Chapter 3 Models of Abnormality Slides & Handouts by Karen Clay Rhines, Ph.D. Seton Hall University.

Chapter 3

Models of Abnormality

Slides & Handouts by Karen Clay Rhines, Ph.D.Seton Hall University

Slide 2


What is a model or paradigm?

• A set of assumptions and concepts that help us explain and interpret observations

• A school of thought

• Helpful because it spells out basic assumptions and sets guidelines for investigation

• It influences what investigators observe, the questions they ask, the information they seek, and their interpretation of that information

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Historically, clinical scientists of a given time and place agreed on a single model of abnormality – a model strongly influenced by cultural beliefs

Currently, there are several competing models of abnormality

• Why? Each model focuses on one aspect of human functioning and no single model can explain all aspects of abnormality

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The Biological Model

Takes a medical perspective

Main focus is that psychological abnormality is an illness brought about by malfunctioning parts of the organism

• Typically focused on the BRAIN

Slide 5

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

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Brain anatomy and abnormal behavior

• Clinical researchers have found connections between certain psychological disorders and problems in specific brain areas

• Example: Huntington’s disease & basal ganglia (forebrain)

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Brain chemistry

• Information spreads throughout the brain in the form of electrical impulses that travel from one neuron to one or more others

• An impulse is first received at a neuron’s dendrites, travels down the axon, and is transmitted to other neurons through the nerve endings

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Brain chemistry

• Neurons don’t touch; they are separated by a space (the synapse), across which a message moves

• When an electrical impulse reaches a nerve ending, the nerve ending is stimulated to release a chemical (a neurotransmitter or “NT”)

• Some NTs tell receiving neurons to “fire”; other NTs tell receiving neurons to stop firing

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Role of brain chemistry in 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

• Examples: depression (serotonin and norepinephrine) and anxiety (GABA)

Slide 11


Role of brain chemistry

• Additionally, researchers have learned that mental disorders are sometimes related to abnormal chemical activity in the endocrine system

• Hormone release, triggered by a variety of factors, propels body organs into action. Abnormal secretions have been linked to psychological disorders

• Example: cortisol release is related to anxiety and mood disorders

Slide 12


Biological abnormalities – genetics • Humans have 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, mental retardation, Alzheimer’s disease, and other mental disorders

• Aren’t able (yet) to identify specific genes

• Don’t know the extent to which genetic factors contribute to disorders

• Seems no SINGLE gene is responsible for a particular behavior or disorder

Slide 13


Biological abnormalities – evolution • Genes that contribute to mental disorders are viewed as

unfortunate occurrences:• May be mutations

• May be inherited after a mutation in the family line

• Evolutionary theorists argue that we can best understand abnormality by examining the millions of years of human evolution

• Looking at a combination of adaptive behaviors of the past, genes, and the interaction between genes and current environmental events

• This model has been criticized and remains controversial

Slide 14


Biological abnormalities – viral infections

• Infection provides another possible source of abnormal brain structure or biochemical dysfunction

• 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

Slide 15

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

Slide 16


Drug therapy:

• 1950s = advent of psychotropic medications

• Changed outlook for a number of mental disorders

• Four groups of drugs:

• Antianxiety drugs (anxiolytics; tranquilizers)

• Antidepressant drugs

• Antibipolar drugs (mood stabilizers)

• Antipsychotic drugs

Slide 17


Electroconvulsive therapy (ECT):

• Currently experiencing a revival

• Used for severe depression when drugs and other therapies have failed

• In 60% of cases, ECT can lift symptoms within a few weeks

Slide 18


Psychosurgery:

• Historical roots in trephination

• 1930s = first lobotomy

• Much more precise than in the past

• Considered experimental and used only in extreme cases

Slide 19

Assessing the Biological Model

Weaknesses:

• Can limit rather than enhance our understanding

• Too simplistic

• Evidence is incomplete or inconclusive

• Treatments produce significant undesirable (negative) effects

Strengths:

• Earns considerable respect in the field

• Fruitful

• Creates new therapies

• Suggests new avenues of research

Slide 20

The Psychodynamic Model

Oldest and most famous psychological model

Based on belief that a person’s behavior is determined largely by underlying dynamic psychological forces of which she or he is not aware

• Abnormal symptoms are the result of conflict among these forces

Father of psychodynamic theory and psychoanalytic therapy:

• Sigmund Freud (1856 – 1939)

Slide 21

How Did Freud Explain Normal and Abnormal Behavior?

