CHAPTER Models of Abnormality

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C H A P T E R   :3
Models of

          TO P I C OV E RV I E W
     The Biological Model
         How Do Biological Theorists Explain Abnormal Behavior?
         Biological Treatments

     The Psychodynamic Model
         How Did Freud Explain Normal and Abnormal Functioning?
         How Do Other Psychodynamic Explanations Differ from Freud's?
         Psychodynamic Therapies

     The Behavioral Model
         How Do Behaviorists Explain Abnormal Functioning?
         Behavioral Therapies

     The Cognitive Model
         How Do Cognitive Theorists Explain Abnormal Functioning?
         Cognitive Therapies

     The Humanistic-Existential Model
         Rogers's Humanistic Theory and Treatment
         Gestalt Theory and Therapy
         Spiritual Views and Interventions
         Existential Theories and Therapy

     The Sociocultural Model:The Family-Social and Multicultural Perspectives
         How Do Family-Social Theorists Explain Abnormal Functioning?
         Family-Social Treatments
         How Do Multicultural Theorists Explain Abnormal Functioning?
         Multicultural Treatments

     Putting It Together: Integration of the Models

26   CHAPTER 3

                               LECTURE OUTLINE
           A. In science, the perspectives used to explain events are known as models or paradigms
              1.    Each spells out basic assumptions, gives order to the field under study, and sets
                    guidelines for investigation
              2.    They influence what investigators observe, the questions they ask, the information
                    they seek, and how they interpret this information
           B. Historically, clinical scientists of a given time and place tended to agree on a single model
              of abnormality--a model greatly influenced by the beliefs of their culture
           C. Today, several models are used to explain and treat abnormal functioning
              1.    Each model focuses on one aspect of human functioning and no single model can ex-
                    plain all aspects of abnormality

           A. This model adopts a medical perspective
           B.  The main focus is that psychological abnormality is an illness brought about by malfunc-
               tioning parts of the organism--typically focused on the BRAIN
           C. How Do Biological Theorists Explain Abnormal Behavior?
               1.    The first area of examination is brain anatomy
                     a.    The brain is composed of approximately 100 billion nerve cells (called neurons)
                           and thousands of billions of support cells (called glia)
                     b.    Within the brain, large groups of neurons form distinct areas called brain re-
                     c.    Clinical researchers have discovered connections between certain psychologi-
                           cal disorders and problems in specific brain areas
                           (a) Example: Huntington's disease and the basal ganglia (forebrain)
               2.    A second avenue of examination is brain chemistry
                     a.    Information is communicated throughout the brain in the form of electrical im-
                           pulses that travel from one neuron to one (or more) others
                     b.    An impulse first is received at a neuron's dendrites, travels down the axon, and
                           is transmitted to other neurons through the nerve endings
                     c.    Neurons don't actually touch--they are separated by a space (the synapse)
                           across which a message moves
                     d.    When an electrical impulse reaches a nerve ending, the ending is stimulated to
                           release a chemical (a neurotransmitter or "NT") that travels across the synaptic
                           space to receptors on the dendrites of neighboring neurons
                           (a) Some NTs tell receiving neurons to "fire;" other NTs tell receiving neurons
                                 to stop firing
                           (b) Researchers have identified dozens of NTs
                                 (i) Examples: serotonin, dopamine, GABA
                     e.    Studies indicate that abnormal activity in certain NTs can lead to specific men-
                           tal disorders
                           (a) Examples: depression (serotonin and norepinephrine) and anxiety (GABA)
                     f.    Additionally, researchers have learned that mental disorders are sometimes re-
                           lated to abnormal chemical activity in the endocrine system
                           (a) Endocrine glands release hormones which propel body organs into action.
                                 Abnormal secretions have been linked to psychological disorders
                                 (i) Example: Cortisol release is related to anxiety and mood disorders
               3.    A third area of investigation is genetic abnormalities
                     a.    Each cell in the human body has 23 pairs of chromosomes, each with numerous
                           genes that control the characteristics and traits a person inherits
                     b.    Studies suggest that inheritance plays a part in mood disorders, schizophrenia,
                           Alzheimer's disease, and other mental disorders
                                                                           Models of Abnormality    27

