DB3 – Chapter 2

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We will explore psychological perspectives (also known as theories or paradigms).

Be sure to review the textbook, readings and activities in the Module.

Then choose the one perspective/theory/paradigm which you think best explains abnormal behavior in TODAY’S world. You must choose one. Justify your choice. Give an example of how this perspective would explain behavior.

Models of Abnormality

Chapter 2

Fundamentals of Abnormal Psychology

RONALD J. COMER | JONATHAN S. COMER| ninth edition

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Models of Abnormality

Models or paradigms used by scientists and clinicians to treat abnormality

Explain events and basic assumptions

Guide treatment techniques and principles

Involve several models to explain abnormality

Models influence what investigators observe, the questions they ask, the information they seek, and how they interpret this information.

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

Has biological basis and medical perspective

Considers illness to be brought about by malfunctioning parts of the organism

Points to problems in brain anatomy or brain chemistry

Full understanding of thoughts, emotions, and behavior must include understanding of their biological basis.

How Do Biological Theorists Explain Abnormal Behavior? (part 1)

Brain anatomy

Neurons and glia cells

Brain structures

Cerebrum (cortex, corpus callosum, basal ganglia, hippocampus, amygdala)

Connections found among some psychological disorders and specific brains structures

Some psychological disorders can be traced to abnormal functioning of neurons in the cerebrum, which includes brain structures such as the cerebral cortex, corpus callosum, basal ganglia, hippocampus, and amygdala.

How Do Biological Theorists Explain Abnormal Behavior? (part 2)

Brain chemistry

Neuron-to-neuron transmission

Dendrites

Axons

Nerve endings

Synapses

Neurotransmitters

Receptors

A message in the form of an electrical impulse travels down the sending neuron’s axon to its nerve ending, where neurotransmitters are released and carry the message across the synaptic space to the dendrites of a receiving neuron.

How Do Biological Theorists Explain Abnormal Behavior? (part 3)

More about neurotransmitters (NTs)

Dozens of identified NTs in brain

Abnormal activity in certain NTs can lead to specific mental disorders

Chemical activity

Abnormal activity in endocrine system (hormones) is also related to mental disorders

Abnormal secretion of the hormone cortisol is linked to anxiety and mood disorders

Sources of Biological Abnormalities: Genetics (part 1)

Abnormalities in brain anatomy or chemistry are sometimes the result of genetic inheritance

Studies suggest that inheritance plays a part in mood disorders, schizophrenia, and other mental disorders

In most cases, several genes combine to produce actions and reactions

Each cell in the human body contains 23 pairs of chromosomes, each with numerous genes that control the characteristics and traits a person inherits.

Sources of Biological Abnormalities: Genetics (part 2)

Genes that contribute to mental disorders may be viewed as mistakes of inheritance

Mutations

Inherited after a mutation in the family line

Result of normal evolutionary principles

Evolutionary theorists suggest:

Genes contribute to adaption and survival

Contemporary pressures may cause this genetic inheritance to be less adaptive and leave some people prone to abnormal psychological patterns

Biological Treatments (part 1)

Biological practitioners attempt to identify the physical source of dysfunction to determine the course of treatment

Three leading biological treatments today

Drug therapy

Brain stimulation

Psychosurgery

Biological Treatments (part 2)

Drug therapy

1950s: Advent of psychotropic medications

Four major drug groups used in therapy

Antianxiety drugs (anxiolytics; minor tranquilizers)

Antidepressant drugs

Antibipolar drugs (mood stabilizers)

Antipsychotic drugs

Trending: TV Drug Ads Come Under Attack

Direct-to-consumer (DTC) drug advertisement

Appeals directly to the consumer; seen by 80 percent of Americans

Has information about psychotropic drugs 50 percent of the time

Allowed only in the United States and New Zealand

Contributions

Patient education about available drugs

Increased involvement of patients in their own care

Drawbacks

Higher drug costs related to advertising expenses

Patient misinformation

Pressure on doctors to prescribe inappropriate DTC-advertised drugs

Biological Treatments (part 3)

Brain stimulation

Direct or indirect brain stimulation

Approaches

Electroconvulsive therapy (ECT)

Transcranial magnetic stimulation (TMS)

Vagus nerve stimulation (VNS)

Deep brain stimulation

Psychosurgery (or neurosurgery)

Brain surgery for mental disorders

Assessing the Biological Model

Strengths

Enjoys considerable respect in the field

Constantly produces valuable new information

Treatments bring great relief

Weaknesses

Limits understanding of abnormal function by excluding nonbiological factors

May produce significant undesirable effects

The Psychodynamic Model

Freud (1856–1939) developed theory of psychoanalysis

Proposed person’s behavior determined largely by underlying unconscious, dynamic, psychological forces

Suggested abnormal symptoms are the result of conflict among these forces

Oldest and most famous psychological model

Sigmund Freud, founder of psychoanalytic theory and therapy, contemplates a sculptured bust of himself in 1931 at his village home in Potzlein, near Vienna. As Freud and the bust go eyeball to eyeball, one can only imagine what conclusions each is drawing about the other.

