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Models of Abnormality
Chapter 3
Slides & Handouts by Karen Clay Rhines, Ph.D.
American Public University System
Comer, Abnormal Psychology, 8e, DSM-5 Update
Models of Abnormality

In science, the perspectives used to explain
events are known as models or paradigms

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
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Models of Abnormality

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
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The Biological Model

Adopts a medical perspective

Main focus is that psychological
abnormality is an illness brought about by
malfunctioning parts of the organism

Typically point to problems in brain anatomy
or brain chemistry
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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
Comer, Abnormal Psychology, 8e, DSM-5
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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

Example: Huntington’s disease and basal ganglia
and cortex
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How Do Biological Theorists
Explain Abnormal Behavior?

Brain chemistry

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
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How Do Biological Theorists
Explain Abnormal Behavior?

Brain chemistry

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
Comer, Abnormal Psychology, 8e, DSM-5
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How Do Biological Theorists
Explain Abnormal Behavior?

Brain chemistry and 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

For example: depression has been linked to low
activity of serotonin and norepinephrine
Comer, Abnormal Psychology, 8e, DSM-5
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How Do Biological Theorists
Explain Abnormal Behavior?

Brain chemistry and 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
Comer, Abnormal Psychology, 8e, DSM-5
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Sources of Biological
Abnormalities – Genetics

Abnormalities in brain anatomy or chemistry are
sometimes the result of genetic inheritance

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
Comer, Abnormal Psychology, 8e, DSM-5
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Sources of Biological
Abnormalities – Genetics

Genes that contribute to mental disorders
are viewed as unfortunate occurrences:

May be mutations

May be inherited after a mutation in the family
line

May be the result of normal evolutionary
principles
Comer, Abnormal Psychology, 8e, DSM-5
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Sources of Biological
Abnormalities – Evolution

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


Example: The fear response
In today’s world, however, those genes and
reactions may not be so adapative
Comer, Abnormal Psychology, 8e, DSM-5
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Sources of Biological
Abnormalities – Evolution

This model has been criticized and remains
controversial, yet it receives considerable
attention
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Sources of Biological
Abnormalities – Viral Infections

Another possible source of abnormal brain
structure or biochemical dysfunction is viral
infections


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
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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
Comer, Abnormal Psychology, 8e, DSM-5
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Biological Treatments

Drug therapy:

1950s = advent of psychotropic medications


Greatly changed the outlook for a number of mental disorders
Four major drug groups:

Antianxiety drugs (anxiolytics; minor tranquilizers)

Antidepressant drugs

Antibipolar drugs (mood stabilizers)

Antipsychotic drugs
Comer, Abnormal Psychology, 8e, DSM-5
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Biological Treatments

Electroconvulsive therapy (ECT):

Used primarily for depression, particularly
when drugs and other therapies have failed

This treatment is used on tens of thousands of
depressed persons annually
Comer, Abnormal Psychology, 8e, DSM-5
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Biological Treatments

Psychosurgery (or neurosurgery):

Historical roots in trephination

1930s = first lobotomy

Much more precise today than in the past

Considered experimental and used only in
extreme cases
Comer, Abnormal Psychology, 8e, DSM-5
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Assessing the
Biological Model

Strengths:


Enjoys considerable
respect in the field

Constantly produces
valuable new
information

Treatments bring great
relief
Weaknesses:

Can limit, rather than
enhance, our
understanding


Too simplistic
Treatments produce
significant undesirable
(negative) effects
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The Psychodynamic Model

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


Abnormal symptoms are the result of conflict among these forces
Father of psychodynamic theory and psychoanalytic
therapy:

Sigmund Freud (1856–1939)
Comer, Abnormal Psychology, 8e, DSM-5
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How Did Freud Explain
Normal and Abnormal Functioning?

Shaped by three unconscious forces:
1.
2.
Id – guided by the Pleasure Principle

Instinctual needs, drives, and impulses

Sexual; fueled by libido (sexual energy)
Ego – guided by the Reality Principle

Seeks gratification, but guides us to know when we can and
cannot express our wishes

Ego defense mechanisms protect us from anxiety
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How Did Freud Explain
Normal and Abnormal Functioning?

