, the ties that bind: the decision to co-offend in fraud, the audit expectations gap—plus ca change, plus c'est la meme chose, regulating audit beyond the crisis: a critical discussion of the eu green paper, twenty‐five years of audit deregulation and re‐regulation: what does it mean for 2005 and beyond, related papers.
Showing 1 through 3 of 0 Related Papers
Last updated 20/06/24: Online ordering is currently unavailable due to technical issues. We apologise for any delays responding to customers while we resolve this. For further updates please visit our website: https://www.cambridge.org/news-and-insights/technical-incident
We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings .
1 introduction, 1.1 what is positive deviance, 1.2 the origins of positive deviance and its underpinning assumptions, 1.3 applying positive deviance to healthcare improvement, 1.4 what the approach is (and what it is not), 2 the positive deviance approach in action, 2.1 stage 1: identifying positive deviants, 2.2 stage 2: generating hypotheses about how positive deviants succeed, 2.3 stage 3: testing hypotheses in larger samples, 2.4 stage 4: disseminating positively deviant strategies to others, 3 critiques of the positive deviance approach, 3.1 robust discoveries require robust data, 3.2 using positive deviance in healthcare is unlikely to uncover surprises, 3.3 the positive deviance approach must account for the complexity of the healthcare system, 3.4 applications need to explore the mechanisms of change, 3.5 there is a lot we do not yet know about positive deviance, 4 conclusions, 5 further reading, conflicts of interest, acknowledgements, about the authors.
Published online by Cambridge University Press: 17 August 2022
Generally speaking, the term ‘deviance’ can be used to refer to both:
a behaviour or practice that deviates from the norm and may not be socially acceptable
an individual or group that is an outlier in terms of their overall performance.
What we describe in this Element uses the second of these meanings. When we refer to positive deviance, we are describing an approach that involves identifying those who demonstrate exceptionally good performance on particular measures (the ‘positive deviants’) and then trying to understand what allows them to achieve this high level of performance. Their behaviours may differ from the norm, but more importantly they represent behaviours, practices, or systems that facilitate exceptional success.
The term ‘positive deviance’ was first used in the field of international public health in the 1960s. The approach was fuelled by a backlash against a perceived imperialist, professionalised view of public health interventions, and a move to recognise the knowledge and expertise that already exists within communities. For example, Wray, writing in 1972, describing mothers who were able to keep their children fed in the harshest conditions, proposed that:
Such mothers, it would appear, know more than we professionals do. They know how, in that incredible environment, to provide their children with basically adequate diets and to protect them from too frequent infections. Perhaps they can teach us. At the very least, we ought to search out the successful mothers in such circumstances, examine their child care practices, and try to identify what it is they are doing that makes the difference in their children. If we cannot teach these things to other mothers in that environment, perhaps they can. Reference Wray 1
The approach is perhaps even more clearly articulated in one of the earliest papers to refer to positive deviance as an alternative approach to studying and improving public health:
[T]o identify those families in which a child between age six months and five years falls in the upper 25 per cent in height and weight measurements. These families are labelled as being ‘Positive Deviants’ from the undernutrition that prevails in the population. They are then studied anthropologically to uncover any practices related to food sources, storage, preparation, consumption, and content. The information would be used in designing food supplementation or other nutritional promotion in the population at large on the assumption that the observed ‘favourable’ practices, although atypical, are feasible and culturally acceptable because they are indigenously rather than extraneously derived. Reference Wishik 2
Most famously, positive deviance was used in the 1990s to improve the nutritional status of children in Vietnam. 3 In this case, an international charity, Save the Children, identified several positively deviant behaviours, including the unusual practice of feeding shrimps from the paddy fields to small children, and other more accepted behaviours, such as hygienic food preparation. Reference Sternin, Sternin, Marsh, Wollinka, Keeley, Burkhalter and Bashir 4, Reference Sternin, Sternin, Marsh and Marchione 5 Through an education programme to help others adopt these practices and behaviours, the organisation saw a 74% reduction in severe malnutrition among children under three years of age. This impact was sustained many years after Save the Children left the communities. Reference Mackintosh, Marsh and Schroeder 6 Following this, the approach was scaled up to address childhood malnutrition locally and internationally, through a community-based nutrition rehabilitation model combining the positive deviance approach and ‘hearth’ education sessions. 3 The hearth approach gathers communities around fireplaces or kitchen hearths for education and rehabilitation and to promote the wider adoption of positively deviant behaviours. Reference Bisits Bullen 7, 8 Since then, positive deviance has been used to address various public health issues such as pregnancy outcomes, 9 the care of newborn children, Reference Marsh, Sternin and Khadduri 10 weight control, Reference Stuckey, Boan and Kraschnewski 11 and female genital mutilation. Reference Masterson and Swanson 12
Although positive deviance can take different forms, its use in international public health is built on some underpinning assumptions:
that positive deviants succeed despite facing similar constraints as others
◦ already exist within communities (in healthcare, these communities are teams, groups, departments, and organisations)
◦ can be identified or uncovered by anthropological methods
◦ are acceptable, feasible, and sustainable within existing resources because they are already practised by people within the community
that these features increase the likelihood that the solutions are generalisable to, and can be adopted by, other communities.
Use of the term ‘positive deviance’ has increased substantially in recent years, and many different definitions and applications have now emerged. Reference Herington and van de Fliert 13 Since the early 2000s, it has expanded into healthcare and has been implemented in diverse ways. Two key frameworks are often used to help operationalise the positive deviance approach: the 4Ds framework and the Bradley et al. framework. These frameworks are explored in more detail next, although it is important to note that some studies offer only poor descriptions of how positive deviance has been implemented in healthcare. Reference Baxter, Taylor, Kellar and Lawton 14
The 4Ds framework (see Figure 1 ), or variations of it, is most closely aligned to the approach’s origins in international public health. It centres around four steps:
defining the problem
determining the presence of positive deviants
discovering the uncommon but successful strategies
designing interventions to allow others to practise these strategies or behaviours.
Variations of this framework include a fifth Reference Initiative 15 and sometimes sixth step, Reference Singhal and Dura 16 which typically focus on monitoring and evaluating the effectiveness of solutions to support wider dissemination ( Figure 1 ). This framework and its variations have been used across a range of studies, for example to reduce MRSA infections, Reference Singhal and Dura 16 help smoking cessation among prisoners, Reference Awofeso, Irwin and Forrest 17 and to improve how medical students acquire clinical skills. Reference Zaidi, Jaffery and Shahid 18
Box 1 , highlighting research by Bradley et al., Reference Bradley, Curry and Ramanadhan 19 describes one of the most well-known examples of a positive deviance study in healthcare. It led to the development of another four-stage framework ( Figure 2 ) designed to support the positive deviance approach in healthcare organisations specifically. Bradley et al. recommend identifying positive deviants using concrete, routinely collected, and widely endorsed data (stage 1). Qualitative methods should then be used to generate hypotheses about the positively deviant strategies used to succeed (stage 2). These hypotheses can be tested in larger, more representative samples (stage 3), and the newly characterised best practice disseminated to others with the help of key stakeholders (stage 4).
Figure 1 The 4Ds/6Ds framework for implementing the positive deviance approach
The problem.
Prompt treatment is critical for the survival of patients with acute myocardial infarction. During 2004–05, a national guideline stated that the door-to-balloon time – the time from the patient arriving in hospital to a stent being inserted to reopen their blocked artery – should be within 90 minutes. Reference Antman, Anbe and Armstrong 22, Reference Van de Werf, Ardissino and Betriu 23 Yet less than 50% of patients received care that met this target. Door-to-balloon performance had remained static for several years, even though other key cardiac care indicators had improved and some hospitals were managing to meet the target.
A team of academics, clinical academics, and clinicians used national registry data to identify 35 US hospitals that achieved median door-to-balloon times of 90 minutes or less for their past 50 cases. These 35 hospitals were ranked according to improvements in this measure over the previous four years, and 11 positively deviant hospitals that demonstrated the greatest improvement were sampled. Researchers used in-depth visits (tours and open-ended interviews) at these 11 sites to explore multidisciplinary staff members’ perspectives and experiences of improving door-to-balloon times. From their qualitative analysis, the team identified contextual factors (e.g. senior management support, shared goals, physician leaders, and interdisciplinary teams) and specific clinical strategies (e.g. activation of the catheterisation laboratory by emergency medicine physicians instead of cardiologists) that they thought were related to top performance in the positively deviant hospitals. Reference Bradley, Roumanis and Radford 21
These qualitative findings were then used to develop a web-based survey, which 365 US hospitals completed. For each hospital, survey data were combined with data on door-to-balloon times, and regression modelling was used to identify six specific clinical strategies that predicted lower door-to-balloon times: Reference Bradley, Herrin and Wang 20
activation of the catheterisation laboratory by emergency medicine physicians instead of cardiologists
using a single call to activate the catheterisation team
activating the catheterisation team while the patient was still en route to hospital
expecting staff to arrive in the catheterisation laboratory within 20 minutes of being paged
always having an attending cardiologist on site
having real-time feedback for staff on door-to-balloon times.
The American College of Cardiology disseminated these findings to other US hospitals via the Door-to-Balloon Alliance – a public campaign supported by 38 professional associations and agencies. Around 70% of hospitals treating acute myocardial infarction signed up to the alliance and, by 2008, the number of patients receiving treatment within 90 minutes had increased by 25%. Reference Bradley, Curry and Ramanadhan 19
Figure 2 Bradley et al.’s four stages to implementing the positive deviance approach in healthcare organisations
The Bradley et al. framework is more data-driven than the 4Ds/6Ds framework, which rarely tests associations between the behaviours and practices identified and the outcomes of interest. It is also more often used at an organisational, regional, or national level (e.g. see studies by Bradley et al., Gabbay et al., and Klaiman et al. Reference Bradley, Byam and Alpern 24 – Reference Klaiman, O’Connell and Stoto 28 ). Perhaps as a function of this, the framework appears to be predominantly implemented from the top-down, marking a recognisable shift from the original bottom-up applications, where members of the community were integral to all stages of the approach.
Beyond these two frameworks, applications of positive deviance can also broadly be considered to sit on a continuum ranging from those that are ‘community driven’ to those that are ‘externally led’. Positive deviance studies at the community-driven end of the continuum tend to share similarities with those conducted in international public health. Members of the community (i.e. healthcare staff) are typically heavily involved in leading the studies and are central to identifying and creating their own solutions. These studies tend to involve more participatory methods (e.g. discovery and action dialogues or improvisational theatre – see stage 2 of the positive deviance approach in Section 2.2 ). Though quantitative data can be used, less emphasis is placed on statistically identifying positive deviants and assessing the extent to which their behaviours improve outcomes. Box 2 describes a rigorously conducted community-driven controlled trial in which healthcare staff were integral to identifying positive deviants and how they succeed. Reference Marra, Guastelli and de Araujo 31
Healthcare-associated infections such as Methicillin-resistant Staphylococcus aureus (MRSA) are a common cause of ventilator-associated pneumonia, bloodstream infections, and surgical site infections. These infections result in protracted hospital stays and treatment, costing US hospital inpatient services up to $45 billion a year (as estimated in 2007). Reference Buscell, Singhal, Buscell and Lindberg 29, Reference Jain, Kralovic and Evans 30 Good hand hygiene effectively prevents healthcare-associated infections, yet behavioural interventions are rarely successful Reference Marra, Guastelli and de Araujo 31 and compliance rates remain relatively low, at around 50%. Reference Buscell, Singhal, Buscell and Lindberg 29
Marra et al. conducted a controlled trial to improve hand hygiene compliance in two comparable step-down units. Reference Marra, Guastelli and de Araujo 31 After a period of baseline data collection, positive deviance was implemented in one unit, while the other acted as a control. In the intervention unit, nurse managers initially identified positively deviant staff who displayed good hand hygiene compliance. Additional positive deviants were then identified over time. The approach was implemented via twice monthly meetings involving staff who worked across a variety of shifts. Meetings provided opportunities to discuss feelings about hand hygiene, what needed to improve, and examples of good practice. Staff created videos, shared healthcare-associated infection rates, and decided to assess individual performances across shifts to create comparison and competition within the team.
After implementing the positive deviance approach, there was a statistically significant, nearly twofold increase in hand hygiene episodes and a significantly lower infection rate between the intervention and control units. Reference Marra, Guastelli and de Araujo 31 The success of the interventions led to the extension of positive deviance to the control unit after three months of the trial. Throughout, hand hygiene compliance was evaluated using electronic handwashing counters and the incidence of healthcare-associated infections was monitored.
Following this, an observational study explored the sustainability of the positive deviance intervention. Reference Marra, Guastelli and de Araujo 32 For an additional year, staff continued to implement positive deviance on both units and to measure healthcare-associated infections and hand hygiene compliance. Amid concerns that the twice-monthly meetings would become tedious, staff employed motivational techniques (e.g. the parallel thinking process Six Thinking Hats), held interactive sessions to discuss controversial infection control issues, and retained competition among team members. Compared with baseline, each of the two units observed at least a twofold increase in hand hygiene episodes, as well as a significant reduction in the incidence of healthcare-associated infections, suggesting that the improvements gained were sustainable. Reference Marra, Guastelli and de Araujo 32
By contrast, at the other end of the continuum, externally led applications tend to be much more concerned with accurately identifying positive deviants using quantitative data. This means that these studies are often conducted by outsider experts (e.g. academics, clinical academics, or clinical/national leads), with perhaps less community or frontline participation. These externally led applications may also use rigorous research methods, such as interviews or observations, to understand what is contributing to positive deviance. Broadly, community-driven applications tend to steer more towards applying the 4Ds framework, while externally led applications favour the Bradley et al. framework. However, it is important to note that this is not a dichotomy. Some externally led applications have extensive clinical stakeholder involvement, while some community-driven applications are conducted rigorously and published in peer-reviewed journals.