                (a)   Researchers aren't (yet) able to identify specific genes
                (b)   Also, they do not yet know the extent to which genetic factors contribute
                      to various mental disorders
                (c) It appears that in most cases, several genes combine to produce our ac-
                      tions and reactions
     4.   A fourth area of focus is on biological abnormalities passed on through evolution
          a.    Genes that contribute to mental disorders are viewed as unfortunate occur-
                (a) Such genes may be mutations
                (b) Such genes may be inherited after a mutation in the family line
          b.    Evolutionary theorists argue that we can best understand abnormality by ex-
                amining the millions of years of human evolution
                (a) The modern evolutionary focus is looking at a combination of adaptive
                      behaviors of the past, genes, and the interaction between genes and cur-
                      rent environmental events
          c.    This model has been criticized and remains controversial yet it receives con-
                siderable attention
     5.   The fifth avenue of research examines biological abnormalities as a result of viral in-
          a.    Infection provides another possible source of abnormal brain structure or bio-
                chemical dysfunction
                (a) Example: schizophrenia and prenatal viral exposure
          b.    The scientific interest in viral explanations of psychological disorders has been
                growing in the past decade
                (a) Example: anxiety and mood disorders
D.   Biological Treatments
     1.   Biological practitioners attempt to pinpoint the physical source of dysfunction to de-
          termine the course of treatment
     2.   There are three general types of biological treatment:
          a.    Drug therapy
                (a) The 1950s heralded the advent of psychotropic medications and changed
                      the fairly bleak outlook for a number of mental disorders yet the revolu-
                      tion has produced some major problems
                (b) Four groups:
                      (i) Antianxiety drugs (anxiolytics; tranquilizers)
                      (ii) Antidepressant drugs
                      (iii) Antibipolar drugs (mood stabilizers)
                      (iv) Antipsychotic drugs
          b.    Electroconvulsive therapy (ECT)
                (a) Its use is indicated for severe depression when drugs and other therapies
                      have failed
                (b) This treatment is used on tens of thousands of depressed persons an-
          c.    Neurosurgery
                (a) Psychosurgery finds its historical roots in trephination
                (b) The first lobotomy was performed in the 1930s
                (c) The procedure now is much more precise than in the past but is consid-
                      ered experimental and used only in extreme cases
E.   Assessing the Biological Model
     1.   Model strengths:
          a.    The biological model earns considerable respect in the field
          b.    It constantly produces valuable new information
          c.    Biological treatments often bring great relief
     2.   Weaknesses of the model:
          a.    The biological model can limit rather than enhance our understanding
                (a) It is criticized as being too simplistic
28   CHAPTER 3

                     b.    Supporting evidence is incomplete or inconclusive
                     c.    Biological treatments produce significant undesirable (negative) effects

