Psychological Models II PSYC 4500: Introduction to Clinical Psychology Brett Deacon, Ph.D. September 10, 2008

1. Psychological Models II PSYC 4500: Introduction to Clinical PsychologyBrett Deacon, Ph.D.September 10, 2008

2. Announcements • Sona pretest is open • Next response paper is due on Tuesday • NO CLASS next Thursday • Exam #1 is a week from next Thursday (9/24) • Thoughts on response papers

3. Questions for France et al. (2007) article; Response paper due Tuesday 9/15 • 1. The United States is one of 2 countries in the world to allow direct-to-consumer marketing of prescription drugs. How do you think this practice affects the beliefs and behaviors of persons living in the United States? • 2. Look at the percentage of participants who endorsed “agree” or “undecided” to questions 3, 4, and 5 in Table 4 on page 417. Why do you suppose so many people endorsed these questions? • 3. Describe two ways in which depressed clients who believe they suffer from a chemical imbalance might pose a challenge for providers of psychotherapy.

4. The Behavioral Model • Arose in reaction to psychoanalytic model • Disagreement with the “deeper meaning” of symptoms • Rejection of immeasurable concepts as speculative and nonscientific • Emphasis on experimentally demonstrable principles of conditioning and learning

5. Classical Conditioning • First demonstrated by Ivan Pavlov (1927) • Process by which a neutral stimulus acquires the power to elicit a response by being repeatedly paired with an unconditioned stimulus

6. Classical Conditioning How classically conditioned responses are acquired: • An unconditioned stimulus (meat) automatically elicits an unconditioned response (salivation) • A neutral stimulus (bell) is repeatedly paired with the unconditioned stimulus (meat) • Eventually, the neutral stimulus (bell) becomes a conditioned stimulus that has the power to elicit the response (now called a conditioned response)

7. Classical Conditioning • Unconditioned stimulus = meat • Unconditioned response = salivation to meat • Conditioned stimulus = bell • Conditioned response = salivation to bell Pavlov showed that just about any stimulus could evoke salivation in dogs if it was repeatedly paired with the presentation of food.

8. Classical Conditioning • Everyday examples of classical conditioning: • Opening food container for your pet • Many product advertisements • http://www.youtube.com/watch?v=7Sz56mtQB1M • http://www.youtube.com/watch?v=lSmNTqZ3wV4 • Feeling afraid when watching “Jaws” • http://www.usu.edu/psycho101/lectures/chp4learning/jaws.wav

9. Classical Conditioning • One-trial learning • Taste aversions • Stimulus generalization • Example of Jenny, who almost choked and subsequently came to fear shortness of breath, tightness in throat, exercise, spicy foods, and sex

10. Classical Conditioning • How are conditioned responses extinguished? • Repeatedly presenting the CS in the absence of the UCS • Taste aversions (food without illness-causing bacteria) • Invisible fence for dogs (boundary without shock)

11. Classical Conditioning • Exposure therapy: Habituation in anxiety upon prolonged exposure to fear cues

12. Classical Conditioning – Clinical Applications While sitting in the passenger seat, Patti gets in an argument with her boyfriend and gestures toward him in anger. He loses control of the car on the highway, spins off the highway and almost runs into a bridge. He immediately accuses her of being crazy and trying to kill them both. Patti feels terrified and ashamed. She subsequently experiences high anxiety, intrusive recollections of the event, and occasional flashbacks when driving. She avoids driving whenever possible, particularly driving on highways, near bridges, and especially near the scene of the car accident. She avoids watching TV shows with car chases. She seeks therapy when her anxiety persists for weeks and starts to affect her quality of life.

13. Classical Conditioning – Clinical Applications • In Patti’s example, identify the: • Unconditioned stimulus • Unconditioned response • Conditioned stimulus • Conditioned response • Examples of stimulus generalization

14. Classical Conditioning – Clinical Applications • How would you help Patti extinguish her conditioned fear?

15. Classical Conditioning – Clinical Applications Frank is obese. He often stops by McDonalds on his way to and from work for a large snack. At home, he eats in the living room in front of the TV, while watching TV in bed, while working in his garage, and while in the car. Any time he sits down to watch TV, works in his garage, or drives, he becomes hungry. To manage his hunger he has stashes of snack foods in each of these places.

16. Classical Conditioning – Clinical Applications • In Frank’s case, identify the: • Unconditioned stimulus • Unconditioned response • Conditioned stimulus • Conditioned response

17. Classical Conditioning – Clinical Applications How would you help Frank extinguish his conditioned hunger?

18. Operant Conditioning • Behavior is modified by its consequences • Pleasurable consequences strengthen behavior • Positive reinforcement • Negative reinforcement • Aversive consequences weaken behavior • Positive punishment • Negative punishment

19. Operant Conditioning – Clinical Applications • Everyday examples of operant conditioning: • A child learning to be potty trained by receiving M&M’s as rewards • Using an umbrella to avoid being wet • Revoking a child’s TV privileges for misbehaving • Spanking a child for misbehaving

20. Operant Conditioning – Clinical Applications Howard has an anger problem and often loses his temper with his wife. He yells and threatens her if she doesn’t do exactly what he wants. After each explosive episode, Howard’s wife succumbs and he gets his way.

