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

Models ofAbnormality

Chapter 3

Slides & Handouts by Karen Clay Rhines, h!D!American Public University System

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2Comer, "bnormal sy#holo$y, 8e,

DSM-5 Update

Models of Abnormality

%n s#ien#e, the perspe#ties used toe'plain eents are (no)n as models orparadi$ms

*a#h model spells out basi# assumptions,$ies order to the +eld under study, and sets$uidelines or inesti$ation

Models inuen#e )hat inesti$ators obsere,the .uestions they as(, the inormation theysee(, and ho) they interpret this inormation

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DSM-5 Update

Models of Abnormality

Until re#ently, #lini#al s#ientists o a $ienpla#e and time tended to a$ree on a sin$lemodel o abnormality / a model $reatly

inuen#ed by the belies o their #ulture

0oday seeral models are used to e'plainand treat abnormal un#tionin$

Sometimes in #oni#t, ea#h model o#uses onone aspe#t o human un#tionin$ and no sin$lemodel #an e'plain all aspe#ts o abnormality

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DSM-5 Update

The Biological Model

"dopts a medi#al perspe#tie

Main o#us is that psy#holo$i#al

abnormality is an illness brou$htabout by malun#tionin$ parts o theor$anism

0ypi#ally point to problems in brainanatomy or brain #hemistry

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DSM-5 Update

How Do Biological TheoristsExplain Abnormal Behavior?

1rain anatomy

0he brain is #omposed o 244 billion

nere #ells #alled neurons6 andthousands o billions o support #ells#alled $lia6

7ithin the brain, lar$e $roups oneurons orm distin#t areas #alled brainre$ions

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DSM-5 Update


1rain anatomy and abnormal behaior

Clini#al resear#hers hae dis#oered

#onne#tions bet)een #ertainpsy#holo$i#al disorders and problems inspe#i+# brain areas

*'ample Huntin$ton9s disease and basal

$an$lia and #orte'

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DSM-5 Update


1rain #hemistry

%normation is #ommuni#ated

throu$hout the brain in the orm oele#tri#al impulses that trael rom oneneuron to one or more others

"n impulse is +rst re#eied by aneuron9s dendrites, traels do)n thea'on, and is transmitted throu$h thenere endin$s to other neurons

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DSM-5 Update

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DSM-5 Update


1rain #hemistry

:eurons do not a#tually tou#h ea#h other;they are separated by a spa#e the synapse6,

a#ross )hi#h a messa$e moes 7hen an ele#tri#al impulse rea#hes a nere

endin$, the endin$ is stimulated to release a#hemi#al, #alled a neurotransmitter :06, that

traels a#ross the synapti# spa#e to re#eptorson the dendrites o nei$hborin$ neurons

Some :0s tell re#eiin$ neurons to

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10Comer, "bnormal sy#holo$y, 8e,DSM-5 Update


1rain #hemistry and abnormal behaior

Resear#hers hae identi+ed do>ens o

:0s *'amples serotonin, dopamine, and ?"1"

Studies indi#ate that abnormal a#tiity in#ertain :0s #an lead to spe#i+# mentaldisorders

@or e'ample depression has been lin(ed tolo) a#tiity o serotonin and norepinephrine

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1rain #hemistry and abnormal behaior

"dditionally, resear#hers hae learned thatmental disorders are sometimes related to

abnormal #hemi#al a#tiity in the endo#rinesystem

*ndo#rine $lands release hormones )hi#hpropel body or$ans into a#tion

"bnormal se#retions hae been lin(ed topsy#holo$i#al disorders

*'ample Cortisol release is related to an'ietyand mood disorders

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Sorces of BiologicalAbnormalities ! "enetics

"bnormalities in brain anatomy or #hemistryare sometimes the result o $eneti#inheritan#e

*a#h #ell in the human body #ontains A3 pairs o#hromosomes, ea#h )ith numerous $enes that#ontrol the #hara#teristi#s and traits a personinherits

Studies su$$est that inheritan#e plays a part inmood disorders, s#hi>ophrenia, and other mentaldisorders

"ppears that in most #ases seeral $enes #ombine toprodu#e our a#tions and rea#tions


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Sorces of BiologicalAbnormalities ! "enetics