          A. The psychodynamic model is the oldest and most famous psychological model
          B.  It is based on the belief that a person's behavior (whether normal or abnormal) is deter-
              mined largely by underlying dynamic psychological forces of which s/he is not aware
              1.     Abnormal symptoms are the result of conflict among these forces
          C. The father of psychodynamic theory and psychoanalytic therapy was Sigmund Freud
          D. How Did Freud Explain Normal and Abnormal Functioning?
              1.     Freud argued that all behavior was caused by three UNCONSCIOUS forces:
                     a.    The Id, guided by the Pleasure Principle, is comprised of instinctual needs,
                           drives, and impulses; it is sexual and fueled by libido (sexual energy)
                     b.    The Ego is governed by the Reality Principle; it seeks gratification but guides
                           us to know when we can and can't get and express our wishes
                           (a) Ego defense mechanisms protect us from anxiety
                           (b) These defenses include repression, regression, intellectualization, denial,
                                 reaction formation, projection, and sublimation
                     c.    The Superego is considered the moral center of the psyche and is guided by the
                           Morality Principle; it is also called a "conscience" and unconsciously is adopted
                           from our parents
              2.     According to Freud, these three parts of the personality are often in some degree of
                     a.    A healthy personality is one in which compromise exists among the three forces
                     b.    If the id, ego, and superego are in excessive conflict, the person's behavior may
                           show signs of dysfunction
              3.     Freud proposed that humans must negotiate five stages of psychosexual develop-
                     ment in their journeys to adulthood
                     a.    These stages include:
                           (a) Oral (0 to 18 months of age)
                           (b) Anal (18 months to 3 years of age)
                           (c) Phallic (3 to 5 years of age)
                           (d) Latent (5 to 12 years of age)
                           (e) Genital (12 years of age to adulthood)
                     b.    Freud believed that at each stage of development new events and pressures re-
                           quire adjustment in the id, ego, and superego
                           (a) If one is successful negotiating these stages, they will achieve personal
                           (b) If one is unsuccessful, fixation will occur at the developmental stage and
                                 will lead to psychological abnormality
                                 (i) Because parents are the key environmental figures in early life, they
                                        often are seen as the cause of improper development
          E.  How Do Other Psychodynamic Explanations Differ from Freud's?
              1.     Although new theories depart from Freud's ideas in important ways, each retains the
                     belief that human functioning is shaped by dynamic (interacting) forces:
                     a.    Ego theorists emphasize the role of the ego and consider it independent from
                           the id and the superego
                     b.    Self theorists emphasize the unified personality over any one component
                     c.    Object relations theorists emphasize the human need for (healthy) interpersonal
          F.  Psychodynamic Therapies
              1.     These therapies range from Freudian psychoanalysis to more modern therapies
              2.     All psychodynamic therapies seek to uncover past trauma and inner conflicts and be-
                     lieve that an understanding of early life experience is critically important
              3.     The therapist acts as a "subtle guide"
                                                                                  Models of Abnormality    29

           4.   Psychodynamic therapists utilize various techniques, including:
                a.   Free association--A technique in which the patient describes any thought, feel-
                     ing, or image that comes to mind, even if it seems unimportant or irrelevant
                b.   Therapist interpretation, including addressing issues such as:
                     (a) Resistance--An unconscious refusal to participate fully in therapy
                     (b) Transference--A process that occurs during therapy in which patients act
                            toward the therapist as they did or do toward important figures in their
                     (c) Dream interpretation--A process in which the therapist examines the
                            manifest and latent content of a patient's dream
                c.   Catharsis--The reliving of past repressed feelings in order to settle internal con-
                     flicts and overcome problems
                d.   Working through--The process of facing conflicts, reinterpreting feelings, and
                     overcoming one's problems
                e.   Contemporary psychodynamic therapists also may use short-term dynamic or
                     relational psychoanalytic approaches to therapy rather than more traditional
                     but longer/intense psychoanalysis
      G.   Assessing the Psychodynamic Model
           1.   Strengths of the model:
                a.   The psychodynamic model was the first to recognize importance of psycholog-
                     ical theories and treatment
                b.   This model saw/sees internal conflict as an important source of psychological
                     health and abnormality
                c.   Proponents of this model were the first to apply theory and techniques sys-
                     tematically to treatment, a practice which had a monumental impact on the
           2.   Weaknesses of the model:
                a.   The ideas proposed by the model largely are unsupported and difficult or im-
                     possible to research
                     (a) The model addresses components of functioning that are nonobservable
                            and inaccessible to human subjects (unconscious)

      A. Like the psychoanalytic perspective, behaviorism also is deterministic, based on the idea
          that our actions are determined largely by our life experiences
      B.  The model concentrates wholly on behaviors and environmental factors and on how be-
          havior is acquired (learned) and maintained over time
      C. Behavioral theorists base their explanations and treatments on principles of learning, the
          process by which these behaviors change in response to the environment
      D. The historical beginnings of behaviorism is in laboratories where conditioning studies
          were conducted
      E.  How Do Behaviorists Explain Abnormal Functioning?
          1.    There are several forms of conditioning addressed by this model, all of which may
                produce normal or abnormal behavior:
                a.   Operant conditioning
                     (a) According to this conditioning paradigm, humans and animals learn to
                           behave in certain ways as a result of receiving rewards whenever they do
                b.   Modeling
                     (a) In a modeling paradigm, individuals learn responses simply by observing
                           and repeating behavior
                c.   Classical conditioning
                     (a) Classical conditioning is learning by temporal association
                           (i) When two events repeatedly occur close together in time, they be-
                                come fused in a person's mind and, before long, the person responds
                                in the same way to both events
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