Comer, Abnormal Psychology, 6th edition

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Transcript Comer, Abnormal Psychology, 6th edition

Slides & Handouts by Karen Clay Rhines, Ph.D.
Seton Hall University
Chapter 3
Models of Abnormality
Comer, Abnormal Psychology, 6e – Chapter 3
1
Models of Abnormality

In science, the perspectives used to explain phenomena
are known as models or paradigms

Each provides a set of assumptions and concepts that help us
explain and interpret observations

A school of thought

Helpful because they spell out basic assumptions and set
guidelines for investigation

They influence what investigators observe, the questions they
ask, the information they seek, and their interpretation of
that information
Comer, Abnormal Psychology, 6e – Chapter 3
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Models of Abnormality

Historically, clinical scientists of a given time
and place agreed on a single model of
abnormality – a model greatly influenced by
cultural beliefs

Currently, there are several competing models of
abnormality

Why? Each model focuses on one aspect of human
functioning and no single model can explain all
aspects of abnormality
Comer, Abnormal Psychology, 6e – Chapter 3
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The Biological Model

Takes a medical perspective

Main focus is that psychological abnormality is
an illness brought about by malfunctioning parts
of the organism

Typically focused on the brain
Comer, Abnormal Psychology, 6e – Chapter 3
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How Do Biological Theorists
Explain Abnormal Behavior?

Brain anatomy

The brain is composed of ~100 billion nerve cells
(called neurons) and thousands of billions of
support cells (called glia)

Within the brain, large groups of neurons form
distinct areas called brain regions
Comer, Abnormal Psychology, 6e – Chapter 3
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How Do Biological Theorists
Explain Abnormal Behavior?

Brain anatomy and abnormal behavior

Clinical researchers have found connections between
certain psychological disorders and problems in
specific brain areas

Example: Huntington’s disease & basal ganglia (forebrain)
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How Do Biological Theorists
Explain Abnormal Behavior?

Brain chemistry

Information spreads throughout the brain in the
form of electrical impulses that travel from one
neuron to one (or more) other neurons

An impulse is first received at a neuron’s dendrites,
travels down the axon, and is transmitted to other
neurons through the nerve endings
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8
How Do Biological Theorists
Explain Abnormal Behavior?

Brain chemistry

Neurons don’t touch; they are separated by a space
(the synapse), across which a message moves

When an electrical impulse reaches a nerve ending,
the nerve ending is stimulated to release a chemical
called a neurotransmitter (NT)

Some NTs tell receiving neurons to “fire;” other NTs tell
receiving neurons to stop firing
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How Do Biological Theorists
Explain Abnormal Behavior?

Brain chemistry

Researchers have identified dozens of NTs


Examples: serotonin, dopamine, and GABA
Studies indicate that abnormal activity in certain NTs
can lead to specific mental disorders

Examples: depression (serotonin and norepinephrine) and
anxiety (GABA)
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How Do Biological Theorists
Explain Abnormal Behavior?

Brain chemistry

Additionally, researchers have learned that mental disorders
are sometimes related to abnormal chemical activity in the
endocrine system

Hormone release, triggered by a variety of factors, propels
body organs into action. Abnormal secretions have been
linked to psychological disorders

Example: cortisol release is related to anxiety and mood
disorders
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How Do Biological Theorists
Explain Abnormal Behavior?

Sources of biological abnormalities – Genetics


Humans have 23 pairs of chromosomes, each with numerous
genes that control the characteristics and traits a person
inherits
Studies suggest that inheritance plays a part in mood
disorders, schizophrenia, mental retardation, Alzheimer’s
disease, and other mental disorders


Aren’t able (yet) to identify specific genes
Don’t know the extent to which genetic factors contribute to
disorders
 Seems no SINGLE gene is responsible for a particular behavior
or disorder
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How Do Biological Theorists
Explain Abnormal Behavior?

Sources of biological abnormalities – Evolution


Genes that contribute to mental disorders are viewed as
unfortunate occurrences:

May be mutations

May be inherited after a mutation in the family line
Evolutionary theorists argue that we can best understand
abnormality by examining the millions of years of human
evolution


Looking at a combination of adaptive behaviors of the past, genes,
and the interaction between genes and current environmental events
This model has been criticized and remains controversial
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How Do Biological Theorists
Explain Abnormal Behavior?