?enes that #ontribute to mentaldisorders are ie)ed as unortunate

o##urren#es May be mutations

May be inherited ater a mutation in the

amily line May be the result o normal eolutionary

prin#iples


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Sorces of BiologicalAbnormalities ! Evoltion

*olutionary theorists ar$ue that humanrea#tions and the $enes responsible orthem hae suried oer the #ourse otime be#ause they hae helpedindiiduals thrie and adapt

*'ample 0he ear response

%n today9s )orld, ho)eer, those $enesand rea#tions may not be so adapatie


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Sorces of BiologicalAbnormalities ! Evoltion

0his model has been #riti#i>ed andremains #ontroersial, yet it re#eies

#onsiderable attention


S B

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Sorces o B o og caAbnormalities ! #iral

$nfections "nother possible sour#e o abnormal brain

stru#ture or bio#hemi#al dysun#tion isiral ine#tions

*'ample S#hi>ophrenia and prenatal irale'posure

%nterest in iral e'planations o

psy#holo$i#al disorders has been $ro)in$in the past de#ade

*'ample "n'iety and mood disorders


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Biological Treatments

1iolo$i#al pra#titioners attempt topinpoint the physi#al sour#e odysun#tion to determine the #ourseo treatment

0hree types o biolo$i#al treatment

Dru$ therapy

*le#tro#onulsie therapy *C06

sy#hosur$ery

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Dru$ therapy

B54s adent o psy#hotropi# medi#ations

?reatly #han$ed the outloo( or a number o mentaldisorders

@our maor dru$ $roups

"ntian'iety dru$s an'iolyti#s; minor tran.uili>ers6

"ntidepressant dru$s "ntibipolar dru$s mood stabili>ers6

"ntipsy#hoti# dru$s

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*le#tro#onulsie therapy *C06

Used primarily or depression,

parti#ularly )hen dru$s and othertherapies hae ailed

0his treatment is used on tens o thousandso depressed persons annually

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sy#hosur$ery or neurosur$ery6

Histori#al roots in trephination

B34s +rst lobotomy

Mu#h more pre#ise today than in thepast

Considered e'perimental and used onlyin e'treme #ases

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Assessing theBiological Model

7ea(nesses

Can limit, rather thanenhan#e, our

understandin$

0oo simplisti#

0reatments produ#e

si$ni+#ant undesirablene$atie6 eEe#ts

Stren$ths

*noys #onsiderablerespe#t in the +eld

Constantlyprodu#es aluablene) inormation

0reatments brin$$reat relie

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The %sychodynamic Model

Fldest and most amous psy#holo$i#al model

1ased on belie that a person9s behaior )hethernormal or abnormal6 is determined lar$ely by

underlyin$ dynami# - that is, intera#tin$ -psy#holo$i#al or#es o )hi#h she or he is not#ons#iously a)are

"bnormal symptoms are the result o #oni#t amon$these or#es

@ather o psy#hodynami# theory andpsy#hoanalyti# therapy

Si$mund @reud 85G/B3B6

H Did & d E l i

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How Did &red Explain'ormal and Abnormal

&nctioning?

Shaped by three unconsciousor#es

! %d / $uided by the Pleasure Principle

%nstin#tual needs, dries, and impulses

Se'ual; ueled by libido se'ual ener$y6

A! *$o / $uided by the Reality Principle

See(s $rati+#ation, but $uides us to (no) )hen )e

#an and #annot e'press our )ishes *$o deense me#hanisms prote#t us rom an'iety

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H Did & d E l i

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&nctioning?

Caused by three U:CF:SC%FUS or#es

3! Supere$o / $uided by the Morality Principle

Cons#ien#e; un#ons#iously adopted rom our parents

0hese three parts o the personality are otenin some de$ree o #oni#t

" healthy personality is one in )hi#h an eEe#tie)or(in$ relationship e'ists amon$ the three

or#es % the id, e$o, and supere$o are in e'#essie

#oni#t, the person9s behaior may sho) si$ns odysun#tion

H Did & d E l i

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&nctioning?

Deelopmental sta$es

@reud proposed that at ea#h sta$e odeelopment ne) eents and pressures re.uire

adustment in the id, e$o, and supere$o % su##essul personal $ro)th

% unsu##essul +'ation at an early deelopmentalsta$e, leadin$ to psy#holo$i#al abnormality

1e#ause parents are the (ey +$ures in early lie, theyare oten seen as the #ause o improper deelopment

H Did & d E l i

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&nctioning?

