Models of Abnormality Chapter 3 Slides Handouts by

Models of Abnormality Chapter 3 Slides & Handouts by Karen Clay Rhines, Ph. D. American Public University System Comer, Abnormal Psychology, 8 e, DSM-5 Update

Models of Abnormality · In science, the perspectives used to explain events are known as models 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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 2

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 3

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 4

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 5

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 and cortex Comer, Abnormal Psychology, 8 e, DSM-5 Update 6

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 7

Comer, Abnormal Psychology, 8 e, DSM-5 Update 8

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 9

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 of serotonin and norepinephrine Comer, Abnormal Psychology, 8 e, DSM-5 Update 10

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 11

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 12

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 13

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 14

Sources of Biological Abnormalities – Evolution · This model has been criticized and remains controversial, yet it receives considerable attention Comer, Abnormal Psychology, 8 e, DSM-5 Update 15

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 16

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 17

Biological Treatments · Drug therapy: · 1950 s = 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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 18

Biological Treatments · Electroconvulsive therapy (ECT): · Used primarily for depression, particularly when drugs and otherapies have failed · This treatment is used on tens of thousands of depressed persons annually Comer, Abnormal Psychology, 8 e, DSM-5 Update 19

Biological Treatments · Psychosurgery (or neurosurgery): · Historical roots in trephination · 1930 s = first lobotomy · Much more precise today than in the past · Considered experimental and used only in extreme cases Comer, Abnormal Psychology, 8 e, DSM-5 Update 20

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 21

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) Comer, Abnormal Psychology, 8 e, DSM-5 Update 22

How Did Freud Explain Normal and Abnormal Functioning? · Shaped by three unconscious forces: 1. 2. 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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 23

Comer, Abnormal Psychology, 8 e, DSM-5 Update 24

How Did Freud Explain Normal and Abnormal Functioning? · Caused by three UNCONSCIOUS forces: 3. 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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 25

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 26

How Did Freud Explain Normal and Abnormal Functioning? · Developmental stages · Oral (0 to 18 months of age) · Anal (18 months to 3 years of age) · Phallic (3 to 5 years of age) · Latency (5 to 12 years of age) · Genital (12 years of age to adulthood) Comer, Abnormal Psychology, 8 e, DSM-5 Update 27

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 · · Self theorists · · Emphasize the role of the ego; consider it independent and powerful Emphasize the unified personality Object-relations theorists · Emphasize the human need for relationships, especially between children and caregivers Comer, Abnormal Psychology, 8 e, DSM-5 Update 28

Psychodynamic Therapies · Range from Freudian psychoanalysis to modern therapies · All seek to uncover past trauma and inner conflicts · Therapist acts as a “subtle guide” Comer, Abnormal Psychology, 8 e, DSM-5 Update 29

Psychodynamic Therapies · Utilize various techniques: · Free association · Therapist interpretation · Resistance · Transference · Dream interpretation · Catharsis · Working through Comer, Abnormal Psychology, 8 e, DSM-5 Update 30

Psychodynamic Therapies · Contemporary trends: · Short-term psychodynamic therapies · Relational psychoanalytic therapy Comer, Abnormal Psychology, 8 e, DSM-5 Update 31

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 · Weaknesses: · Unsupported ideas; difficult to research · Non-observable · Inaccessible to human subject (unconscious) First to apply theory and techniques systematically to treatment – monumental impact on the field Comer, Abnormal Psychology, 8 e, DSM-5 Update 32

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 33

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 34

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 35

How Do Behaviorists Explain Abnormal Functioning? · Modeling · Individuals learn responses by observing and repeating behavior Comer, Abnormal Psychology, 8 e, DSM-5 Update 36

How Do Behaviorists Explain Abnormal Functioning? · Classical conditioning · Learning by temporal association · · Father of classical conditioning: Ivan Pavlov (1849 – 1936) · · 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 Classic study using dogs and meat powder Explains many familiar behaviors (both normal and abnormal) Comer, Abnormal Psychology, 8 e, DSM-5 Update 37

Classical Conditioning US UR Meat Salivate US UR Meat + Tone Salivate CS CR Tone Salivate Comer, Abnormal Psychology, 8 e, DSM-5 Update 38

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 39

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 40

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 cognitivebehavioral theories Comer, Abnormal Psychology, 8 e, DSM-5 Update 41

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 42

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 43

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 44

Assessing the Cognitive Model · Strengths: · · Very broad appeal · Clinically useful and effective · Weaknesses: · Precise role of cognition in abnormality has yet to be determined Focuses on a uniquely human process · Therapies do not help everyone · Theories lend themselves to research · Some changes may not be possible to achieve · Therapies effective in treating several disorders · In response, a new wave of therapies has emerged, including Acceptance and Commitment Therapy and mindfulness-based techniques Comer, Abnormal Psychology, 8 e, DSM-5 Update 45

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 46

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 47

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 48

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 49

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 50

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 51

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 52

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 53

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 54

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 55

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 56

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 57

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 58

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 59

Multicultural Treatments · Given such findings, some clinicians have developed culture-sensitive therapies as well as gender-sensitive, or feminist, therapies Comer, Abnormal Psychology, 8 e, DSM-5 Update 60

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 61

Integration of the Models · Today’s leading models vary widely and none of the models has proved consistently superior Comer, Abnormal Psychology, 8 e, DSM-5 Update 62

Comparing the Models Comer, Abnormal Psychology, 8 e, DSM-5 Update 63

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 Comer, Abnormal Psychology, 8 e, DSM-5 Update 64

Integration of the Models · Some biopsychosocial theorists favor a diathesis-stress approach · Diathesis = predisposition (bio, psycho, or social) Comer, Abnormal Psychology, 8 e, DSM-5 Update 65

Integration of the Models · Integrative therapists are often called “eclectic” – taking the strengths from each model and using them in combination Comer, Abnormal Psychology, 8 e, DSM-5 Update 66

Theoretical Orientations of Today’s Clinical Psychologists Comer, Abnormal Psychology, 8 e, DSM-5 Update 67

Integration of the Models · Integrative therapists are often called “________” – taking the strengths from each model and using them in combination Comer, Abnormal Psychology, 8 e, DSM-5 Update 68