Transcript Comer, Abnormal Psychology, 8th edition

Chapter 3
Abnormal Psychology | Ronald J. Comer | Ninth Edition
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Models of Abnormality
Models of Abnormality
– Each model spells out basic assumptions, gives order
to the field under study, and sets guidelines for
investigation
– Models influence what investigators observe, the
questions they ask, the information they seek, and
how they interpret this information
Abnormal Psychology | Ronald J. Comer | Ninth Edition
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• In science, the perspectives used to explain
events are known as _________ or paradigms
• Until recently, clinical scientists of a given place
and time tended to agree on a single model of
abnormality – a model greatly influenced by the
beliefs of their culture
• Today several models are used to explain and
treat abnormal functioning
– Sometimes in conflict, each model focuses on one
aspect of human functioning and no single model can
explain all aspects of abnormality
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Models of Abnormality
The Biological Model
– Typically point to problems in brain anatomy or brain
chemistry
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• Adopts a medical perspective
• Main focus is that psychological abnormality is
an illness brought about by malfunctioning parts
of the organism
How Do Biological Theorists Explain
Abnormal Behavior?
– 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
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• Brain anatomy
How Do Biological Theorists Explain
Abnormal Behavior?
• Brain anatomy and abnormal behavior
– Clinical researchers have discovered connections
between certain psychological disorders and
problems in specific brain areas
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• Example: Huntington's disease and basal ganglia (forebrain)
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How Do Biological Theorists Explain
Abnormal Behavior?
– Information is communicated throughout the brain in
the form of electrical impulses that travel from one
neuron to one or more others
– An impulse is first received by a neuron's dendrites,
travels down the axon, and is transmitted through the
nerve endings to other neurons
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• Brain chemistry
How Do Biological Theorists Explain
Abnormal Behavior?
– Neurons do not actually touch each other; they are
separated by a space (the synapse), across which a
message moves
– When an electrical impulse reaches a nerve ending,
the ending is stimulated to release a chemical, called
a neurotransmitter (NT), that travels across the
synaptic space to receptors on the dendrites of
neighboring neurons
• Some NTs tell receiving neurons to “fire;” other NTs tell
receiving neurons to stop firing
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• Brain chemistry
How Do Biological Theorists Explain
Abnormal Behavior?
• Brain chemistry and abnormal behavior
– Researchers have identified dozens of NTs
• Examples: serotonin, dopamine, and GABA
• For example: depression has been linked to low activity in
serotonin and norepinephrine
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– Studies indicate that abnormal activity in certain NTs
can lead to specific mental disorders
How Do Biological Theorists Explain
Abnormal Behavior?
– Additionally, researchers have learned that mental
disorders are sometimes related to abnormal
chemical activity in the endocrine system
– Endocrine glands release hormones which propel
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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• Brain chemistry and abnormal behavior
Sources of Biological Abnormalities –
Genetics
– Each cell in the human body contains 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, and other mental disorders
• Appears that in most cases several genes combine to
produce our actions and reactions
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• Abnormalities in brain anatomy or chemistry are
sometimes the result of genetic inheritance
Sources of Biological Abnormalities –
Genetics
– May be mutations
– May be inherited after a mutation in the family line
– May be the result of normal evolutionary principles
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• Genes that contribute to mental disorders are
viewed as unfortunate occurrences:
Sources of Biological Abnormalities –
Evolution
– Example: The fear response
• In today's world, however, those genes and
reactions may not be so adapative
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• Evolutionary theorists argue that human
reactions and the genes responsible for them
have survived over the course of time because
they have helped individuals thrive and adapt
Sources of Biological Abnormalities – Viral
Infections
• Another possible source of abnormal brain
structure or biochemical dysfunction is viral
infections
• Interest in viral explanations of psychological
disorders has been growing in the past decade
– Example: Anxiety and mood disorders
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– Example: Schizophrenia and prenatal viral exposure
Biological Treatments
– __________
– __________
– __________
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• Biological practitioners attempt to pinpoint the
physical source of dysfunction to determine the
course of treatment
• Three types of biological treatment:
Biological Treatments
• Drug therapy:
– 1950s = advent of psychotropic medications
• Greatly changed the outlook for a number of mental
disorders
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Antianxiety drugs (anxiolytics; minor tranquilizers)
Antidepressant drugs
Antibipolar drugs (mood stabilizers)
Antipsychotic drugs
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– Four major drug groups:
Biological Treatments
• Electroconvulsive therapy (ECT):
– Used primarily for depression, particularly when drugs
and other therapies have failed
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• This treatment is used on tens of thousands of depressed
persons annually
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Biological Treatments
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Historical roots in trephination
1930s = first lobotomy
Much more precise today than in the past
Considered experimental and used only in extreme
cases
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• Psychosurgery (or neurosurgery):
Assessing the Biological Model
• Strengths:
• Weaknesses:
– Can limit, rather than enhance, our understanding
• Too simplistic
– Treatments produce significant undesirable (negative)
effects
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– Enjoys considerable respect in the field
– Constantly produces valuable new information
– Treatments bring great relief
The Psychodynamic Model
– 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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• Oldest and most famous psychological model
• Based on belief that a person's behavior (whether
normal or abnormal) is determined largely by
underlying dynamic - that is, interacting psychological forces of which she or he is not
consciously aware
How Did Freud Explain Normal and
Abnormal Functioning?