Deelopmental sta$es

Fral 4 to 8 months o a$e6

"nal 8 months to 3 years o a$e6

halli# 3 to 5 years o a$e6

Iaten#y 5 to A years o a$e6

?enital A years o a$e to adulthood6

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How Do (ther %sychodynamicExplanations Di)er from &red*s?

"lthou$h ne) theories depart rom @reud9sideas in important )ays, ea#h retains thebelie that human un#tionin$ is shaped bydynami# intera#tin$6 or#es *$o theorists

*mphasi>e the role o the e$o; #onsider it independentand po)erul

Sel theorists

*mphasi>e the uni+ed personality Fbe#t-relations theorists

*mphasi>e the human need or relationships, espe#iallybet)een #hildren and #are$iers

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%sychodynamic Therapies

Ran$e rom @reudian psy#hoanalysisto modern therapies

"ll see( to un#oer past trauma andinner #oni#ts

0herapist a#ts as a

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Utili>e arious te#hni.ues

@ree asso#iation

0herapist interpretation Resistan#e

0ranseren#e

Dream interpretation Catharsis

7or(in$ throu$h

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Contemporary trends

Short-term psy#hodynami# therapies

Relational psy#hoanalyti# therapy

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Assessing the%sychodynamic Model

Stren$ths @irst to re#o$ni>e

importan#e opsy#holo$i#al theories

and treatment Sa) abnormal

un#tionin$ as rooted inthe same pro#esses asnormal un#tionin$

@irst to apply theory andte#hni.uessystemati#ally totreatment / monumentalimpa#t on the +eld

7ea(nesses

Unsupported ideas;diJ#ult to resear#h

:on-obserable

%na##essible tohuman sube#tun#ons#ious6

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The Behavioral Model

Ii(e psy#hodynami# theorists,behaioral theorists beliee that oura#tions are determined lar$ely by oure'perien#es in lie

Con#entrates )holly on behaiorsand enironmental a#tors

1ases e'planations and treatmentson prin#iples o learnin$

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The Behavioral Model

0he model be$an in laboratories )here#onditionin$ studies )ere #ondu#ted

Seeral orms o #onditionin$ Fperant #onditionin$

Modelin$

Classi#al #onditionin$

"ll may produ#e normal or abnormalbehaior

How Do Behaviorists

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How Do BehavioristsExplain Abnormal

&nctioning? Fperant #onditionin$

Humans and animals learn to behae in

#ertain )ays as a result o re#eiin$rewards)heneer they do so

How Do Behaviorists

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&nctioning? Modelin$

%ndiiduals learn responses by obserin$

and repeatin$ behaior

How Do Behaviorists

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&nctioning? Classi#al #onditionin$

Iearnin$ by temporal asso#iation

7hen t)o eents repeatedly o##ur #lose to$ether in

time, they be#ome used in a person9s mind; beorelon$, the person responds in the same )ay to botheents

@ather o #lassi#al #onditionin$ %an alo8B / B3G6

Classi# study usin$ do$s and meat po)der

*'plains many amiliar behaiors both normaland abnormal6

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+lassical +onditioning

UR

Saliat

eUR

Saliate

US

Meat

0one

CS

0one

CR

Saliate

US

MeatL

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Behavioral Therapies

"im to identiy the behaiors that are#ausin$ problems and repla#e them)ith more appropriate ones

May use #lassi#al #onditionin$, operant#onditionin$, or modelin$

0herapist is

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Behavioral Therapies

Classi#al #onditionin$ treatmentsmay be used to #han$e abnormalrea#tions to parti#ular stimuli

