Riya Gehani CHAPTER 3: MODELS OF ABNORMALITY I. MODELS OF ABNORMALITY A. Models perspectives used to explain events, AKA paradigms 1. Previous models scientists of given place and time tended to agree on a single model of abnormality greatly influenced by beliefs ofIf you want to learn more check out umd bsci
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their culture. (single model, influenced by culture) 2. Current models each model focuses on one aspect of human functioning II. THE BIOLOGICAL MODEL  ADOPTS A MEDICAL PERSPECTIVE A. Definition sees physical processes as key to human behavior B. How do biological theorists explain abnormal behavior? Main focus is that psychological abnormalities are illnesses 1. The first area of examination is brain anatomy a. Neurons (100 billion) nerve cells b. Glia thousands of billions of support cells c. Brain regions within the brain, large groups of neurons form these distinct areas d. Clinical researchers have discovered connections between certain psychological disorders and problems in specific brain areas (a) Examples: Huntingon’s disease and basal ganglia (forebrain). Huntington’s disease is a disorder marked by violent emotional outbursts, memory loss, suicidal thinking involuntary body movements, and absurd beliefs. This disease has been traced to a loss of cells in the basal ganglia and cortex. 2. A second avenue of examination is brain chemistry – neurons communicate through electrical impulses; received by dendrites, travels down axon, transmitted through nerve endings to other neurons a. Neurotransmission Process (a) Presynaptic neuron (b) Synapse tiny space between the nerve ending of one neuron and the dendrite of another. (c) Postsynaptic neuron (d)Excitatory (glutamate) and Inhibitory (GABA) neurotransmitters (e)List of neurotransmitters monoamines serotonin, dopamine, norepinephrine b. Studies indicate that abnormal activity in certain NTs can lead to specific mental disorders (a) For example: depression has been linked to low activity c. In addition, 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 lead to psych. disorders (i) Example: cortisol release related to anxiety and mood disorders 3. A third area of investigation is genetic abnormalitiesRiya Gehani a. Abnormalities in brain anatomy or chemistry are sometimes the result of genetic inheritance b. Chromosomes 23 pairs, each with genes that control characteristics and traits c. Studies suggest that inheritance plays a part in mood disorders, schizophrenia, and other mental disorders (a) Multiple genes of small effect govern aspects of brain function, neurotransmitters, and endocrine system 4. A fourth area of focus is on biological abnormalities passed on through evolution a. Genes that contribute to mental disorders are viewed as unfortunate occurrences: (a) mutations (b) inherited after mutation in family line (c) evolutionary principles (d) Why have genes responsible for mental illness survived from an evolutionary perspective exists because adapted. Ex: fear response; b/c helped individuals thrive and adapt; today genes and reactions not as adaptive 5. The fifth avenue of research examines biological abnormalities as a result of viral infections a. Viral infection provides another possible source of abnormal brain structure or biochemical dysfunction (a) Example: Schizophrenia and prenatal viral exposure b. The scientific interest in viral explanations of psychological disorders has been growing in the past decade (a) Example: anxiety and mood disorders C. Biological treatments 1. Biological practitioners attempt to pinpoint the physical source of dysfunction to determine the course of treatment 2. There are three general types of biological treatment: a. Drug therapy 1950sgreatly changed outlook for a # of mental disorders (a) Four groups: 1) antianxiety, 2) antidepressant, 3) antibipolar, 4) antipsychotic b. Electroconvulsive therapy (ECT) –bad side effectsmemory loss c. Psychosurgery (or neurosurgery) D. Assessing the biological model 1. Strengths of the model: enjoys considerable respect in field constantly makes new info treatments bring great relief 2. Weaknesses of the model: -can limit, rather than enhance, our understanding too simplistic treatment produces lots of undesirable side effects III. THE PSYCHODYNAMIC MODEL  OLDEST AND MOST FAMOUS A. Psychodynamic model definition based on belief that a person’s behavior is determined by underlying dynamic psychological forces which they are not consciously aware B. Abnormal symptoms are the result of… conflict among these forcesRiya Gehani C. The father of psychodynamic theory and psychoanalytic therapy was Sigmund Freud (1856 1929) D. How did Freud explain normal and abnormal functioning? 