Models of Abnormality
perspectives used to explain events
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
Past 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 on by malfunctioning parts of the organism
Typically points to problems in anatomy or brain chemistry
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
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 adaptive
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:
Drug therapy
Electroconvulsive therapy (ECT)
Psychosurgery
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
Strengths of Biological Model
Enjoys considerable respect in the field
Constantly produces valuable new information
Treatments bring great relief
Weaknesses of Biological Model
Can limit, rather than enhance, our understanding
Too simplistic
Treatments produce significant undesirable (negative) effects
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
Ego
Superego
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
Superego
guided by the Morality Principle
Conscience; unconsciously adopted from our parents
Defense Mechanisms
Repression, Denial, Projection, Rationalization, Displacement, Intellectualization, Regression
Repression
Person avoids anxiety by simply not allowing painful or dangerous thoughts to become conscious.
Example:
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.
Example:
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.
Example:
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.
Example:
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.
Example:
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.
Example:
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.
Example:
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.
Freud's 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
Sensory Exploration
Oral
0 to 18 months
Potty Training
Anal
18 months to 3 years
Gender Identity
Phallic
3 to 5 years
No big conflicts
Latency
5 to 12 years
Sexual Identity
Genital
12 years to adulthood
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"
Free association
the therapist tells the patient to describe any thought, feeling, or image that comes to mind, even if it seems unimportant. the therapist expects that the patient's associations will eventually uncover unconscious events
Resistance
an unconscious refusal to participate fully in therapy
when they suddenly cannot free associate or when they change the subject to avoid a painful discussion
Transference
when patients act and feel towards the therapist as they did or do toward an important person in their life
dream interpretation
repression and other defense mechanisms operate less completely during sleep, and dreams, if correctly interpreted, can reveal unconscious instincts, needs, and wishes
Catharsis
reliving of past repressed feelings
Strengths of Psychodynamic Model
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
Psychodynamic Model 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
Types of Conditioning
Operant conditioning
Modeling
Classical conditioning
All may produce normal or abnormal behavior
Operant condition
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
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)
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
Using classical conditioning treatments to change abnormalities
Example: systematic desensitization for phobia
Step-by-step procedure
Learn relaxation skills
Construct a fear hierarchy
Confront feared situations
Systematic desensitization
a behavioral treatment in which clients with phobias learn to react calmly instead of with intense fear to the objects or situations they dread
Strengths of the Behavioral Model
Powerful force in the field
Can be tested in the laboratory
Significant research support for behavioral therapies
Weaknesses of the Behavioral Model
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
self-efficacy
the belief that one can master and perform needed behaviors whenever necessary
cognitive-behavioral therapies
therapy approaches that seek to help clients change both counterproductive behaviors and dysfunctional ways of thinking
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?
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
Beck's Cognitive Theory
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
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
Cognitive Model 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
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
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
therapy that encourages clients to accept responsibility for their lives and to live with greater meaning and value
In therapy, people are encouraged to accept personal responsibility for their problems
Goals more important than technique
Great emphasis placed on client-therapist relationship
Humanistic-Existential Model Strengths
Taps into domains missing from other theories
Emphasizes the individual
Optimistic
Emphasizes health
Humanistic-Existential Model 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
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
family systems theory
a theory that views the family as a system of interacting parts whose interactions exhibit consistent patterns and unstated rules
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
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
Sociocultural Model 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
Sociocultural Model Weaknesses
Research is difficult to interpret
Correlation does not equal causation
Model unable to predict abnormality in specific individuals
biopsychosocial theories
explanations that attribute the cause of abnormality to an interaction of genetic, biological, developmental, emotional, behavioral, cognitive, social, and societal influences.
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
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
Diathesis
predispositions (bio, psycho, or social)
The discovery of psychotropic medications in the _____ helped to advance the fields of psychiatry and psychology.
1950s
What is an anxiolytic?
an antianxiety drug
This is the oldest and most famous of the modern psychological models.
psychodynamic
Which model calls the consumer a "patient" and the therapist an "interpreter"?
psychodynamic
Which model calls the consumer a "client" and the therapist a "collaborator"?
existential