*'ample systemati# desensiti>ation orphobia

Step-by-step pro#edure

Iearn rela'ation s(ills Constru#t a ear hierar#hy

Conront eared situations

A i th B h i l

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DSM-5 Update

Assessing the BehavioralModel

Stren$ths

o)erul or#e inthe +eld

Can be tested inthe laboratory

Si$ni+#antresear#h support

or behaioraltherapies

7ea(nesses :o eiden#e that

symptoms areordinarily a#.uiredthrou$h #onditionin$

1ehaior therapy islimited

0oo simplisti#

:e) o#us onsel-eJ#a#y, so#ial#o$nition, and#o$nitie-behaioraltheories

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DSM-5 Update

The +ognitive Model

0his model proposes that )e #an bestunderstand abnormal un#tionin$ byloo(in$ at #o$nitie pro#esses / the #enter

o behaiors, thou$hts, and emotions "r$ues that #lini#ians must as( .uestions

about assumptions, attitudes, and

thou$hts o a #lient

How Do +ognitive Theorists

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DSM-5 Update

How Do +ognitive TheoristsExplain Abnormal

&nctioning? "bnormal un#tionin$ #an result rom

seeral (inds o #o$nitie problems

@aulty assumptions and attitudes %llo$i#al thin(in$ pro#esses

*'ample oer$enerali>ation

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DSM-5 Update

+ognitive Therapies

eople #an oer#ome their problems bydeelopin$ ne) )ays o thin(in$

Main model 1e#(9s Co$nitie 0herapy

0he $oal o therapy is to help #lients re#o$ni>eand restru#ture their thin(in$

0herapists also $uide #lients to #hallen$e their

dysun#tional thou$hts, try out ne) interpretations,and apply ne) )ays o thin(in$ in their daily lies

7idely used in treatin$ depression

A i th

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DSM-5 Update

Assessing the+ognitive Model

Stren$ths

ery broad appeal

Clini#ally useul and

eEe#tie @o#uses on a uni.uely

human pro#ess

0heories lend

themseles to resear#h 0herapies eEe#tie in

treatin$ seeraldisorders

7ea(nesses re#ise role o #o$nition in

abnormality has yet to bedetermined

0herapies do not helpeeryone

Some #han$es may notbe possible to a#hiee

%n response, a ne) )ae otherapies has emer$ed,in#ludin$ "##eptan#e andCommitment 0herapy andmindulness-basedte#hni.ues

Th H i ti E i t ti l

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DSM-5 Update

The Hmanistic,ExistentialModel

Combination model

0he humanist ie)

*mphasis on people as riendly, #ooperatie,and #onstru#tie; o#us on drie to sel-a#tuali>e throu$h honest re#o$nition ostren$ths and )ea(nesses

0he e'istentialist ie) *mphasis on sel-determination, #hoi#e, and

indiidual responsibility; o#us on authenti#ity

- * H i ti

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DSM-5 Update

-ogers* HmanisticTheory and Therapy

1eliees in the basi# human need or unconditionalpositive regard

% re#eied, leads to un#onditional sel-re$ard

% not, leads to ation be#ause o distortion / do not(no) )hat they really need, et#!

Ro$ers9

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"estalt Theory and Therapy

Humanisti# approa#h

Deeloped by @rit> erls

?oal is to $uide #lients to)ard sel-re#o$nition throu$h #hallen$e and rustration

0e#hni.ues

S(illul rustration

Role playin$ Rules, in#ludin$

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Spirital #iews and$nterventions

@or most o the t)entieth #entury, #lini#als#ientists ie)ed reli$ion as a ne$atieNorat best neutralNa#tor in mental health

0his histori#al alienation bet)een the#lini#al +eld and reli$ion seems to beendin$

Resear#hers hae learned that spirituality#an, in a#t, be o psy#holo$i#al bene+t topeople


DSM-5 Update

Existential Theories and

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Existential Theories andTherapy

1elie that psy#holo$i#al dysun#tion is#aused by sel-de#eption; people hide romlie9s responsibilities and ail to re#o$ni>e

that it is up to them to $ie meanin$ to theirlies

%n therapy, people are en#oura$ed to a##eptpersonal responsibility or their problems

?oals more important than te#hni.ue ?reat emphasis pla#ed on #lient-therapist

relationship


DSM-5 Update

Existential Theories and

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Existential Theories andTherapy

*'istential therapists do not belieethat e'perimental methods #anade.uately test the eEe#tieness otheir treatments; as a result, little#ontrolled resear#h has been#ondu#ted