Traditionally, healthcare has taken a deficit-based, find-and-fix approach to safety management, using methods such as incident reporting and root cause analysis, and producing guidelines and procedures to eliminate the risks identified. Reference Mannion and Braithwaite 33 This approach to managing safety, now commonly referred to as Safety I, seeks to identify the causes of error and harm to eliminate or contain them. The effectiveness of Safety I has been questioned in recent years, Reference Mannion and Braithwaite 33, Reference Dixon-Woods and Martin 34 resulting in the emergence of the so-called Safety II approach to managing safety. Reference Hollnagel, Wears and Braithwaite 35, Reference Hollnagel, Braithwaite and Wears 36 Rather than focusing on error and harm, Safety II seeks to understand everyday performance to ensure that as much as possible goes right – that safe care is delivered as frequently as possible under both expected and unexpected conditions. Reference Hollnagel, Wears and Braithwaite 35 Furthermore, asset-based approaches, such as Learning from Excellence 37 and appreciative inquiry, Reference People 38 are increasingly used to improve both the quality and safety of care. Safety II and asset-based approaches share elements in common with positive deviance: they focus on identifying and learning from what goes right rather than being dominated by what has gone wrong and, broadly speaking, they seek to understand ‘work as done’ rather than ‘work as imagined’.
The positive deviance approach is distinctive, however ( Table 1 ). For example, Safety II seeks to generate learning from everyday performance, rather than focusing on extreme performance outliers. Reference Hollnagel, Wears and Braithwaite 35, Reference Hollnagel, Braithwaite and Wears 36 Acknowledging the complexity of healthcare, Safety II assumes that good and bad outcomes occur in the same way and that safe care is created by people constantly adapting and adjusting to the variable conditions and situations that they face. Reference Hollnagel, Wears and Braithwaite 35, Reference Hollnagel, Braithwaite and Wears 36 By contrast, positive deviance takes a more linear approach assuming that it is possible to identify and then spread the causes of exceptional performance – the behaviours or processes that reliably lead to exceptional outcomes. Although positive deviance shifts our gaze to the opposite end of the performance spectrum, it could, in essence, be considered akin to a Safety I approach, albeit one that focuses on finding and fixing (i.e. spreading) the causes of sustained positive performances rather than one-off negative incidents or events.
Table 1 Key differences between Safety I, Safety II, and the positive deviance approach
Safety I | Safety II | Positive deviance | |
---|---|---|---|
Underpinning premise | To ensure that as few things as possible go wrong. Focus on negative outliers. | To ensure that as many things as possible go right. Focus on everyday performance. | To learn from those who demonstrate exceptional performance on outcomes of interest. Focus on positive outliers. |
Safety management principle | Reactive – respond when something happens or risk is deemed unacceptable. | Proactive – continually try to anticipate developments and events. | Either reactive or proactive – learn from those who overcome specific problems learn from those who achieve excellence. |
View of human factors | Humans are predominantly seen as a liability or hazard. They are a problem to be fixed. | Humans are seen as a resource for system flexibility and resilience. They provide flexible solutions to potential problems. | Humans are seen as a source of exceptional performance – they have developed solutions to overcome problems as individuals or within groups. |
Investigations | Accidents are caused by failures and malfunctions. The purpose of an investigation is to identify the causes. | Things go wrong for the same reasons that they go right. The purpose of an investigation is to understand how care usually goes right, as a basis for explaining how care occasionally goes wrong. | Exceptional performance is caused by positively deviant behaviours. The purpose of an investigation is to identify these behaviours and learn from them. |
Similar distinctions can be drawn between positive deviance and approaches such as Learning from Excellence and appreciative inquiry. Learning from Excellence aims to improve quality of care and staff morale through peer-reported episodes of success, which are shared and, in some instances, discussed or analysed in more depth to generate learning. Reference Kelly, Blake and Plunkett 39 Despite its name, Learning from Excellence typically focuses on discrete episodes of everyday success that arise through workarounds, improvisations, and the generosity of staff. 40 By contrast, positive deviance focuses on exceptional performance outliers who typically sustain exceptional performance over time.
Appreciative inquiry is a participatory approach that generates organisational change by reframing problems, building on positive ideas, and fostering learning. Reference People 38, Reference Richer, Ritchie and Marchionni 41 Although appreciative inquiry is used in some applications of positive deviance to uncover success (particularly those that are community-driven or conducted in international public health), it does not specifically seek to learn from those who demonstrate exceptional performance. Reference Trajkovski, Schmied, Vickers and Jackson 42
Positive deviance has been applied to healthcare improvement at different levels of the system and to address a variety of different problems. This section is structured around Bradley et al.’s framework, as it is thus far the only one that has been designed specifically for healthcare settings. Reference Bradley, Curry and Ramanadhan 19 We present cases that exemplify each stage, while also drawing on examples of community-driven applications. Cases are used to highlight some of the challenges and the opportunities of using the positive deviance approach.
Identifying positive deviants is fundamental to the positive deviance approach, regardless of which framework is followed. Bradley et al. suggest using routinely collected, accessible data to do so. Reference Bradley, Curry and Ramanadhan 19 Three major challenges must be overcome at this stage of the approach: measurement, which is notoriously difficult in healthcare; how to analyse the available data to identify exceptional performers; and making like-for-like comparisons to identify true positive deviants.
The quality and safety of patient care is measured via outcomes and processes. Outcomes relate to observed measures of morbidity and mortality and so are of greatest interest to patients, clinicians, improvers, and policy-makers. However, process measures, which measure performance based on adherence to established clinical standards, are often more sensitive to differences in the quality of care. Reference Lilford, Mohammed, Spiegelhalter and Thomson 43 When looking to apply the positive deviance approach to some improvement problems, routinely collected or accessible outcome data simply do not exist. Reference Dixon-Woods, Leslie, Bion and Tarrant 44 – Reference Woodcock, Liberati and Dixon-Woods 46 Where outcome data do exist, they may not be useful. This may be because clinical outcome data represent a measure that is too blunt (e.g. ‘all’ rather than ‘avoidable’ readmissions) or distal (e.g. mortality). In these situations, process measures may provide a more accurate measure. Reference Lilford, Mohammed, Spiegelhalter and Thomson 43, Reference Pronovost, Nolan, Zeger, Miller and Rubin 47 For example, if assessing the success of a public health campaign, bowel cancer screening rates could be measured rather than bowel cancer cases.
Furthermore, the expression ‘garbage in, garbage out’ is highly relevant to data issues in applications of positive deviance. Through our own work Reference O’Hara, Grasic and Gutacker 48 – to explore what routinely available data are available to compare the safety performance of wards, units, and services – we identified some of the pitfalls. They include problems with the measures used to collect data, such as a mandatory staff survey question that asks: ‘When errors, near misses or incidents are reported, my organisation takes action to ensure that they do not happen again.’ At first sight, this item seems reasonable. But, if the organisation’s action is to discipline everyone who makes a mistake, a positive value on this item does not necessarily indicate an organisation that demonstrates safety. Likewise, if reported incidents are used to measure safety, the motivations to report are likely to skew the outcome. People may not report incidents because they are fearful, while others might report incidents, including near misses, in an attempt to get something done about a problem they experience regularly (e.g. short-staffing). Self-reported data are subject to many influences that can make them unreliable for comparing organisations.
To be useful, data also need to be accessible. Data are not always publicly available or collected in a standardised way (e.g. clinical coding can vary across organisations), making it difficult to compare performances across organisations. Furthermore, data may not be available at a level that is relevant to the aims of the study. For example, hospital readmission data are published at speciality level, making it difficult to explore how ward teams achieve exceptionally safe hospital discharges. Though some data are available at team or individual level (e.g. for surgical outcomes 49 and national clinical audits 50 ), it is often sparse, unavailable, or very difficult or costly to obtain.
Many applications of positive deviance rank performance data and identify positive deviants as those who perform best. Reference Baxter, Taylor, Kellar and Lawton 14 However, rankings (e.g. in league tables) may not actually identify the best and worst performers. Reference Austin, Jha and Romano 51 – Reference Rothberg, Morsi, Benjamin, Pekow and Lindenauer 53 It is also important to consider the time frame over which positive deviants demonstrate exceptional performance. Some studies identify and learn from one-off successes, Reference Zaidi, Jaffery and Shahid 18 while in others positive deviants must sustain their performance over a period of time. Reference O’Hara, Grasic and Gutacker 48, Reference Baxter, Taylor and Kellar 54 Since a one-off outlying status may not be a reliable indicator of success, it may be preferable to learn from those who have demonstrated excellence over a longer period of time.
A variety of sophisticated statistical techniques can be used to identify high performers, but statistical process control methods are increasingly promoted as an accessible way of measuring variation within healthcare. Reference Pronovost, Nolan, Zeger, Miller and Rubin 47, Reference Benneyan, Lloyd and Plsek 55, Reference Mohammed, Worthington and Woodall 56 These methods combine statistical rigour with the ability to sensitively measure performance variation – they distinguish between variation that is to be expected (noise) and variation that may have an assignable cause (e.g. variation that may result from the presence of positive or negative deviants). The methods are sensitive to small sample sizes, can facilitate temporal analysis, and the visual rather than tabular presentation of data makes it easier to identify performance outliers. Reference Marshall, Mohammed and Rouse 57 For more information, see the Element on statistical process control. Reference Dixon-Woods, Brown and Marjanovic 58
The third challenge relates to an underpinning assumption of the approach – that positive deviants succeed despite facing similar constraints as others. This is important, because, for example, some apparent high performers may succeed simply because they care for a less complex or acute patient population, or because the service is better funded. It is important that study samples are carefully selected to account, control for, or minimise confounding variables so that, as far as possible, like-for-like comparisons are made. Nevertheless, accurate case-mix adjustments are often extremely difficult and, depending on how they are made, different high and low performers may be identified. Some confounders will also always remain unmeasured and thus unaccounted for within the adjustments. For a more detailed discussion of this, see Lilford et al. Reference Lilford, Mohammed, Spiegelhalter and Thomson 43
If the positive deviance approach is to be distinguished from other asset-based improvement approaches, based on its premise of learning from exceptional performers, then positive deviants should represent an outlying population. To overcome the challenges above, several studies have identified positive deviants in non-data-driven ways, for example by selecting award nominees. 59, Reference Sheard, Jackson and Lawton 60 Marra et al. Reference Marra, Guastelli and de Araujo 31, 3 Reference Wishik 2 ,6 Reference Wray 1 identified positive deviants using tacit knowledge rather than data (see Box 2 for an overview of the study). Initially, nurse managers identified healthcare workers who they considered to be positively deviant and, over time, these individuals identified other positive deviants within their team. Positive deviants displayed good hand hygiene compliance, had a desire to change and develop ideas, and stimulated compliance across the team. 3 Reference Wray 1 Alternatively, some projects, predominantly those that are community-driven, do not identify positively deviant individuals or teams. Instead, discovery and action dialogues (see stage 2 in Section 2.2 ) are used to define and generate ownership of problems and to identify uncommon behaviours or practices. When positive deviants are identified in non-data-driven ways, it is not known whether they truly display exceptional performance. However, despite this, Marra et al. were able to demonstrate significant improvements in hand hygiene compliance and associated outcomes. Reference Marra, Guastelli and de Araujo 31, Reference Marra, Guastelli and de Araujo 32, Reference Marra, Noritomi and Westheimer Cavalcante 61
In this stage, qualitative methods are used to generate hypotheses about the positively deviant strategies that facilitate exceptional performance. Reference Bradley, Curry and Ramanadhan 19 In our own work, we have explored how positively deviant older people’s medical ward teams deliver exceptionally safe patient care, as measured by the UK’s National Health Service (NHS) Safety Thermometer data – a routinely collected measure of four commonly occurring harms. Reference Baxter, Taylor and Kellar 54, Reference Baxter, Taylor, Kellar and Lawton 62, Reference Baxter, Taylor, Kellar and Lawton 63 We conducted multidisciplinary focus groups and informal observations on four positively deviant and four above-average comparator wards to gather a wide range of perspectives and generate discussion about how teams successfully deliver safe patient care. We also made brief field notes following each focus group to capture factors such as team dynamics. In total, 14 positively deviant characteristics were identified, such as knowing one another well, working together, having integrated allied health professionals, and team stability. These characteristics were either present only on the positively deviant wards or enacted in a substantially different way on the positively deviant wards compared with the comparators. Reference Baxter, Taylor, Kellar and Lawton 63
This study illustrates some important considerations for undertaking stage 2 of the positive deviance approach: what lens should be applied and should a framework be used to guide data collection; do teams have the skills and capacity required; how might sampling and comparators influence the hypotheses generated; and are there other ways to create opportunities for discussion to generate learning?
Many studies focus on specific processes and outcomes of care, such as providing weight loss advice Reference Kraschnewski, Sciamanna, Pollak, Stuckey and Sherwood 64 or anticoagulation control. Reference Rose, Petrakis and Callahan 65 Bounding the scope of studies may make it more feasible to generate an in-depth nuanced understanding of the behaviours or processes that facilitate success, particularly if time and resources are limited. However, in doing so, it is still important to apply a broad lens so as to explicate the wider contextual influences (e.g. policies, leadership, and culture) that facilitate success and to illuminate any unintended consequences (positive or negative) that may arise from the positively deviant strategies. If trying to improve narrow processes or outcomes of care, it is important to think broadly about the factors that may influence exceptional performance and direct the qualitative gaze appropriately.
Alternatively, studies may want to explore how positive deviants succeed on broad outcomes of care to deliver high-quality or safe care in the round. For example, rather than focusing on specific harms (e.g. falls or pressure ulcers), our study on medical wards for older people explored how teams deliver exceptionally safe care across a range of measures. Reference Baxter, Taylor, Kellar and Lawton 63 By looking at those who succeed across a bigger picture, it may be possible to uncover latent factors that facilitate their success – the upstream, system-level factors that are more difficult to observe, such as staffing and skill mix, leadership style, culture, and physical environment. In doing so, it may be possible to target these latent factors to generate improvement across a range of outcomes.