Sources of biological abnormalities – Viral
infections

Infection provides another possible source of
abnormal brain structure or biochemical dysfunction


Example: schizophrenia and prenatal viral exposure
Interest in viral explanations of psychological
disorders has been growing in the past decade

Example: anxiety and mood disorders
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Biological Treatments

Biological practitioners attempt to pinpoint the
physical source of dysfunction to determine the
course of treatment

Three types of biological treatment:

Drug therapy

Electroconvulsive therapy (ECT)

Psychosurgery
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Biological Treatments

Drug therapy:

1950s = advent of psychotropic medications


Changed outlook for a number of mental disorders
Four groups of drugs:

Antianxiety drugs (anxiolytics; tranquilizers)

Antidepressant drugs

Antibipolar drugs (mood stabilizers)

Antipsychotic drugs
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Biological Treatments

Electroconvulsive therapy (ECT):

Currently experiencing a revival

Used for depression when drugs and other therapies
have failed

In 60% of cases, ECT can lift symptoms within a few
weeks
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Biological Treatments

Psychosurgery (or neurosurgery):

Historical roots in trephination

1930s = first lobotomy

Much more precise than in the past

Considered experimental and used only in extreme
cases
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Assessing the Biological Model

Strengths:


Enjoys considerable
respect in the field

Fruitful

Creates new therapies

Suggests new avenues of
research
Weaknesses:

Can limit rather than
enhance our
understanding

Too simplistic

Evidence is incomplete or
inconclusive

Treatments produce
significant undesirable
(negative) effects
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The Psychodynamic Model


Oldest and most famous psychological model
Based on belief that a person’s behavior (whether
normal or abnormal) is determined largely by
underlying dynamic psychological forces of which she
or he is not aware


Abnormal symptoms are the result of conflict among these
forces
Father of psychodynamic theory and psychoanalytic
therapy:

Sigmund Freud (1856 – 1939)
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How Did Freud Explain
Normal and Abnormal Functioning?

Caused by three UNCONSCIOUS forces:
1.
2.
Id – guided by the Pleasure Principle

Instinctual needs, drives, & impulses

Sexual; fueled by libido (sexual energy)
Ego – guided by the Reality Principle

Seeks gratification but guides us to know when we can
& can’t express our wishes

Ego defense mechanisms protect us from anxiety
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How Did Freud Explain
Normal and Abnormal Functioning?

Caused by three UNCONSCIOUS forces:
3.
Superego – guided by the Morality Principle


Conscience; unconsciously adopted from our parents
These three parts of the personality are often in
conflict

A healthy personality is one in which compromise exists
among the three forces

If the id, ego, and superego are in excessive conflict, the
person’s behavior may show signs of dysfunction
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How Did Freud Explain
Normal and Abnormal Functioning?

Developmental stages

Freud proposed that at each stage of development,
new events and pressures require adjustment in the
id, ego, and superego

If successful → personal growth

If unsuccessful → fixation at an early developmental
stage, leading to psychological abnormality

Because parents are the key figures in early life, they are often
seen as the cause of improper development
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How Did Freud Explain
Normal and Abnormal Functioning?

Developmental stages

Oral (0 to 18 months of age)

Anal (18 months to 3 years of age)

Phallic (3 to 5 years of age)

Latency (5 to 12 years of age)

Genital (12 years of age to adulthood)
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How Do Other Psychodynamic
Explanations Differ from Freud’s?

Although current models deviate from Freud’s in
important ways, each retains the belief that human
functioning is shaped by dynamic (interacting) forces:

Ego theorists


Self theorists


Emphasize the role of the ego; consider it independent
Emphasize the unified personality over any one component
Object-relations theorists

Emphasize the human need for interpersonal relationships
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Psychodynamic Therapies

Range from Freudian psychoanalysis to more
modern therapies

All seek to uncover past trauma and inner
conflicts


Understanding early life experience critically
important
Therapist acts as “subtle guide”
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Psychodynamic Therapies

Utilize various techniques:

