1. Models of Abnormality
Chapter 3

2. Models of Abnormality
In science, the perspectives used to explain events are known as _________ or paradigms
Each model spells out basic assumptions, gives order to the field under study, and sets guidelines for investigation
Models influence what investigators observe, the questions they ask, the information they seek, and how they interpret this information

3. Models of Abnormality
Until recently, clinical scientists of a given place and time tended to agree on a single model of abnormality – a model greatly influenced by the beliefs of their culture
Today several models are used to explain and treat abnormal functioning
Sometimes in conflict, each model focuses on one aspect of human functioning and no single model can explain all aspects of abnormality

4. The Biological Model Adopts a medical perspective
Main focus is that psychological abnormality is an illness brought about by malfunctioning parts of the organism
Typically point to problems in brain anatomy or brain chemistry

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 discovered connections between certain psychological disorders and problems in specific brain areas
Example: Huntington's disease and basal ganglia (forebrain)

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

8. How Do Biological Theorists Explain Abnormal Behavior?
Brain chemistry
Neurons do not actually touch each other; they are separated by a space (the synapse), across which a message moves
When an electrical impulse reaches a nerve ending, the ending is stimulated to release a chemical, called a neurotransmitter (NT), that travels across the synaptic space to receptors on the dendrites of neighboring neurons
Some NTs tell receiving neurons to “fire;” other NTs tell receiving neurons to stop firing

9. How Do Biological Theorists Explain Abnormal Behavior?
Brain chemistry and 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
For example: depression has been linked to low activity in serotonin and norepinephrine

10. How Do Biological Theorists Explain Abnormal Behavior?
Brain chemistry and abnormal behavior
Additionally, researchers have learned that mental disorders are sometimes related to abnormal chemical activity in the endocrine system
Endocrine glands release hormones which propel body organs into action
Abnormal secretions have been linked to psychological disorders
Example: Cortisol release is related to anxiety and mood disorders

11. Sources of Biological Abnormalities – Genetics
Abnormalities in brain anatomy or chemistry are sometimes the result of genetic inheritance
Each cell in the human body contains 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, and other mental disorders
Appears that in most cases several genes combine to produce our actions and reactions

12. Sources of Biological Abnormalities – Genetics
Genes that contribute to mental disorders are viewed as unfortunate occurrences:
May be mutations
May be inherited after a mutation in the family line
May be the result of normal evolutionary principles

13. Sources of Biological Abnormalities – Evolution
Evolutionary theorists argue that human reactions and the genes responsible for them have survived over the course of time because they have helped individuals thrive and adapt
Example: The fear response
In today's world, however, those genes and reactions may not be so adapative
This model has been criticized and remains controversial, yet it receives considerable attention

14. Sources of Biological Abnormalities – Viral Infections
Another possible source of abnormal brain structure or biochemical dysfunction is viral infections
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:
__________

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

17. Biological Treatments
Electroconvulsive therapy (ECT):
Used primarily for depression, particularly when drugs and other therapies have failed
This treatment is used on tens of thousands of depressed persons annually

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

19. Assessing the Biological Model
Strengths:
Enjoys considerable respect in the field
Constantly produces valuable new information
Treatments bring great relief
Weaknesses:
Can limit, rather than enhance, our understanding
Too simplistic
Treatments produce significant undesirable (negative) effects

20. The Psychodynamic Model
Oldest and most famous psychological model
Based on belief that a person's behavior (whether normal or abnormal) is determined largely by underlying dynamic - that is, interacting - psychological forces of which she or he is not consciously 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 Functioning?
Shaped by three UNCONSCIOUS forces:
Id – guided by the Pleasure Principle
Instinctual needs, drives, and impulses
Sexual; fueled by libido (sexual energy)
Ego – guided by the Reality Principle
Seeks gratification, but guides us to know when we can and cannot express our wishes
Ego defense mechanisms protect us from anxiety

22. The Defense Never Rests: Defense Mechanisms to the Rescue
Operation
Example
Repression
Person avoids anxiety by simply not allowing painful or dangerous thoughts to become conscious.
An executive’s desire to run amok and attack his boss and colleagues at a board meeting is denied access to his awareness.
Denial
Person simply refuses to acknowledge the existence of an external source of anxiety.
You are not prepared for tomorrow’s final exam, but you tell yourself that it’s not actually an important exam and that there’s no good reason not to go to a movie tonight.
Projection
Person attributes own unacceptable impulses, motives, or desires to other individuals.
The executive who repressed his destructive desires may project his anger onto his boss and claim that it is actually
the boss who is hostile.
Rationalization
Person creates a socially acceptable reason for an action that actually reflects unacceptable motives.
A student explains away poor grades by citing the importance of the “total experience” of going to college and claiming that too much emphasis on grades would actually interfere with a well-rounded education.
Displacement
Person displaces hostility away from a dangerous object and onto a safer substitute.
After a perfect parking spot is taken by a person who cuts in front of your car, you release your pent-up anger by starting an argument with your roommate.
Intellectualization
Person represses emotional reactions in favor of overly logical response to a problem.
A woman who has been beaten and raped gives a detached, methodical description of the effects that such attacks may have on victims.
Regression
Person retreats from an upsetting conflict to an early developmental stage at which no one is expected to behave maturely or responsibly.
A boy who cannot cope with the anger he feels toward his rejecting mother regresses to infantile behavior, soiling his clothes and no longer taking care of his basic needs.

