Chapter 3

1. Chapter 3 Models of Abnormality Slides & Handouts by Karen Clay Rhines, Ph.D. Seton Hall University

2. Models of Abnormality • What is a model or paradigm? • A set of assumptions and concepts that help us explain and interpret observations • A school of thought • Helpful because it spells out basic assumptions and sets guidelines for investigation • It influences what investigators observe, the questions they ask, the information they seek, and their interpretation of that information

3. Models of Abnormality • Historically, clinical scientists of a given time and place agreed on a single model of abnormality – a model strongly influenced by cultural beliefs • Currently, there are several competing models of abnormality • Why? Each model focuses on one aspect of human functioning and no single model can explain all aspects of abnormality

4. 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

5. How Do Biological Theorists Explain Abnormal Behavior? • Brain anatomy • 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

6. How Do Biological Theorists Explain Abnormal Behavior? • Brain anatomy and abnormal behavior • Clinical researchers have found connections between certain psychological disorders and problems in specific brain areas • Example: Huntington’s disease & basal ganglia (forebrain)

7. How Do Biological Theorists Explain Abnormal Behavior? • Brain chemistry • Information spreads throughout the brain in the form of electrical impulses that travel from one neuron to one or more others • An impulse is first received at a neuron’s dendrites, travels down the axon, and is transmitted to other neurons through the nerve endings

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9. How Do Biological Theorists Explain Abnormal Behavior? • Brain chemistry • Neurons don’t touch; they are separated by a space (the synapse), across which a message moves • When an electrical impulse reaches a nerve ending, the nerve ending is stimulated to release a chemical (a neurotransmitter or “NT”) • Some NTs tell receiving neurons to “fire”; other NTs tell receiving neurons to stop firing

10. How Do Biological Theorists Explain Abnormal Behavior? • Role of brain chemistry in abnormal behavior • 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)

11. How Do Biological Theorists Explain Abnormal Behavior? • Role of 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

12. How Do Biological Theorists Explain Abnormal Behavior? • 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

13. How Do Biological Theorists Explain Abnormal Behavior? • Biological abnormalities – evolution • Genes that contribute to mental disorders are viewed as unfortunate occurrences: • May be mutations • May be inherited after a mutation in the family line • Evolutionary theorists argue that we can best understand abnormality by examining the millions of years of human evolution • Looking at a combination of adaptive behaviors of the past, genes, and the interaction between genes and current environmental events • This model has been criticized and remains controversial

14. How Do Biological Theorists Explain Abnormal Behavior? • 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 • Example: anxiety and mood disorders

15. 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

16. Biological Treatments • Drug therapy: • 1950s = advent of psychotropic medications • Changed outlook for a number of mental disorders • Four groups of drugs: • Antianxiety drugs (anxiolytics; tranquilizers) • Antidepressant drugs • Antibipolar drugs (mood stabilizers) • Antipsychotic drugs

17. Biological Treatments • Electroconvulsive therapy (ECT): • Currently experiencing a revival • Used for severe depression when drugs and other therapies have failed • In 60% of cases, ECT can lift symptoms within a few weeks

18. Biological Treatments • Psychosurgery: • Historical roots in trephination • 1930s = first lobotomy • Much more precise than in the past • Considered experimental and used only in extreme cases

19. Weaknesses: Can limit rather than enhance our understanding Too simplistic Evidence is incomplete or inconclusive Treatments produce significant undesirable (negative) effects Strengths: Earns considerable respect in the field Fruitful Creates new therapies Suggests new avenues of research Assessing the Biological Model

20. The Psychodynamic Model • Oldest and most famous psychological model • Based on belief that a person’s behavior 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)

21. How Did Freud Explain Normal and Abnormal Behavior? • Caused by three UNCONSCIOUS forces: • Id – guided by the Pleasure Principle • Instinctual needs, drives, & impulses • Sexual; fueled by libido (sexual energy) • Ego – guided by the Reality Principle • Seeks gratification but guides us to know when we can & can’t get and express our wishes • Ego defense mechanisms protect us from anxiety

23. How Did Freud Explain Normal and Abnormal Behavior? • Caused by three UNCONSCIOUS forces: • Superego – guided by the Morality Principle • 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 between the parts • If the id, ego, and superego are in excessive conflict, the person’s behavior may show signs of dysfunction

24. How Did Freud Explain Normal and Abnormal Behavior? • 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

25. How Did Freud Explain Normal and Abnormal Behavior? • 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)

26. How Do Other Psychodynamic Explanations Differ from Freud’s? • Although current models deviate from Freud’s in fundamental ways, each retains the belief that human functioning is shaped by 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

27. 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”

28. Psychodynamic Therapies • Utilize various techniques: • Free association • Therapist interpretation • Resistance • Transference • Dream interpretation • Catharsis • Working through • Short-term dynamic therapies

29. Strengths: 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 Weaknesses: Unsupported ideas; difficult to research Non-observable Inaccessible to human subject (unconscious) Assessing the Psychodynamic Model

31. 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 • Emphasis is on observable behavior and environmental factors • Focus on how behavior is acquired (learned) and maintained over time

32. The Behavioral Model • Historical beginnings in laboratories where conditioning studies were conducted • Several forms of conditioning: • Operant conditioning • Modeling • Classical conditioning • May produce normal or abnormal behavior

33. 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

34. How Do Behaviorists Explain Abnormal Functioning? • Modeling • Individuals learn behavioral responses by observing and repeating behavior • No direct reinforcement

35. 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

36. Classical Conditioning US Meat UR Salivate US Meat Tone UR Salivate + CS Tone CR Salivate

37. 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)

38. 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

39. 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)

40. Strengths: Powerful force in the field Rooted in empiricism Phenomena can be observed and measured Significant research support for behavioral therapies Weaknesses: Too simplistic Unrealistic Downplays role of cognition New focus on self-efficacy, social cognition, and cognitive-behavioral theories Assessing the Behavioral Model

41. 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 • Concerned with internal processes • Present-focused

42. 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

43. 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 also 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

44. Strengths: 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 Weaknesses: Singular, narrow focus Overemphasis on the present Limited effectiveness Verification of cognition is difficult Precise role is hard to determine Assessing the Cognitive Model

45. 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

46. 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 providesunconditional positive regard • Both accurate & genuine in reflection (reflective listening) • Focus on the “experiencing person” • Little research support

47. Gestalt Theory and Therapy • Humanistic approach • Developed by Fritz Perls • Goal is to achieve self-recognition through challenge and frustration • Techniques: • Skillful frustration • Role playing • Rules, including “Here and Now” and “I” language

48. Spiritual Views and Interventions • For most of the twentieth century, clinical scientists viewed religion as a negative factor in mental health • This alienation now seems to be ending: • Numerous books have been published • Ethical codes now include religion under “diversity” • 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

49. Existential Theories and Therapy • 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 • 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

50. Strengths: Emphasizes the individual Taps into domains missing from other theories Non-deterministic Optimistic Emphasizes health Weaknesses: Focuses on abstract issues Not much influence Weakened by disapproval of scientific approach Changing somewhat Assessing the Humanistic-Existential Model