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Chapter 2
Theories and Treatment of
Abnormality
Diathesis-Stress Models
Chapter 2
Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved.
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Biological Theories of Abnormality
Chapter 2
Copyright © 2011 by The McGraw-Hill Companies, Inc. All rights reserved.
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Biological Theories of Abnormality
Brain Dysfunction
Biochemical
Imbalances
Genetic
Abnormalities
Chapter 2
Abnormalities in the structure
of the brain cause mental
disorders
Imbalances in the levels of
neurotransmitters or
hormones, or poor
functioning of receptors
cause mental disorders
Disordered genes lead to
mental disorders
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Brain Dysfunction as the Cause of
Abnormality
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Can occur in three areas of the brain:
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Cerebral cortex
Hypothalamus
Limbic system
Can result from injury, such as an automobile
accident, and from diseases that cause
deterioration
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Chapter 2
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Chapter 2
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Chapter 2
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Biochemical Causes of Abnormality

The brain needs a number of chemicals to
operate properly.
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Neurotransmitters
Hormones
Neurotransmitters are biochemical “messengers.”
Reuptake occurs when the neurons that initially
released the neurotransmitter into the synapse
reabsorb the neurotransmitter.
Degradation occurs when the receiving neuron
releases an enzyme into the synapse that breaks
down the neurotransmitter into other
biochemicals.
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Chapter 2
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Endocrine System

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Other biochemical theories focus on the
body’s endocrine system
This system of glands produces chemicals
called hormones
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Released directly into the blood
Carries messages throughout the body, potentially
affecting a person's moods, levels of energy, and
reactions to stress
Hypothalamic-pituitary-adrenal axis (or HPA axis).
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Chapter 2
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Genetic Factors in Abnormality

Behavioral Genetics is concerned with two
questions
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1. To what extent are behaviors or behavioral
tendencies inherited?
2. What are the processes by which genes affect
behavior?
Chapter 2
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Chapter 2
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Biological Therapies

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Drug Therapies
Electroconvulsive Therapy and Newer Brain
Stimulation Techniques
Psychosurgery
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Chapter 2
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PSYCHOLOGICAL APPROACHES
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Behavioral
Cognitive
Psychodynamic and humanistic
Family systems
Emotion-focused approaches
Chapter 2
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Behavioral Theories of Abnormality
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Classical Conditioning
Operant Conditioning
Modeling and Observational Learning
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Classical Conditioning
Chapter 2
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Behavioral Therapies

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Focus on identifying the reinforcements and
punishments contributing to a person’s
maladaptive behaviors and on changing
specific behaviors.
Foundation for behavioral therapy is the
behavioral assessment of the client’s
problem.
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Specific techniques for behavior change
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Cognitive Theories of Abnormality
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Argue that it is not just rewards and
punishments that motivate human behavior.
Instead, our cognitions—thoughts or
beliefs—shape our behaviors and the
emotions we experience.
Types of cognition
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Causal attributions
Global assumptions
Chapter 2
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Some Common Global Dysfunctional
Assumptions
Once
something
affects my life,
it will affect it
forever.
I should be
loved by
everyone for
everything I
do.
I must have
perfect self
control.
Chapter 2
It is better to
avoid problems
than to face
them.
I should be
terribly upset
by certain
situations.
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Cognitive Therapies
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Help clients identify and challenge negative
thoughts and dysfunctional belief systems.
Help clients learn more effective problemsolving techniques to deal with the concrete
problems in their lives.
Designed to be short term
Often combined with behavioral techniques,
known as cognitive-behavioral therapy
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Psychodynamic Approaches
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Suggest that all behavior, thoughts, and emotions,
whether normal or abnormal, are influenced to a
large extent by unconscious processes
Includes psychoanalysis and several newer
approaches
Freud developed psychoanalysis
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(1) a theory of personality and psychopathology
(2) a method of investigating the mind
(3) a form of treatment for psychopathology
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Freud’s 3 Systems of the Human Psyche
Id
Pleasure principle, primary
process (wish fulfillment)
Ego
Reality principle, secondary
process thinking (rational
deliberation)
Superego
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Introject (internalize) social
standards. Conscience and ego ideal
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Chapter 2
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Defense Mechanisms
Chapter 2
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Psychosexual Stages
Chapter 2
Stages
Age
Oral
0–18 months
Anal
18 months to 3 years
Phallic
3 to 6 years
Latent
6 years to puberty
Genital
Puberty to adulthood
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Newer Psychodynamic Theories:
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Ego Psychology
Object Relations
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Psychodynamic Therapies
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Focus on uncovering and resolving
unconscious processes that are thought to
drive psychological symptoms.
Help clients recognize their maladaptive
coping strategies and the sources of their
unconscious conflicts.
Insights are thought to free clients from the
grip of the past and give them a sense of
agency in making changes in the present.
Chapter 2
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Interpersonal therapy (IPT)
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Emerged out of modern psychodynamic theories
Shifted focus from the unconscious conflicts of the
individual to the client’s pattern of relationships with
important people in his or her life
Therapist is much more structuring and directive in
the therapy, offering interpretations much earlier and
focusing on how to change current relationships
Designed to be short-term
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Humanistic Approaches
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Based on the assumption that humans have an
innate capacity for goodness and for living a full life
Pressure from society to conform to certain norms
rather than to seek one’s most developed self
interferes with the fulfillment of this capacity.
Underlying philosophy: Although humans may not
be aware of the forces shaping their behavior, once
people recognized these forces and became freer to
direct their own lives, they would naturally make
good choices and be happier.
Chapter 2
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Humanistic Therapy

