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Chapter 3 Models of Abnormality Models of Abnormality What is a model or paradigm? • A set of assumptions and concepts that help us explain and interpret observations • A school of thought • Helpful because it spells out basic assumptions and sets guidelines for investigation • It influences what investigators observe, the questions they ask, the information they seek, and their interpretation of that information Slide 2 Models of Abnormality Historically, clinical scientists of a given time and place agreed on a single model of abnormality – a model strongly influenced by cultural beliefs Currently, there are several competing models of abnormality • Why? Each model focuses on one aspect of human functioning and no single model can explain all aspects of abnormality Slide 3 The Biological Model Takes a medical perspective Main focus is that psychological abnormality is an illness brought about by malfunctioning parts of the organism • Typically focused on the BRAIN Slide 4 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 Slide 5 How Do Biological Theorists Explain Abnormal Behavior? Brain anatomy and abnormal behavior • Clinical researchers have found connections between certain psychological disorders and problems in specific brain areas • Example: Huntington’s disease & basal ganglia (forebrain) Slide 6 How Do Biological Theorists Explain Abnormal Behavior? Brain chemistry • Information spreads throughout the brain in the form of electrical impulses that travel from one neuron to one or more others • An impulse is first received at a neuron’s dendrites, travels down the axon, and is transmitted to other neurons through the nerve endings Slide 7 Slide 8 How Do Biological Theorists Explain Abnormal Behavior? Brain chemistry • Neurons don’t touch; they are separated by a space (the synapse), across which a message moves • When an electrical impulse reaches a nerve ending, the nerve ending is stimulated to release a chemical (a neurotransmitter or “NT”) • Some NTs tell receiving neurons to “fire”; other NTs tell receiving neurons to stop firing Slide 9 How Do Biological Theorists Explain Abnormal Behavior? Role of brain chemistry in 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 • Examples: depression (serotonin and norepinephrine) and anxiety (GABA) Slide 10 How Do Biological Theorists Explain Abnormal Behavior? Role of brain chemistry • Additionally, researchers have learned that mental disorders are sometimes related to abnormal chemical activity in the endocrine system • Hormone release, triggered by a variety of factors, propels body organs into action. Abnormal secretions have been linked to psychological disorders • Example: cortisol release is related to anxiety and mood disorders Slide 11 How Do Biological Theorists Explain Abnormal Behavior? Biological abnormalities – genetics • Humans have 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, mental retardation, Alzheimer’s disease, and other mental disorders • Aren’t able (yet) to identify specific genes • Don’t know the extent to which genetic factors contribute to disorders • Seems no SINGLE gene is responsible for a particular behavior or disorder Slide 12 How Do Biological Theorists Explain Abnormal Behavior? Biological abnormalities – evolution • Genes that contribute to mental disorders are viewed as unfortunate occurrences: • May be mutations • May be inherited after a mutation in the family line • Evolutionary theorists argue that we can best understand abnormality by examining the millions of years of human evolution • Looking at a combination of adaptive behaviors of the past, genes, and the interaction between genes and current environmental events • This model has been criticized and remains controversial Slide 13 How Do Biological Theorists Explain Abnormal Behavior? Biological abnormalities – viral infections • Infection provides another possible source of abnormal brain structure or biochemical dysfunction • 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 Slide 14 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 Slide 15 Biological Treatments Drug therapy: • 1950s = advent of psychotropic medications • Changed outlook for a number of mental disorders • Four groups of drugs: • Antianxiety drugs (anxiolytics; tranquilizers) • Antidepressant drugs • Antibipolar drugs (mood stabilizers) • Antipsychotic drugs Slide 16 Biological Treatments Electroconvulsive therapy (ECT): • Currently experiencing a revival • Used for severe depression when drugs and other therapies have failed • In 60% of cases, ECT can lift symptoms within a few weeks Slide 17 Biological Treatments Psychosurgery: • Historical roots in trephination • 1930s = first lobotomy • Much more precise than in the past • Considered experimental and used only in extreme cases Slide 18 Assessing the Biological Model Strengths: • Earns considerable respect in the field • Fruitful • Creates new therapies • Suggests new avenues of research Weaknesses: • Can limit rather than enhance our understanding • Too simplistic • Evidence is incomplete or inconclusive • Treatments produce significant undesirable (negative) effects Slide 19 The Psychodynamic Model Oldest and most famous psychological model Based on belief that a person’s behavior is determined largely by underlying dynamic psychological forces of which she or he is not aware • Abnormal symptoms are the result of conflict among these forces Father of psychodynamic theory and psychoanalytic therapy: • Sigmund Freud (1856 – 1939) Slide 20 How Did Freud Explain Normal and Abnormal Behavior? Caused by three UNCONSCIOUS forces: 1. Id – guided by the Pleasure Principle • Instinctual needs, drives, & impulses • Sexual; fueled by libido (sexual energy) 2. Ego – guided by the Reality Principle • Seeks gratification but guides us to know when we can & can’t get and express our wishes • Ego defense mechanisms protect us from anxiety Slide 21 Slide 22 How Did Freud Explain Normal and Abnormal Behavior? 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 conflict • A healthy personality is one in which compromise exists between the parts • If the id, ego, and superego are in excessive conflict, the person’s behavior may show signs of dysfunction Slide 23 How Did Freud Explain Normal and Abnormal Behavior? 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 Slide 24 How Did Freud Explain Normal and Abnormal Behavior? 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) Slide 25 How Do Other Psychodynamic Explanations Differ from Freud’s? Although current models deviate from Freud’s in fundamental ways, each retains the belief that human functioning is shaped by interacting forces: • Ego theorists • Emphasize the role of the ego; consider it independent • Self theorists • Emphasize the unified personality over any one component • Object-relations theorists • Emphasize the human need for interpersonal relationships Slide 26 Psychodynamic Therapies Range from Freudian psychoanalysis to more modern therapies All seek to uncover past trauma and inner conflicts • Understanding early life experience critically important Therapist acts as “subtle guide” Slide 27 Psychodynamic Therapies Utilize various techniques: • Free association • Therapist interpretation • Resistance • Transference • Dream interpretation • Catharsis • Working through • Short-term dynamic therapies Slide 28 Assessing the Psychodynamic Model Strengths: • First to recognize importance of psychological theories & treatment • Saw internal conflict as important source of psychological health and abnormality 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 Slide 29 Slide 30 The Behavioral Model Like the psychodynamic perspective, behaviorism is deterministic, and is based on the idea that our actions are determined largely by our life experiences Emphasis is on observable behavior and environmental factors Focus on how behavior is acquired (learned) and maintained over time Slide 31 The Behavioral Model Historical beginnings in laboratories where conditioning studies were conducted • Several forms of conditioning: • Operant conditioning • Modeling • Classical conditioning • May produce normal or abnormal behavior Slide 32 How Do Behaviorists Explain Abnormal Functioning? Operant conditioning • Organism “operates” on environment and produces an effect • Humans and animals learn to behave in certain ways as a result of receiving rewards whenever they do so Slide 33 How Do Behaviorists Explain Abnormal Functioning? Modeling • Individuals learn behavioral responses by observing and repeating behavior • No direct reinforcement Slide 34 How Do Behaviorists Explain Abnormal Functioning? Classical conditioning • Learning by temporal association • 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 • Father of classical conditioning: Ivan Pavlov (1849 – 1936) • Classic study using dogs & meat powder Slide 35 Classical Conditioning US UR Meat Salivate US UR Meat + Tone Salivate CS CR Tone Salivate Slide 36 How Do Behaviorists Explain Abnormal Functioning? Classical conditioning • If, after conditioning, the CS is repeatedly presented alone, it will eventually stop eliciting the CR • This process is called extinction • Explains many familiar behaviors (both normal and abnormal) Slide 37 Behavioral Therapies Aim is 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 • Early life experiences important only in providing clues to current learning Slide 38 