Models of Abnormality Chapter 2 Fundamentals of Abnormal

Models of Abnormality Chapter 2 Fundamentals of Abnormal Psychology RONALD J. COMER | JONATHAN S. COMER| ninth edition

What causes mental illness?

Theories of Abnormality • Models or paradigms used by scientists and clinicians to treat abnormality • Explain events and basic assumptions • Guide treatment techniques and principles

The Biological Model • Medical perspective • Considers illness to be brought about by malfunctioning parts of the organism • Points to problems in brain anatomy or brain chemistry

How Do Biological Theorists Explain Abnormal Behavior? • Brain anatomy • Brain structures • Cerebrum (cortex, corpus callosum, basal ganglia, hippocampus, amygdala) • Connections found among some psychological disorders and specific brains structures • https: //www. youtube. com/ watch? v=Myx. Cjn. Hq. Bq 8

How Do Biological Theorists Explain Abnormal Behavior? • 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 • 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

Biological Treatments • 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

Biological Treatments • Drug therapy • Four major drug groups used in therapy • Antianxiety drugs-anxiolytics; minor tranquilizers, alprazolam (Xanax) diazepam (Valium)) • Antidepressant drug-sescitalopram (Lexapro), fluoxetine (Prozac), sertraline (Zoloft) • Antibipolar drugs -mood stabilizers-Divalproex sodium (Depakote) Valproic acid (Depakene), Lithium • Antipsychotic drugs-risperidone (Risperdal), quetiapine (Seroquel

Biological Treatments • Brain stimulation • Direct or indirect brain stimulation • Approaches • Electroconvulsive therapy (ECT) • Transcranial magnetic stimulation (TMS) • Vagus nerve stimulation (VNS)

The Psychodynamic Model • Normal or abnormal behavior is determined largely by underlying, unconscious DYNAMIC interacting psychological forces • Abnormal symptoms are the result of conflict among these forces Freud Looking at Freud Father of psychodynamic theory and psychoanalytic therapy

How Did Freud Explain Normal and Abnormal Functioning? • 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 Comer, Fundamentals of Abnorma 12

How Did Freud Explain Normal and Abnormal Functioning? • Three unconscious forces shape personality: instinctual needs, rational thinking, and moral standards • Id: Pleasure principle • Ego: Reality principle • Superego: Morality principle

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? • 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

Psychodynamic Therapies • Seek to uncover past trauma and inner conflicts with therapist acting as a guide • Free association • Therapist interpretation • Resistance • Transference • Dream interpretation

Psychodynamic Therapies • Current trends • Short-term psychodynamic therapies

• https: //www. youtube. com/watch? v=Fn. RBAU 6 Yg 2 A&t= 6 s

Techniques • • • Free Association Dream Resistance Transference Work through those with Confrontation (help clients see behaviors in a new way using statements) • Clarification (restating in clear terms) • Interpretation (explicitly connecting current behavior to unconscious processes)

Therapy session • https: //www. youtube. com/watch? v=o. S_L 8 efa. J-E

Behavioral

The Behavioral Model • BEHAVIORAL THEORIES • Positive actions are determined largely by life experiences • Concentrate on behaviors and environmental factors • Base explanations and treatments on principles of learning • Began in laboratories where conditioning studies were conducted

The Behavioral Model • • Behavioral dimension Classical conditioning Operant conditioning Therapists, as teachers, seek to help replace problematic behaviors with more appropriate behaviors

Behavioral Therapies • Aim to identify problematic behaviors and replace these with more appropriate ones • May use classical conditioning, operant conditioning, or modeling • View therapist as teacher, rather than healer

The Cognitive-Behavioral Model • Focuses on maladaptive behaviors and/or cognitions in understanding and treating psychological abnormality • Shares key principles between behavioral and cognitive perspectives • https: //www. youtube. com/watch? v=Sw. NU 9 s. Ndj 3 E (Example of CBT) • https: //www. youtube. com/watch? v=Gy. RE-78 g_z 0 (Albert Ellis’s perspective)

The Cognitive-Behavioral Model • 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

The Cognitive-Behavioral Model • • • Cognitive dimension Focuses on maladaptive thinking processes Inaccurate/disturbing assumptions and attitudes Illogical thinking Therapists help clients recognize, challenge, and change problematic thinking

Assessing the Cognitive-Behavioral Model • 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

Modeling

The Humanistic-Existential Model • Humanist view • Emphasis on people as friendly, cooperative, and constructive • Focus on drive to selfactualize 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 selfdeception

The Humanistic-Existential Model • 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 1. Unconditional positive regard 2. Accurate empathy 3. Genuineness

The Humanistic-Existential Model • Existential theories and therapy • Psychological abnormality • Arises when client uses self-deception to hide from responsibilities • Existential therapy • Clients are encouraged to accept responsibility for their lives and problems • Relationship between therapist and client includes shared learning and growth

The Sociocultural Model • 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

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

The Sociocultural Model • 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 • 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

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 Moderate Consumer designation Patient Client Patient or 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 Selfactualization Authentic life Effective family or social system Cultural awareness and comfort