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Chapter 3 Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved Models of Abnormality Models of Abnormality – Each model spells out basic assumptions, gives order to the field under study, and sets guidelines for investigation – Models influence what investigators observe, the questions they ask, the information they seek, and how they interpret this information Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • In science, the perspectives used to explain events are known as _________ or paradigms • Until recently, clinical scientists of a given place and time tended to agree on a single model of abnormality – a model greatly influenced by the beliefs of their culture • Today several models are used to explain and treat abnormal functioning – Sometimes in conflict, each model focuses on one aspect of human functioning and no single model can explain all aspects of abnormality Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved Models of Abnormality The Biological Model – Typically point to problems in brain anatomy or brain chemistry Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Adopts a medical perspective • Main focus is that psychological abnormality is an illness brought about by malfunctioning parts of the organism How Do Biological Theorists Explain Abnormal Behavior? – 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 Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Brain anatomy How Do Biological Theorists Explain Abnormal Behavior? • Brain anatomy and abnormal behavior – Clinical researchers have discovered connections between certain psychological disorders and problems in specific brain areas Copyright © 2015 by Worth Publishers. All rights reserved • Example: Huntington's disease and basal ganglia (forebrain) Abnormal Psychology | Ronald J. Comer | Ninth Edition How Do Biological Theorists Explain Abnormal Behavior? – Information is communicated throughout the brain in the form of electrical impulses that travel from one neuron to one or more others – An impulse is first received by a neuron's dendrites, travels down the axon, and is transmitted through the nerve endings to other neurons Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Brain chemistry How Do Biological Theorists Explain Abnormal Behavior? – Neurons do not actually touch each other; they are separated by a space (the synapse), across which a message moves – When an electrical impulse reaches a nerve ending, the ending is stimulated to release a chemical, called a neurotransmitter (NT), that travels across the synaptic space to receptors on the dendrites of neighboring neurons • Some NTs tell receiving neurons to “fire;” other NTs tell receiving neurons to stop firing Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Brain chemistry How Do Biological Theorists Explain Abnormal Behavior? • Brain chemistry and abnormal behavior – Researchers have identified dozens of NTs • Examples: serotonin, dopamine, and GABA • For example: depression has been linked to low activity in serotonin and norepinephrine Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved – Studies indicate that abnormal activity in certain NTs can lead to specific mental disorders How Do Biological Theorists Explain Abnormal Behavior? – Additionally, researchers have learned that mental disorders are sometimes related to abnormal chemical activity in the endocrine system – Endocrine glands release hormones which propel body organs into action • Abnormal secretions have been linked to psychological disorders – Example: Cortisol release is related to anxiety and mood disorders Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Brain chemistry and abnormal behavior Sources of Biological Abnormalities – Genetics – Each cell in the human body contains 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, and other mental disorders • Appears that in most cases several genes combine to produce our actions and reactions Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Abnormalities in brain anatomy or chemistry are sometimes the result of genetic inheritance Sources of Biological Abnormalities – Genetics – May be mutations – May be inherited after a mutation in the family line – May be the result of normal evolutionary principles Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Genes that contribute to mental disorders are viewed as unfortunate occurrences: Sources of Biological Abnormalities – Evolution – Example: The fear response • In today's world, however, those genes and reactions may not be so adapative Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Evolutionary theorists argue that human reactions and the genes responsible for them have survived over the course of time because they have helped individuals thrive and adapt Sources of Biological Abnormalities – Viral Infections • Another possible source of abnormal brain structure or biochemical dysfunction is viral infections • Interest in viral explanations of psychological disorders has been growing in the past decade – Example: Anxiety and mood disorders Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved – Example: Schizophrenia and prenatal viral exposure Biological Treatments – __________ – __________ – __________ Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Biological practitioners attempt to pinpoint the physical source of dysfunction to determine the course of treatment • Three types of biological treatment: Biological Treatments • Drug therapy: – 1950s = advent of psychotropic medications • Greatly changed the outlook for a number of mental disorders • • • • Antianxiety drugs (anxiolytics; minor tranquilizers) Antidepressant drugs Antibipolar drugs (mood stabilizers) Antipsychotic drugs Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved – Four major drug groups: Biological Treatments • Electroconvulsive therapy (ECT): – Used primarily for depression, particularly when drugs and other therapies have failed Copyright © 2015 by Worth Publishers. All rights reserved • This treatment is used on tens of thousands of depressed persons annually Abnormal Psychology | Ronald J. Comer | Ninth Edition Biological Treatments – – – – Historical roots in trephination 1930s = first lobotomy Much more precise today than in the past Considered experimental and used only in extreme cases Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Psychosurgery (or neurosurgery): Assessing the Biological Model • Strengths: • Weaknesses: – Can limit, rather than enhance, our understanding • Too simplistic – Treatments produce significant undesirable (negative) effects Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved – Enjoys considerable respect in the field – Constantly produces valuable new information – Treatments bring great relief The Psychodynamic Model – Abnormal symptoms are the result of conflict among these forces • Father of psychodynamic theory and psychoanalytic therapy: – Sigmund Freud (1856–1939) Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Oldest and most famous psychological model • Based on belief that a person's behavior (whether normal or abnormal) is determined largely by underlying dynamic - that is, interacting psychological forces of which she or he is not consciously aware How Did Freud Explain Normal and Abnormal Functioning? • Shaped by three UNCONSCIOUS forces: – Id – guided by the Pleasure Principle • Instinctual needs, drives, and impulses • Sexual; fueled by libido (sexual energy) • Seeks gratification, but guides us to know when we can and cannot express our wishes • Ego defense mechanisms protect us from anxiety Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved – Ego – guided by the Reality Principle Defense Operation Example Repression Person avoids anxiety by simply not allowing painful or dangerous thoughts to become conscious. An executive’s desire to run amok and attack his boss and colleagues at a board meeting is denied access to his awareness. Denial Person simply refuses to acknowledge the existence of an external source of anxiety. You are not prepared for tomorrow’s final exam, but you tell yourself that it’s not actually an important exam and that there’s no good reason not to go to a movie tonight. Projection Person attributes own unacceptable impulses, motives, or desires to other individuals. The executive who repressed his destructive desires may project his anger onto his boss and claim that it is actually the boss who is hostile. Rationalization Person creates a socially acceptable reason for an action that actually reflects unacceptable motives. A student explains away poor grades by citing the importance of the “total experience” of going to college and claiming that too much emphasis on grades would actually interfere with a well-rounded education. Displacement Person displaces hostility away from a dangerous object and onto a safer substitute. After a perfect parking spot is taken by a person who cuts in front of your car, you release your pent-up anger by starting an argument with your roommate. Intellectualization Person represses emotional reactions in favor of overly logical response to a problem. A woman who has been beaten and raped gives a detached, methodical description of the effects that such attacks may have on victims. Regression Person retreats from an upsetting conflict to an early developmental stage at which no one is expected to behave maturely or responsibly. A boy who cannot cope with the anger he feels toward his rejecting mother regresses to infantile behavior, soiling his clothes and no longer taking care of his basic needs. Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved The Defense Never Rests: Defense Mechanisms to the Rescue How Did Freud Explain Normal and Abnormal Functioning? • Caused by three UNCONSCIOUS forces: – Superego – guided by the Morality Principle • Conscience; unconsciously adopted from our parents – A healthy personality is one in which an effective working relationship exists among the three forces – If the id, ego, and superego are in excessive conflict, the person's behavior may show signs of dysfunction Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • These three parts of the personality are often in some degree of conflict How Did Freud Explain Normal and Abnormal Functioning? • Developmental stages • 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 Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved – Freud proposed that at each stage of development new events and pressures require adjustment in the id, ego, and superego • • • • • • Developmental stages _________ (0 to 18 months of age) _________ (18 months to 3 years of age) _________ (3 to 5 years of age) _________ (5 to 12 years of age) _________ (12 years of age to adulthood Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved How Did Freud Explain Normal and Abnormal Functioning? How Do Other Psychodynamic Explanations Differ from Freud's? • Although new theories depart from Freud's ideas in important ways, each retains the belief that human functioning is shaped by dynamic (interacting) forces: – Ego theorists – Self theorists • Emphasize the unified personality – Object-relations theorists • Emphasize the human need for relationships, especially between children and caregivers Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Emphasize the role of the ego; consider it independent and powerful • Range from Freudian psychoanalysis to modern therapies • All seek to uncover past trauma and inner conflicts • Therapist acts as a “subtle guide” Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved Psychodynamic Therapies Psychodynamic Therapies • Utilize various techniques: • Resistance • Transference • Dream interpretation – Catharsis – Working through Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved – Free association – Therapist interpretation Psychodynamic Therapies • Contemporary trends: Copyright © 2015 by Worth Publishers. All rights reserved – Short-term psychodynamic therapies – Relational psychoanalytic therapy Abnormal Psychology | Ronald