Approaches to Clinical Psychology

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Approaches to Clinical Psychology

• Past and Present

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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.

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Paradigms used to study Clinical Psychology

• Biological
• Psychodynamic (Psychoanalytical)
• Behavioral
• Cognitive
• Humanistic

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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.

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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).

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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

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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.

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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
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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 dont account for the diagnosis
  of schizophrenia.

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  How do we study behavior genetics?

• 1. Family members
• 2. Twin studies
• 3. Adoption studies
• 4. Linkage analysis

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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).

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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

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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.

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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.

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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.

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Linkage Analysis

• Uses DNA blood testing to examine the influence
  of genetics inmental disorders.  

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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.

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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.

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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.

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Defense mechanisms- unconscious protect ego
from anxiety.

• Repression
• Projection
• Reaction formation
• Displacement
• Denial
• rationalization

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Problems with Freudian theory

• 1.   Freud had no scientific data to support his
  theories.
• 2.   Freuds theories (unconscious, libido, etc.)
  cannot be observed.
• 3.   Theory explains behavior (post-hoc) after
  the fact.
• 4.    Observations not representative of
  population.

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Freuds therapy

• Premisewe have repressed information in
  unconscious that needs to come out.
• How???
• Free-association, dream analysis, hypnosis.

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III. Behavior paradigm

• Focuses on observable behaviors.
• Premiseabnormal behavior is learned!!
• Learning (classical operant conditioning,
  modeling)

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Classical conditioning

• Pavlovs study
• Step 1 Meat Powder (UCS)---Salivation
  (UCR)
• Step 2 Bell (CS) ---- Salivation (UCR)
• -Meat Powder (UCS)----
• Step 3 Bell (CS)---------Salivation (CR)

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Conditioning emotional responses Watson Raynor

• Classically conditioned 11-month-old infant to
  fear white rats (Santa beard, cotton).
• Presented infant with cute white ratchild showed
  interest in rat, was then presented with a loud
  noise (startle response).

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Operant conditioning

• Desired behaviors are reinforced (positive,
  negative), whereas undesirable behaviors are
  extinguished (punishment).

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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)

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Behavioral therapies

• Systematic desensitization (phobias, anxiety)
• Flooding (phobias, anxiety)
• Aversion conditioning (pedophiles)

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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.

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Criticisms of theory contd

• 2. Simplistic circular reasoning (Description as
  explanation).
• 3. Useful for treatment, but not as cause for
  most mental disorders.

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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.

 
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Therapy

• Cognitive-Behavioral therapy
• Rational Emotive therapy

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V. Humanistic Paradigm

• Theorists argue we are driven to self-actualize,
  that is, to fulfill our potential for goodness
  and growth.

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Rogers 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.