How Did Freud Explain Normal and Abnormal Functioning? (part 1)

Three unconscious forces shape personality: instinctual needs, rational thinking, and moral standards

Id: Pleasure principle

Ego: Reality principle

Superego: Morality principle

Conflicts

Some degree of conflict

Healthy personality = balance

Dysfunction = excessive conflict

The Defense Never Rests

Defense Mechanism	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 his or her 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 later.
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 in 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? (part 2)

Freud’s proposed developmental stages

New events and pressures require adjustment in the id, ego, and superego at each stage

If successful → personal growth

If unsuccessful → fixation at early developmental stage, leading to psychological abnormality

Because parents are the key figures in children’s early life, they are often seen as the cause of improper development.

How Do Other Psychodynamic Explanations Differ from Freud’s?

Despite differences, each theory posits human functioning is shaped by dynamic (interacting) forces

Self theorists

Emphasize the unified personality

Object-relations theorists

Emphasize the human need for relationships, especially between children and caregivers

Psychodynamic Therapies (part 1)

Seek to uncover past trauma and inner conflicts with the therapist acting as a guide

Free association

Therapist interpretation

Resistance

Transference

Dream interpretation

Catharsis

Working through

Psychodynamic Therapies (part 2)

Current trends

Short-term psychodynamic therapies

Relational psychoanalytic therapy

Assessing the Psychodynamic Model

Strengths

First to recognize the importance of psychological theories and systematic treatment for abnormality

Saw abnormal functioning nested in the same processes as normal functioning

Weaknesses

Unsupported ideas; difficult to research

Non-observable concepts

Inaccessible to human subjects (unconscious)

The Cognitive-Behavioral Model (part 1)

Focuses on maladaptive behaviors and/or cognitions in understanding and treating psychological abnormality

Shares key principles between behavioral and cognitive perspectives

Readily accessible, observable, reportable human functioning

Empirical studies conducted in laboratories or the field, rather than case studies

Action-oriented, instructional, present-focused, directive, and structured therapies

The Cognitive-Behavioral Model (part 2)

Behavioral dimension

Using conditioning

Classical conditioning

Modeling

Operant conditioning

Therapists, as teachers, seek to help replace problematic behaviors with more appropriate behaviors

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.

The Cognitive-Behavioral Model (part 3)

See and do: Modeling may account for some forms of abnormal behavior. A well-known study by Bandura and his colleagues (1963) demonstrated that children learned to abuse a doll by observing an adult hit it. Children who had not been exposed to the adult model did not mistreat the doll.

The Cognitive-Behavioral Model (part 4)

Cognitive dimension

Focuses on maladaptive thinking processes

Inaccurate/disturbing assumptions and attitudes

Illogical thinking

Therapists help clients recognize, challenge, and change problematic thinking

This model proposes that we can best understand abnormal functioning by looking at cognitive processes—the center of behaviors, thoughts, and emotions.

It argues that clinicians must ask questions about the assumptions, attitudes, and thoughts of a client.

The Cognitive-Behavioral Model (part 5)

Cognitive-behavioral interplay

Behavioral and cognitive components are interwoven in most contemporary theories and therapies

Example: Social anxiety disorder

Anxiety levels increase when clients enter social situations; avoidance and safety behaviors appear

Exposure therapy

Assessing the Cognitive-Behavioral Model (part 1)

Strengths

Powerful force in clinical field

Very broad appeal

Clinically useful

Focuses on a uniquely human process

Theories lend themselves to research

Therapies are effective in treating several disorders

In surveys, 22 percent of clinical psychologists labeled their approach as “eclectic,” 46 percent considered their model “cognitive” and/or “behavioral,” and 18 percent called their orientation “psychodynamic.” (Information from Prochaska & Norcross, 2013.)

Assessing the Cognitive-Behavioral Model (part 2)

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

A new wave of therapies has emerged

Acceptance and commitment therapy

Mindfulness-based techniques

The Humanistic-Existential Model (part 1)

Humanist view

Emphasis on people as friendly, cooperative, and constructive

Focus on drive to self-actualize through honest recognition of strengths and weaknesses

Existentialist view

Emphasis on accurate self-awareness and meaningful life (authentic)

Total freedom from birth can result in negative or positive behaviors/outcomes

Psychological dysfunction is caused by self-deception

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.