Regardless of which lens is taken, qualitative data collection and analysis in positive deviance studies may benefit from using a theoretical framework to help ensure that factors underpinning exceptional performance are comprehensively assessed. Reference Baxter, Taylor, Kellar and Lawton 14, Reference Davidoff, Dixon-Woods, Leviton and Michie 66, Reference Rose and McCullough 67 For example, Rose et al. structured their qualitative enquiry in anticoagulation clinics around nine key domains that were considered essential to establishing and maintaining a high-quality anticoagulation control. Reference Rose, Petrakis and Callahan 65 For patient safety research, the Yorkshire Contributory Factors Framework Reference Lawton, McEachan and Giles 68 or the Manchester Patient Safety Framework 69 might be useful.
Beyond safety, researchers or improvers could use frameworks such as the COM-B behaviour change wheel Reference Michie, van Stralen and West 70 or the PARIHS (Promoting Action on Research Implementation in Health Services) framework. Reference Rycroft-Malone, Harvey and Seers 71 Nonetheless, care must also be taken. Positive deviance is inherently an inductive (i.e. emergent) approach. Reference Stuckey, Boan and Kraschnewski 11 If applied rigidly, the use of a theory or framework might bias the data generated and blind the observer to those unusual, perhaps deviant practices or factors that might have been identified inductively or that fall outside the scope of the particular theory or framework used.
In choosing a method to generate hypotheses about how success is achieved, those conducting a positive deviance study should consider the skills and capacity within their teams. Particularly among externally led applications of positive deviance, a common approach to generate hypotheses about success has been to use ethnographic methods such as extensive observations and formal or informal interviews. These methods facilitate a robust in-depth inquiry and may be well suited to uncovering the beliefs, values, and assumptions that underpin success on broad outcomes of care. For example, Liberati et al. Reference Liberati, Tarrant and Willars 72 conducted an ethnography consisting of approximately 143 hours of observation, semi-structured interviews, and focus groups to explore how a maternity unit in England achieved and sustained exceptional safety outcomes.
Yet these methods are rarely accessible to frontline clinicians and improvement organisations (e.g. national audit teams, clinical commissioning groups) that may lack the capability and capacity required to conduct them. If positive deviance is to be used for healthcare improvement, as distinct from research, it may be necessary to challenge one of the underpinning assumptions of positive deviance: that success should be uncovered anthropologically. Our study on older people’s medical wards Reference Baxter, Taylor, Kellar and Lawton 63 tested pragmatic methods that were more (although not completely) accessible to an improvement community. We found that relationships across the multidisciplinary teams enabled people to know one another socially, as well as understand and value each other’s roles. The teams worked to extremely high standards and expectations, and staff could raise safety concerns or ask for emotional and technical help when needed. These findings share similarities with those produced by the more extended investigations undertaken by Liberati et al. Reference Liberati, Tarrant and Willars 72 and so, given this, it may be possible to develop a method that is both feasible within an improvement context and sufficient for generating robust hypotheses about how positive deviants succeed. Future research could usefully explore the extent to which different methods can generate robust hypotheses at stage 2, and what the resource implications of these different methods are.
Having a comparator is a useful addition to a positive deviance study, not least because it is important to understand how positive deviants differ from the rest of a population. Many positive deviance studies do not sample comparators during stage 2 and, where they do, they tend to be negative deviants – the worst performers in a population. Reference Baxter, Taylor, Kellar and Lawton 14 The stark comparison provided by sampling positive and negative deviants may make it easier to identify very obvious differences between the two groups. However, this comparison does not necessarily help identify behaviours and strategies that distinguish positive deviants from those in a population who simply perform well – those with average performances. Sampling comparators that demonstrate good or average performances may help uncover how positive deviants differ from the majority of a population in order to achieve truly exceptional performance.
It is also important to consider how many positive deviants and comparators to sample. Sampling multiple positive deviants and comparators (e.g. Baxter et al. Reference Baxter, Taylor, Kellar and Lawton 63 and Curry et al. Reference Curry, Spatz and Cherlin 73 ) may lead to more generalisable hypotheses, whereas sampling a single positive deviant (e.g. Liberati et al. Reference Liberati, Tarrant and Willars 72 and Hughes et al. Reference Hughes, Sheard, Pinkney and Lawton 74 ) may help generate an in-depth picture of exceptional performance within that particular context.
Many positive deviance studies do not necessarily use rigorous research methods to uncover positively deviant strategies. Particularly when following the 4Ds framework, some, as we noted above, use discovery and action dialogues. For these dialogues, interested people are brought together for facilitated discussions to uncover positively deviant practices (and positive deviants in some cases), to generate new solutions for improvement, and to identify ways of overcoming existing barriers. 75 For example, in trying to reduce bloodstream infections, Lindberg et al. Reference Lindberg, Downham and Buscell 76 used discovery and action dialogues to discuss infection causes, strategies and barriers to prevent infection, whether certain people frequently overcame these barriers, other improvement ideas, and how these ideas might be initiated. Other studies use improvisational theatre in which short dramas and scenarios are acted out, providing frontline staff with a social, sensory, and collaborative way to learn and discover together. Reference Hughes, Sheard, Pinkney and Lawton 77
In stage 3, the hypotheses generated during stage 2 can be tested in larger, more representative samples to explore their associations with improved outcomes. Reference Bradley, Curry and Ramanadhan 19 Few publications explicitly report this stage of the framework; we use Bradley et al.’s original research Reference Bradley, Herrin and Wang 20 to exemplify this stage.
Box 1 outlines Bradley et al.’s use of national registry data to identify 11 positively deviant US hospitals that had consistently achieved and shown improvements in the 90-minute door-to-balloon time target. After identifying several processes and organisational contextual factors that were thought to facilitate exceptional performance, Reference Bradley, Roumanis and Radford 21 the researchers conducted stage 3 by creating a web-based survey to explore the extent to which hospitals within the wider community implemented the processes that had been identified. Reference Bradley, Herrin and Wang 20 The survey addressed 28 key hospital strategies that could be objectively and reliably measured using close-ended, multiple choice questions (e.g. the process for activating the catheterisation team). It was piloted for clarity and comprehensiveness, and then distributed to 500 hospitals across the USA.
Hierarchical generalised linear modelling was used to identify six hospital strategies that were associated with significantly faster door-to-balloon times (e.g. the emergency department activating the catheterisation laboratory while the patient is en route to hospital, and always having an attending cardiologist on site). Some of these associations were particularly strong and were estimated to save 10–15 minutes. Hospitals with faster door-to-balloon times had implemented more of the effective strategies.
Bradley et al.’s study Reference Bradley, Herrin and Wang 20 highlights the benefits of conducting stage 3 of the positive deviance approach. By testing hypotheses in larger, more representative samples, they demonstrated which strategies were associated with improved outcomes and dismissed those that were not, allowing them to focus on the most important strategies. Stage 3 complements an evidence-based approach to medicine and enables resources to be directed in ways that are most likely to generate improvement. Quantitative evidence, such as this, can also provide a powerful motivator for change by convincing others that strategies are worth adopting. Reference Michie, Richardson and Johnston 78
Nonetheless, there are various challenges to conducting stage 3. First, cross-sectional surveys only demonstrate correlation – not causation – and so implementing strategies may not improve outcomes. Furthermore, the direction of the relationship between strategies and outcomes is not always clear. In some cases, exceptional performance may lead to the positively deviant factors observed, rather than the other way round; for example, exceptional performance may generate high levels of job satisfaction within positively deviant teams. Reference Baxter, Taylor, Kellar and Lawton 63
Second, positively deviant strategies are not always amenable to measurement. Routinely collected data are rarely available to adequately assess the hypotheses that are generated through stage 2. It can be difficult to simplify positively deviant strategies into discrete survey items, and to generate valid and reliable questions that sufficiently measure the hypotheses. Furthermore, asking people to rate themselves, their teams, or their organisations presents its own challenges. Survey questions are open to interpretation, especially if they have not been validated. These problems are most pertinent if the survey is assessing contextual or cultural factors, rather than whether specific processes, policies, or procedures are in place. In this case, the contribution of latent factors (e.g. leadership, psychological safety) in facilitating success may be downplayed.
Some community-driven applications of positive deviance collect data to continually monitor performance throughout the life cycle of improvement. This allows improvers to observe the effects of positive deviance strategies on performance, Reference Singhal, Greiner, Singhal, Buscell and Lindberg 79 although it is not always clear from the published research articles which changes in practice actually produced any improvements in performance (e.g. when bundles of interventions are implemented). In addition to measuring processes and outcomes, many community-driven applications use social network analysis to measure the impact of positive deviance. This does not provide a measure of the effectiveness of specific positively deviant practices, but can provide an indicator of culture change, which often accompanies the ability to overcome ‘wicked issues’: challenges that are complex and multifaceted, and are therefore beyond the ability of any one organisation to handle in isolation. Reference Lindberg, Downham and Buscell 76, Reference Singhal, Greiner, Singhal, Buscell and Lindberg 79, Reference Singhal, McCandless, Buscell and Lindberg 80
Given the difficulties of measurement and testing associations between positively deviant strategies and outcomes – particularly when these strategies represent latent or upstream factors (e.g. culture and leadership) rather than more concrete processes or strategies – further critical appraisal of the worth of this stage of the framework is needed. While it is important to develop improvement strategies and processes based on rigorous evidence, qualitative evidence may be sufficient when identifying cultural factors (e.g. trusting relationships, people who know one another) that serve to underpin good outcomes.
In stage 4, positively deviant strategies are disseminated to others in the wider population with the help of key stakeholders. Reference Bradley, Curry and Ramanadhan 19 There are very few published examples of this stage. One possible explanation is that articles simply do not refer to a positive deviance framework and so dissemination activities cannot be linked to applications of the approach, or it may represent a time lag between completing and publishing this final stage. Another interpretation is that the positive deviance studies may have failed to produce generalised improvement.
Due to the dearth of literature on this stage, we refer again to the work of Bradley et al., who disseminated their positively deviant strategies with the support of a group of highly influential organisations. Reference Krumholz, Bradley and Nallamothu 81 The American College of Cardiology, in partnership with the American Heart Association and 37 other organisations, implemented a well-coordinated and highly promoted national campaign called the Door-to-Balloon Alliance. When healthcare organisations signed up to the alliance, they committed to treat at least 75% of patients within the 90-minute window, and benefitted from a toolkit and change programme based on the positive deviance evidence, individually tailored actions plans, educational initiatives (e.g. workshops, seminars, and an online community), and regional champions to help motivate and facilitate change. Contextually the alliance was set up at a time when national reporting and financial incentives were also being implemented. Evaluation of the alliance showed significant three-year improvements in door-to-balloon times, whereby 25% more patients received treatment within the 90-minute window than before. Reference Bradley, Curry and Ramanadhan 19
By contrast, Sreeramoju et al. Reference Sreeramoju, Dura and Fernandez 82 took a different approach to spread practices to reduce healthcare-associated infections. Researchers implemented a positive deviance intervention on three randomly selected wards. They conducted interviews and focus groups, collected data via graffiti boards and drop boxes, and identified 12 positively deviant individuals. To disseminate their findings and generate improvement (equivalent to stage 4), the positive deviants, along with the ward managers, infection preventionists, and a research team member, created an action planning group to help spread and implement some of the ideas. The group used the data that had been gathered to sort, prioritise, implement, and evaluate the improvement ideas that had been generated, often through plan-do-study-act (PDSA) cycles. Importantly, it was the healthcare staff, rather than the researchers, who owned these plans. Compared with three randomly selected control wards, the positive deviance intervention significantly impacted a trend in patient safety culture (prevented a decline), although no differences were found in social network maps or healthcare-associated infections.
These two examples highlight the different ways in which positively deviant strategies can be disseminated. Bradley et al. Reference Bradley, Curry and Ramanadhan 19, Reference Krumholz, Bradley and Nallamothu 81 took a top-down approach – national organisations created the alliance. By contrast, Sreeramoju et al.’s approach Reference Sreeramoju, Dura and Fernandez 82 was more bottom-up – although external researchers supported the earlier qualitative work, findings were acted upon and improvement projects were owned by members of the ward teams. There is limited evidence to say which approach is the most effective, and in what circumstances.
Top-down approaches may be better suited to organisation and system-level applications of positive deviance, where influence is required to instigate change at a regional or national level. A bottom-up approach to dissemination is more aligned with the original international public health and community-driven applications of positive deviance. They may suit individual or team level applications, where it is easier to promote the meaningful community involvement. A bottom-up approach may also be better suited to disseminating positively deviant strategies that are less concrete and tangible (e.g. cultural factors), as bringing communities together may enable them to gather a more nuanced understanding of how success is achieved, making it more likely that they will adopt the strategies and appreciate the relevance to their own context. When planning positive deviance studies, greater attention should be given to the role of communities (e.g. staff and patients) and how they can be effectively involved in the approach without it becoming too burdensome.
A further unanswered question relating to stage 4 is whether other individuals, teams, organisations, and so on should seek to replicate and mimic positively deviant strategies, or instead adopt only their underlying premise. The importance of context in quality improvement is well recognised. Reference Bate, Robert, Fulop, Øvretveit and Dixon-Woods 83 Many successful interventions have failed to scale: they do not achieve the same impacts in wards or organisations that were not involved in the original improvement project (e.g. Bion et al. Reference Bion, Richardson and Hibbert 84 and Dixon-Woods et al. Reference Dixon-Woods, Leslie, Tarrant and Bion 85 ). Again, the extent to which positively deviant strategies should be mimicked or adapted (and in what ways) may depend on whether it is a procedural or cultural strategy that is being disseminated. In either situation though, it is important that the qualitative inquiries (stage 2) explore not just what positively deviants do to succeed, but also how they achieve these things, and the contextual factors that support or hinder them.
To summarise the four stages in this section, Table 2 outlines some of the key barriers to implementing the positive deviance approach and offers potential strategies to mitigate them.