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
some degree of conflict

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
Comer, Abnormal Psychology, 8e, DSM-5
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How Did Freud Explain
Normal and Abnormal Functioning?

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
Comer, Abnormal Psychology, 8e, DSM-5
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How Did Freud Explain
Normal and Abnormal Functioning?

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)
Comer, Abnormal Psychology, 8e, DSM-5
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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 role of the ego; consider it independent and
powerful
Emphasize the unified personality
Object-relations theorists

Emphasize the human need for relationships, especially
between children and caregivers
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Psychodynamic Therapies

Range from Freudian psychoanalysis to
modern therapies

All seek to uncover past trauma and inner
conflicts

Therapist acts as a “subtle guide”
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Psychodynamic Therapies

Utilize various techniques:

Free association

Therapist interpretation

Resistance

Transference

Dream interpretation

Catharsis

Working through
Comer, Abnormal Psychology, 8e, DSM-5
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Psychodynamic Therapies

Contemporary trends:

Short-term psychodynamic therapies

Relational psychoanalytic therapy
Comer, Abnormal Psychology, 8e, DSM-5
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Assessing the
Psychodynamic Model

Strengths:


First to recognize
importance of psychological
theories and treatment

Saw abnormal functioning
as rooted in the same
processes as normal
functioning

Weaknesses:

Unsupported ideas;
difficult to research

Non-observable

Inaccessible to human
subject (unconscious)
First to apply theory and
techniques systematically to
treatment – monumental
impact on the field
Comer, Abnormal Psychology, 8e, DSM-5
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The Behavioral Model

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
Comer, Abnormal Psychology, 8e, DSM-5
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The Behavioral Model

The model began in laboratories where
conditioning studies were conducted


Several forms of conditioning:

Operant conditioning

Modeling

Classical conditioning
All may produce normal or abnormal behavior
Comer, Abnormal Psychology, 8e, DSM-5
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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
Comer, Abnormal Psychology, 8e, DSM-5
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How Do Behaviorists
Explain Abnormal Functioning?

Modeling

Individuals learn responses by observing and
repeating behavior
Comer, Abnormal Psychology, 8e, DSM-5
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How Do Behaviorists
Explain Abnormal Functioning?

Classical conditioning

Learning by temporal association


Father of classical conditioning: Ivan Pavlov (1849 –
1936)


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
Classic study using dogs and meat powder
Explains many familiar behaviors (both normal and
abnormal)
Comer, Abnormal Psychology, 8e, DSM-5
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Classical Conditioning
US
UR
Meat
Salivate
US
UR
Meat
+
Tone
Salivate
CS
CR
Tone
Salivate
Comer, Abnormal Psychology, 8e, DSM-5
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Behavioral Therapies

Aim 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
Comer, Abnormal Psychology, 8e, DSM-5
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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

Construct a fear hierarchy

Confront feared situations
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Assessing the Behavioral Model


Strengths:

Powerful force in the
field

Can be tested in the
laboratory

Significant research
support for behavioral
therapies
Weaknesses:



No evidence that
symptoms are
ordinarily acquired
through conditioning
Behavior therapy is
limited
Too simplistic

New focus on
self-efficacy, social
cognition, and cognitivebehavioral theories
Comer, Abnormal Psychology, 8e, DSM-5
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The Cognitive Model

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
Comer, Abnormal Psychology, 8e, DSM-5
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How Do Cognitive Theorists
Explain Abnormal Functioning?

Abnormal functioning can result from
several kinds of cognitive problems:

Faulty assumptions and attitudes

Illogical thinking processes

Example: overgeneralization
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Cognitive Therapies

People can overcome their problems by
developing new ways of thinking

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 their dysfunctional
thoughts, try out new interpretations, and apply new ways of
thinking in their daily lives

Widely used in treating depression
Comer, Abnormal Psychology, 8e, DSM-5
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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
Weaknesses:

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
Comer, Abnormal Psychology, 8e, DSM-5
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The Humanistic-Existential
Model

Combination model

The humanist view


Emphasis on people as friendly, cooperative, and
constructive; focus on drive to self-actualize
through honest recognition of strengths and
weaknesses
The existentialist view