Goal is to help clients discover their greatest potential
through self-exploration

Therapist provides the optimal conditions for the client
to heal him- or herself.

In Carl Rogers’s (1951) client-centered therapy,
therapist
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communicates a genuineness in his or her role as helper to
the client, acting as an authentic person rather than an
authority figure
shows unconditional positive regard for the client
communicates an empathic understanding of the client’s
underlying feelings and search for self
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Family Systems Theory

Views the family as a complex interpersonal
system, with its own hierarchy and rules that
govern family members’ behavior.
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Can function well, promoting the well-being of its
members, supporting their growth and accepting
their change.
Or can be dysfunctional, creating and maintaining
psychopathology in one or more members.
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Views a family member’s psychological
disorder as an indication of a dysfunctional
family system.
The particular form that any individual’s
psychopathology takes depends on the
complex interactions among the family’s
cohesiveness, adaptability to change, and
communication style.
Chapter 2
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Family Systems Therapy
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Based on the belief that an individual’s problems are
always rooted in interpersonal systems, particularly
in family systems.
An individual cannot be helped without treating the
entire family system that created and is maintaining
the individual’s problems.
In fact, the individual may not actually even have a
problem but has become the “identified patient” in
the family, carrying the responsibility or blame for
the dysfunction of the family system
Chapter 2
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Emotion-Focused Approaches
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Focus on people’s ability to understand and
regulate their emotions
Often referred to as third-wave approaches,
view poor regulation of emotions as at the
core of many types of psychopathology
Incorporate techniques from behavioral and
cognitive therapy with mindfulness practices
derived from Zen Buddhism
Examples: Dialectical Behavior Therapy ,
Acceptance and Commitment Therapy
Chapter 2
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Sociocultural Approaches

We need to look beyond the individual or family to the larger
society to understand people’s problems:

Socioeconomic disadvantage is a risk factor for a wide range of
mental health problems

Upheaval and disintegration of societies due to war, famine, and
natural disaster are potent risk factors for mental health problems

Social norms and policies that stigmatize and marginalize certain
groups put these individuals at increased risk for mental health
problems

Societies may influence the types of psychopathology their
members show by having implicit or explicit rules about what types
of abnormal behavior are acceptable
Chapter 2
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Prevention Programs
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Primary Prevention: Stopping the
development of disorders before they start
Secondary Prevention: Detecting a disorder
at its earliest stages to prevent the
development of the full-blown disorder
Tertiary Prevention: Preventing relapse and
reducing the impact of the disorder on the
person’s quality of life
Chapter 2
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COMMON ELEMENTS IN
EFFECTIVE TREATMENTS
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Have a positive relationship with the client
Provide clients with an explanation or
interpretation of why they are suffering
Encourage clients to confront painful
emotions and have techniques for helping
them become less sensitive to these
emotions
Chapter 2
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