Barrier | Potential mitigation |
---|---|
Routinely collected data are not available at the level required (e.g. hospital or individual level) to assess the outcome that I am interested in. | and Awofeso et al. as examples). |
I don’t have much confidence in the quality of the data. | using data recorded over multiple time points using multiple sources of data that measure the same thing, and look for similar patterns across different sources identifying a site as a positive deviant only when it has demonstrated consistently high performance, sustained improvement, and/or high performance across multiple measures. |
I don’t have the specialist skills that are required to analyse the data. | Although skills in statistical process control were rare a few years ago, now many data managers in healthcare and research organisations have these skills. Ask for help. |
I am concerned that the organisation(s), units, or people identified as positive deviants might not be. | With good data and analyses, and by controlling for factors that are known to lead to greater success (e.g. higher amounts of funding, a younger patient population, fewer comorbidities), you can largely avoid this risk. However, it is important to involve the community you are interested in. For example, you might identify five maternity units as positive deviants, but then the doctors and midwives in your community tell you that site four (of these five) is a specialist centre, with higher levels of funding that attracts all of the best junior doctors. Formally then, this site does not succeed despite facing similar constraints as others. It is useful to know this and to understand what resources impact performance, but it should not be included as a positively deviant site for further investigation. |
I am worried that excellence might not actually be excellence (related to the barrier above). | This is a trap that everyone working in this field needs to be aware of and is why working with the community is so important. Say, for example, you were conducting a study that focuses on injury during restraint in mental health settings. You identify three sites where injury from restraint is much lower. The problem here is a lack of denominator (i.e. the number of restraints), but more worrying is that without assessing the use of anti-psychotics you do not know whether lack of injury is simply a function of fewer restraints due to over-medication. So, always be aware of these balancing measures in your analysis. |
I don’t have a theory to frame the qualitative work. | |
I don’t know which qualitative method to use. | |
I am not sure how to test the hypotheses that I have generated about factors leading to success. | As part of a Safety I approach to safety management, it is rarely possible to test hypotheses about factors leading to failure before implementing interventions based on these ideas, so, at one level, you could argue that stage 3 is not essential. There is also little evidence about the importance of this stage or the rigour with which it can be conducted. In some cases, it is very simple to conduct, for example, if you have routinely collected data (e.g. audits) that assess outcomes relating to the specific hypotheses you have generated. However, this is not always possible. As a minimum, we recommend checking the face validity of the hypotheses with members of the population that you are working with – do clinicians and/or patients think the hypotheses are likely to be associated with improved outcomes? |
Implementing or spreading the ideas is difficult. | making culture change happen, and approaches to spread, scale-up, and sustainability. There is no magic bullet, sadly! staff have engaged positively with an approach that asks them to reflect success and solutions rather than failure and problems. |
We use ‘community’ to refer to the group of people who deliver (and receive) the care under investigation, and staff who deliver care, have patient contact, or administer the process of patient care.
The use of positive deviance as an improvement approach in healthcare is relatively new, with much of the research published in the past 10–15 years. It is also fair to say that most positive deviance studies in the field are reported in a largely uncritical way. As we have described elsewhere, Reference Baxter, Taylor, Kellar and Lawton 14 limitations include limited detail on how positively deviant individuals or teams were identified, under-use of comparisons and controls, and absent or poorly reported involvement of staff and patients. Despite the lack of critical reflection in the studies themselves, some opinion and thought pieces that espouse the value of positive deviance do acknowledge its limitations and the difficulties of applying it at scale. Reference Bradley, Curry and Ramanadhan 19, Reference Rose and McCullough 67, Reference Lawton, Taylor, Clay-Williams and Braithwaite 90 Here we describe the key issues to consider before choosing to adopt a positive deviance approach.
When embarking on a positive deviance project, it is vital that someone in the team understands data, and that all involved are encouraged to adopt a critical stance on the data, identifying only those measures that are reliable, valid, and meet a set of previously agreed criteria. These problems with poor quality data are not unique to positive deviance. Reference Woodcock, Liberati and Dixon-Woods 46 Many improvement approaches (e.g. see the Element on audit, feedback, and behaviour change Reference Ivers, Audit, Dixon-Woods, Brown and Marjanovic 91 ) rely on data either to drive the improvement or to evaluate its impact. Indeed, these same data are used to identify, and take action against, negative deviants.
Given the challenges of identifying positive deviants accurately, it is important to consider the extent to which we should prevent the perfect from being the enemy of the good. If we can improve by learning from those who perform well, rather than from those who perform exceptionally well, perhaps a more pragmatic approach should be embraced. It could be argued that the risk of promoting a practice that is not definitively associated with the highest performing teams or services may be lower than reconfiguring or closing down a service that has been identified to be a negative deviant. Nonetheless, caution should be applied: focusing on the wrong positive deviants may lead to learning that is actually counterproductive for improvement.
Using positive deviance in healthcare organisations in high-income countries is very different from its origins in international public health. The solutions identified in studies of healthcare are rarely exceptionally deviant . They are not, typically, like shrimps in the paddy fields, the unusual practices so often associated with early positive deviance work in Vietnam. Reference Sternin, Sternin, Marsh, Wollinka, Keeley, Burkhalter and Bashir 4, Reference Sternin, Sternin, Marsh and Marchione 5 Solutions identified in positively deviant healthcare teams and organisations are often things that are acceptable to others; they may be commonly known or evidence based, but perhaps just not uniformly adopted. For example, using alcohol gel in addition to soap and water rather than relying on just one or the other when ensuring hand hygiene prior to central line insertion. Reference Cohen, Gesser-Edelsburg, Singhal, Benenson and Moses 92 Alternatively, the hypotheses generated by qualitatively studying positive deviants in depth (stage 2 of the Bradley et al. framework) may be structural or cultural. They might be about psychological safety and trust in multidisciplinary teams, common goals, and transformational leadership. In fact, what these findings might suggest, and it is difficult with the current evidence to deny, is that positive deviance in healthcare may be synonymous with the ability to identify good practice and the contexts that facilitate their achievement.
Healthcare organisations are complex Reference Plsek and Greenhalgh 93 and, as such, systems often act in unpredictable ways to produce emergent outcomes. International public health and some of the more community-driven positive deviance studies have been cognisant of this complexity. They have, for example, used participatory methods that engage frontline staff, foster relationships/networks, encourage diverse participation and perspectives, and empower staff to make decisions (see Lindberg and Schneider Reference Lindberg and Schneider 94 for further discussion). Through this, the positive deviance approach is able to influence the parameters that shape self-organisation in complex adaptive systems – the natural and local emergence of order, innovation, and progress. Namely, it improves information flow, enhances the number and quality of connections, includes diverse perspectives, and shifts power differentials. Reference Lindberg and Schneider 94 However, it might be argued that positive deviance, particularly as conceptualised in Bradley et al.’s framework or by externally led applications, fails to recognise this complexity.
Limited community involvement risks a loss of engagement, connections, diversity, and empowerment, instead reducing the approach to simply finding specific solutions and spreading these to others to fix problems – a somewhat reductionist and linear approach to generating improvement. For positive deviance, key qualities are its asset-based character and its commitment to learning from the bottom up. It is important, then, that the underpinning principle that communities themselves hold the expertise and skill is not lost in a hierarchical healthcare system where policies, targets, and regulation are externally driven.
At the beginning of this Element, we outlined a set of underlying assumptions of positive deviance: solutions exist within communities; positive deviants succeed despite facing similar constraints; and this tacit knowledge can be generalised to others. In addition, Marsh et al. have proposed that the approach facilitates three important mechanisms of change: Reference Marsh, Schroeder, Dearden, Sternin and Sternin 95 social mobilisation, whereby communities are motivated to engage with the approach; information gathering , to identify behaviours that facilitate good outcomes; and behaviour change, whereby the wider community adopts these new behaviours. The way that positive deviance has been operationalised in healthcare, a sector where quantitative evidence is central to decision-making, may mean that the mechanisms of social mobilisation and behaviour change have been lost in translation. For example, social mobilisation (bottom-up community involvement) has a central role in many of the typically community-driven studies, but, in the externally led studies, particularly at organisational level, this aspect is typically missing almost completely. If improvers are to stay true to the origins of positive deviance, then it is important that studies clearly align with the underlying assumption of actively involving positive deviants in identifying solutions and spreading them to others. Without social mobilisation, behaviour change becomes something that has to be done at the end of the project to ensure the spread of practices, rather than being an integral part of the process of conducting positive deviance. As such, applications of positive deviance that lack community involvement may face the same implementation challenges, including behaviour change, of any other quality improvement approach.
The use of positive deviance in healthcare is very much in its infancy, meaning there are many questions about its use and effectiveness still to be answered. Much more needs to be understood about how positive deviance works and what the mechanisms of action are. For example, given our aforementioned comments, how critical are social mobilisation, information gathering, and behaviour change? In what ways is positive deviance distinctive or advantageous compared with other improvement approaches? For example, a comparative study that explores the processes and outcomes of audit and feedback versus, or perhaps combined with, positive deviance is one possible avenue for further research.
Future research also needs to test different ways of conducting the qualitative stage of positive deviance. It is important to identify what level of effort is sufficient for generating reliable hypotheses about the factors underpinning excellence. This is even more critical if these hypotheses will not be tested in larger samples before implementation. To what extent should we learn from those who truly outperform? What is the most appropriate comparator group? How important is the wider testing of hypotheses? What do we spread – specific practices, or contextual and relational factors, or both?
One other important but unanswered question is the extent to which the learning from one context can be applied to another. This applies both to specific practices and processes as well as to the structural and cultural features of organisations. In our work in two very different settings (elective hip and knee surgery Reference Hughes, Sheard, Pinkney and Lawton 74 and older people’s care Reference Baxter, Taylor and Kellar 54, Reference Baxter, Taylor, Kellar and Lawton 62, Reference Baxter, Taylor, Kellar and Lawton 63 ) we have found that while some of our findings were similar in both settings (strong multidisciplinary teams and psychological safety), other factors were entirely different, reflecting the nature of these two services. In the more predictable elective service, reliability and standardisation of process were key, whereas in the more unpredictable older people’s service, personalisation and adaptability were critical. Based on these and other findings, we would hypothesise that there will be some fundamental and transferable learning about cultural and structural factors that facilitate excellence across settings and that the growing evidence base will allow, through systematic review, identification of these. But, in addition, there will be other factors (practices, processes, and ways of working) that are not generalisable beyond the service, specialty, or client group.
Positive deviance offers a set of core ideas: expertise being held within communities, the importance of learning from communities that succeed, and mobilising communities to spread the learning. Positive deviance resonates with the changing landscape of quality and safety research and improvement, particularly in its growing attempt to understand ‘work as done’ rather than ‘work as imagined’ – a distinction that is at the fore of Safety II thinking. Adopting positive deviance enables learning from the experts doing the work rather than those who commission or regulate the work. This is attractive in conditions where the strain on healthcare resources is high and approaches to improvement based on what is imagined are likely to be increasingly removed from the reality of what is achievable.
Despite its challenges, positive deviance remains promising, particularly as the availability of good quality and cross-sector data grow. As with any relatively new approach, however, many questions remain to be answered about its optimal use and the extent to which findings in one domain are generalisable to another. We must also be prepared to be more critical in applying and evaluating this approach than we have been to date. Finally, it will be important to reflect on the way that positive deviance is being applied in healthcare, with its strong focus on rigorous research methods and data. This may mean losing some of the espoused benefits of community involvement and mobilisation. This tension between rigour and community engagement is likely to be enduring.
Several applications of the positive deviance approach have been presented as cases and/or referenced throughout this Element. The following further reading is for those who want to find out more about the approach.
Positive Deviance Collaborative 3 – a website containing tools, manuals, case studies, and publications, and that helps to connect people who are implementing the approach. It predominantly aligns with an international public health approach of positive deviance and covers applications from a variety of counties and settings, including nutrition, education, business, and healthcare.
Bradley et al. Reference Bradley, Curry and Ramanadhan 19 – a summary of the four-stage framework for applying the positive deviance approach in healthcare organisations, and work to improve door-to-balloon times for patients with acute myocardial infarction.
Lawton et al. Reference Lawton, Taylor, Clay-Williams and Braithwaite 90 – a critique of positive deviance as a new approach to improving patient safety within healthcare organisations.
Marsh et al. Reference Marsh, Schroeder, Dearden, Sternin and Sternin 95 – a commentary introducing the positive deviance approach and describing evidence for its effectiveness.
Rose and McCullough Reference Rose and McCullough 67 – a narrative review of the authors’ experiences of applying the positive deviance approach in healthcare organisations, including potential applications in healthcare and methodological guidance.
Baxter et al. Reference Baxter, Taylor, Kellar and Lawton 14 – a systematic review of healthcare applications of positive deviance, exploring how positive deviance is defined, the quality of existing applications, and the methods used within them.
Hibbert and Trubacik Reference Hibbert and Trubacik 96 – a report detailing how the National Audit for Intermediate Care has used positive deviance to identify and learn from home-based and bed-based intermediate care services in the UK.
Rebecca Lawton and Ruth Baxter conceptualised the outline for this Element together. Both authors contributed to the drafting and reviewing of the Element and have approved the final version.
We thank the peer reviewers for their insightful comments and recommendations to improve the Element. A list of peer reviewers is published at www.cambridge.org/IQ-peer-reviewers . We also thank all the staff and patients who have participated in our positive deviance studies.
This Element was funded by THIS Institute (The Healthcare Improvement Studies Institute, www.thisinstitute.cam.ac.uk ). THIS Institute is strengthening the evidence base for improving the quality and safety of healthcare. THIS Institute is supported by a grant to the University of Cambridge from the Health Foundation – an independent charity committed to bringing about better health and healthcare for people in the UK. Our positive deviance studies were funded by the Health Foundation (via a PhD for Improvement Science) and by the NIHR Yorkshire and Humber Collaboration for Leadership in Applied Health Research and Care (CLAHRC – under the Evidence-Based Transformation Theme).