Free association

Therapist interpretation

Resistance

Transference

Dream interpretation

Catharsis

Working through
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Psychodynamic Therapies

Contemporary trends:

Short-term psychodynamic therapies

Relational psychoanalytic therapy
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Assessing the Psychodynamic
Model

Strengths:


First to recognize importance
of psychological theories &
treatment

Saw internal conflict as
important source of
psychological health and
abnormality

Weaknesses:

Unsupported ideas;
difficult to research

Non-observable

Inaccessible to human
subject (unconscious)
First to apply theory and
techniques systematically to
treatment – monumental
impact on the field
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The Behavioral Model

Like the psychodynamic perspective,
behaviorism is deterministic, and is based on the
idea that our actions are determined largely by
our life experiences

Emphasizes observable behavior and
environmental factors

Focuses on how behavior is acquired (learned)
and maintained over time
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The Behavioral Model

Historical beginnings in laboratories where
conditioning studies were conducted


Several forms of conditioning:

Operant conditioning

Modeling

Classical conditioning
May produce normal or abnormal behavior
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How Do Behaviorists
Explain Abnormal Functioning?

Operant conditioning

Organism “operates” on environment and produces
an effect

Humans and animals learn to behave in certain ways
as a result of receiving rewards whenever they do so
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How Do Behaviorists
Explain Abnormal Functioning?

Modeling

Individuals learn behavioral responses by observing
and repeating behavior

No direct reinforcement
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How Do Behaviorists
Explain Abnormal Functioning?

Classical conditioning

Learning by temporal association


When two events repeatedly occur close together in time,
they become fused in a person’s mind; before long, the
person responds in the same way to both events
Father of classical conditioning: Ivan Pavlov (1849 –
1936)

Classic study using dogs & meat powder
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Classical Conditioning
US
UR
Meat
Salivate
US
UR
Meat
+
Tone
Salivate
CS
CR
Tone
Salivate
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How Do Behaviorists
Explain Abnormal Functioning?

Classical conditioning

If, after conditioning, the CS is repeatedly presented
alone, it will eventually stop eliciting the CR


This process is called extinction
Explains many familiar behaviors (both normal and
abnormal)
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Behavioral Therapies

Aim is to identify the behaviors that are causing
problems and replace them with more
appropriate ones


May use classical conditioning, operant conditioning,
or modeling
Therapist is “teacher” rather than healer

Early life experiences important only in providing
clues to current learning
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Behavioral Therapies

Classical conditioning treatments may be used to
change abnormal reactions to particular stimuli

Example: systematic desensitization for phobia

Step-by-step procedure

Learn relaxation skills

Develop a fear hierarchy

Confront feared situations (covertly or in vivo)
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Assessing the Behavioral Model

Strengths:

Weaknesses:

Powerful force in the field

Too simplistic

Rooted in empiricism

Unrealistic

Downplays role of
cognition


Phenomena can be
observed and measured
Significant research
support for behavioral
therapies

New focus on self-efficacy,
social cognition, and
cognitive-behavioral
theories
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The Cognitive Model

Seeks to account for behavior by studying the
ways in which the person attends to, interprets,
and uses available information

Argues that clinicians must ask questions about
assumptions, attitudes, and thoughts of a client

Concerned with internal processes

Present-focused
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How Do Cognitive Theorists
Explain Abnormal Functioning?

Maladaptive thinking is the cause of maladaptive
behavior

Several kinds of faulty thinking:

Faulty assumptions and attitudes

Illogical thinking processes

Example: overgeneralization
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Cognitive Therapies

People must be taught a new way of thinking to
prevent maladaptive behavior

Main model: Beck’s Cognitive Therapy

The goal of therapy is to help clients recognize and
restructure their thinking


Therapists also guide clients to challenge dysfunctional thoughts,
try out new interpretations, and apply new ways of thinking in
their daily lives
Widely used in treating depression
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Assessing the Cognitive Model

Strengths:


Very broad appeal

Clinically useful & effective

Focuses on a uniquely human
process



Singular, narrow focus

Overemphasis on the
present
Correlation between symptoms
and maladaptive cognition

Limited effectiveness
Therapies effective in treating
several disorders

Verification of cognition
is difficult


Weaknesses:
Adapt well to technology
Research-based

Precise role is hard to
determine
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The Humanistic-Existential
Model