23. How Did Freud Explain Normal and Abnormal Functioning?
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 some degree of conflict
A healthy personality is one in which an effective working relationship exists among the three forces
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 Functioning?
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 Functioning?
Developmental stages
_________ (0 to 18 months of age)
_________ (18 months to 3 years of age)
_________ (3 to 5 years of age)
_________ (5 to 12 years of age)
_________ (12 years of age to adulthood

26. How Do Other Psychodynamic Explanations Differ from Freud's?
Although new theories depart from Freud's ideas in important ways, each retains the belief that human functioning is shaped by dynamic (interacting) forces:
Ego theorists
Emphasize the role of the ego; consider it independent and powerful
Self theorists
Emphasize the unified personality
Object-relations theorists
Emphasize the human need for relationships, especially between children and caregivers

27. Psychodynamic Therapies
Range from Freudian psychoanalysis to modern therapies
All seek to uncover past trauma and inner conflicts
Therapist acts as a “subtle guide”

28. Psychodynamic Therapies
Utilize various techniques:
Free association
Therapist interpretation
Resistance
Transference
Dream interpretation
Catharsis
Working through

29. Psychodynamic Therapies
Contemporary trends:
Short-term psychodynamic therapies
Relational psychoanalytic therapy

30. Assessing the Psychodynamic Model
Strengths:
First to recognize importance of psychological theories and treatment
Saw abnormal functioning as rooted in the same processes as normal functioning
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 psychodynamic theorists, behavioral theorists believe that our actions are determined largely by our experiences in life
Concentrates wholly on behaviors and environmental factors
Bases explanations and treatments on principles of learning

32. The Behavioral Model
The model began in laboratories where conditioning studies were conducted
Several forms of conditioning:
Operant conditioning
Modeling
Classical conditioning
All may produce normal or abnormal behavior

33. How Do Behaviorists Explain Abnormal Functioning?
Operant conditioning
Humans and animals learn to behave in certain ways as a result of receiving rewards whenever they do so
Modeling
Individuals learn responses by observing and repeating behavior

34. 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 and meat powder
Explains many familiar behaviors (both normal and abnormal)

35. Classical Conditioning__
Meat __
Salivate __
Meat __
Salivate +
Tone __
Tone __
Salivate

36. Behavioral Therapies
Aim 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

37. 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
Construct a fear hierarchy
Confront feared situations

38. Assessing the Behavioral Model
Strengths:
Powerful force in the field
Can be tested in the laboratory
Significant research support for behavioral therapies
Weaknesses:
No evidence that symptoms are ordinarily acquired through conditioning
Behavior therapy is limited
Too simplistic
New focus on self-efficacy, social cognition, and cognitive-behavioral theories

39. The Cognitive Model
This model proposes that we can best understand abnormal functioning by looking at cognitive processes – the center of behaviors, thoughts, and emotions
Argues that clinicians must ask questions about assumptions, attitudes, and thoughts of a client

40. How Do Cognitive Theorists Explain Abnormal Functioning?
Abnormal functioning can result from several kinds of cognitive problems:
Faulty assumptions and attitudes
Illogical thinking processes
Example: overgeneralization

41. Cognitive Therapies
People can overcome their problems by developing new ways of thinking
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 their dysfunctional thoughts, try out new interpretations, and apply new ways of thinking in their daily lives
Widely used in treating depression

42. Assessing the Cognitive Model
Strengths:
Very broad appeal
Clinically useful and effective
Focuses on a uniquely human process
Theories lend themselves to research
Therapies effective in treating several disorders
Weaknesses:
Precise role of cognition in abnormality has yet to be determined
Therapies do not help everyone
Some changes may not be possible to achieve
In response, a new wave of therapies has emerged, including Acceptance and Commitment Therapy and mindfulness-based techniques

43. Cybertherapy: Surfing for help
Cybertherapy has come to complement or even replace face-to-face therapy
Computer software therapy
therapy
Visual e-therapy
Virtual support groups