Ruth Baxter is a THIS Institute post-doctoral fellow in the Yorkshire Quality and Safety Research Group. Her research interests include the positive deviance approach, adopting a resilient healthcare and Safety II approach to improving healthcare, and involving patients to improve the quality and safety of healthcare services.
Rebecca Lawton is a health psychologist with two main research interests: patient safety and behaviour change. She is Professor, Psychology of Healthcare, at the University of Leeds, founder member of the Yorkshire Quality and Safety Research Group, and Director of NIHR Yorkshire and Humber Patient Safety Translational Research Centre, with a focus on delivering research that makes healthcare safer.
The online version of this work is published under a Creative Commons licence called CC-BY-NC-ND 4.0 ( https://creativecommons.org/licenses/by-nc-nd/4.0 ). It means that you’re free to reuse this work. In fact, we encourage it. We just ask that you acknowledge THIS Institute as the creator, you don’t distribute a modified version without our permission, and you don’t sell it or use it for any activity that generates revenue without our permission. Ultimately, we want our work to have impact. So if you’ve got a use in mind but you’re not sure it’s allowed, just ask us at [email protected] .
The printed version is subject to statutory exceptions and to the provisions of relevant licensing agreements, so you will need written permission from Cambridge University Press to reproduce any part of it.
All versions of this work may contain content reproduced under licence from third parties. You must obtain permission to reproduce this content from these third parties directly.
Mary Dixon-Woods
THIS Institute (The Healthcare Improvement Studies Institute)
Mary is Director of THIS Institute and is the Health Foundation Professor of Healthcare Improvement Studies in the Department of Public Health and Primary Care at the University of Cambridge. Mary leads a programme of research focused on healthcare improvement, healthcare ethics, and methodological innovation in studying healthcare.
Graham Martin
Graham is Director of Research at THIS Institute, leading applied research programmes and contributing to the institute’s strategy and development. His research interests are in the organisation and delivery of healthcare, and particularly the role of professionals, managers, and patients and the public in efforts at organisational change.
Katrina Brown
Katrina is Communications Manager at THIS Institute, providing editorial expertise to maximise the impact of THIS Institute’s research findings. She managed the project to produce the series.
Sonja Marjanovic
RAND Europe
Sonja is Director of RAND Europe’s healthcare innovation, industry, and policy research. Her work provides decision-makers with evidence and insights to support innovation and improvement in healthcare systems, and to support the translation of innovation into societal benefits for healthcare services and population health.
Tom is Head of Evaluation at RAND Europe and President of the European Evaluation Society, leading evaluations and applied research focused on the key challenges facing health services. His current health portfolio includes evaluations of the innovation landscape, quality improvement, communities of practice, patient flow, and service transformation.
Ellen Perry
Ellen supported the production of the series during 2020–21.
The past decade has seen enormous growth in both activity and research on improvement in healthcare. This series offers a comprehensive and authoritative set of overviews of the different improvement approaches available, exploring the thinking behind them, examining evidence for each approach, and identifying areas of debate.
Table 2 Barriers to implementing the positive deviance approach (as designed by Bradley et al. 19 ) and potential strategies for mitigation
To save this element to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle .
Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Find out more about the Kindle Personal Document Service .
To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox .
To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive .
Charlotte Nickerson
Research Assistant at Harvard University
Undergraduate at Harvard University
Charlotte Nickerson is a student at Harvard University obsessed with the intersection of mental health, productivity, and design.
Learn about our Editorial Process
Saul Mcleod, PhD
Editor-in-Chief for Simply Psychology
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul Mcleod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
On This Page:
Building off of Durkheim’s work on anomie , Merton (1957) was the first person to write about what sociologists call strain theory. To Merton, anomie was a condition that existed in the discrepancy between societal goals and the means that individuals have to achieve them.
Merton noticed that American society had high rates of crime and proposed that this was because the achievement of the American Dream — wealth attainment — was deeply ingrained by Americans, even those for whom factors such as race and class had made it highly improbable that they would ever achieve large monetary success.
Holding this cultural value in high regard, they turn to illegitimate means of obtaining wealth, becoming criminals in the process. The discrepancy or strain between the aspirations and the means of achieving them became known as “strain theory.”
Implicit in Robert Merton’s approach is that the factors that lead to order and disorder in a society (such as crime versus the order of social norms) are not mutually exclusive and that cultural values that have desirable functions often contain or produce undesirable consequences (Hagen & Daigle, 2018).
“The extreme emphasis on the accumulation of wealth as a symbol of success in our own society militates against the completely effective control of institutionally regulated modes of acquiring a fortune. Fraud, corruption, vice, crime, in short the entire catalogue of proscribed behavior becomes increasingly common…” (Merton, 1938, p.59).
Society’s emphasis on financial success and materialism through the mythology of the “American Dream” can be stressful for those whose chances of realizing that dreams are limited (Messner & Rosenfeld, 2012).
The rewards of conformity are available only to those who can pursue approved goals through approved means. Any other combination of means and goals is deviant in one way or another.
Merton argued that individuals at the bottom of society could respond to this strain in a number of ways. Different orientations toward society’s goals and differential access to the means to achieve those goals combine to create different categories of deviance.
Conformity : individuals are following a societal goal through legitimate means. Although a conformist may not necessarily achieve the societal goal, he has enough faith in society to follow legitimate means.
For example, a student who is going to school to advance a professional career is conforming, as he is following the American cultural value of success through an approved means (Inderbitzen, Bates, & Gainey 2016).
Innovation : the individual shares the cultural goal of the society but reaches this goal through illegitimate means. Thieves – who share the cultural goal of wealth obtainment but do so through breaking the law (such as drug dealing or embezzlement), are innovators.
Ritualists : individuals who have given up hope of achieving society’s approved goals but still operate according to society’s approved means. A member of middle management, for example, who accepts that they will never progress but stays in their position is a ritualist.
Retreatists (like dropouts or hermits): individuals who have rejected both a society’s goals and the legitimate means of obtaining them and live outside conventional norms altogether.
Drug addicts and figures such as Chris McCandleless — an Emory University graduate found dead in Alaska after attempting to reject capitalism, hitchhike north, and live off the land — a retreat from both societal rule and societally-approved means (Krakauer 2018).
Rebellion exists outside of Merton’s system altogether. Rebels aim to replace societal goals with those of their own and devise their own means of achieving them.
The most obvious examples of rebellion are terrorist organizations, which attempt to advance a goal, typically political, through means such as violence (Inderbitzen, Bates, & Gainey 2016)
Merton’s strain theory became the basis of much criminal sociology in the 1950s and 1960s but received substantial and damaging criticism.
Writers such as Hirschi (1969), Johnson (1979), and Kornhauser (1978) have argued that Merton’s theory is not supported empirically; however, others (such as Farnworth and Lieber, 1989) argue that it does.
Direct evidence for Merton’s strain theory, though sparse, is conflicting. Some research finds that there are not particularly high delinquency rates between those with the greatest gap between aspirations and expectations — those with low aspirations and low expectations had the highest offense rates.
However, others have shown support for this hypothesis (Agnew et al. 1996; Cullen & Agnew 2003).
Outside of empirical measurement, criticisms of Merton’s strain theory emphasize Merton’s assumption that the U.S. uniformly commits to materialistic goals when, in reality, the U.S. has highly pluralistic and heterogeneous cultural values (people tend to set themselves a variety of goals).
For example, people might prioritize helping others less fortunate than themselves (such as teachers or nurses) or striving for a healthy work-life balance over material success (Valier, 2001).
Sociologists have also criticized Merton’s emphasis on criminality in lower classes, failing to examine why elites break laws, such as corporate and white-collar criminals (Taylor et al., 1973).
Lastly, the theory emphasizes monetary and not violent crimes and brings up the question: If Merton is correct, why does the U.S. have lower property crime rates than many other developed countries? (Hagen & Daigle, 2018).
Some have attempted to revise Merton’s strain theory. One such revision introduces the concept of “relative deprivation” — those who have less in comparison to those around them have higher rates of criminality.
Others have argued that adolescents pursue a variety of non-monetary goals, such as popularity, grades, athletic prowess, and positive relationships with parents (Agnew et al., 1996; Cullen & Agnew, 2003; Hagen & Daigle, 2018).
General Strain Theory’s core is that individuals who experience stress or stressors often become upset and sometimes cope with crime (Agnew & Brezina, 2019).
According to General Strain Theory, strain increases crime because it leads to negative emotions such as anger, frustration, depression, and fear.
Individuals want to do something to correct these emotions, and their circumstances may make it so that committing a crime is an individual’s most accessible option for coping (Agnew & Brezina, 2019).
These negative emotions may also lower the barriers to crime. For example, angry people often have a strong desire for revenge (Agnew 2006).
Agnew (1985) argues that delinquency is most common among those experiencing negative life events , such as divorce or financial problems (Hagen & Daigle, 2018).
He also argues that delinquency comes from an inability to avoid painful environments – such as a school environment where there are interaction problems with teachers.
This creates negative affect, and delinquency becomes a means of obtaining what one has been prevented from obtaining (instrumental), retaliation, or escapism (Hagen & Daigle 2018).
Consequently, there are three types of strain, according to Agnew (Agnew & Brezina, 2019):
General Strain Theory differentiates between strains on two different axes: objective vs. subjective strain and experienced, vicarious, and anticipated strains.
Objective strain happens because of events and conditions that most people in a given group dislike, while subjective strain results from events and conditions disliked by one particular person or the particular persons being studied. This is an important distinction because the negativity of an experience can differ radically between individuals.
For example, one person may call divorce the worst experience of their life, while another may consider it a cause for celebration (Agnew & Brezina, 2019; Agnew, 2006).
Most researchers ask about objective levels of strain — whether or not individuals have experienced events that researchers assume are negative — however, it is important to consider that some so-called negative events can be positive to certain individuals and vice-versa (Agnew & Brezina, 2019).
Agnew (2002) also differentiates between experienced, vicarious, and anticipated strain. Experienced strains are strains directly experienced by someone. Vicarious strains are strains experienced by others, often those that the individual feels protective toward.
Finally, anticipated strains are strains that individuals expect to experience, especially in the near future.
However, General Strain Theory does not consider negative emotions to be the only factor that increases crime in trained individuals.
Strain can reduce levels of social control, such as how much someone values conformity and the belief that crime is wrong.
When strain comes from negative treatment from those in authority — such as parents, teachers, employers, and the police — this can decrease the individual’s stake in conformity and conventional society.
Rather than conforming to traditional ideas of social controls , strained individuals tend to adopt a values system that minimizes concern for others and prioritizes self-interest (Agnew & Brezina 2019; Brezina & Agnew 2017; Konty, 2005).
Strain can also encourage the social learning of crime. A student who is bullied can be regularly exposed to models of aggression, and chronically employed individuals living in communities where there is little room for economic opportunity may belong to groups that believe theft and drug dealing are acceptable.
The strains most likely to result in crime are those that are high in magnitude, that are seen as unjust, strains associated with low social control — such as parental rejection — and strains that create a pressure or incentive to cope criminally — such as a desperate need for money (Agnew & Brezina, 2019).
Many sociologists have researched which strains are the most likely to cause crime (such as Arter, 2008, Baron & Hartnagel, 1997, and Ellwanger, 2007), and Agnew (2002) compiles a list of these strains:
Some sociologists, such as De Coster and Kort Butler (2006) have found that strains in certain life domains — such as family, school, and peer groups — are especially related to delinquency in that domain (Agnew & Brezina, 2019).
Langton (2007) found that general strain theory is able to explain certain types of upper-class “white-collar crimes” (such as tax fraud) but that Agnew’s theory cannot generalize to all corporate crimes.
Indeed, Langton suggests, the types of strain and negative emotions experienced by white-collar workers may differ from those of other populations.
Not all individuals respond to stress with crimes.
For example, someone can cope with living in a poor urban area by moving away, a lack of financial resources by borrowing money, or low grades by studying more effectively.
Nonetheless, General Strain Theory outlines a few factors that make criminal coping more likely (Agnew & Brezina 2019):
Steven Messner and Richard Rosenfeld, in their book Crime and the American Dream (2012), extend Agnew’s General Strain Theory into “Institutional Anomie Theory.”
In this view, society is made up of social institutions (such as family, religion, and economic structure), and greater rates of crime result when one institution — the institution of economic structure — trumps all others.
People in this society begin to try to accumulate material wealth at the cost of all else, and a lack of control and authority by noneconomic institutions institutionalized anomie.
Hay & Meldrum (2010) examined self-harm in 426 adolescents in the rural United States from the perspective of Agnew’s General Strain Theory.
They emphasized two seldom spoken-about areas of strain and deviance: self-harm as deviance and bullying as strain. Self-harm, according to Hay & Meldrum, is an internalized deviant act (as it usually only affects oneself) and can result from strainful relationships with peers (such as bullying).
Hay & Meldrum hypothesized three things. Firstly, bullying is significantly and positively associated with self-harm. Secondly, this self-harm is mediated by the negative emotional experiences of those who are bullied — such as anxiety, depression, and low self-worth.
Thirdly, prosocial, authoritative parenting and high levels of self-control would be associated with lower levels of self-harm. Hay & Meldrum considered authoritative parenting to be a “moderating variable” because it indicates high access to family support.
Ultimately, the researchers found that General Strain Theory did align with the behavior they observed. Adolescents who experienced bullying, in-person or over the internet, had more negative emotions.
These negative emotions were especially high among females, people of color, those living in immigrant or non-intact households, and those low in self-control.
And those who had more negative emotions but few avenues to “mediate them” (such as through strong, prosocial family support) had higher levels of self-harm (Hay & Meldrum, 2010).
Many researchers have attempted to create theories of terrorism by accounting for particular types of strain — such as poverty — but they consider all of the factors that could lead to terrorism (Inderbitzen, Bates, & Gainey, 2016).