Combination model

The humanist view


Emphasis on people as friendly, cooperative, and
constructive; focus on drive to self-actualization
The existentialist view

Emphasis on self-determination, choice, and individual
responsibility; focus on authenticity
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Rogers’ Humanistic
Theory and Therapy

Basic human need for unconditional positive regard

If received, leads to unconditional self-regard

If not, leads to “conditions of worth”


Incapable of self-actualization because of distortion – don’t know
what they really need, etc.
Rogers’ “client-centered” therapy

Therapist provides unconditional positive regard

Both accurate & genuine in reflection (reflective listening)

Focus on the “experiencing person”

Little research support
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Gestalt Theory and Therapy

Humanistic approach

Developed by Fritz Perls

Goal is to help clients achieve self-recognition
through challenge and frustration

Techniques:

Skillful frustration

Role playing

Rules, including “Here and Now” and “I” language
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Existential Theories and Therapy

Psychological dysfunction is caused by selfdeception: people hide from life’s responsibilities
and fail to recognize that it is up to them to give
meaning to their lives

Therapy is focused on patient acceptance of
personal responsibility and recognition of freedom
of action

Goals more important than technique

Great emphasis placed on client-therapist relationship
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Assessing the HumanisticExistential Model

Strengths:


Emphasizes the individual

Taps into domains
missing from other
theories

Non-deterministic

Optimistic

Emphasizes health
Weaknesses:

Focuses on abstract issues

Difficult to research

Not much influence

Weakened by disapproval
of scientific approach

Changing somewhat
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The Sociocultural Model

Argues that abnormal behavior is best
understood in light of the social and cultural
forces that influence an individual

Addresses norms and roles in society

Influenced by sociology and anthropology

Argues that we must examine a person’s social
surroundings to understand their (abnormal)
behavior
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How Do Sociocultural Theorists
Explain Abnormal Functioning?

Focus on:


Societal labels & roles

Diagnostic labels (example: Rosenhan study)

Sick role
Social networks and support
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How Do Sociocultural Theorists
Explain Abnormal Functioning?

Focus on:

Family structure and communication

Family systems theory = abnormal functioning within
family leads to abnormal behavior (insane behavior
becomes sane in an insane environment)

Examples: enmeshed, disengaged structures
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How Do Sociocultural Theorists
Explain Abnormal Functioning?

Focus on:

Culture

Set of values, attitudes, beliefs, history, and behaviors
shared by a group of people and communicated from one
generation to the next

“Multicultural” psychology is a growing field of study
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How Do Sociocultural Theorists
Explain Abnormal Functioning?

Focus on:

Religion and spirituality

For most of the twentieth century, clinical scientists
viewed religion as a negative factor in mental health but
this alienation now seems to be ending:

Researchers have begun to systematically study the influence of
religion and spirituality on mental health

Many therapists now address spiritual issues when treating
religious clients
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Sociocultural Treatments

May include traditional individual therapy

Broadened therapy to include:

Culturally sensitive therapy

Group therapy

Family therapy

Couple therapy

Community treatment

Includes prevention work
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Assessing the Sociocultural
Model

Strengths:

Added greatly to the
clinical understanding of
abnormality



Increased awareness of
labeling
Clinically successful when
other treatments have
failed
Weaknesses:

Research is difficult to
interpret


Correlation  causation
Model unable to predict
abnormality in specific
individuals
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Integration of the Models

Each perspective is valuable to understanding
abnormal behavior

Different perspectives are more appropriate
under differing conditions

An integrative approach provides a general
framework for thinking about abnormal
behavior, and also allows for specification of the
factors that are especially pertinent to particular
disorders
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Integration of the Models

Many theorists, clinicians, and practitioners
adhere to a biopsychosocial model


Abnormality results from the interaction of genetic,
biological, developmental, emotional, behavioral,
cognitive, social, and societal influences
Also popular:

Diathesis-stress approach


Diathesis = predisposition (bio, psycho, or social)
Reciprocal effects explanation
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Integration of the Models

Integrative therapists are often called “eclectic”
– taking the strengths from each model and
using them in combination
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