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

8. Slide 8

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

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. Assessing the Psychodynamic Model
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)

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 ConditioningUS
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. Assessing the Behavioral Model
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

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. Assessing the Cognitive Model
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

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 provides unconditional 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. Assessing the Humanistic-Existential Model
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

51. The Sociocultural Model
Argues that abnormal behavior is best understood in light of the social and cultural forces that influence an individual
Addresses norms and roles in society
Influenced by sociology and anthropology
Argues that we must examine a person’s social surroundings to understand their (abnormal) behavior

52. How Do Sociocultural Theorists Explain Abnormal Functioning?
Focus on:
Family structure and communication
Family systems theory = abnormal functioning within family leads to abnormal behavior (insane behavior becomes sane in an insane environment)
Examples: enmeshed, disengaged structures
Role of culture
Role of social networks/support

53. How Do Sociocultural Theorists Explain Abnormal Functioning?
Focus on:
Societal conditions
Abnormality more common in lower classes. Why?
Societal labels & roles
Diagnostic labels (example: Rosenhan study)
Sick role

54. Sociocultural Treatments
May include traditional individual therapy
Broadened therapy to include:
Culturally-sensitive therapy
Group therapy
Family therapy
Couples therapy
Community treatment
Includes prevention work

55. Assessing the Sociocultural Model
Strengths:
Added greatly to the clinical understanding of abnormality
Increased awareness of labeling
Clinically successful when other treatments have failed
Weaknesses:
Research is difficult to interpret
Correlation  causation
Model unable to predict abnormality in specific individuals

57. Integration of the Models
Each perspective is valuable to understanding abnormal behavior
Different perspectives are more appropriate under differing conditions
An integrative approach provides a general framework for thinking about abnormal behavior while also allowing for specification of the factors that are especially pertinent to particular disorders

58. Integration of the Models
Many theorists, clinicians, and practitioners adhere to a biopsychosocial model
Abnormality results from the interaction of genetic, biological, developmental, emotional, behavioral, cognitive, social, and societal influences
Also popular:
Diathesis-stress approach
Diathesis = predisposition (bio, psycho, or social)
Reciprocal effects explanation

59. Integration of the Models
Integrative therapists are often called “eclectic” – taking the strengths from each model and using them in combination