Emphasis on self-determination, choice, and
individual responsibility; focus on authenticity
Comer, Abnormal Psychology, 8e, DSM-5
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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.
Rogers’ “client-centered” therapy

Therapist creates a supportive climate




Unconditional positive regard
Accurate empathy
Genuineness
Little research support but positive impact on clinical practice
Comer, Abnormal Psychology, 8e, DSM-5
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Gestalt Theory and Therapy

Humanistic approach

Developed by Fritz Perls

Goal is to guide clients toward self-recognition
through challenge and frustration

Techniques:


Skillful frustration

Role playing

Rules, including “Here and Now” and “I” language
Little research support
Comer, Abnormal Psychology, 8e, DSM-5
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Spiritual Views and
Interventions

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
Comer, Abnormal Psychology, 8e, DSM-5
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Existential Theories and Therapy

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
Comer, Abnormal Psychology, 8e, DSM-5
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Existential Theories and Therapy

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
Comer, Abnormal Psychology, 8e, DSM-5
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Assessing the HumanisticExistential Model

Strengths:

Weaknesses:
Taps into domains
missing from other
theories


Emphasizes the
individual


Optimistic

Emphasizes health

Focuses on abstract
issues

Difficult to research
Weakened by
disapproval of
scientific approach

Changing somewhat
Comer, Abnormal Psychology, 8e, DSM-5
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The Sociocultural Models

Argue that abnormal behavior is best
understood in light of the social and
cultural forces that influence an individual


Address norms and roles in society
Comprised of two major perspectives:

Family-Social perspective

Multicultural perspective
Comer, Abnormal Psychology, 8e, DSM-5
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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


Diagnostic labels (example: Rosenhan study)
Social connections and supports
Comer, Abnormal Psychology, 8e, DSM-5
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How Do Family-Social Theorists
Explain Abnormal Functioning?

Focus on:

Family structure and communication

Family systems theory argues that abnormal
functioning within a family leads to abnormal
behavior (insane behavior becomes sane in an
insane environment)

Examples: enmeshed, disengaged structures
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Family-Social Treatments

This perspective has helped spur the
growth of several treatment approaches,
including:

Group therapy

Family therapy

Couple therapy

Community treatment

Includes prevention work
Comer, Abnormal Psychology, 8e, DSM-5
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How Do Multicultural Theorists
Explain Abnormal Functioning?

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 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
Comer, Abnormal Psychology, 8e, DSM-5
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How Do Multicultural Theorists
Explain Abnormal Functioning?

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
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Multicultural Treatments

Studies have found that members of ethnic
and racial minority groups tend to show
less improvement in clinical treatment
than members of majority groups

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
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Multicultural Treatments

Given such findings, some clinicians have
developed culture-sensitive therapies as
well as gender-sensitive, or feminist,
therapies
Comer, Abnormal Psychology, 8e, DSM-5
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Assessing the
Sociocultural Models

Strengths:

Added greatly to the
clinical understanding
and treatment of
abnormality



Increased awareness of
clinical and social roles
Weaknesses:

Research is difficult to
interpret


Correlation  causation
Model unable to predict
abnormality in specific
individuals
Clinically successful
when other treatments
have failed
Comer, Abnormal Psychology, 8e, DSM-5
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Integration of the Models

Today’s leading models vary widely and
none of the models has proved consistently
superior
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Comparing the Models
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Integration of the Models

A growing number of clinicians favor
explanations of abnormal behavior that
consider more than one cause at a time

These are sometimes called biopsychosocial
theories

Abnormality results from the interaction of genetic,
biological, developmental, emotional, behavioral,
cognitive, social, and societal influences
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Integration of the Models

Some biopsychosocial theorists favor a
diathesis-stress approach

Diathesis = predisposition (bio, psycho, or social)
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Integration of the Models

Integrative therapists are often called
“eclectic” – taking the strengths from each
model and using them in combination
Comer, Abnormal Psychology, 8e, DSM-5
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Theoretical Orientations of
Today’s Clinical Psychologists
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Integration of the Models

Integrative therapists are often called
“_______________” – taking the strengths
from each model and using them in
combination
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