J. Comer | Ninth Edition Assessing the Psychodynamic Model • Strengths: • Weaknesses: – Unsupported ideas; difficult to research • Non-observable • Inaccessible to human subject (unconscious) Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved – First to recognize importance of psychological theories and treatment – Saw abnormal functioning as rooted in the same processes as normal functioning – First to apply theory and techniques systematically to treatment – monumental impact on the field • Like psychodynamic theorists, behavioral theorists believe that our actions are determined largely by our experiences in life • Concentrates wholly on behaviors and environmental factors • Bases explanations and treatments on principles of learning Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved The Behavioral Model The Behavioral Model • The model began in laboratories where conditioning studies were conducted • Operant conditioning • Modeling • Classical conditioning – All may produce normal or abnormal behavior Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved – Several forms of conditioning: How Do Behaviorists Explain Abnormal Functioning? • Operant conditioning – Humans and animals learn to behave in certain ways as a result of receiving rewards whenever they do so – Individuals learn responses by observing and repeating behavior Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Modeling How Do Behaviorists Explain Abnormal Functioning? • Classical conditioning – Learning by temporal association – Father of classical conditioning: Ivan Pavlov (1849 – 1936) • Classic study using dogs and meat powder – Explains many familiar behaviors (both normal and abnormal) Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • 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 __ __ Meat Salivate __ __ Meat + Tone Salivate __ __ Tone Salivate Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved Classical Conditioning Behavioral Therapies • Aim to identify the behaviors that are causing problems and replace them with more appropriate ones • Therapist is “teacher” rather than healer Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved – May use classical conditioning, operant conditioning, or modeling Behavioral Therapies • Classical conditioning treatments may be used to change abnormal reactions to particular stimuli – Example: systematic desensitization for phobia – Learn relaxation skills – Construct a fear hierarchy – Confront feared situations Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Step-by-step procedure Assessing the Behavioral Model • Strengths: – Powerful force in the field – Can be tested in the laboratory – Significant research support for behavioral therapies – No evidence that symptoms are ordinarily acquired through conditioning – Behavior therapy is limited – Too simplistic • New focus on self-efficacy, social cognition, and cognitive-behavioral theories Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Weaknesses: • This model proposes that we can best understand abnormal functioning by looking at cognitive processes – the center of behaviors, thoughts, and emotions • Argues that clinicians must ask questions about assumptions, attitudes, and thoughts of a client Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved The Cognitive Model How Do Cognitive Theorists Explain Abnormal Functioning? • Abnormal functioning can result from several kinds of cognitive problems: – Faulty assumptions and attitudes – Illogical thinking processes Copyright © 2015 by Worth Publishers. All rights reserved – Example: overgeneralization Abnormal Psychology | Ronald J. Comer | Ninth Edition Cognitive Therapies – The goal of therapy is to help clients recognize and restructure their thinking • Therapists also guide clients to challenge their dysfunctional thoughts, try out new interpretations, and apply new ways of thinking in their daily lives • Widely used in treating depression Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • People can overcome their problems by developing new ways of thinking • Main model: Beck's Cognitive Therapy Assessing the Cognitive Model • Strengths: – – – – – Very broad appeal Clinically useful and effective Focuses on a uniquely human process Theories lend themselves to research Therapies effective in treating several disorders – Precise role of cognition in abnormality has yet to be determined – Therapies do not help everyone – Some changes may not be possible to achieve • In response, a new wave of therapies has emerged, including Acceptance and Commitment Therapy and mindfulness-based techniques Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Weaknesses: Cybertherapy: Surfing for help – – – – Computer software therapy E-mail therapy Visual e-therapy Virtual support groups Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Cybertherapy has come to complement or even replace face-to-face therapy The Humanistic-Existential Model • Combination model – The humanist view – The existentialist view • Emphasis on self-determination, choice, and individual responsibility; focus on authenticity Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Emphasis on people as friendly, cooperative, and constructive; focus on drive to self-actualize through honest recognition of strengths and weaknesses Rogers' Humanistic Theory and Therapy • Believes in the 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 – do not know what they really need, etc. – Therapist creates a supportive climate • Unconditional positive regard • Accurate empathy • Genuineness – Little research support but positive impact on clinical practice Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Rogers' “client-centered” therapy Gestalt Theory and Therapy • Humanistic approach • Skillful frustration • Role playing • Rules, including “Here and Now” and “I” language – Little research support Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved – Developed by Fritz Perls – Goal is to guide clients toward self-recognition through challenge and frustration – Techniques: • For most of the twentieth century, clinical scientists viewed religion as a negative—or at best neutral—factor in mental health • This historical alienation between the clinical field and religion seems to be ending • Researchers have learned that spirituality can, in fact, be of psychological benefit to people Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved Spiritual Views and Interventions • Belief that 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 • In therapy, people are encouraged to accept personal responsibility for their problems – Goals more important than technique – Great emphasis placed on client-therapist relationship Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved Existential Theories and Therapy Existential Theories and Therapy Copyright © 2015 by Worth Publishers. All rights reserved • Existential therapists do not believe that experimental methods can adequately test the effectiveness of their treatments; as a result, little controlled research has been conducted Abnormal Psychology | Ronald J. Comer | Ninth Edition Saving Minds Along with Souls • Might there be serious drawbacks to placing care in the hands of religious persons, even if they receive lay training? Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Initiatives to involve churches and religious organizations in the care of serious mental illnesses Assessing the Humanistic-Existential Model • Strengths: Taps into domains missing from other theories Emphasizes the individual Optimistic Emphasizes health • Weaknesses: – Focuses on abstract issues • Difficult to research – Weakened by disapproval of scientific approach • Changing somewhat Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved – – – – The Sociocultural Models • Argue that abnormal behavior is best understood in light of the social and cultural forces that influence an individual • Comprised of two major perspectives: – Family-Social perspective – Multicultural perspective Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved – Address norms and roles in society How Do Family-Social Theorists Explain Abnormal Functioning? • Proponents of this model argue that theorists should concentrate on forces that operate directly on an individual, including: – Social labels and roles – Social connections and supports Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Diagnostic labels (example: Rosenhan study) How Do Family-Social Theorists Explain Abnormal Functioning? • Focus on: – Family structure and communication – Examples: enmeshed, disengaged structures Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Family systems theory argues that abnormal functioning within a family leads to abnormal behavior (insane behavior becomes sane in an insane environment) Family-Social Treatments – – – – Group therapy Family therapy Couple therapy Community treatment • Includes prevention work Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • This perspective has helped spur the growth of several treatment approaches, including: Have Your Avatar Call My Avatar • Clients know they are entering a make-believe world when they receive avatar therapy, so why do so many apparently make real-life progress? Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Avatar therapy – relatively new form of cybertherapy where clients use threedimensional graphical representations to interact in a virtual world How Do Multicultural Theorists Explain Abnormal Functioning? – The multicultural, or culturally diverse, perspective has emerged as a growing field of study – Multicultural psychologists seek to understand how culture, race, ethnicity, gender, and similar factors affect behavior and thought, as well as how people of different cultures, races, and genders differ psychologically Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Culture refers to the set of values, attitudes, beliefs, history, and behaviors shared by a group of people and communicated from one generation to the next • The model holds that an individual's behavior is best understood when examined in the light of that individual's unique cultural context • They also have noticed that the prejudice and discrimination faced by many minority groups may contribute to certain forms of abnormal functioning Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved How Do Multicultural Theorists Explain Abnormal Functioning? Multicultural Treatments – Two features of treatment can increase a therapist's effectiveness with minority clients: • Greater sensitivity to cultural issues • Inclusion of cultural models in treatment, especially in therapies for children and adolescents Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Studies have found that members of ethnic and racial minority groups tend to show less improvement in clinical treatment than members of majority groups Assessing the Sociocultural Models • Strengths: – Added greatly to the clinical understanding and treatment of abnormality • Increased awareness of clinical and social roles – Clinically successful when other treatments have failed – Research is difficult to interpret • Correlation causation – Model unable to predict abnormality in specific individuals Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Weaknesses: Integration of the Models • A growing number of clinicians favor explanations of abnormal behavior that consider more than one cause at a time • Abnormality results from the interaction of genetic, biological, developmental, emotional, behavioral, cognitive, social, and societal influences Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved – These are sometimes called biopsychosocial theories Integration of the Models • Some biopsychosocial theorists favor a diathesis-stress approach – Integrative therapists are often called “eclectic” – taking the strengths from each model and using them in combination Abnormal Psychology | Ronald J. Comer | Ninth Edition Copyright © 2015 by Worth Publishers. All rights reserved • Diathesis = predisposition (bio, psycho, or social)