Theories and Treatment of Abnormality

1. Theories and Treatment of Abnormality Chapter 2

2. Diathesis-Stress Models

3. Biological Theories of Abnormality

4. Brain Dysfunction Abnormalities in the structure of the brain cause mental disorders Imbalances in the levels of neurotransmitters or hormones, or poor functioning of receptors cause mental disorders Biochemical Imbalances Disordered genes lead to mental disorders Genetic Abnormalities Biological Theories of Abnormality

5. Brain Dysfunction as the Cause of Abnormality • Can occur in three areas of the brain: • Cerebral cortex • Hypothalamus • Limbic system • Can result from injury, such as an automobile accident, and from diseases that cause deterioration

9. Biochemical Causes of Abnormality • The brain needs a number of chemicals to operate properly. • Neurotransmitters • Hormones • Neurotransmitters are biochemical “messengers.” • Reuptake occurs when the neurons that initially released the neurotransmitter into the synapse reabsorb the neurotransmitter. • Degradation occurs when the receiving neuron releases an enzyme into the synapse that breaks down the neurotransmitter into other biochemicals.

11. Endocrine System • Other biochemical theories focus on the body’s endocrine system • This system of glands produces chemicals called hormones • Released directly into the blood • Carries messages throughout the body, potentially affecting a person's moods, levels of energy, and reactions to stress • Hypothalamic-pituitary-adrenal axis (or HPA axis).

13. Genetic Factors in Abnormality • Behavioral Genetics is concerned with two questions • 1. To what extent are behaviors or behavioral tendencies inherited? • 2. What are the processes by which genes affect behavior?

15. Biological Therapies • Drug Therapies • Electroconvulsive Therapy and Newer Brain Stimulation Techniques • Psychosurgery

17. PSYCHOLOGICAL APPROACHES • Behavioral • Cognitive • Psychodynamic and humanistic • Family systems • Emotion-focused approaches

18. Behavioral Theories of Abnormality • Classical Conditioning • Operant Conditioning • Modeling and Observational Learning

19. Classical Conditioning

20. Behavioral Therapies • Focus on identifying the reinforcements and punishments contributing to a person’s maladaptive behaviors and on changing specific behaviors. • Foundation for behavioral therapy is the behavioral assessment of the client’s problem.

21. Specific techniques for behavior change

22. Cognitive Theories of Abnormality • Argue that it is not just rewards and punishments that motivate human behavior. Instead, our cognitions—thoughts or beliefs—shape our behaviors and the emotions we experience. • Types of cognition • Causal attributions • Global assumptions

23. Some Common Global Dysfunctional Assumptions Once something affects my life, it will affect it forever. It is better to avoid problems than to face them. I should be loved by everyone for everything I do. I should be terribly upset by certain situations. I must have perfect self control.

24. Cognitive Therapies • Help clients identify and challenge negative thoughts and dysfunctional belief systems. • Help clients learn more effective problem-solving techniques to deal with the concrete problems in their lives. • Designed to be short term • Often combined with behavioral techniques, known as cognitive-behavioral therapy

25. Psychodynamic Approaches • Suggest that all behavior, thoughts, and emotions, whether normal or abnormal, are influenced to a large extent by unconscious processes • Includes psychoanalysis and several newer approaches • Freud developed psychoanalysis • (1) a theory of personality and psychopathology • (2) a method of investigating the mind • (3) a form of treatment for psychopathology

26. Freud’s 3 Systems of the Human Psyche Pleasure principle, primary process (wish fulfillment) Id Ego Reality principle, secondary process thinking (rational deliberation) Superego Introject (internalize) social standards. Conscience and ego ideal

28. Defense Mechanisms

29. Psychosexual Stages

30. Newer Psychodynamic Theories: • Ego Psychology • Object Relations

31. Psychodynamic Therapies • Focus on uncovering and resolving unconscious processes that are thought to drive psychological symptoms. • Help clients recognize their maladaptive coping strategies and the sources of their unconscious conflicts. • Insights are thought to free clients from the grip of the past and give them a sense of agency in making changes in the present.

32. Interpersonal therapy (IPT) • Emerged out of modern psychodynamic theories • Shifted focus from the unconscious conflicts of the individual to the client’s pattern of relationships with important people in his or her life • Therapist is much more structuring and directive in the therapy, offering interpretations much earlier and focusing on how to change current relationships • Designed to be short-term

33. Humanistic Approaches • Based on the assumption that humans have an innate capacity for goodness and for living a full life • Pressure from society to conform to certain norms rather than to seek one’s most developed self interferes with the fulfillment of this capacity. • Underlying philosophy: Although humans may not be aware of the forces shaping their behavior, once people recognized these forces and became freer to direct their own lives, they would naturally make good choices and be happier.

34. Humanistic Therapy • Goal is to help clients discover their greatest potential through self-exploration • Therapist provides the optimal conditions for the client to heal him- or herself. • In Carl Rogers’s (1951) client-centered therapy, therapist • communicates a genuineness in his or her role as helper to the client, acting as an authentic person rather than an authority figure • shows unconditional positive regard for the client • communicates an empathic understanding of the client’s underlying feelings and search for self

35. Family Systems Theory • Views the family as a complex interpersonal system, with its own hierarchy and rules that govern family members’ behavior. • Can function well, promoting the well-being of its members, supporting their growth and accepting their change. • Or can be dysfunctional, creating and maintaining psychopathology in one or more members.

36. Views a family member’s psychological disorder as an indication of a dysfunctional family system. • The particular form that any individual’s psychopathology takes depends on the complex interactions among the family’s cohesiveness, adaptability to change, and communication style.

37. Family Systems Therapy • Based on the belief that an individual’s problems are always rooted in interpersonal systems, particularly in family systems. • An individual cannot be helped without treating the entire family system that created and is maintaining the individual’s problems. • In fact, the individual may not actually even have a problem but has become the “identified patient” in the family, carrying the responsibility or blame for the dysfunction of the family system

38. Emotion-Focused Approaches • Focus on people’s ability to understand and regulate their emotions • Often referred to as third-wave approaches, view poor regulation of emotions as at the core of many types of psychopathology • Incorporate techniques from behavioral and cognitive therapy with mindfulness practices derived from Zen Buddhism • Examples: Dialectical Behavior Therapy , Acceptance and Commitment Therapy

39. Sociocultural Approaches • We need to look beyond the individual or family to the larger society to understand people’s problems: • Socioeconomic disadvantage is a risk factor for a wide range of mental health problems • Upheaval and disintegration of societies due to war, famine, and natural disaster are potent risk factors for mental health problems • Social norms and policies that stigmatize and marginalize certain groups put these individuals at increased risk for mental health problems • Societies may influence the types of psychopathology their members show by having implicit or explicit rules about what types of abnormal behavior are acceptable

40. Prevention Programs • Primary Prevention: Stopping the development of disorders before they start • Secondary Prevention: Detecting a disorder at its earliest stages to prevent the development of the full-blown disorder • Tertiary Prevention: Preventing relapse and reducing the impact of the disorder on the person’s quality of life

41. COMMON ELEMENTS IN EFFECTIVE TREATMENTS • Have a positive relationship with the client • Provide clients with an explanation or interpretation of why they are suffering • Encourage clients to confront painful emotions and have techniques for helping them become less sensitive to these emotions