• Shaped by three UNCONSCIOUS forces:
– Id – guided by the Pleasure Principle
• Instinctual needs, drives, and impulses
• Sexual; fueled by libido (sexual energy)
• Seeks gratification, but guides us to know when we can and
cannot express our wishes
• Ego defense mechanisms protect us from anxiety
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– Ego – guided by the Reality Principle
Defense
Operation
Example
Repression
Person avoids anxiety by simply not allowing
painful or dangerous thoughts to become
conscious.
An executive’s desire to run amok and attack his boss and colleagues at
a board meeting is denied access to his awareness.
Denial
Person simply refuses to acknowledge the
existence of an external source of anxiety.
You are not prepared for tomorrow’s final exam, but you tell yourself that
it’s not actually an important exam and that there’s no good reason not to
go to a movie tonight.
Projection
Person attributes own unacceptable impulses,
motives, or desires to other individuals.
The executive who repressed his destructive desires may project his
anger onto his boss and claim that it is actually
the boss who is hostile.
Rationalization
Person creates a socially acceptable reason for
an action that actually reflects unacceptable
motives.
A student explains away poor grades by citing the importance of the
“total experience” of going to college and claiming that too much
emphasis on grades would actually interfere with a well-rounded
education.
Displacement
Person displaces hostility away from a
dangerous object and onto a safer substitute.
After a perfect parking spot is taken by a person who cuts in front of your
car, you release your pent-up anger by starting an argument with your
roommate.
Intellectualization
Person represses emotional reactions in favor of
overly logical response to a problem.
A woman who has been beaten and raped gives a detached, methodical
description of the effects that such attacks may have on victims.
Regression
Person retreats from an upsetting conflict to an
early developmental stage at which no one is
expected to behave maturely or responsibly.
A boy who cannot cope with the anger he feels toward his rejecting
mother regresses to infantile behavior, soiling his clothes and no longer
taking care of his basic needs.
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The Defense Never Rests: Defense
Mechanisms to the Rescue
How Did Freud Explain Normal and
Abnormal Functioning?
• Caused by three UNCONSCIOUS forces:
– Superego – guided by the Morality Principle
• Conscience; unconsciously adopted from our parents
– A healthy personality is one in which an effective working
relationship 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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• These three parts of the personality are often in
some degree of conflict
How Did Freud Explain Normal and
Abnormal Functioning?
• Developmental stages
• 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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– Freud proposed that at each stage of development
new events and pressures require adjustment in the
id, ego, and superego
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Developmental stages
_________ (0 to 18 months of age)
_________ (18 months to 3 years of age)
_________ (3 to 5 years of age)
_________ (5 to 12 years of age)
_________ (12 years of age to adulthood
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How Did Freud Explain Normal and
Abnormal Functioning?
How Do Other Psychodynamic Explanations
Differ from Freud's?