Terrorism is likely to result from a group or collective experiencing “collective strains” (Inderbitzen, Bates, & Gainey 2016). These strains can be because of several factors, such as race and ethnicity, religion, class, politics, or territorial groups.
However, the strains mostly resulting in terrorism are high in magnitude with civilian victims, unjust, or caused by more powerful others (Agnew 1992).
For example, case studies of terrorist organizations such as the Tamil Tigers, Basque Homeland and Liberty, Kurdistan Workers Party, and the Irish Republican Army reveal that the strains faced by these groups involved serious violence — such as death and rape — threats to livelihood, large scale imprisonment and detention, and attempts to eradicate ethnic identity (Inderbitzen, Bates, & Gainey, 2016).
These strains happened over long periods and affected many people, largely civilians (Callaway and Harrelson-Stephens 2006, Inderbitzen, Bates, & Gainey 2016).
Members of terrorist groups that do not seem to have experienced high-magnitude strains still report experiencing high-magnitude strains (Hoffman 2006).
For example, some right-wing terrorists in the United States believe in a “Zionist Occupation Government,” which threatens their values (Blazak, 2001; Inderbitzen, Bates, & Gainey, 2016).
These strains must be seen as unjust — for example, if they violate strongly held social norms or values or if they differ substantially from how members of the collective have been treated in the past.
These strains lead to strong negative emotions — such as anger, humiliation, and hopelessness, and make it difficult to cope legally and militarily, leaving terrorism as one of the few viable coping options (Inderbitzen, Bates, & Gainey 2016).
They also reduce social control and provide models for and foster beliefs favorable to terrorism (Inderbitzen, Bates, & Gainey 2016).
As a result, following General Strain Theory, terrorist groups resort to deviance in the form of collective violence.
Agnew, R. (1985). A revised strain theory of delinquency. Social Forces, 64 (1), 151-167.
Agnew, R. (2002). Experienced, vicarious, and anticipated strain: An exploratory study on physical victimization and delinquency. Justice Quarterly, 19(4), 603-632.
Agnew, R., & Brezina, T. (2019). General Strain Theory. In M. D. Krohn, N. Hendrix, G. Penly Hall, & A. J. Lizotte (Eds.), Handbook on Crime and Deviance (pp. 145-160). Cham: Springer International Publishing.
Agnew, R., & Brezina, T. (2019). General strain theory. In Handbook on crime and deviance (pp. 145-160): Springer.
Agnew, R., Cullen, F. T., Burton Jr, V. S., Evans, T. D., & Dunaway, R. G. (1996). A new test of classic strain theory. Justice Quarterly, 13 (4), 681-704.
Baron, S. W., & Hartnagel, T. F. (1997). ATTRIBUTIONS, AFFECT, AND CRIME: STREET YOUTHS”REACTIONS TO UNEMPLOYMENT. Criminology, 35 (3), 409-434.
Blazak, R. (2001). White boys to terrorist men: Target recruitment of Nazi skinheads. American Behavioral Scientist, 44 (6), 982-1000.
Brezina, T., & Agnew, R. (2017). Juvenile delinquency and subterranean values revisited. Delinquency and Drift Revisited, 73-97.
Callaway, R. L., & Harrelson-Stephens, J. (2006). Toward a theory of terrorism: Human security as a determinant of terrorism. Studies in conflict & terrorism, 29(8), 773-796.
Cullen, F. T., & Agnew, R. (2003). Criminological theory. Past to present.
De Coster, S., & Kort-Butler, L. (2006). How general is general strain theory? Assessing determinacy and indeterminacy across life domains. Journal of Research in Crime and Delinquency, 43 (4), 297-325.
Durkheim, E. (2000). The division of labor in society (1893): Blackwell.
Durkheim, E. (2005). Suicide: A study in sociology : Routledge.
Ellwanger, S. J. (2007). Strain, attribution, and traffic delinquency among young drivers: Measuring and testing general strain theory in the context of driving. Crime & Delinquency, 53(4), 523-551.
Farnworth, M., & Leiber, M. J. (1989). Strain theory revisited: Economic goals, educational means, and delinquency. American Sociological Review , 263-274.
Hagan, F. E., & Daigle, L. E. (2018). Introduction to criminology: Theories, methods, and criminal behavior: Sage Publications.
Hay, C., & Meldrum, R. (2010). Bullying Victimization and Adolescent Self-Harm: Testing Hypotheses from General Strain Theory. Journal of Youth and Adolescence, 39 (5), 446-459. doi:10.1007/s10964-009-9502-0
Hirschi, T., & Stark, R. (1969). Hellfire and delinquency. Social Problems, 17 (2), 202-213.
Hoffman, B. (2006). Insurgency and counterinsurgency in Iraq. Studies in conflict & terrorism, 29(2), 103-121.
Inderbitzin, M., Bates, K. A., & Gainey, R. R. (2018). Perspectives on deviance and social control: Sage Publications.
Johnson, R. E., & Johnson, E. E. (1979). Juvenile delinquency and its origins: An integrated theoretical approach: CUP Archive.
Konty, M. (2005). Microanomie: The cognitive foundations of the relationship between anomie and deviance. Criminology, 43 (1), 107-132.
Kornhauser, R. R. (1978). Social sources of delinquency: An appraisal of analytic models.
Krakauer, J. (2018). Into the wild (Vol. 78): Pan Macmillan.
Langton, L., & Piquero, N. L. (2007). Can general strain theory explain white-collar crime? A preliminary investigation of the relationship between strain and select white-collar offenses. Journal of Criminal Justice, 35(1), 1-15. doi:https://doi.org/10.1016/j.jcrimjus.2006.11.011
Ménard, K. S., & Arter, M. L. (2013). Police officer alcohol use and trauma symptoms: Associations with critical incidents, coping, and social stressors. International journal of stress management, 20(1), 37.
Merton, R.K. (1938). Social structure and anomie . American Sociological Review 3(5) , 672–682.
Merton, R.K. (1949). Social structure and anomie: revisions and extensions. In: Anshen, R.N. (Ed.), The Family: Its Functions and Destiny . Harper, New York, pp. 226–257.
Merton, R.K. (1957). Social structure and anomie. In: Merton, R.K. (Ed.), Social Theory and Social Structure . The Free Press, New York, pp. 185–214.
Merton, R.K. (1957). Continuities in the theory of social structure and anomie. In: Merton, R.K. (Ed.), Social Theory and Social Structure . The Free Press, New York, pp. 215–248.
Messner, S. F., & Rosenfeld, R. (2012). Crime and the American dream: Cengage Learning.
Messner, S. F., Thome, H., & Rosenfeld, R. (2008). Institutions, anomie, and violent crime: Clarifying and elaborating institutional-anomie theory. International Journal of Conflict and Violence (IJCV), 2 (2), 163-181.
Valier, C. (2001). Criminal detection and the weight of the past: critical notes on Foucault, subjectivity and preventative control. Theoretical Criminology, 5(4), 425-443.
Sociological theory and criminological research: Views from Europe and the United States
Featherstone, R., & Deflem, M. (2003). Anomie and strain: Context and consequences of Merton’s two theories. Sociological inquiry, 73(4), 471-489.
Messner, S. F. (1988). Merton’s “social structure and anomie”: The road not taken. Deviant Behavior, 9(1), 33-53.
Agnew’s General Strain Theory: Context, Synopsis, and Application
Jang, S. J., & Rhodes, J. R. (2012). General strain and non-strain theories: A study of crime in emerging adulthood. Journal of Criminal Justice, 40, 176-186.
Chamlin, M. B., & Cochran, J. K. (2007). An evaluation of the assumptions that underlie institutional anomie theory. Theoretical Criminology , 11 (1), 39-61.
Merton’s Strain Theory deals with broader societal structures and the consequent deviance, while role strain focuses on difficulties experienced in meeting multiple expectations of a single societal role. For example, a working mother might experience role strain in balancing job responsibilities with parental duties.
Related Articles
Criminology
What Do Criminal Psychologists Do?
Self-Control Theory Of Crime
Social Reaction Theory (Criminology)
What Is Social Control In Sociology?
Subcultural Theories of Deviance
Tertiary Deviance: Definition & Examples
Want to create or adapt books like this? Learn more about how Pressbooks supports open publishing practices.
Learning objective.
If we want to reduce violent crime and other serious deviance, we must first understand why it occurs. Many sociological theories of deviance exist, and together they offer a more complete understanding of deviance than any one theory offers by itself. Together they help answer the questions posed earlier: why rates of deviance differ within social categories and across locations, why some behaviors are more likely than others to be considered deviant, and why some kinds of people are more likely than others to be considered deviant and to be punished for deviant behavior. As a whole, sociological explanations highlight the importance of the social environment and of social interaction for deviance and the commision of crime. As such, they have important implications for how to reduce these behaviors. Consistent with this book’s public sociology theme, a discussion of several such crime-reduction strategies concludes this chapter.
We now turn to the major sociological explanations of crime and deviance. A summary of these explanations appears in Table 7.1 “Theory Snapshot: Summary of Sociological Explanations of Deviance and Crime” .
Table 7.1 Theory Snapshot: Summary of Sociological Explanations of Deviance and Crime
Major theory | Related explanation | Summary of explanation |
---|---|---|
Functionalist | Durkheim’s views | Deviance has several functions: (a) it clarifies norms and increases conformity, (b) it strengthens social bonds among the people reacting to the deviant, and (c) it can help lead to positive social change. |
Social ecology | Certain social and physical characteristics of urban neighborhoods contribute to high crime rates. These characteristics include poverty, dilapidation, population density, and population turnover. | |
Strain theory | According to Robert Merton, deviance among the poor results from a gap between the cultural emphasis on economic success and the inability to achieve such success through the legitimate means of working. According to Richard Cloward and Lloyd Ohlin, differential access to illegitimate means affects the type of deviance in which individuals experiencing strain engage. | |
Deviant subcultures | Poverty and other community conditions give rise to certain subcultures through which adolescents acquire values that promote deviant behavior. Albert Cohen wrote that lack of success in school leads lower-class boys to join gangs whose value system promotes and rewards delinquency. Walter Miller wrote that delinquency stems from focal concerns, a taste for trouble, toughness, cleverness, and excitement. Marvin Wolfgang and Franco Ferracuti argued that a subculture of violence in inner-city areas promotes a violent response to insults and other problems. | |
Social control theory | Travis Hirschi wrote that delinquency results from weak bonds to conventional social institutions such as families and schools. These bonds include attachment, commitment, involvement, and belief. | |
Conflict | Conflict Theory | People with power pass laws and otherwise use the legal system to secure their position at the top of society and to keep the powerless on the bottom. The poor and minorities are more likely because of their poverty and race to be arrested, convicted, and imprisoned. |
Feminist perspectives | Inequality against women and antiquated views about relations between the sexes underlie rape, sexual assault, intimate partner violence, and other crimes against women. Sexual abuse prompts many girls and women to turn to drugs and alcohol use and other antisocial behavior. Gender socialization is a key reason for large gender differences in crime rates. | |
Symbolic interactionism | Differential association theory | Edwin H. Sutherland argued that criminal behavior is learned by interacting with close friends and family members who teach us how to commit various crimes and also about the values, motives, and rationalizations we need to adopt in order to justify breaking the law. |
Labeling theory | Deviance results from being labeled a deviant; nonlegal factors such as appearance, race, and social class affect how often labeling occurs. |
Several explanations may be grouped under the functionalist perspective in sociology, as they all share this perspective’s central view on the importance of various aspects of society for social stability and other social needs.
As noted earlier, Émile Durkheim said deviance is normal, but he did not stop there. In a surprising and still controversial twist, he also argued that deviance serves several important functions for society.
First, Durkheim said, deviance clarifies social norms and increases conformity. This happens because the discovery and punishment of deviance reminds people of the norms and reinforces the consequences of violating them. If your class were taking an exam and a student was caught cheating, the rest of the class would be instantly reminded of the rules about cheating and the punishment for it, and as a result they would be less likely to cheat.
A second function of deviance is that it strengthens social bonds among the people reacting to the deviant. An example comes from the classic story The Ox-Bow Incident (Clark, 1940), in which three innocent men are accused of cattle rustling and are eventually lynched. The mob that does the lynching is very united in its frenzy against the men, and, at least at that moment, the bonds among the individuals in the mob are extremely strong.
A final function of deviance, said Durkheim, is that it can help lead to positive social change. Although some of the greatest figures in history—Socrates, Jesus, Joan of Arc, Mahatma Gandhi, and Martin Luther King Jr. to name just a few—were considered the worst kind of deviants in their time, we now honor them for their commitment and sacrifice.
Émile Durkheim wrote that deviance can lead to positive social change. Many Southerners had strong negative feelings about Dr. Martin Luther King Jr. during the civil rights movement, but history now honors him for his commitment and sacrifice.
U.S. Library of Congress – public domain.
Sociologist Herbert Gans (1996) pointed to an additional function of deviance: deviance creates jobs for the segments of society—police, prison guards, criminology professors, and so forth—whose main focus is to deal with deviants in some manner. If deviance and crime did not exist, hundreds of thousands of law-abiding people in the United States would be out of work!
Although deviance can have all of these functions, many forms of it can certainly be quite harmful, as the story of the mugged voter that began this chapter reminds us. Violent crime and property crime in the United States victimize millions of people and households each year, while crime by corporations has effects that are even more harmful, as we discuss later. Drug use, prostitution, and other “victimless” crimes may involve willing participants, but these participants often cause themselves and others much harm. Although deviance according to Durkheim is inevitable and normal and serves important functions, that certainly does not mean the United States and other nations should be happy to have high rates of serious deviance. The sociological theories we discuss point to certain aspects of the social environment, broadly defined, that contribute to deviance and crime and that should be the focus of efforts to reduce these behaviors.