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 • Develop a fear hierarchy • Confront feared situations (covertly or in vivo) Slide 39 Assessing the Behavioral Model Strengths: Weaknesses: • Powerful force in the field • Too simplistic • Rooted in empiricism • Downplays role of cognition • Phenomena can be observed and measured • Significant research support for behavioral therapies • Unrealistic • New focus on selfefficacy, social cognition, and cognitive-behavioral theories Slide 40 The Cognitive Model Seeks to account for behavior by studying the ways in which the person attends to, interprets, and uses available information Argues that clinicians must ask questions about assumptions, attitudes, and thoughts • Concerned with internal processes • Present-focused Slide 41 How Do Cognitive Theorists Explain Abnormal Functioning? Maladaptive thinking is the cause of maladaptive behavior • Several kinds of faulty thinking: • Faulty assumptions and attitudes • Illogical thinking processes • Example: overgeneralization Slide 42 Cognitive Therapies People must be taught a new way of thinking to prevent maladaptive behavior 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 dysfunctional thoughts, try out new interpretations, and apply new ways of thinking in their daily lives • Widely used in treating depression Slide 43 Assessing the Cognitive Model Strengths: • Broad appeal • Clinically useful & effective • Focuses on a uniquely human process • Correlation between symptoms and maladaptive cognition • Therapies effective in treating several disorders • Adapt well to technology Weaknesses: • Singular, narrow focus • Overemphasis on the present • Limited effectiveness • Verification of cognition is difficult • Precise role is hard to determine • Research-based Slide 44 The Humanistic-Existential Model Combination model • The humanist view • Emphasis on people as friendly, cooperative, and constructive; focus on drive to self-actualization • The existentialist view • Emphasis on self-determination, choice, and individual responsibility; focus on authenticity Slide 45 Spiritual Views and Interventions For most of the twentieth century, clinical scientists viewed religion as a negative factor in mental health This alienation now seems to be ending: • Numerous books have been published • Ethical codes now include religion under “diversity” • Researchers have begun to systematically study the influence of religion and spirituality on mental health • Many therapists now address spiritual issues when treating religious clients Slide 46 Assessing the HumanisticExistential Model Strengths: Weaknesses: • Emphasizes the individual • Focuses on abstract issues • Taps into domains missing from other theories • Not much influence • Non-deterministic • Optimistic • Weakened by disapproval of scientific approach • Changing somewhat • Emphasizes health Slide 47 The Sociocultural Model Argues that abnormal behavior is best understood in light of the social and cultural forces that influence an individual • Addresses norms and roles in society Influenced by sociology and anthropology Argues that we must examine a person’s social surroundings to understand their (abnormal) behavior Slide 48 How Do Sociocultural Theorists Explain Abnormal Functioning? Focus on: • Family structure and communication • Family systems theory = abnormal functioning within family leads to abnormal behavior (insane behavior becomes sane in an insane environment) • Examples: enmeshed, disengaged structures • Role of culture • Role of social networks/support Slide 49 How Do Sociocultural Theorists Explain Abnormal Functioning? Focus on: • Societal conditions • Abnormality more common in lower classes. Why? • Societal labels & roles • Diagnostic labels (example: Rosenhan study) • Sick role Slide 50 Sociocultural Treatments May include traditional individual therapy Broadened therapy to include: • Culturally-sensitive therapy • Group therapy • Family therapy • Couples therapy • Community treatment • Includes prevention work Slide 51 Assessing the Sociocultural Model Strengths: • Added greatly to the clinical understanding of abnormality • Increased awareness of labeling • Clinically successful when other treatments have failed Weaknesses: • Research is difficult to interpret • Correlation causation • Model unable to predict abnormality in specific individuals Slide 52 Slide 53 Integration of the Models Each perspective is valuable to understanding abnormal behavior Different perspectives are more appropriate under differing conditions An integrative approach provides a general framework for thinking about abnormal behavior while also allowing for specification of the factors that are especially pertinent to particular disorders Slide 54