The Humanistic-Existential Model (part 2)

Rogers’ humanistic theory and therapy

Basic human need for unconditional positive regard

If received → unconditional self-regard

If not → conditions of worth

Rogers’ client-centered therapy

Therapist creates a supportive climate

Unconditional positive regard

Accurate empathy

Genuineness

Little research support but positive impact on clinical practice

The Humanistic-Existential Model (part 3)

Gestalt theory and therapy (Fritz Perls; 1950s)

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; subjective experiences and self-awareness cannot be objectively measured

The Humanistic-Existential Model (part 4)

Spiritual views and interventions

Historical alienation between the clinical field and religion seems to be ending

Researchers suggest spirituality can correlate with psychological health

Many clinicians now encourage use of spiritual resources to cope with stressors

For most of the twentieth century, clinical scientists viewed religion as a negative—or at best neutral—factor in mental health.

The Humanistic-Existential Model (part 5)

Existential theories and therapy

Psychological abnormality

Arises when client uses self-deception to hide from responsibilities

Clients feel overwhelmed by societal forces; quitting becomes habitual

Existential therapy

Clients are encouraged to accept responsibility for their lives and problems

Relationship between therapist and client includes shared learning and growth

Assessing the Humanistic-Existential Model

Strengths

Taps into domains missing from other models

Emphasizes the individual

Optimistic

Emphasizes health

Weaknesses

Focuses on abstract issues

Difficult to research

Weakened by disapproval of scientific approach; may be changing

The Sociocultural Model (part 1)

Abnormal behavior includes social and cultural forces that influence an individual

Address norms and roles in society

Includes two major perspectives

Family-social perspective

Multicultural perspective

The Sociocultural Model (part 2)

How do family-social theorists explain abnormal functioning?

Proponents argue that theorists should concentrate on forces that operate directly on an individual

Social labels and roles; diagnostic labels

Social connections and supports

Family structure and communication

Family systems theory

Enmeshed; disengaged structures

The Sociocultural Model (part 3)

Family-social treatments

Psychological problems emerge and are best treated in family and social settings

Perspective helped spur growth of several treatment approaches

Group therapy

Family therapy

Couple (marital) therapy

Community treatment

Psychodrama, developed by psychiatrist Jacob Moreno in 1921, is one of the oldest forms of group treatment. Its group members act out their emotions, past or present situations, social interactions, and the like—often in creative ways and sometimes on a stage. Although not as widely conducted as conventional group therapy, this format continues to have many proponents and is offered in many locations, such as this psychodrama group in Pignan, France.

Have Your Avatar Call My Avatar

Avatar therapy (virtual reality therapy)

Clients use three-dimensional graphical representations to interact in a virtual world of social situations

Treating phobias, traumatic memories, fears, and other disorders

Treating social anxiety, loneliness, and hallucinations

Clients know they are entering a make-believe world when they receive avatar therapy, so why do so many apparently make real-life progress?

Relatively new form of cybertherapy

How Do Multicultural Theorists Explain Abnormal Functioning?

Multicultural perspective

All behavior and treatment are best understood in the context of culture, cultural values, and external pressures in that context

Prejudice and discrimination may impact abnormal functioning

Treatment

Therapist effectiveness enhanced

Greater sensitivity to cultural issues

Inclusion of cultural morals and models

Culture-sensitive therapies, gender-sensitive therapies

Culture: The set of values, attitudes, beliefs, history, and behaviors shared by a group of people and communicated from one generation to the next.

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.

Assessing the Sociocultural Models

Strengths

Added to clinical understanding and treatment of abnormality

Increased awareness of clinical and social roles

Have been clinically successful when other treatments have failed

Weaknesses

Research is difficult to interpret

Models are unable to predict abnormality in specific individuals

Comparing the Models

	Biological	Psychodynamic	Cognitive- Behavioral	Humanistic	Existential	Family-Social	Multicultural
Cause of dysfunction	Biological malfunction	Underlying conflicts	Maladaptive thinking and learning	Self-deceit	Avoidance of responsibility	Family or social stress	External pressures or cultural conflicts
Research support	Strong	Modest	Strong	Weak	Weak	Moderate	Moderate
Consumer designation	Patient	Patient	Client	Patient or client	Patient or client	Client	Client
Therapist role	Doctor	Interpreter	Collaborator/ teacher	Observer	Collaborator	Family/social facilitator	Cultural advocate/teacher
Key therapy technique	Biological intervention	Free association and interpretation	Reasoning and conditioning	Reflection	Varied	Family/social intervention	Culture-sensitive intervention
Therapy goal	Biological repair	Broad psychological change	Functional thoughts and behaviors	Self-actualization	Authentic life	Effective family or social system	Cultural awareness and comfort

Integrating the Models: The Developmental Psychopathology Perspective

Many theorists suggest abnormal behavioral theories should include multiple causes at a time

Developmental psychopathology perspective

Uses an integrative framework to understand how variables and principles from the various models may collectively account for adaptive and maladaptive human functioning

Central perspective principles

Equifinality and multifinality

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