1. three unconscious forces: a. The id pleasure needs, drives, impulses (sexual, aggression (sex fueled by libido)) b. The ego reality gratification, protects from anxiety c. The superego morality conscience, unconsciously adopted by parents 2. Conflict among the 3 forces healthy= works 3 conflicts, excessive conflict= dysfunction 3. five stages of psychosexual development each stage adjusts id, ego, superego successful= personal growth, unsuccessful= fixation at early stage, abnormality a. These stages include: (a) Oral (0 to 18 months of age) (b) Anal (18 months to 3 years of age) (c) Phallic (3 to 5 years of age) (d) Latent (5 to 12 years of age) (e) Genital (12 years of age to adulthood) E. How do other psychodynamic explanations differ from Freud’s? shaped by interacting forces a. Ego theorists emphasize role of ego as independent and powerful b. Self theorists emphasize unified personality c. Object relations theorists emphasize human need for relationships F. Psychodynamic therapies 1. Characteristics of psychodynamic therapy 2. Techniques a. Free association— patient describes thought, feeling, or image even if unimportant or irrelevant b. Therapist interpretation gain insight (a) Resistance— patient has unconscious refusal to participate fully in therapy (b) Transference— patient acts toward therapist as they do towards important figures in their life (c) Dream interpretation— therapist examines manifest and latent content (in Northeast mostly) c. Catharsis— reliving of past, repressed feelings to settle internal conflicts and overcome problems d. Working through— process of facing conflicts, reinterpreting feelings, and overcoming problems Defense Mechanisms ● Repressionavoids anxiety ● Denial refuses to acknowledge anxiety ● Projection attributes own impulses to others ● Rationalization creates acceptable reason for unacceptable motive ● Displacement hostility towards others ● Intellectualization logical response ● Regression retreats from upsetting conflict G. Assessing the psychodynamic model 1. Strengths of the model: -1st to recognize importance of psychological theories and treatmentsRiya Gehani -saw abnormal functioning rooted in same processes as normal functioning -1st to apply theory and techniques systematically to treatment 2. Weaknesses of the model: unsupported ideas; difficult to research nonobservable inaccessible (unconscious) IV. THE BEHAVIORAL MODEL  ACTIONS DETERMINED BY EXPERIENCES IN LIFE A. Definition of behavioral model concentrates wholly on behaviors and environmental factors B. How do behaviorists explain abnormal functioning? principles of learning 1. There are several forms of conditioning addressed by this model, all of which may produce normal or abnormal behavior: a. Operant conditioning rewards and punishments (feedback to shape behavior) b. Modeling learn by observation and repetition of observations c. Classical conditioning pairing two thing closely to associate, temporal association father=Ivan Pavlov (18491936) classic study using dogs/meat powder/salivary system explains many familiar behaviors (normal and abnormal) Terms: Unconditioned stimulus US: stimulus that produces the natural response Unconditioned Response UR: innate response to US, PAIR WITH CS Conditioned stimulus CS: stimulus that is repeatedly paired with the CS, initially neutral Conditioned Response CR: learned response after pairing of US and CS Extinction: If after conditioning, the CS is repeatedly resented alone it will eventually stop eliciting the CR C. Behavioral therapies may use classical, operant, or modeling, or combination of all three. Therapist is ‘teacher’ rather than healer. 1. The aim of behavioral therapy is to… identify the behaviors that are causing problems and replace them with more appropriate ones 2. Classical conditioning treatments may be used to change abnormal reactions to particular stimuli (a) Example: systematic desensitization for phobia Step by step procedure: Learn relaxation skills (breathing) Construct a fear hierarchy Confront feared situations D. Strengths of this model: Powerful force in the field Can be tested in the lab very precisely Significant research support for behavioral therapies E. Weaknesses of this model: No evidence that symptoms are ordinarily acquired through conditioning Behavior therapy is limited Too simplistic New focus on selfefficacy, social cognition, and cognitive behavioral theories V. THE COGNITIVE MODEL A. Definition of cognitive model proposes that we can best understand abnormal functioning by looking at cognitive processes the center of behaviors, thoughts, and emotions; Aaron BeckRiya Gehani B. How do cognitive theorists explain abnormal functioning? Argues that clinicians must ask questions about assumptions, attitudes, and thoughts of a client Focuses on cognitive distortions: faulty assumptions and attitudes; illogical thinking processes (ex: overgeneralization) C. Cognitive therapies 1. Key elements people can overcome their problems by developing new ways of thinking 2. The main therapy model is Aaron Beck’s Cognitive Therapy a. The goal of this therapy is to help clients recognize and restructure their thinking b. Techniqueswidely used in treating depression Challenge dysfunctional thoughts Try out new interpretations Apply new ways of thinking in their daily lives D. Assessing the cognitive model 1. Strengths of this model: Very broad appeal Clinically useful and effective Focuses on uniquely human process Theories lend themselves in treating several disorders 2. Weaknesses of this model: Precise role of cognition in abnormality has yet to be determined Theories 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 mindfulnessbased techniques Cybertherapy has come to complement or even replace facetoface therapy Computer software therapy Email therapy Visual therapy Virtual support groups VI. THE HUMANISTICEXISTENTIAL MODEL A. Humanisticexistential model definition Humanistic view: emphasis on people as friendly, cooperative, and constructive; focus on drive to self actualize through honest recognition of strengths and weaknesses. Differs from others bc is focuses more on recovery, rather than decreasing symptoms Existentialist view: emphasis on selfdetermination, choice, and individual responsibility; focus on authenticity B. The primary theory and therapy associated with the humanistic component of the model is Rogers’ Humanistic Theory and Therapy believes in the basic human need for unconditional positive regard If received, leads to unconditional selfregard If not, leads to ‘conditions of worth’ o Incapable of selfactualization bc of distortiondo not know what they really need, etc. Carl Roger’s Clientcentered therapy o Therapist creates a supportive climate o Unconditional positive regard o Accurate empathy (cognitive and emotional aspects of empathy)Riya Gehani o Genuineness o Little research support, but positive impact on clinical practice C. Another primary theory in the humanistic model is gestalt theory and its associated therapy o Developed by Fritz Perls o Goal is to guide clients toward selfrecognition through challenge and frustration o Little research support o Techniques: o Skillful frustration o Role playing o Rules, including ‘Here and Now’ and ‘I’ language D. More general theoretical and therapeutic models represent the existential half of the combined model o Belief that psychological dysfunction is caused by selfdeception; people hide from life’s responsibilities and fail to recognize that it is up to them to give meaning to their lives o In therapy, people are encouraged to accept personal responsibility for their problems o Goals more important than technique o Great emphasis placed on clienttherapist relationship E. Assessing the humanisticexistential model 1. Strengths of the model: o Taps into domains missing from other theories o Emphasizes individual o Optimistic o Emphasizes health 2. Weaknesses of the model: o Focuses on abstract issues o Difficult to research o Weakened by disapproval of scientific approach o Changing somewhat anti science attitude changing over recent years VII. THE SOCIOCULTURAL MODEL: THE FAMILYSOCIAL AND MULTICULTURAL PERSPECTIVES A. Sociocultural model and multicultural model definition argue that abnormal behavior is best understood in light of social and cultural forces that influence an individual B. How do familysocial theorists explain abnormal functioning? Addresses norms and roles in society; say one should concentrate on forces that operate directly on an individual o Social labels and roles o Diagnostic labels (ex: Rosenhan studygrad students to mental hospitals, labeled regardless of normal actions) o Social connections and supports C. Familysocial treatments a. Group therapy— b. Family therapy— focuses on functioning within the family and patterns of behavior that families get into that lead to psychiatric conditions (too engaged or disengaged) c. Couple therapy— d. Community treatment— includes prevention work (suicide prevention week) D. How do multicultural theorists explain abnormal functioning? 1. The role of culture leads to the understanding of how culture, race, ethnicity, gender, and similar factors affect behavior, thought, and mental health. E. Multicultural treatments Riya Gehani o Greater sensitivity to cultural issues o Inclusion of cultural modes in treatment, esp in children and adolescents F. Assessing the sociocultural model 1. Strengths of this model: ● family, cultural, social, and societal issues taken into account ● clinicians have become more aware of the impact of clinical and social roles 2. Weaknesses of this model: ● findings are difficult to interpret ● fail to establish social or cultural factors as the cause ● unable to predict abnormality in specific individuals VIII. INTEGRATION OF THE MODELS A. Today’s leading models vary widely, and none of the models has proved consistently superior (See Table 34, text p. 92.) B. A growing number of clinicians favor explanations of abnormal behavior that consider more than one cause at a time C. biopsychosocial model states that abnormality results from the interaction of genetic, biological, developmental, emotional, behavioral, cognitive, social, cultural, and societal influences 1. diathesisstress approach predisposed tendency as an explanation of how various factors work together to cause abnormal functioning LEARNING OBJECTIVES 3.1. Define and describe the basic biological terminology, including parts of neurons, the brain, and types of neurotransmitters. Discuss the various therapies used by the biological model, including a discussion of drugs, electroconvulsive therapy, and psychosurgery. 3.2. Summarize the origins of Freud’s theory. Describe Freud’s explanation of abnormal functioning, including descriptions of the id, ego, superego, ego defense mechanisms, and psychosexual stages. 3.3. Summarize the behavioral model of abnormal functioning, including the main features of classical conditioning and operant conditioning and how they are used to explain abnormal behavior. 3.4. Summarize the cognitive model. Give examples of typical maladaptive assumptions, specific upsetting thoughts, and illogical thinking processes. Describe cognitive therapy. 3.5. Summarize Rogers’ theory and therapy, including definitions of unconditional positive regard, unconditional selfregard, and conditions of worth. Describe gestalt theory and therapy. Describe existential theories and therapies. 3.6. Summarize the sociocultural models. Describe the various socioculturalbased therapies. 