44. The Humanistic-Existential Model
Combination model
The humanist view
Emphasis on people as friendly, cooperative, and constructive; focus on drive to self-actualize through honest recognition of strengths and weaknesses
The existentialist view
Emphasis on self-determination, choice, and individual responsibility; focus on authenticity

45. Rogers' Humanistic Theory and Therapy
Believes in the 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 – do not know what they really need, etc.
Rogers' “client-centered” therapy
Therapist creates a supportive climate
Unconditional positive regard
Accurate empathy
Genuineness
Little research support but positive impact on clinical practice

46. Gestalt Theory and Therapy
Humanistic approach
Developed by Fritz Perls
Goal is to guide clients toward self-recognition through challenge and frustration
Techniques:
Skillful frustration
Role playing
Rules, including “Here and Now” and “I” language
Little research support

47. Spiritual Views and Interventions
For most of the twentieth century, clinical scientists viewed religion as a negative—or at best neutral—factor in mental health
This historical alienation between the clinical field and religion seems to be ending
Researchers have learned that spirituality can, in fact, be of psychological benefit to people

48. Existential Theories and Therapy
Belief that 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
In therapy, people are encouraged to accept personal responsibility for their problems
Goals more important than technique
Great emphasis placed on client-therapist relationship

49. Existential Theories and Therapy
Existential therapists do not believe that experimental methods can adequately test the effectiveness of their treatments; as a result, little controlled research has been conducted

50. Saving Minds Along with Souls
Initiatives to involve churches and religious organizations in the care of serious mental illnesses
Might there be serious drawbacks to placing care in the hands of religious persons, even if they receive lay training?

51. Assessing the Humanistic-Existential Model
Strengths:
Taps into domains missing from other theories
Emphasizes the individual
Optimistic
Emphasizes health
Weaknesses:
Focuses on abstract issues
Difficult to research
Weakened by disapproval of scientific approach
Changing somewhat

52. The Sociocultural Models
Argue that abnormal behavior is best understood in light of the social and cultural forces that influence an individual
Address norms and roles in society
Comprised of two major perspectives:
Family-Social perspective
Multicultural perspective

53. How Do Family-Social Theorists Explain Abnormal Functioning?
Proponents of this model argue that theorists should concentrate on forces that operate directly on an individual, including:
Social labels and roles
Diagnostic labels (example: Rosenhan study)
Social connections and supports

54. How Do Family-Social Theorists Explain Abnormal Functioning?
Focus on:
Family structure and communication
Family systems theory argues that abnormal functioning within a family leads to abnormal behavior (insane behavior becomes sane in an insane environment)
Examples: enmeshed, disengaged structures

55. Family-Social Treatments
This perspective has helped spur the growth of several treatment approaches, including:
Group therapy
Family therapy
Couple therapy
Community treatment
Includes prevention work

56. Have Your Avatar Call My Avatar
Avatar therapy – relatively new form of cybertherapy where clients use three-dimensional graphical representations to interact in a virtual world
Clients know they are entering a make-believe world when they receive avatar therapy, so why do so many apparently make real-life progress?

57. How Do Multicultural Theorists Explain Abnormal Functioning?
Culture refers to the set of values, attitudes, beliefs, history, and behaviors shared by a group of people and communicated from one generation to the next
The multicultural, or culturally diverse, perspective has emerged as a growing field of study
Multicultural psychologists seek to understand how culture, race, ethnicity, gender, and similar factors affect behavior and thought, as well as how people of different cultures, races, and genders differ psychologically

58. How Do Multicultural Theorists Explain Abnormal Functioning?
The model holds that an individual's behavior is best understood when examined in the light of that individual's unique cultural context
They also have noticed that the prejudice and discrimination faced by many minority groups may contribute to certain forms of abnormal functioning

59. Multicultural Treatments
Studies have found that members of ethnic and racial minority groups tend to show less improvement in clinical treatment than members of majority groups
Two features of treatment can increase a therapist's effectiveness with minority clients:
Greater sensitivity to cultural issues
Inclusion of cultural models in treatment, especially in therapies for children and adolescents
Given such findings, some clinicians have developed culture-sensitive therapies as well as gender-sensitive, or feminist, therapies

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

61. Integration of the Models
A growing number of clinicians favor explanations of abnormal behavior that consider more than one cause at a time
These are sometimes called biopsychosocial theories
Abnormality results from the interaction of genetic, biological, developmental, emotional, behavioral, cognitive, social, and societal influences

62. Integration of the Models
Some biopsychosocial theorists favor a diathesis-stress approach
Diathesis = predisposition (bio, psycho, or social)
Integrative therapists are often called “eclectic” – taking the strengths from each model and using them in combination