• Although new theories depart from Freud's ideas in
important ways, each retains the belief that human
functioning is shaped by dynamic (interacting)
forces:
– Ego theorists
– Self theorists
• Emphasize the unified personality
– Object-relations theorists
• Emphasize the human need for relationships, especially
between children and caregivers
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• Emphasize the role of the ego; consider it independent and
powerful
• Range from Freudian psychoanalysis to modern
therapies
• All seek to uncover past trauma and inner
conflicts
• Therapist acts as a “subtle guide”
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Psychodynamic Therapies
Psychodynamic Therapies
• Utilize various techniques:
• Resistance
• Transference
• Dream interpretation
– Catharsis
– Working through
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– Free association
– Therapist interpretation
Psychodynamic Therapies
• Contemporary trends:
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– Short-term psychodynamic therapies
– Relational psychoanalytic therapy
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Assessing the Psychodynamic Model
• Strengths:
• Weaknesses:
– Unsupported ideas; difficult to research
• Non-observable
• Inaccessible to human subject (unconscious)
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– First to recognize importance of psychological theories and
treatment
– Saw abnormal functioning as rooted in the same
processes as normal functioning
– First to apply theory and techniques systematically to
treatment – monumental impact on the field
• Like psychodynamic theorists, behavioral
theorists believe that our actions are determined
largely by our experiences in life
• Concentrates wholly on behaviors and
environmental factors
• Bases explanations and treatments on principles
of learning
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The Behavioral Model
The Behavioral Model
• The model began in laboratories where
conditioning studies were conducted
• Operant conditioning
• Modeling
• Classical conditioning
– All may produce normal or abnormal behavior
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– Several forms of conditioning:
How Do Behaviorists Explain Abnormal
Functioning?
• Operant conditioning
– Humans and animals learn to behave in certain ways
as a result of receiving rewards whenever they do so
– Individuals learn responses by observing and
repeating behavior
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• Modeling
How Do Behaviorists Explain Abnormal
Functioning?
• Classical conditioning
– Learning by temporal association
– Father of classical conditioning: Ivan Pavlov (1849 –
1936)
• Classic study using dogs and meat powder
– Explains many familiar behaviors (both normal and
abnormal)
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• 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
__
__
Meat
Salivate
__
__
Meat
+
Tone
Salivate
__
__
Tone
Salivate
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Classical Conditioning
Behavioral Therapies
• Aim to identify the behaviors that are causing
problems and replace them with more
appropriate ones
• Therapist is “teacher” rather than healer
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– May use classical conditioning, operant conditioning,
or modeling
Behavioral Therapies
• Classical conditioning treatments may be used
to change abnormal reactions to particular
stimuli
– Example: systematic desensitization for phobia
– Learn relaxation skills
– Construct a fear hierarchy
– Confront feared situations
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• Step-by-step procedure
Assessing the Behavioral Model
• Strengths:
– Powerful force in the field
– Can be tested in the laboratory
– Significant research support for behavioral therapies
– No evidence that symptoms are ordinarily acquired
through conditioning
– Behavior therapy is limited
– Too simplistic
• New focus on
self-efficacy, social cognition, and cognitive-behavioral theories
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• Weaknesses:
• This model proposes that we can best
understand abnormal functioning by looking at
cognitive processes – the center of behaviors,
thoughts, and emotions
• Argues that clinicians must ask questions about
assumptions, attitudes, and thoughts of a client
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The Cognitive Model
How Do Cognitive Theorists Explain
Abnormal Functioning?
• Abnormal functioning can result from several
kinds of cognitive problems:
– Faulty assumptions and attitudes
– Illogical thinking processes
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– Example: overgeneralization
Abnormal Psychology | Ronald J. Comer | Ninth Edition
Cognitive Therapies
– The goal of therapy is to help clients recognize and
restructure their thinking
• Therapists also guide clients to challenge their 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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• People can overcome their problems by
developing new ways of thinking
• Main model: Beck's Cognitive Therapy
Assessing the Cognitive Model
• Strengths:
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Very broad appeal
Clinically useful and effective
Focuses on a uniquely human process
Theories lend themselves to research
Therapies effective in treating several disorders
– Precise role of cognition in abnormality has yet to be determined
– Therapies do not help everyone
– Some changes may not be possible to achieve
• In response, a new wave of therapies has emerged, including Acceptance
and Commitment Therapy and mindfulness-based techniques
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• Weaknesses:
Cybertherapy: Surfing for help
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Computer software therapy
E-mail therapy
Visual e-therapy
Virtual support groups
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• Cybertherapy has come to complement or even
replace face-to-face therapy
The Humanistic-Existential Model
• Combination model
– The humanist view
– The existentialist view
• Emphasis on self-determination, choice, and individual
responsibility; focus on authenticity
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• Emphasis on people as friendly, cooperative, and
constructive; focus on drive to self-actualize through honest
recognition of strengths and weaknesses
Rogers' Humanistic Theory and Therapy
• Believes in the 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 – do not know what
they really need, etc.