Caused by three UNCONSCIOUS forces:

1. Id – guided by the Pleasure Principle

• Instinctual needs, drives, & impulses

• Sexual; fueled by libido (sexual energy)

2. Ego – guided by the Reality Principle

• Seeks gratification but guides us to know when we can & can’t get and express our wishes

• Ego defense mechanisms protect us from anxiety

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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 conflict

• A healthy personality is one in which compromise exists between the parts

• If the id, ego, and superego are in excessive conflict, the person’s behavior may show signs of dysfunction

Slide 24


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

Slide 25


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)

Slide 26

How Do Other Psychodynamic Explanations Differ from Freud’s?

Although current models deviate from Freud’s in fundamental ways, each retains the belief that human functioning is shaped by interacting forces:

• Ego theorists

• Emphasize the role of the ego; consider it independent

• Self theorists

• Emphasize the unified personality over any one component

• Object-relations theorists

• Emphasize the human need for interpersonal relationships

Slide 27

Psychodynamic Therapies

Range from Freudian psychoanalysis to more modern therapies

All seek to uncover past trauma and inner conflicts

• Understanding early life experience critically important

Therapist acts as “subtle guide”

Slide 28

Psychodynamic Therapies

Utilize various techniques:

• Free association

• Therapist interpretation

• Resistance

• Transference

• Dream interpretation

• Catharsis

• Working through

• Short-term dynamic therapies

Slide 29

Assessing the Psychodynamic Model

Strengths:

• First to recognize importance of psychological theories & treatment

• Saw internal conflict as important source of psychological health and abnormality

• First to apply theory and techniques systematically to treatment – monumental impact on the field

Weaknesses:

• Unsupported ideas; difficult to research

• Non-observable

• Inaccessible to human subject (unconscious)

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The Behavioral Model

Like the psychodynamic perspective, behaviorism is deterministic, and is based on the idea that our actions are determined largely by our life experiences

Emphasis is on observable behavior and environmental factors

Focus on how behavior is acquired (learned) and maintained over time

Slide 32

The Behavioral Model

Historical beginnings in laboratories where conditioning studies were conducted

• Several forms of conditioning:

• Operant conditioning

• Modeling

• Classical conditioning

• May produce normal or abnormal behavior

Slide 33

How Do Behaviorists Explain Abnormal Functioning?

Operant conditioning

• Organism “operates” on environment and produces an effect

• Humans and animals learn to behave in certain ways as a result of receiving rewards whenever they do so

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Modeling

• Individuals learn behavioral responses by observing and repeating behavior

• No direct reinforcement

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Classical conditioning

• Learning by temporal association

• 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

• Father of classical conditioning: Ivan Pavlov (1849 – 1936)

• Classic study using dogs & meat powder

Slide 36

Classical Conditioning

UR

Salivate

UR

Salivate

US

Meat

Tone

CS

Tone

CR

Salivate

US

Meat+

Slide 37


Classical conditioning

• If, after conditioning, the CS is repeatedly presented alone, it will eventually stop eliciting the CR

• This process is called extinction

• Explains many familiar behaviors (both normal and abnormal)

Slide 38

Behavioral Therapies

Aim is 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

• Early life experiences important only in providing clues to current learning

Slide 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

• Develop a fear hierarchy

• Confront feared situations (covertly or in vivo)

Slide 40

Assessing the Behavioral Model

Strengths:

• Powerful force in the field

• Rooted in empiricism

• Phenomena can be observed and measured

• Significant research support for behavioral therapies

Weaknesses:

• Too simplistic

• Unrealistic

• Downplays role of cognition

• New focus on self-efficacy, social cognition, and cognitive-behavioral theories

Slide 41

The Cognitive Model

Seeks to account for behavior by studying the ways in which the person attends to, interprets, and uses available information

Argues that clinicians must ask questions about assumptions, attitudes, and thoughts

• Concerned with internal processes

• Present-focused

Slide 42

How Do Cognitive Theorists Explain Abnormal Functioning?

