Transcript Chapter 3 - Models of Abnormality

Slides & Handouts by Karen Clay Rhines, Ph.D.
Seton Hall University
Chapter 3
Models of Abnormality
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Models of Abnormality
• Paradigms: the perspectives used to explain
phenomena (abnormal behavior for this class)
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Biological model
Psychodynamic model
Behavioral model
Cognitive model
Humanistic-Existential model
Sociocultural model
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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
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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 – 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
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• Example: anxiety
and Psychology,
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
• 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:
• Weaknesses:
– Enjoys considerable
respect in the field
– Fruitful
• Creates new therapies
• Suggests new avenues
of research
– Can limit rather than
enhance our
understanding
• Too simplistic
– Evidence is
incomplete or
inconclusive
– Treatments produce
significant undesirable
(negative) effects
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Sometimes a cigar is just a cigar!
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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?
•
Freud says abnormal behavior is caused
by three UNCONSCIOUS forces:
1. Id – guided by the Pleasure Principle
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Instinctual needs, drives, & impulses
Sexual; fueled by libido (sexual energy)
2. Ego – guided by the Reality Principle
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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
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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
• Emphasize the role of the ego; consider it independent
– Self theorists
• 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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Assessing the Psychodynamic
Model
• Strengths:
• Weaknesses:
– First to recognize
importance of
psychological theories &
treatment
– Saw internal conflict as
important source of
psychological health and
abnormality
– First to apply theory and
techniques systematically
to treatment – monumental
impact on the field
– Unsupported ideas;
difficult to research
• Non-observable
• Inaccessible to human
subject (unconscious)
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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
– Three forms of conditioning (learning):
• 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
– Rooted in empiricism
• Phenomena can be
observed and
measured
– Significant research
support for behavioral
therapies
– Too simplistic
– Unrealistic
– Downplays role of
cognition
• New focus on selfefficacy, social
cognition, and cognitivebehavioral 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 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:
• Weaknesses:
– Very broad appeal
– Clinically useful & effective
– Focuses on a uniquely
human process
– Correlation between
symptoms and maladaptive
cognition
– Therapies effective in
treating several disorders
• Adapt well to
technology
– Research-based
– Singular, narrow focus
– Overemphasis on the
present
– Limited effectiveness
– Verification of
cognition is difficult
• 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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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:
• Weaknesses:
– Emphasizes the
individual
– Taps into domains
missing from other
theories
• Non-deterministic
– Optimistic
– Emphasizes health
– 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:
• Weaknesses:
– Added greatly to the
clinical understanding
of abnormality
• Increased awareness of
labeling
– Clinically successful
when other treatments
have failed
– 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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