21. Operant Conditioning – Clinical Applications • What operant conditioning process is maintaining Howard’s angry behavior? • What operant conditioning process is maintaining his wife’s submissive behavior? • How could you use operant conditioning to help Howard reduce his angry behavior?

22. Operant Conditioning – Clinical Applications Irene is a recovering heroin addict with mild mental retardation. On the inpatient substance abuse unit, she often engages in a form of self-injurious behavior in which she stares at a staff member, smiles, strikes her ears with her hands, and repeats the word “no” while shaking her head. Staff members typically respond by approaching her, gently grabbing her hands, and reminding her that such behavior is not acceptable. The persistent nature of this behavior is a serious concern among staff members who don’t want Irene to hurt herself but are also concerned that she is manipulating them.

23. Operant Conditioning – Clinical Applications • What operant conditioning process is maintaining Irene’s self-injurious behavior? • What operant conditioning process is maintaining the staff’s response to Irene’s self-injurious behavior? • How could you use operant conditioning to change Irene’s behavior?

24. Operant and Classical Conditioning Can Work Together A friend sent Ken pornographic pictures over the internet. Looking at the pictures made Ken sexually aroused and Ken masturbated to orgasm while looking at them and sitting in front of the computer. The next day, Ken found himself sexually aroused and he went to his computer, opened the pornographic images, and again masturbated. This happened several times over the course of a few days. Now, Ken is worried that he can’t stop thinking about sex since every time he sits down at his computer to try to work, he notices himself becoming sexually aroused, and he ends up looking at the sexual images and masturbating.

25. Operant and Classical Conditioning Can Work Together • How is classical conditioning contributing to Ken’s sexual arousal? • How is operant conditioning contributing to Ken’s sexual behavior?

26. Operant and Classical Conditioning Can Work Together While traveling in a military convoy, Jon witnessed a truck roll off the road to the right and injure the soldiers inside. He later became afraid of driving his car off the right side of the road. Jon began experiencing intrusive, unwanted, highly distressing urges to jerk the steering wheel to the right while driving. Afraid he might act on the urges, he began to avoid driving in places where he felt especially likely to drive his car off the road. To reduce the intense anxiety he feels when driving, Jon developed an array of strategies to prevent himself from driving off the road, including driving slowly, driving only in the left lane, gripping the steering wheel only with his left hand, distracting himself, reassuring himself that he would stay on the road, praying, and attempting to suppress his unwanted urges. He sought psychotherapy after he became unable to drive to his graduate school classes.

27. Operant and Classical Conditioning Can Work Together • How is classical conditioning contributing to Jon’s fear of driving? • How is operant conditioning contributing to Jon’s fear of driving?

28. Classical and Operant Conditioning • Classical conditioning may cause psychological problems (e.g., phobias, PTSD) to develop • Problems disappear as a result of extinction • Operant conditioning can prevent extinction via negative reinforcement which prevents exposure to the CS, which is necessary to learn that CS is no longer associated with the UCS

29. Operant Conditioning – Clinical Applications Jenny was a shy child with poor social skills. She was teased and taunted by her classmates throughout elementary and secondary school. She tries to avoid interpersonal contact whenever possible, and when she cannot she avoids eye contact and tries to be “invisible.” She worries that other people will be critical of her social skills and that she will behave in a socially inept fashion. She is particularly self-conscious about her propensity to sweat when anxious and has had several surgical procedures to reduce sweating in her armpits. She manages to function well in college and gets into medical school. Unfortunately, her first year class is very small and she finds she cannot be “invisible” in this new setting. Her social anxiety increases to the point where she can no longer attend her classes. She goes on medical leave and is referred for treatment.

30. Clinical Applications • What learning process caused Jenny’s social anxiety to develop? • What conditioning process is maintaining Jenny’s social anxiety?

31. Cognition • But what about cognition? Do Jenny’s thoughts and beliefs play a role in the problem? • Did she experience any cognitive changes (e.g., expectancies, beliefs) when her fear of negative evaluation by others was acquired? • How might Jenny’s social avoidance, avoidance of eye contact, attempts to appear invisible, and armpit surgeries actually be maintaining her negative beliefs about other people?

32. Problems with “Pure” Behavioral Models • Difficulty explaining fears that arise in the absence of conditioning • Difficulty explaining why aversive conditioning doesn’t invariably produce fear • Difficulty explaining why irrational fears persist when they never come to pass • Insufficient attention to the cognitive aspects of learning