3.7. Compare and contrast the various models of abnormal functioning. Riya Gehani KEY TERMS antianxiety drugs psychotropic drugs that help reduce tension and anxiety antibipolar drugs psychotropic drugs that help stabilize the moods of people suffering from a bipolar disorder antidepressant drugs psychotropic drugs that improve the mood of people with depression antipsychotic drugs drugs that help correct grossly confused or distorted thinking biopsychosocial theories explanations that attribute the cause of abnormality to an interaction of genetic, biological, developmental, emotional, behavioral, cognitive, social, and societal influences catharsis reliving of past repressed feelings in order to settle internal conflicts and overcome problems classical conditioning process of learning in which 2 events that repeatedly occur close together in time become tied together clientcentered therapy where clinicians try to help clients by being accepting, empathizing accurately, and conveying genuineness. cognitive therapy helps people identify and change the maladaptive assumptions and ways of thinking that help cause their psychological problems. cognitivebehavioral therapies therapy approaches that seek to help clients change both counterproductive behaviors and dysfunctional ways of thinking community mental health treatment treatment approach that emphasizes community care conditioning simple form of learning couple therapy therapy format in which the therapist works with two people who share a longterm relationship culturesensitive therapies approaches that are designed to address the unique issues faced by members of minority groups. dream series of ideas and images that form during sleep ego psychological force that employs reason and operates in accordance with the reality principle ego defense mechanisms strategies developed by the ego to control unacceptable id impulses and to avoid or reduce the anxiety they arouse ego theory emphasizes the ego and considers it an independent force electroconvulsive therapy (ECT) treatment for depression in which electrodes attached to a patient’s head send an electrical current through the brain, causing a seizure. existential therapy therapy that encourages clients to accept responsibility for their lives and to live with greater meaning and value. family systems theory theory that views the family as a system of interacting parts whose interactions exhibit consistent patterns and unstated rules. family therapy therapy format in which the therapist meets with all members of a family and helps them to change in therapeutic ways. fixation according to Freud, a condition in which the id, ego, and superego do not mature properly and are frozen at an early stage of development free association a psychodynamic technique in which the patient describes any thought, feeling, or image that comes to mind, even if it seems unimportant.Riya Gehani gendersensitive therapies approaches geared to the pressures of being a woman in Western society (AKA feminist therapies) gene chromosome segments that control the characteristics and traits we inherit gestalt therapy humanistic therapy devel. by Fritz Perls in which clinicians actively move clients towards selfrecognition and selfacceptance by using techniques such as role playing and self discovery exercises. group therapy therapy format in which a group of people with similar problems meet together with a therapist while the therapist confronts feared items hormones chemicals released by endocrine glands into the bloodstream id psychological force that produces instinctual needs, drives, and impulses model set of assumptions and concepts that help scientists explain and interpret observations. modeling process of learning in which a person acquires responses by observing and imitating others. multicultural perspective argue that abnormal behavior is best understood in light of social and cultural forces that influence an individual neuron a nerve cell neurotransmitter a chemical that, released by one neuron, crosses the synaptic space to be received at receptors on the dendrites of neighboring neurons. object relations theory psychodynamic theory that views the desire for relationships as the key motivating force in human behavior. operant conditioning process of learning in which behavior that leads to satisfying consequences is likely to be repeated. psychosurgery brain surgery for mental disorders psychotropic medications drugs that mainly affect the brain and reduce many symptoms of mental dysfunctioning receptor a site on a neuron that receives a neurotransmitter relational psychoanalytic therapy form of psychodynamic therapy that considers therapists to be active participants in the formation of patient's’ feelings and reactions and therefore calls for therapists to disclose their own experiences and feelings in discussions with patients. resistance an unconscious refusal to participate fully in therapy selfactualization the humanistic process by which people fulfill their potential for goodness and growth selfefficacy the belief that one can master and perform needed behaviors whenever necessary selfhelp group group made up of people with similar problems who help and support one another without the direct leadership of a clinician self theory psychodynamic theory that emphasizes the role of the self a person’s unified personality superego psychological force that represents a person’s values and ideals synapse tiny space between the nerve ending of one neuron and the dendrite of another systematic desensitization a behavioral treatment that uses relaxation training and a fear hierarchy to help clients with phobias react calmly to the objects or situations they dread. transference redirection towards psychotherapist of feelings associated with important figures in a patient’s life, now or in the past working through psychoanalytical process of facing conflicts, reinterpreting feelings, and overcoming one’s problems