Transcript Psychology 3318 - Centre Londres 94

Psychology 3318
Davison and Neale
Chapter 2: Current Paradigms in
Psychopathology and Therapy
Overview of Davison and Neale Paradigms
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Biological (Medical, Disease)
Psychoanalytic
Humanistic/Existential
Learning
Cognitive
Biological Paradigm
• Types of Disease: Infectious vs.
Traumatic
• Basic Model
– Predisposition (resistance) and exposure
(germs, trauma, etc.) interact to produce
disease
– Disease causes symptoms and signs
• Symptoms: what is reported
• Signs: what is observable (more important)
Representation of Biological Model
Behavior Genetics
• Key concepts: Genes, genotype,
phenotype
– Family method: index case (probands),
– Twin method: monozygotic (MZ) vs.
dizygotic (DZ) twins, concordance,
– Adoptee method
– Linkage analysis: looks for particular gene
based upon genetic markers
Central Nervous System Biochemistry
• Key concepts; Neurons, nerve impulses,
synapse, neurotransmitters (see Figs. 2.1
and 2.2)
• Some key neurotransmitters:
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Norepinephrine (noradrenalin)
Gamma-aminobutyric acid (GABA)
Dopamine (schizophrenia?)
Serotonin (depression?)
• Very important to drug therapy
Classical Freudian Concepts
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Strongly Darwinian
Sex is a basic motive
Structures: Id (motives), ego (executive), superego (morality)
Levels of consciousness: Conscious, preconscious, unconscious
Principles: Pleasure vs. reality
Processes: Primary vs. secondary
Psychosexual stages: Polymorphous perverse, oral-passive, oral-biting,
anal, phallic, latent, genital
Fixations and regressions
Oedipus (Electra) complex
Anxiety: Objective (realistic), neurotic, moral
Defense mechanisms: Repression, denial, projection, displacement,
rationalization, reaction formation, sublimation (see Table 2.1)
Freudian Disease Model
Other Early Psychoanalysts (“NeoFreudians”)
Carl Jung
Early Humanist, stressed collective
unconscious
Alfred Adler Power is basic motive, individual
psychology
Karen
Early feminist
Horney
Traditional Therapeutic Concepts
• Free Association
• Resistance
• Dream analysis (latent vs. manifest
content)
• Transference and countertransference
• Interpretation
• Analyst sits in background; patient is
prone
Newer Concepts
• Ego analysis (many, including Freud):
Ability of person to control environment
• Brief therapy: Ferenczi; Alexander and
French
• Interpersonal therapy (Klerman and
Weissman): concenrates on person’s
current difficulties; active teaching
Evaluation
• “Blame your parents” and rejection of
responsibility
• Child is “father” to the “man”.
• Unconscious influences on behavior
• Role of defense mechanisms
• Causes of behavior may not be
apparent
Humanistic/Existential: Rogers Client-Centered
Therapy
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Importance of phenomenology
Healthy people are aware of behavior
Healthy people are good
Healthy people are purposive and goaldirected
• Importance of self-actualization
• Therapeutic techniques
– Reflection
– Unconditional positive regard
– Empathy: primary (understanding) vs. advanced
(inferential)
Humanistic/Existential: Existential
• Based (perhaps loosely) on philosophic
movement
• Stresses the present and responsibility
for choice
• Goal is to change behavior
Humanistic/Existential: Gestalt Therapy (Fritz Perls)
• Existential in orientation
• Techniques
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I-language
Empty chair
Projection of feelings
Attending to nonverbal cues
Use of metaphor
• (For comparison of the three approaches, see
Table 2.3)
Learning Paradigms
• Basic model: psychopathology is learned
• Important early names
– Pavlov
– Watson
– Thorndike
• Major types of learning
– Classical (Pavlovian) conditioning
– Operant (instrumental) conditioning
– Modeling (vicarious learning)
Pavlovian Concepts
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Unconditioned stimulus: US or UCS
Conditioned stimulus: CS
Unconditioned response: UR or UCR
Conditioned response: CR
Many prefer “conditional” and
“unconditional” to “conditioned” and
“unconditioned”
• Extinction
Operant Concepts
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Law of effect
Discriminative stimulus
Positive and negative reinforcement
Shaping
Avoidance conditioning
Mediational vs. Skinnerian approaches
Skinner: There is no difference between
disease and symptoms
Behavior Therapy and Modification
• Use of behavioral techniques to modify
pathological behavior
• Behavior therapy is more mediational
• Behavioral modification is more Skinnerian
• Counterconditioning
• Systematic desensitization
• Flooding (implosion)
• Aversive conditioning
• Time-out
• Token economy
Modeling
• Role Playing
• Rehearsal
• Self-efficacy
Cognitive Paradigm
• Although Skinner denied the importance of
cognition (thought) many of his followers
became cognitive.
• Schema
• Cognitive behavior therapy
– Beck
– Ellis and Rational-emotional Behavior Therpy
(REBT)
– Group therapies
– Self-efficacy
General Considerations
• See Table 2.4 for a comparison of
psychoanalytic and cognitive-behavioral
approaches.
• Diathesis-stress is unifying concept
• Importance of eclecticism: Good
therapists are seen as more alike one
another, despite paradigm, than bad
ones