An important sociological approach, begun in the late 1800s and early 1900s by sociologists at the University of Chicago, stresses that certain social and physical characteristics of urban neighborhoods raise the odds that people growing up and living in these neighborhoods will commit deviance and crime. This line of thought is now called the social ecology approach (Mears, Wang, Hay, & Bales, 2008). Many criminogenic (crime-causing) neighborhood characteristics have been identified, including high rates of poverty, population density, dilapidated housing, residential mobility, and single-parent households. All of these problems are thought to contribute to social disorganization , or weakened social bonds and social institutions, that make it difficult to socialize children properly and to monitor suspicious behavior (Mears, Wang, Hay, & Bales, 2008; Sampson, 2006).
Improving Neighborhood Conditions Helps Reduce Crime Rates
One of the sociological theories of crime discussed in the text is the social ecology approach. To review, this approach attributes high rates of deviance and crime to the neighborhood’s social and physical characteristics, including poverty, high population density, dilapidated housing, and high population turnover. These problems create social disorganization that weakens the neighborhood’s social institutions and impairs effective child socialization.
Much empirical evidence supports social ecology’s view about negative neighborhood conditions and crime rates and suggests that efforts to improve these conditions will lower crime rates. Some of the most persuasive evidence comes from the Project on Human Development in Chicago Neighborhoods (directed by sociologist Robert J. Sampson), in which more than 6,000 children, ranging in age from birth to 18, and their parents and other caretakers were studied over a 7-year period. The social and physical characteristics of the dozens of neighborhoods in which the subjects lived were measured to permit assessment of these characteristics’ effects on the probability of delinquency. A number of studies using data from this project confirm the general assumptions of the social ecology approach. In particular, delinquency is higher in neighborhoods with lower levels of “collective efficacy,” that is, in neighborhoods with lower levels of community supervision of adolescent behavior.
The many studies from the Chicago project and data in several other cities show that neighborhood conditions greatly affect the extent of delinquency in urban neighborhoods. This body of research in turn suggests that strategies and programs that improve the social and physical conditions of urban neighborhoods may well help decrease the high rates of crime and delinquency that are so often found there. (Bellair & McNulty, 2009; Sampson, 2006)
Failure to achieve the American dream lies at the heart of Robert Merton’s (1938) famous strain theory (also called anomie theory). Recall from Chapter 1 “Sociology and the Sociological Perspective” that Durkheim attributed high rates of suicide to anomie, or normlessness, that occurs in times when social norms are unclear or weak. Adapting this concept, Merton wanted to explain why poor people have higher deviance rates than the nonpoor. He reasoned that the United States values economic success above all else and also has norms that specify the approved means, working, for achieving economic success. Because the poor often cannot achieve the American dream of success through the conventional means of working, they experience a gap between the goal of economic success and the means of working. This gap, which Merton likened to Durkheim’s anomie because of the resulting lack of clarity over norms, leads to strain or frustration. To reduce their frustration, some poor people resort to several adaptations, including deviance, depending on whether they accept or reject the goal of economic success and the means of working. Table 7.2 “Merton’s Anomie Theory” presents the logical adaptations of the poor to the strain they experience. Let’s review these briefly.
Table 7.2 Merton’s Anomie Theory
Adaptation | Goal of economic success | Means of working |
---|---|---|
I. Conformity | + | + |
II. Innovation | + | − |
III. Ritualism | − | + |
IV. Retreatism | − | − |
V. Rebellion | ± | ± |
+ means accept, − means reject, ± means reject and work for a new society |
Merton defined five ways people respond to this gap between having a socially accepted goal and having no socially accepted way to pursue it.
Despite their strain, most poor people continue to accept the goal of economic success and continue to believe they should work to make money. In other words, they continue to be good, law-abiding citizens. They conform to society’s norms and values, and, not surprisingly, Merton calls their adaptation conformity .
Faced with strain, some poor people continue to value economic success but come up with new means of achieving it. They rob people or banks, commit fraud, or use other illegal means of acquiring money or property. Merton calls this adaptation innovation .
Other poor people continue to work at a job without much hope of greatly improving their lot in life. They go to work day after day as a habit. Merton calls this third adaptation ritualism . This adaptation does not involve deviant behavior but is a logical response to the strain poor people experience.
Franco Folini – Homeless woman with dogs – CC BY-SA 2.0.
In Merton’s fourth adaptation, retreatism , some poor people withdraw from society by becoming hobos or vagrants or by becoming addicted to alcohol, heroin, or other drugs. Their response to the strain they feel is to reject both the goal of economic success and the means of working.
Merton’s fifth and final adaptation is rebellion . Here poor people not only reject the goal of success and the means of working but work actively to bring about a new society with a new value system. These people are the radicals and revolutionaries of their time. Because Merton developed his strain theory in the aftermath of the Great Depression, in which the labor and socialist movements had been quite active, it is not surprising that he thought of rebellion as a logical adaptation of the poor to their lack of economic success.
Although Merton’s theory has been popular over the years, it has some limitations. Perhaps most important, it overlooks deviance such as fraud by the middle and upper classes and also fails to explain murder, rape, and other crimes that usually are not done for economic reasons. It also does not explain why some poor people choose one adaptation over another.
Merton’s strain theory stimulated other explanations of deviance that built on his concept of strain. Differential opportunity theory , developed by Richard Cloward and Lloyd Ohlin (1960), tried to explain why the poor choose one or the other of Merton’s adaptations. Whereas Merton stressed that the poor have differential access to legitimate means (working), Cloward and Ohlin stressed that they have differential access to illegitimate means . For example, some live in neighborhoods where organized crime is dominant and will get involved in such crime; others live in neighborhoods rampant with drug use and will start using drugs themselves.
In a more recent formulation, two sociologists, Steven F. Messner and Richard Rosenfeld (2007), expanded Merton’s view by arguing that in the United States crime arises from several of our most important values, including an overemphasis on economic success, individualism, and competition. These values produce crime by making many Americans, rich or poor, feel they never have enough money and by prompting them to help themselves even at other people’s expense. Crime in the United States, then, arises ironically from the country’s most basic values.
In yet another extension of Merton’s theory, Robert Agnew (2007) reasoned that adolescents experience various kinds of strain in addition to the economic type addressed by Merton. A romantic relationship may end, a family member may die, or students may be taunted or bullied at school. Repeated strain-inducing incidents such as these produce anger, frustration, and other negative emotions, and these emotions in turn prompt delinquency and drug use.
Some sociologists stress that poverty and other community conditions give rise to certain subcultures through which adolescents acquire values that promote deviant behavior. One of the first to make this point was Albert K. Cohen (1955), whose status frustration theory says that lower-class boys do poorly in school because schools emphasize middle-class values. School failure reduces their status and self-esteem, which the boys try to counter by joining juvenile gangs. In these groups, a different value system prevails, and boys can regain status and self-esteem by engaging in delinquency. Cohen had nothing to say about girls, as he assumed they cared little about how well they did in school, placing more importance on marriage and family instead, and hence would remain nondelinquent even if they did not do well. Scholars later criticized his disregard for girls and assumptions about them.
Another sociologist, Walter Miller (1958), said poor boys become delinquent because they live amid a lower-class subculture that includes several focal concerns , or values, that help lead to delinquency. These focal concerns include a taste for trouble, toughness, cleverness, and excitement. If boys grow up in a subculture with these values, they are more likely to break the law. Their deviance is a result of their socialization. Critics said Miller exaggerated the differences between the value systems in poor inner-city neighborhoods and wealthier, middle-class communities (Akers & Sellers, 2008).
A very popular subcultural explanation is the so-called subculture of violence thesis, first advanced by Marvin Wolfgang and Franco Ferracuti (1967). In some inner-city areas, they said, a subculture of violence promotes a violent response to insults and other problems, which people in middle-class areas would probably ignore. The subculture of violence, they continued, arises partly from the need of lower-class males to “prove” their masculinity in view of their economic failure. Quantitative research to test their theory has failed to show that the urban poor are more likely than other groups to approve of violence (Cao, Adams, & Jensen, 1997). On the other hand, recent ethnographic (qualitative) research suggests that large segments of the urban poor do adopt a “code” of toughness and violence to promote respect (Anderson, 1999). As this conflicting evidence illustrates, the subculture of violence view remains controversial and merits further scrutiny.
Travis Hirschi (1969) argued that human nature is basically selfish and thus wondered why people do not commit deviance. His answer, which is now called social control theory (also known as social bonding theory ), was that their bonds to conventional social institutions such as the family and the school keep them from violating social norms. Hirschi’s basic perspective reflects Durkheim’s view that strong social norms reduce deviance such as suicide.
Hirschi outlined four types of bonds to conventional social institutions: attachment, commitment, involvement, and belief.
More Good Foundation – Mormon Family Dinner – CC BY-NC 2.0.
Hirschi’s theory has been very popular. Many studies find that youths with weaker bonds to their parents and schools are more likely to be deviant. But the theory has its critics (Akers & Sellers, 2008). One problem centers on the chicken-and-egg question of causal order. For example, many studies support social control theory by finding that delinquent youths often have worse relationships with their parents than do nondelinquent youths. Is that because the bad relationships prompt the youths to be delinquent, as Hirschi thought? Or is it because the youths’ delinquency worsens their relationship with their parents? Despite these questions, Hirschi’s social control theory continues to influence our understanding of deviance. To the extent it is correct, it suggests several strategies for preventing crime, including programs designed to improve parenting and relations between parents and children (Welsh & Farrington, 2007).
Example of conflict theory: crime and social class.
While crime is often associated with the underprivileged, crimes committed by the wealthy and powerful remain an under-punished and costly problem within society. The FBI reported that victims of burglary, larceny, and motor vehicle theft lost a total of $15.3 billion dollars in 2009 (FB1 2010). In comparison, when former advisor and financier Bernie Madoff was arrested in 2008, the U.S. Securities and Exchange Commission reported that the estimated losses of his financial Ponzi scheme fraud were close to $50 billion (SEC 2009).
This imbalance based on class power is also found within U.S. criminal law. In the 1980s, the use of crack cocaine (cocaine in its purest form) quickly became an epidemic that swept the country’s poorest urban communities. Its pricier counterpart, cocaine, was associated with upscale users and was a drug of choice for the wealthy. The legal implications of being caught by authorities with crack versus cocaine were starkly different. In 1986, federal law mandated that being caught in possession of 50 grams of crack was punishable by a ten-year prison sentence. An equivalent prison sentence for cocaine possession, however, required possession of 5,000 grams. In other words, the sentencing disparity was 1 to 100 (New York Times Editorial Staff 2011). This inequality in the severity of punishment for crack versus cocaine paralleled the unequal social class of respective users. A conflict theorist would note that those in society who hold the power are also the ones who make the laws concerning crime. In doing so, they make laws that will benefit them, while the powerless classes who lack the resources to make such decisions suffer the consequences. The crack-cocaine punishment disparity remained until 2010, when President Obama signed the Fair Sentencing Act, which decreased the disparity to 1 to 18 (The Sentencing Project 2010).
Not surprisingly, conflict explanations have sparked much controversy (Akers & Sellers, 2008). Many scholars dismiss them for painting an overly critical picture of the United States and ignoring the excesses of noncapitalistic nations, while others say the theories overstate the degree of inequality in the legal system. In assessing the debate over conflict explanations, a fair conclusion is that their view on discrimination by the legal system applies more to victimless crime (discussed in a later section) than to conventional crime, where it is difficult to argue that laws against such things as murder and robbery reflect the needs of the powerful. However, much evidence supports the conflict assertion that the poor and minorities face disadvantages in the legal system (Reiman & Leighton, 2010). Simply put, the poor cannot afford good attorneys, private investigators, and the other advantages that money brings in court. As just one example, if someone much poorer than O. J. Simpson, the former football player and media celebrity, had been arrested, as he was in 1994, for viciously murdering two people, the defendant would almost certainly have been found guilty. Simpson was able to afford a defense costing hundreds of thousands of dollars and won a jury acquittal in his criminal trial (Barkan, 1996). Also in accordance with conflict theory’s views, corporate executives, among the most powerful members of society, often break the law without fear of imprisonment, as we shall see in our discussion of white-collar crime later in this chapter. Finally, many studies support conflict theory’s view that the roots of crimes by poor people lie in social inequality and economic deprivation (Barkan, 2009).
Feminist perspectives on crime and criminal justice also fall into the broad rubric of conflict explanations and have burgeoned in the last two decades. Much of this work concerns rape and sexual assault, intimate partner violence, and other crimes against women that were largely neglected until feminists began writing about them in the 1970s (Griffin, 1971). Their views have since influenced public and official attitudes about rape and domestic violence, which used to be thought as something that girls and women brought on themselves. The feminist approach instead places the blame for these crimes squarely on society’s inequality against women and antiquated views about relations between the sexes (Renzetti, 2011).
Another focus of feminist work is gender and legal processing. Are women better or worse off than men when it comes to the chances of being arrested and punished? After many studies in the last two decades, the best answer is that we are not sure (Belknap, 2007). Women are treated a little more harshly than men for minor crimes and a little less harshly for serious crimes, but the gender effect in general is weak.
A third focus concerns the gender difference in serious crime, as women and girls are much less likely than men and boys to engage in violence and to commit serious property crimes such as burglary and motor vehicle theft. Most sociologists attribute this difference to gender socialization. Simply put, socialization into the male gender role, or masculinity, leads to values such as competitiveness and behavioral patterns such as spending more time away from home that all promote deviance. Conversely, despite whatever disadvantages it may have, socialization into the female gender role, or femininity, promotes values such as gentleness and behavior patterns such as spending more time at home that help limit deviance (Chesney-Lind & Pasko, 2004). Noting that males commit so much crime, Kathleen Daly and Meda Chesney-Lind (1988, p. 527) wrote, A large price is paid for structures of male domination and for the very qualities that drive men to be successful, to control others, and to wield uncompromising power.…Gender differences in crime suggest that crime may not be so normal after all. Such differences challenge us to see that in the lives of women, men have a great deal more to learn.
Philippe Put – Fight – CC BY 2.0.