DSM-5 Update

Assessing the Hmanistic

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DSM-5 Update

Assessing the Hmanistic,Existential Model

Stren$ths

0aps into domainsmissin$ rom other

theories *mphasi>es the

indiidual

Fptimisti#

*mphasi>es health

7ea(nesses

@o#uses on abstra#tissues

DiJ#ult to resear#h

7ea(ened bydisapproal os#ienti+# approa#h

Chan$in$ some)hat

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DSM-5 Update

The Sociocltral Models

"r$ue that abnormal behaior is bestunderstood in li$ht o the so#ial and#ultural or#es that inuen#e an

indiidual "ddress norms and roles in so#iety

Comprised o t)o maor perspe#ties

@amily-So#ial perspe#tie

Multi#ultural perspe#tie

How Do &amily,Social

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DSM-5 Update

How Do &amily SocialTheorists Explain Abnormal

&nctioning? roponents o this model ar$ue that

theorists should #on#entrate onor#es that operate dire#tly on anindiidual, in#ludin$

So#ial labels and roles

Dia$nosti# labels e'ample Rosenhan study6

So#ial #onne#tions and supports

How Do &amily,Social

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DSM-5 Update

How Do &amily SocialTheorists Explain Abnormal

&nctioning? @o#us on

@amily stru#ture and #ommuni#ation

@amily systems theory ar$ues that abnormalun#tionin$ )ithin a amily leads toabnormal behaior insane behaiorbe#omes sane in an insane enironment6

*'amples enmeshed, disen$a$ed stru#tures

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DSM-5 Update

&amily,Social Treatments

0his perspe#tie has helped spur the$ro)th o seeral treatmentapproa#hes, in#ludin$

?roup therapy

@amily therapy

Couple therapy

Community treatment

%n#ludes preention )or(

How Do Mlticltral Theorists

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DSM-5 Update

How Do Mlticltral TheoristsExplain Abnormal &nctioning?

Culture reers to the set o alues, attitudes,belies, history, and behaiors shared by a$roup o people and #ommuni#ated rom one$eneration to the ne't

0he multi#ultural, or #ulturally dierse,perspe#tie has emer$ed as a $ro)in$ +eld ostudy

Multi#ultural psy#holo$ists see( to understand

ho) #ulture, ra#e, ethni#ity, $ender, and similara#tors aEe#t behaior and thou$ht, as )ell asho) people o diEerent #ultures, ra#es, and$enders diEer psy#holo$i#ally

How Do Mlticltral Theorists

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DSM-5 Update

How Do Mlticltral TheoristsExplain Abnormal &nctioning?

0he model holds that an indiidual9sbehaior is best understood )hen e'aminedin the li$ht o that indiidual9s uni.ue

#ultural #onte't 0hey also hae noti#ed that the preudi#e

and dis#rimination a#ed by many minority$roups may #ontribute to #ertain orms o

abnormal un#tionin$

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Mlticltral Treatments

Studies hae ound that members oethni# and ra#ial minority $roups tend tosho) less improement in #lini#al

treatment than members o maority$roups

0)o eatures o treatment #an in#rease atherapist9s eEe#tieness )ith minority #lients

?reater sensitiity to #ultural issues %n#lusion o #ultural models in treatment, espe#ially

in therapies or #hildren and adoles#ents


DSM-5 Update

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Mlticltral Treatments

?ien su#h +ndin$s, some #lini#ianshae deeloped #ulture-sensitietherapies as )ell as $ender-sensitie,or eminist, therapies

60

Comer, "bnormal sy#holo$y, 8e,

DSM-5 Update

Assessing the

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61


DSM-5 Update

Assessing theSociocltral Models

Stren$ths

"dded $reatly to the#lini#al understandin$

and treatment oabnormality

%n#reased a)arenesso #lini#al and so#ialroles

Clini#ally su##essul)hen othertreatments hae ailed

7ea(nesses

Resear#h is diJ#ult tointerpret

Correlation #ausation

Model unable topredi#t abnormality in

spe#i+# indiiduals

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$ntegration of the Models

0oday9s leadin$ models ary )idelyand none o the models has proed#onsistently superior

62


DSM-5 Update

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+omparing the Models

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DSM-5 Update

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" $ro)in$ number o #lini#ians aore'planations o abnormal behaior that#onsider more than one #ause at a time

0hese are sometimes #alledbiopsy#hoso#ial theories

"bnormality results rom the intera#tion o

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