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Psychology 3318 Davison and Neale Chapter 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 Early feminist Horney 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 goaldirected • 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