Two decades later, that challenge still remains.
Because symbolic interactionism focuses on the means people gain from their social interaction, symbolic interactionist explanations attribute deviance to various aspects of the social interaction and social processes that normal individuals experience. These explanations help us understand why some people are more likely than others living in the same kinds of social environments. Several such explanations exist.
One popular set of explanations, often called learning theories , emphasizes that deviance is learned from interacting with other people who believe it is OK to commit deviance and who often commit deviance themselves. Deviance, then, arises from normal socialization processes. The most influential such explanation is Edwin H. Sutherland’s (1947) differential association theory , which says that criminal behavior is learned by interacting with close friends and family members. These individuals teach us not only how to commit various crimes but also the values, motives, and rationalizations that we need to adopt in order to justify breaking the law. The earlier in our life that we associate with deviant individuals and the more often we do so, the more likely we become deviant ourselves. In this way, a normal social process, socialization, can lead normal people to commit deviance.
Sutherland’s theory of differential association was one of the most influential sociological theories ever. Over the years much research has documented the importance of adolescents’ peer relationships for their entrance into the world of drugs and delinquency (Akers & Sellers, 2008). However, some critics say that not all deviance results from the influences of deviant peers. Still, differential association theory and the larger category of learning theories it represents remain a valuable approach to understanding deviance and crime.
If we arrest and imprison someone, we hope they will be “scared straight,” or deterred from committing a crime again. Labeling theory assumes precisely the opposite: it says that labeling someone deviant increases the chances that the labeled person will continue to commit deviance. According to labeling theory, this happens because the labeled person ends up with a deviant self-image that leads to even more deviance. Deviance is the result of being labeled (Bohm & Vogel, 2011).
This effect is reinforced by how society treats someone who has been labeled. Research shows that job applicants with a criminal record are much less likely than those without a record to be hired (Pager, 2009). Suppose you had a criminal record and had seen the error of your ways but were rejected by several potential employers. Do you think you might be just a little frustrated? If your unemployment continues, might you think about committing a crime again? Meanwhile, you want to meet some law-abiding friends, so you go to a singles bar. You start talking with someone who interests you, and in response to this person’s question, you say you are between jobs. When your companion asks about your last job, you reply that you were in prison for armed robbery. How do you think your companion will react after hearing this? As this scenario suggests, being labeled deviant can make it difficult to avoid a continued life of deviance.
Labeling theory also asks whether some people and behaviors are indeed more likely than others to acquire a deviant label. In particular, it asserts that nonlegal factors such as appearance, race, and social class affect how often official labeling occurs.
Victor – Handcuffs – CC BY 2.0.
William Chambliss’s (1973) classic analysis of the “Saints” and the “Roughnecks” is an excellent example of this argument. The Saints were eight male high-school students from middle-class backgrounds who were very delinquent, while the Roughnecks were six male students in the same high school who were also very delinquent but who came from poor, working-class families. Although the Saints’ behavior was arguably more harmful than the Roughnecks’, their actions were considered harmless pranks, and they were never arrested. After graduating from high school, they went on to college and graduate and professional school and ended up in respectable careers. In contrast, the Roughnecks were widely viewed as troublemakers and often got into trouble for their behavior. As adults they either ended up in low-paying jobs or went to prison.
Labeling theory’s views on the effects of being labeled and on the importance of nonlegal factors for official labeling remain controversial. Nonetheless, the theory has greatly influenced the study of deviance and crime in the last few decades and promises to do so for many years to come.
Agnew, R. (2007). Pressured into crime: An overview of general strain theory . Los Angeles, CA: Roxbury.
Akers, R. L., & Sellers, C. S. (2008). Criminological theories: Introduction, evaluation, and application . New York, NY: Oxford University Press.
Anderson, E. (1999). Code of the street: Decency, violence, and the moral life of the inner city . New York, NY: W. W. Norton.
Barkan, S. E. (1996). The social science significance of the O. J. Simpson case. In G. Barak (Ed.), Representing O. J.: Murder, criminal justice and mass culture (pp. 36–42). Albany, NY: Harrow and Heston.
Barkan, S. E. (2009). The value of quantitative analysis for a critical understanding of crime and society. Critical Criminology, 17 , 247–259.
Belknap, J. (2007). The invisible woman: Gender, crime, and justice. Belmont, CA: Wadsworth.
Bellair, P. E., & McNulty, T. L. (2009). Gang membership, drug selling, and violence in neighborhood context. Justice Quarterly, 26 , 644–669.
Bohm, R. M., & Vogel, B. (2011). A Primer on crime and delinquency theory (3rd ed.). Belmont, CA: Wadsworth.
Bonger, W. (1916). Criminality and economic conditions (H. P. Horton, Trans.). Boston, MA: Little, Brown.
Cao, L., Adams, A., & Jensen, V. J. (1997). A test of the black subculture of violence thesis: A research note. Criminology, 35, 367–379.
Chambliss, W. J. (1973). The saints and the roughnecks. Society, 11, 24–31.
Chesney-Lind, M., & Pasko, L. (2004). The female offender: Girls, women, and crime . Thousand Oaks, CA: Sage.
Clark, W. V. T. (1940). The ox-bow incident . New York, NY: Random House.
Cloward, R. A., & Ohlin, L. E. (1960). Delinquency and opportunity: A theory of delinquent gangs . New York, NY: Free Press.
Cohen, A. K. (1955). Delinquent boys: The culture of the gang . New York, NY: Free Press.
Daly, K., & Chesney-Lind, M. (1988). Feminism and criminology. Justice Quarterly, 5, 497–538.
Gans, H. J. (1996). The war against the poor: The underclass and antipoverty policy . New York, NY: Basic Books.
Griffin, S. (1971, September). Rape: The all-American crime. Ramparts, 10 , 26–35.
Hirschi, T. (1969). Causes of delinquency . Berkeley: University of California Press.
Mears, D. P., Wang, X., Hay, C., & Bales, W. D. (2008). Social ecology and recidivism: Implications for prisoner reentry. Criminology, 46, 301–340.
Merton, R. K. (1938). Social structure and anomie. American Sociological Review, 3, 672–682.
Messner, S. F., & Rosenfeld, R. (2007). Crime and the American dream . Belmont, CA: Wadsworth.
Miller, W. B. (1958). Lower class culture as a generating milieu of gang delinquency. Journal of Social Issues, 14 , 5–19.
Pager, D. (2009). Marked: Race, crime, and finding work in an era of mass incarceration . Chicago, IL: University of Chicago Press.
Reiman, J., & Leighton, P. (2010). The rich get richer and the poor get prison: Ideology, class, and criminal justice (9th ed.). Boston, MA: Allyn & Bacon.
Renzetti, C. (2011). Feminist criminology . Manuscript submitted for publication.
Sampson, R. J. (2006). How does community context matter? Social mechanisms and the explanation of crime rates. In P.-O. H. Wikström & R. J. Sampson (Eds.), The explanation of crime: Context, mechanisms, and development (pp. 31–60). New York, NY: Cambridge University Press.
Sutherland, E. H. (1947). Principles of criminology . Philadelphia, PA: J. P. Lippincott.
Welsh, B. C., & Farrington, D. P. (Eds.). (2007). Preventing crime: What works for children, offenders, victims and places . New York, NY: Springer.
Wolfgang, M. E., & Ferracuti, F. (1967). The subculture of violence . London, England: Social Science Paperbacks.
Introduction to Sociology: Understanding and Changing the Social World Copyright © 2016 by University of Minnesota is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.
In order to continue enjoying our site, we ask that you confirm your identity as a human. Thank you very much for your cooperation.
A level sociology students should be looking to using contemporary examples and case studies to illustrate points and evaluate theories whenever possible. In the exams, the use of contemporary evidence is something examiners look for and reward.
Below are a few examples of some recent events in the news which are relevant to the sociology of crime and deviance . You’ll need to read the items for more depth on how to apply them.
Leave a reply cancel reply.
This site uses Akismet to reduce spam. Learn how your comment data is processed .
IMAGES
VIDEO
COMMENTS
Peers have long been of interest to the study of deviance, especially within differential association and social learning approaches (Burgess & Akers, 1966; ... Examining labeling theory: The case of mental retardation. In Gove W. R. (Ed.) The labeling of deviance: Evaluating a perspective (pp. 83-146). New York, NY: Wiley. Google Scholar ...
Summary of explanation. Functionalist. Durkheim's views. Deviance has several functions: (a) it clarifies norms and increases conformity, (b) it strengthens social bonds among the people reacting to the deviant, and (c) it can help lead to positive social change. Social ecology.
Another functionalist theory of deviance is Travis Hirschi's (1969) ... Sexual Assault in Canada: A Case Study. Until the 1970s, two major types of criminal deviance were largely ignored or were difficult to prosecute as crimes: sexual assault and spousal assault. Through the 1970s, women worked to change the criminal justice system and ...
Deviance in sociology refers to actions or behaviors that violate widely-accepted cultural norms within a society. Since deviance is defined relative to sociocultural standards, what is considered deviant differs across societies and time periods, and is largely determined by those in power. Sociologists study how and why certain behaviors are ...
The sociology of deviance refuses to die, despite decades-long critiques. In the 1970s, Scheff, Gove, and Chauncey treated the pages of the American Sociological Review to debates about labeling theories' approaches to mental illness (e.g. Chauncey Citation 1975; Gove Citation 1975; Scheff Citation 1975).Around the same time, feminist sociologists, Marxist criminologists, critical race ...
The study of social deviance is the study of the violation of cultural norms in either formal or informal contexts. Social deviance is a phenomenon that has existed in all societies with norms. Sociological theories of deviance are those that use social context and social pressures to explain deviance. Crime: The study of social deviance is the ...
To conceptualize the impact of violations on norm development, I draw on legal theory, the sociology of deviance, and organization studies. ... The case studies reconstruct how, in the 1960s and 1970s, ECHR institutions defined torture and determined Greek and British interrogation practices as torture, and how, in the 1990s and early 2000s ...
The association of peers' deviance with individual deviance, especially in the case of substance use, is one of the most robust findings in sociology. Yet, classic theories such as those by Sutherland, Becker, and Akers describe a more complex process than simply imitation; rather, peer influences are multifaceted and, as we contend, intertwined.
10.2 What Can Development Policy Learn From Positive Deviance?. The analysis of high-performing outliers is a promising approach for the formulation and implementation of development policy on both technical and nontechnical grounds. The literature on case studies in the social sciences highlights the methodological value-added of positive deviant cases in research designs.
Secondary deviance occurs when a person's self-concept and behavior begin to change after his or her actions are labeled as deviant by members of society. The person may begin to take on and fulfill the role of a "deviant" as an act of rebellion against the society that has labeled that individual as such.
DOI: 10.2308/AJPT-51665 Corpus ID: 157822738; The "Normalization" of Deviance: A Case Study on the Process Underlying the Adoption of Deviant Behavior @article{Courtois2017TheO, title={The "Normalization" of Deviance: A Case Study on the Process Underlying the Adoption of Deviant Behavior}, author={Cynthia Courtois and Yves Gendron}, journal={Auditing-a Journal of Practice \& Theory ...
approach. This study investigated how PD is used in practice and evidence of its effectiveness by analyzing case studies of 40 PD programs and 32 PD inquiries implemented in a range of high, middle, and low income countries by both national and international organizations. Case studies were developed using data from publicly available documents.
those social problems which involve violations of culturally. widespread conduct standards. The other definition is an. omnibus one, holding that deviance consists of violations of. major and minor rules alike, occurring in social systems of all sizes, from dyads and small groups to societal collectivities.
Positive Deviance Collaborative 3 - a website containing tools, manuals, case studies, and publications, and that helps to connect people who are implementing the approach. It predominantly aligns with an international public health approach of positive deviance and covers applications from a variety of counties and settings, including ...
Several issues in the study of deviance are discussed: the definition of deviance; the significance of the deviant act; cultural relativism; the influence of social structures. and causation. By using departures from rules to define deviance, sociologists may repeat fallacies of formalistic jurisprudence. Deviance is best left undefined, and ...
Merton's Theory of Deviance. Building off of Durkheim's work on anomie, Merton (1957) was the first person to write about what sociologists call strain theory. To Merton, anomie was a condition that existed in the discrepancy between societal goals and the means that individuals have to achieve them. ... For example, case studies of ...
Criminology and the Study of Deviance. James F. Short, Jr and Robert F. Meier View ... J L. McCartney, and B Baum (1974 ) "Nebraska's marijuana law A case of unexpected legislative innovation " Law and ... L. E. (1978) "Theories of deviance and the self-concept" Social Psychology 41 189-204. Google Scholar. Werthman, C. and I Piliavin ( 1967 ...
Sexual Assault in Canada: A Case Study Until the 1970s, two major types of criminal deviance were largely ignored or were difficult to prosecute as crimes: sexual assault and spousal assault. Through the 1970s, women worked to change the criminal justice system and establish rape crisis centers and battered women's shelters, bringing ...
Cynthia Courtois, Yves Gendron; The "Normalization" of Deviance: A Case Study on the Process Underlying the Adoption of Deviant Behavior. AUDITING: A Journal of Practice & Theory 1 August 2017; 36 (3): 15-43.
Deviance has several functions: (a) it clarifies norms and increases conformity, (b) it strengthens social bonds among the people reacting to the deviant, and (c) it can help lead to positive social change. Social ecology. Certain social and physical characteristics of urban neighborhoods contribute to high crime rates.
Social deviance can be defined as any behavior that a society finds offensive. Such behavior can cause condemnation, disapproval, hostility and punishment. The social groups or society in general ...
How store managers can empower their teams to engage in constructive deviance: Theory development through a multiple case study August 2019 Journal of Retailing and Consumer Services 52(55)
A level sociology students should be looking to using contemporary examples and case studies to illustrate points and evaluate theories whenever possible. In the exams, the use of contemporary evidence is something examiners look for and reward. Below are a few examples of some recent events in the news which are relevant to the sociology