Psychology 3318 Davison and Neale Chapter 2: Current Paradigms in Psychopathology and Therapy
Dec 22, 2015
Psychology 3318
Davison and NealeChapter 2: Current Paradigms in Psychopathology and Therapy
Overview of Davison and Neale Paradigms
• Biological (Medical, Disease)• Psychoanalytic• Humanistic/Existential• Learning• Cognitive
Biological Paradigm
• Types of Disease: Infectious vs. Traumatic
• Basic Model– Predisposition (resistance) and
exposure (germs, trauma, etc.) interact to produce disease
– Disease causes symptoms and signs• Symptoms: what is reported• Signs: what is observable (more
important)
Representation of Biological Model
Behavior Genetics
• Key concepts: Genes, genotype, phenotype – Family method: index case (probands), – Twin method: monozygotic (MZ) vs.
dizygotic (DZ) twins, concordance, – Adoptee method– Linkage analysis: looks for particular
gene based upon genetic markers
Central Nervous System Biochemistry
• Key concepts; Neurons, nerve impulses, synapse, neurotransmitters (see Figs. 2.1 and 2.2)
• Some key neurotransmitters: – Norepinephrine (noradrenalin)– Gamma-aminobutyric acid (GABA)– Dopamine (schizophrenia?)– Serotonin (depression?)
• Very important to drug therapy
Classical Freudian Concepts
• Strongly Darwinian• Sex is a basic motive• Structures: Id (motives), ego (executive), superego (morality)• Levels of consciousness: Conscious, preconscious, unconscious• Principles: Pleasure vs. reality• Processes: Primary vs. secondary• Psychosexual stages: Polymorphous perverse, oral-passive, oral-
biting, anal, phallic, latent, genital• Fixations and regressions• Oedipus (Electra) complex• Anxiety: Objective (realistic), neurotic, moral• Defense mechanisms: Repression, denial, projection, displacement,
rationalization, reaction formation, sublimation (see Table 2.1)
Freudian Disease Model
Other Early Psychoanalysts (“NeoFreudians”)
Carl Jung Early Humanist, stressed collective unconscious
Alfred Adler Power is basic motive, individual psychology
Karen Horney
Early feminist
Erich Fromm
Early existentialist, stressed role of society
Traditional Therapeutic Concepts
• Free Association• Resistance• Dream analysis (latent vs. manifest
content)• Transference and countertransference• Interpretation• Analyst sits in background; patient is
prone
Newer Concepts
• Ego analysis (many, including Freud): Ability of person to control environment
• Brief therapy: Ferenczi; Alexander and French
• Interpersonal therapy (Klerman and Weissman): concenrates on person’s current difficulties; active teaching
Evaluation
• “Blame your parents” and rejection of responsibility
• Child is “father” to the “man”.• Unconscious influences on behavior• Role of defense mechanisms• Causes of behavior may not be
apparent
Humanistic/Existential: Rogers Client-Centered Therapy
• Importance of phenomenology• Healthy people are aware of behavior• Healthy people are good• Healthy people are purposive and goal-
directed• Importance of self-actualization• Therapeutic techniques
– Reflection– Unconditional positive regard– Empathy: primary (understanding) vs. advanced
(inferential)
Humanistic/Existential: Existential
• Based (perhaps loosely) on philosophic movement
• Stresses the present and responsibility for choice
• Goal is to change behavior
Humanistic/Existential: Gestalt Therapy (Fritz Perls)
• Existential in orientation• Techniques
– I-language– Empty chair– Projection of feelings– Attending to nonverbal cues– Use of metaphor
• (For comparison of the three approaches, see Table 2.3)
Learning Paradigms
• Basic model: psychopathology is learned
• Important early names– Pavlov– Watson– Thorndike
• Major types of learning– Classical (Pavlovian) conditioning– Operant (instrumental) conditioning– Modeling (vicarious learning)
Pavlovian Concepts
• Unconditioned stimulus: US or UCS• Conditioned stimulus: CS• Unconditioned response: UR or UCR• Conditioned response: CR• Many prefer “conditional” and
“unconditional” to “conditioned” and “unconditioned”
• Extinction
Operant Concepts
• Law of effect• Discriminative stimulus• Positive and negative reinforcement• Shaping• Avoidance conditioning• Mediational vs. Skinnerian approaches• Skinner: There is no difference between
disease and symptoms
Behavior Therapy and Modification
• Use of behavioral techniques to modify pathological behavior
• Behavior therapy is more mediational• Behavioral modification is more Skinnerian• Counterconditioning• Systematic desensitization• Flooding (implosion)• Aversive conditioning• Time-out• Token economy
Modeling
• Role Playing• Rehearsal• Self-efficacy
Cognitive Paradigm
• Although Skinner denied the importance of cognition (thought) many of his followers became cognitive.
• Schema• Cognitive behavior therapy
– Beck– Ellis and Rational-emotional Behavior
Therpy (REBT)– Group therapies– Self-efficacy
General Considerations
• See Table 2.4 for a comparison of psychoanalytic and cognitive-behavioral approaches.
• Diathesis-stress is unifying concept• Importance of eclecticism: Good
therapists are seen as more alike one another, despite paradigm, than bad ones