Models of Abnormality Chapter 3

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

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

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

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

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)

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

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

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

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

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

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

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

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

Biological Treatments Biological practitioners attempt to pinpoint the physical source of dysfunction to determine the course of treatment Three types of biological treatment: __________

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

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

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

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

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)

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

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.

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

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

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

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

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

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

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

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)

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

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

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

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)

Classical Conditioning __ Meat __ Salivate __ Meat __ Salivate + Tone __ Tone __ Salivate

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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?

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

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

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

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

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

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?

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

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

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

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

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

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