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Psychology 3318. Davison and Neale Chapter 2: Current Paradigms in Psychopathology and Therapy. Overview of Davison and Neale Paradigms. Biological (Medical, Disease) Psychoanalytic Humanistic/Existential Learning Cognitive. Biological Paradigm. Types of Disease: Infectious vs. Traumatic
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Psychology 3318 Davison and Neale Chapter 2: Current Paradigms in Psychopathology and Therapy
Overview of Davison and Neale Paradigms • Biological (Medical, Disease) • Psychoanalytic • Humanistic/Existential • Learning • Cognitive
Biological Paradigm • Types of Disease: Infectious vs. Traumatic • Basic Model • Predisposition (resistance) and exposure (germs, trauma, etc.) interact to produce disease • Disease causes symptoms and signs • Symptoms: what is reported • Signs: what is observable (more important)
Behavior Genetics • Key concepts: Genes, genotype, phenotype • Family method: index case (probands), • Twin method: monozygotic (MZ) vs. dizygotic (DZ) twins, concordance, • Adoptee method • Linkage analysis: looks for particular gene based upon genetic markers
Central Nervous System Biochemistry • Key concepts; Neurons, nerve impulses, synapse, neurotransmitters (see Figs. 2.1 and 2.2) • Some key neurotransmitters: • Norepinephrine (noradrenalin) • Gamma-aminobutyric acid (GABA) • Dopamine (schizophrenia?) • Serotonin (depression?) • Very important to drug therapy
Classical Freudian Concepts • Strongly Darwinian • Sex is a basic motive • Structures: Id (motives), ego (executive), superego (morality) • Levels of consciousness: Conscious, preconscious, unconscious • Principles: Pleasure vs. reality • Processes: Primary vs. secondary • Psychosexual stages: Polymorphous perverse, oral-passive, oral-biting, anal, phallic, latent, genital • Fixations and regressions • Oedipus (Electra) complex • Anxiety: Objective (realistic), neurotic, moral • Defense mechanisms: Repression, denial, projection, displacement, rationalization, reaction formation, sublimation (see Table 2.1)
Traditional Therapeutic Concepts • Free Association • Resistance • Dream analysis (latent vs. manifest content) • Transference and countertransference • Interpretation • Analyst sits in background; patient is prone
Newer Concepts • Ego analysis (many, including Freud): Ability of person to control environment • Brief therapy: Ferenczi; Alexander and French • Interpersonal therapy (Klerman and Weissman): concenrates on person’s current difficulties; active teaching
Evaluation • “Blame your parents” and rejection of responsibility • Child is “father” to the “man”. • Unconscious influences on behavior • Role of defense mechanisms • Causes of behavior may not be apparent
Humanistic/Existential: Rogers Client-Centered Therapy • Importance of phenomenology • Healthy people are aware of behavior • Healthy people are good • Healthy people are purposive and goal-directed • Importance of self-actualization • Therapeutic techniques • Reflection • Unconditional positive regard • Empathy: primary (understanding) vs. advanced (inferential)
Humanistic/Existential: Existential • Based (perhaps loosely) on philosophic movement • Stresses the present and responsibility for choice • Goal is to change behavior
Humanistic/Existential: Gestalt Therapy (Fritz Perls) • Existential in orientation • Techniques • I-language • Empty chair • Projection of feelings • Attending to nonverbal cues • Use of metaphor • (For comparison of the three approaches, see Table 2.3)
Learning Paradigms • Basic model: psychopathology is learned • Important early names • Pavlov • Watson • Thorndike • Major types of learning • Classical (Pavlovian) conditioning • Operant (instrumental) conditioning • Modeling (vicarious learning)
Pavlovian Concepts • Unconditioned stimulus: US or UCS • Conditioned stimulus: CS • Unconditioned response: UR or UCR • Conditioned response: CR • Many prefer “conditional” and “unconditional” to “conditioned” and “unconditioned” • Extinction
Operant Concepts • Law of effect • Discriminative stimulus • Positive and negative reinforcement • Shaping • Avoidance conditioning • Mediational vs. Skinnerian approaches • Skinner: There is no difference between disease and symptoms
Behavior Therapy and Modification • Use of behavioral techniques to modify pathological behavior • Behavior therapy is more mediational • Behavioral modification is more Skinnerian • Counterconditioning • Systematic desensitization • Flooding (implosion) • Aversive conditioning • Time-out • Token economy
Modeling • Role Playing • Rehearsal • Self-efficacy
Cognitive Paradigm • Although Skinner denied the importance of cognition (thought) many of his followers became cognitive. • Schema • Cognitive behavior therapy • Beck • Ellis and Rational-emotional Behavior Therpy (REBT) • Group therapies • Self-efficacy
General Considerations • See Table 2.4 for a comparison of psychoanalytic and cognitive-behavioral approaches. • Diathesis-stress is unifying concept • Importance of eclecticism: Good therapists are seen as more alike one another, despite paradigm, than bad ones