– Therapist creates a supportive climate
• Unconditional positive regard
• Accurate empathy
• Genuineness
– Little research support but positive impact on clinical practice
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• Rogers' “client-centered” therapy
Gestalt Theory and Therapy
• Humanistic approach
• Skillful frustration
• Role playing
• Rules, including “Here and Now” and “I” language
– Little research support
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– Developed by Fritz Perls
– Goal is to guide clients toward self-recognition
through challenge and frustration
– Techniques:
• For most of the twentieth century, clinical
scientists viewed religion as a negative—or at
best neutral—factor in mental health
• This historical alienation between the clinical
field and religion seems to be ending
• Researchers have learned that spirituality can,
in fact, be of psychological benefit to people
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Spiritual Views and Interventions
• Belief that psychological dysfunction is caused
by self-deception; people hide from life's
responsibilities and fail to recognize that it is up
to them to give meaning to their lives
• In therapy, people are encouraged to accept
personal responsibility for their problems
– Goals more important than technique
– Great emphasis placed on client-therapist relationship
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Existential Theories and Therapy
Existential Theories and Therapy
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• Existential therapists do not believe that
experimental methods can adequately test the
effectiveness of their treatments; as a result,
little controlled research has been conducted
Abnormal Psychology | Ronald J. Comer | Ninth Edition
Saving Minds Along with Souls
• Might there be serious drawbacks to placing
care in the hands of religious persons, even if
they receive lay training?
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• Initiatives to involve churches and religious
organizations in the care of serious mental
illnesses
Assessing the Humanistic-Existential Model
• Strengths:
Taps into domains missing from other theories
Emphasizes the individual
Optimistic
Emphasizes health
• Weaknesses:
– Focuses on abstract issues
• Difficult to research
– Weakened by disapproval of scientific approach
• Changing somewhat
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The Sociocultural Models
• Argue that abnormal behavior is best
understood in light of the social and cultural
forces that influence an individual
• Comprised of two major perspectives:
– Family-Social perspective
– Multicultural perspective
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– Address norms and roles in society
How Do Family-Social Theorists Explain
Abnormal Functioning?
• Proponents of this model argue that theorists
should concentrate on forces that operate
directly on an individual, including:
– Social labels and roles
– Social connections and supports
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• Diagnostic labels (example: Rosenhan study)
How Do Family-Social Theorists Explain
Abnormal Functioning?
• Focus on:
– Family structure and communication
– Examples: enmeshed, disengaged structures
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• Family systems theory argues that abnormal functioning
within a family leads to abnormal behavior (insane behavior
becomes sane in an insane environment)
Family-Social Treatments
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Group therapy
Family therapy
Couple therapy
Community treatment
• Includes prevention work
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• This perspective has helped spur the growth of
several treatment approaches, including:
Have Your Avatar Call My Avatar
• Clients know they are entering a make-believe
world when they receive avatar therapy, so why
do so many apparently make real-life progress?
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• Avatar therapy – relatively new form of
cybertherapy where clients use threedimensional graphical representations to interact
in a virtual world
How Do Multicultural Theorists Explain
Abnormal Functioning?
– The multicultural, or culturally diverse, perspective has
emerged as a growing field of study
– Multicultural psychologists seek to understand how culture,
race, ethnicity, gender, and similar factors affect behavior
and thought, as well as how people of different cultures,
races, and genders differ psychologically
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• Culture refers to the set of values, attitudes, beliefs,
history, and behaviors shared by a group of people
and communicated from one generation to the next
• The model holds that an individual's behavior is
best understood when examined in the light of
that individual's unique cultural context
• They also have noticed that the prejudice and
discrimination faced by many minority groups
may contribute to certain forms of abnormal
functioning
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How Do Multicultural Theorists Explain
Abnormal Functioning?
Multicultural Treatments
– Two features of treatment can increase a therapist's
effectiveness with minority clients:
• Greater sensitivity to cultural issues
• Inclusion of cultural models in treatment, especially in
therapies for children and adolescents
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• Studies have found that members of ethnic and
racial minority groups tend to show less
improvement in clinical treatment than members
of majority groups
Assessing the Sociocultural Models
• Strengths:
– Added greatly to the clinical understanding and treatment
of abnormality
• Increased awareness of clinical and social roles
– 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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• Weaknesses:
Integration of the Models
• A growing number of clinicians favor
explanations of abnormal behavior that consider
more than one cause at a time
• Abnormality results from the interaction of genetic, biological,
developmental, emotional, behavioral, cognitive, social, and
societal influences
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– These are sometimes called biopsychosocial theories
Integration of the Models
• Some biopsychosocial theorists favor a
diathesis-stress approach
– Integrative therapists are often called “eclectic” –
taking the strengths from each model and using them
in combination
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• Diathesis = predisposition (bio, psycho, or social)