Download Current Paradigms in Psychopathology and Therapy

Approaches to Clinical Psychology
Past and Present
Several approaches have been applied in
the field of Clinical Psychology.

These approaches are based on theoretical views
or perspectives within the field of psychology.

Each of these approaches uses a different
conceptual framework or paradigm to examine
behavior & mental processes.

Furthermore, within each paradigm there are
certain assumptions that influence the methods
employed to examine the phenomenon.
Paradigms used to study Clinical
Psychology:
 Biological
 Psychodynamic
 Behavioral
 Cognitive
 Humanistic
(Psychoanalytical)
I. Biological Paradigm: assumes behavior &
mental processes can be explained by organic
events.

Assumptions of paradigm:
 A. Biology plays a role in pathological
behavior.
B. Psychopathology is caused by disease.
Problems with Biological model

1. Factors unrelated to biology may influence the
onset of psychopathology.
E.g., environmental factors (life-style, abuse) may
play role in some mental disorders (depression).

2. Multiple factors may influence onset of
psychopathology.

3. Some forms of psychopathology are learned
(e.g., phobias).
Is there evidence to support the
Biological Paradigm??

Yes!!! There is evidence from two sources .

1. Behavioral Genetics – examines how
much of individual differences in behavior
are due to genetic makeup.

2. Biochemistry in the nervous system
Behavioral Genetics: Theory

Genotype – the physiological genetic constitution
of a person. (fixed at birth, but not static)

Phenotype- the observable expression of our
genes (changes over time & is product of
interaction with genotype & environment).

E.g., A child may be hard-wired for high
intellectual achievement, but will need
environmental stimulation to produce
development.
Can we possess a biological predisposition
for certain mental illnesses or behavioral
problems?

Yes!! This is called a Diathesis.

Many individuals have psychopathology in
their family backgrounds that have a genetic
link.
Examples include depression,
schizophrenia, ADHD, autism, antisocial
behaviors
Does having a diathesis automatically mean
you will develop the mental disorder?

Not necessarily!!! A lot depends on the
interaction of your biology with environmental
factors (parents, peers).

(E.g., while monozygotic twins share 100% of
each others genes, if one twin has
schizophrenia, the other twin only have a 44%
chance of developing the disorder.

So genetics alone don’t account for the
diagnosis of schizophrenia.
How do we study behavior genetics?

1. Family members
 2. Twin studies
 3. Adoption studies
 4. Linkage analysis
Family Members:

Studies the 1st & 2nd degree relatives of individual
with a given mental disorder.

1st-degree relatives-parents & siblings (50%shared genes)

2nd-degree relatives-aunts, uncles (25%-shared
genes)

Are compared with index cases (probands).
If there is a genetic predisposition:
 1st
degree relatives of the index case(s),
should have the disorder at a higher
rate than in the general pop.

E.g., 10% of 1st degree relatives of
index cases with schizophrenia can be
diagnosed with schizophrenia
Twin studies

Monozygotic (100% shared genes) &
dizygotic twins (50% shared genes) are
compared.

Start with diagnosis of one twin & see if
other twin develops same disorder.

When twins are similarly diagnosed, they
are said to be concordant.
If disorder is heritable-- concordance rate
will be higher for MZ than for DZ twins.
 However,
since most twins are reared
together in the same environment, the
shared influence of environment
cannot be ruled out.
Adoption studies
 Examine
children who were adopted &
reared apart from their “abnormal”
parents.
 This
method reduces the influence of
shared environmental influences on
behavior and should reflect influence
of genetics.
Linkage Analysis:

Uses DNA blood testing to examine the
influence of genetics in
mental disorders.
II. Psychodynamic Paradigm:
 Argues
that our behavior results from
unconscious conflicts.

Conflicts occur outside of overt awareness.
This is referred to as the iceberg theory.
Structures of mind:

1. Id (unconscious) “wants” to satisfy basic
urges (thirst, hunger, sex).

2. Ego (primarily conscious) tries to
satisfy id impulses without breaking societal
norms.

3. Super-ego (conscious) our morality
center which tells us right from wrong.
Psychosexual stages of development

1. Oral (birth to 1 yr)- needs gratified
orally (sucking).
2. Anal (2yr)-needs met- through elimination
of waste.
 3. Phallic (3-5 yrs)-needs met through
genital stimulation.
 4. Latency (6-12 yrs)-impulses dormant.
 5. Genital (13+)-needs met through
intercourse.
Defense mechanisms- unconscious &
protect ego from anxiety.

Repression
 Projection
 Reaction formation
 Displacement
 Denial
 rationalization
Problems with Freudian theory:

1. Freud had no scientific data to support
his theories.

2. Freud’s theories (unconscious, libido,
etc.) cannot be observed.

3. Theory explains behavior (post-hoc)
after the fact.

4. Observations not representative of
population.
Freud’s therapy


Premise—we have repressed information in
unconscious that needs to come out.
How???
 Free-association, dream analysis, hypnosis.
III. Behavior paradigm

Focuses on observable behaviors.

Premise—abnormal behavior is learned!!

Learning (classical & operant conditioning,
modeling)
Classical conditioning


Pavlov’s study:
Step 1: Meat Powder (UCS)---Salivation
(UCR)
 Step 2: Bell (CS) ---- Salivation (UCR)

-Meat Powder (UCS)--- Step 3: Bell (CS)---------Salivation (CR)
Conditioning emotional responses:
Watson & Raynor

Classically conditioned 11-month-old infant
to fear white rats (Santa beard, cotton).

Presented infant with cute white rat—child
showed interest in rat, was then presented
with a loud noise (startle response).
Operant conditioning:

Desired behaviors are reinforced (positive,
negative), whereas undesirable behaviors
are extinguished (punishment).
Modeling (Albert Bandura)

We learn how to behavior, by watching
others.

Whether we will produce a given behavior
is determined by whether we have seen it
reinforced or punished.(Famous Bobo Doll
study)
Behavioral therapies

Systematic desensitization (phobias,
anxiety)
 Flooding (phobias, anxiety)
 Aversion conditioning (pedophiles)
Criticisms of theory:

1. Abnormal behavior is not always
associated with learned behavior.
E.g., Schizophrenia, Bipolar disorder, &
autism are largely related to organic causes.
Criticisms of theory contd:
2. Simplistic circular reasoning (Description as
explanation).
Mark hits John
Mark must be aggressive
Why is Mark Aggressive?
Because he hit John

3. Useful for treatment, but not as cause for
most mental disorders.
IV. Cognitive Paradigm:


Premise- Psychopathology develops from
faulty perceptions and thinking.
Criticism of Cognitive Paradigm
 1. Concepts are slippery, not well defined.
 2. Cognitive explanations do not explain
much.
E.g., depressed person has negative
cognition--I am worthless.
Therapy
Cognitive-Behavioral therapy
 Rational Emotive therapy

V. Humanistic Paradigm:

Theorists argue we are driven to selfactualize, that is, to fulfill our potential for
goodness and growth.
Roger’s Humanistic therapy

We all have a basic need to receive positive
regard from the important people in our lives
(parents).

Those who receive unconditional positive
regard early in life are likely to develop
unconditional self-regard.

That is, they come to recognize their worth
as persons, even while recognizing that they
are not perfect. Such people are in good
shape to actualize their positive potential.