Maladaptive thinking is the cause of maladaptive behavior

• Several kinds of faulty thinking:

• Faulty assumptions and attitudes

• Illogical thinking processes

• Example: overgeneralization

Slide 43

Cognitive Therapies

People must be taught a new way of thinking to prevent maladaptive behavior

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 dysfunctional thoughts, try out new interpretations, and apply new ways of thinking in their daily lives

• Widely used in treating depression

Slide 44

Assessing the Cognitive Model

Strengths:• Broad appeal

• Clinically useful & effective

• Focuses on a uniquely human process

• Correlation between symptoms and maladaptive cognition

• Therapies effective in treating several disorders

• Adapt well to technology

• Research-based

Weaknesses:

• Singular, narrow focus

• Overemphasis on the present

• Limited effectiveness

• Verification of cognition is difficult

• Precise role is hard to determine

Slide 45

The Humanistic-Existential Model

Combination model

• The humanist view

• Emphasis on people as friendly, cooperative, and constructive; focus on drive to self-actualization

• The existentialist view

• Emphasis on self-determination, choice, and individual responsibility; focus on authenticity

Slide 46

Rogers’ Humanistic Theory and Therapy

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 – don’t know

what they really need, etc.

Rogers’ “client-centered” therapy• Therapist provides unconditional positive regard

• Both accurate & genuine in reflection (reflective listening)

• Focus on the “experiencing person”

• Little research support

Slide 47

Gestalt Theory and Therapy

Humanistic approach

• Developed by Fritz Perls

• Goal is to achieve self-recognition through challenge and frustration

• Techniques:

• Skillful frustration

• Role playing

• Rules, including “Here and Now” and “I” language

Slide 48

Spiritual Views and Interventions

For most of the twentieth century, clinical scientists viewed religion as a negative factor in mental health

This alienation now seems to be ending:

• Numerous books have been published

• Ethical codes now include religion under “diversity”

• Researchers have begun to systematically study the influence of religion and spirituality on mental health

• Many therapists now address spiritual issues when treating religious clients

Slide 49

Existential Theories and Therapy

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

Therapy is focused on patient acceptance of personal responsibility and recognition of freedom of action

• Goals more important than technique

• Great emphasis placed on client-therapist relationship

Slide 50

Assessing the Humanistic-Existential Model

Strengths:

• Emphasizes the individual

• Taps into domains missing from other theories

• Non-deterministic

• Optimistic

• Emphasizes health

Weaknesses:

• Focuses on abstract issues

• Not much influence

• Weakened by disapproval of scientific approach

• Changing somewhat

Slide 51

The Sociocultural Model

Argues that abnormal behavior is best understood in light of the social and cultural forces that influence an individual

• Addresses norms and roles in society

Influenced by sociology and anthropology

Argues that we must examine a person’s social surroundings to understand their (abnormal) behavior

Slide 52

How Do Sociocultural Theorists Explain Abnormal Functioning?

Focus on:

• Family structure and communication

• Family systems theory = abnormal functioning within family leads to abnormal behavior (insane behavior becomes sane in an insane environment)

• Examples: enmeshed, disengaged structures

• Role of culture

• Role of social networks/support

Slide 53

How Do Sociocultural Theorists Explain Abnormal Functioning?

Focus on:

• Societal conditions

• Abnormality more common in lower classes. Why?

• Societal labels & roles

• Diagnostic labels (example: Rosenhan study)

• Sick role

Slide 54

Sociocultural Treatments

May include traditional individual therapy

Broadened therapy to include:

• Culturally-sensitive therapy

• Group therapy

• Family therapy

• Couples therapy

• Community treatment • Includes prevention work

Slide 55

Assessing the Sociocultural Model

Strengths:

• Added greatly to the clinical understanding of abnormality

• Increased awareness of labeling

• Clinically successful when other treatments have failed

Weaknesses:

• Research is difficult to interpret

• Correlation causation

• Model unable to predict abnormality in specific individuals

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Slide 57

Integration of the Models

Each perspective is valuable to understanding abnormal behavior

Different perspectives are more appropriate under differing conditions

An integrative approach provides a general framework for thinking about abnormal behavior while also allowing for specification of the factors that are especially pertinent to particular disorders

Slide 58


Many theorists, clinicians, and practitioners adhere to a biopsychosocial model• Abnormality results from the interaction of genetic,

biological, developmental, emotional, behavioral, cognitive, social, and societal influences

Also popular:

• Diathesis-stress approach• Diathesis = predisposition (bio, psycho, or social)

• Reciprocal effects explanation

Slide 59


Integrative therapists are often called “eclectic” – taking the strengths from each model and using them in combination

Chapter 3 Models of Abnormality Slides & Handouts by Karen Clay Rhines, Ph.D. Seton Hall University.

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