Models of Abnormality

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Chapter 3
Slides Handouts by Karen Clay Rhines,
Ph.D. Seton Hall University

• Models of Abnormality

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Models of Abnormality

• In science, the perspectives used to explain
  phenomena are known as models or paradigms
• Each provides a set of assumptions and concepts
  that help us explain and interpret observations
• A school of thought
• Helpful because they spell out basic assumptions
  and set guidelines for investigation
• They influence what investigators observe, the
  questions they ask, the information they seek,
  and their interpretation of that information

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Models of Abnormality

• Historically, clinical scientists of a given time
  and place agreed on a single model of abnormality
  a model greatly 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

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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

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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

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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 Huntingtons disease basal ganglia
  (forebrain)

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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) other neurons
• An impulse is first received at a neurons
  dendrites, travels down the axon, and is
  transmitted to other neurons through the nerve
  endings

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How Do Biological Theorists Explain Abnormal
Behavior?

• Brain chemistry
• Neurons dont 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 called a neurotransmitter (NT)
• Some NTs tell receiving neurons to fire other
  NTs tell receiving neurons to stop firing

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How Do Biological Theorists Explain Abnormal
Behavior?

• Brain chemistry
• 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)

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How Do Biological Theorists Explain Abnormal
Behavior?

• 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

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How Do Biological Theorists Explain Abnormal
Behavior?

• Sources of 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, Alzheimers disease, and other
  mental disorders
• Arent able (yet) to identify specific genes
• Dont know the extent to which genetic factors
  contribute to disorders
• Seems no SINGLE gene is responsible for a
  particular behavior or disorder

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How Do Biological Theorists Explain Abnormal
Behavior?

• Sources of 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

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How Do Biological Theorists Explain Abnormal
Behavior?

• Sources of 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

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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

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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

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Biological Treatments

• Electroconvulsive therapy (ECT)
• Currently experiencing a revival
• Used for depression when drugs and other
  therapies have failed
• In 60 of cases, ECT can lift symptoms within a
  few weeks

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Biological Treatments

• Psychosurgery (or neurosurgery)
• Historical roots in trephination
• 1930s first lobotomy
• Much more precise than in the past
• Considered experimental and used only in extreme
  cases

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Assessing the Biological Model

• Weaknesses
• Can limit rather than enhance our understanding
• Too simplistic
• Evidence is incomplete or inconclusive
• Treatments produce significant undesirable
  (negative) effects

• Strengths
• Enjoys considerable respect in the field
• Fruitful
• Creates new therapies
• Suggests new avenues of research

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The Psychodynamic Model

• Oldest and most famous psychological model
• Based on belief that a persons behavior (whether
  normal or abnormal) 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)

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How Did Freud Explain Normal and Abnormal
Functioning?

• Caused by three UNCONSCIOUS forces
• Id guided by the Pleasure Principle
• Instinctual needs, drives, impulses
• Sexual fueled by libido (sexual energy)
• Ego guided by the Reality Principle
• Seeks gratification but guides us to know when we
  can cant 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
• 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 among the three forces
• If the id, ego, and superego are in excessive
  conflict, the persons behavior may show signs of
  dysfunction

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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

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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)

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How Do Other Psychodynamic Explanations Differ
from Freuds?

• Although current models deviate from Freuds in
  important ways, each retains the belief that
  human functioning is shaped by dynamic
  (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

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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

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Psychodynamic Therapies

• Utilize various techniques
• Free association
• Therapist interpretation
• Resistance
• Transference
• Dream interpretation
• Catharsis
• Working through

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Psychodynamic Therapies

• Contemporary trends
• Short-term psychodynamic therapies
• Relational psychoanalytic therapy

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Assessing the Psychodynamic Model

• Strengths
• First to recognize importance of psychological
  theories treatment
• Saw internal conflict as important source of
  psychological health and abnormality
• First to apply theory and techniques
  systematically to treatment monumental impact
  on the field

• Weaknesses
• Unsupported ideas difficult to research
• Non-observable
• Inaccessible to human subject (unconscious)

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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
• Emphasizes observable behavior and environmental
  factors
• Focuses on how behavior is acquired (learned) and
  maintained over time

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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

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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

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How Do Behaviorists Explain Abnormal
Functioning?

• Modeling
• Individuals learn behavioral responses by
  observing and repeating behavior
• No direct reinforcement

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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 persons 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

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Classical Conditioning
UR Salivate
US Meat
UR Salivate
Tone
US Meat

CS Tone
CR Salivate
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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)

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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

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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
• Develop a fear hierarchy
• Confront feared situations (covertly or in vivo)

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Assessing the Behavioral Model

• Strengths
• Powerful force in the field
• Rooted in empiricism
• Phenomena can be observed and measured
• Significant research support for behavioral
  therapies

• Weaknesses
• Too simplistic
• Unrealistic
• Downplays role of cognition
• New focus on self-efficacy, social cognition, and
  cognitive-behavioral theories

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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 of a client
• Concerned with internal processes
• Present-focused

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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

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Cognitive Therapies

• People must be taught a new way of thinking to
  prevent maladaptive behavior
• Main model Becks 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

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Assessing the Cognitive Model

• Strengths
• Very 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
• Research-based

• Weaknesses
• Singular, narrow focus
• Overemphasis on the present
• Limited effectiveness
• Verification of cognition is difficult
• Precise role is hard to determine

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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-actualization
• The existentialist view
• Emphasis on self-determination, choice, and
  individual responsibility focus on authenticity

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Rogers Humanistic Theory and Therapy

• 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 dont know what they really need,
  etc.
• Rogers client-centered therapy
• Therapist provides unconditional positive regard
• Both accurate genuine in reflection (reflective
  listening)
• Focus on the experiencing person
• Little research support

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Gestalt Theory and Therapy

• Humanistic approach
• Developed by Fritz Perls
• Goal is to help clients achieve self-recognition
  through challenge and frustration
• Techniques
• Skillful frustration
• Role playing
• Rules, including Here and Now and I language

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Existential Theories and Therapy

• Psychological dysfunction is caused by
  self-deception people hide from lifes
  responsibilities and fail to recognize that it is
  up to them to give meaning to their lives
• Therapy is focused on patient acceptance of
  personal responsibility and recognition of
  freedom of action
• Goals more important than technique
• Great emphasis placed on client-therapist
  relationship

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Assessing the Humanistic-Existential Model

• Strengths
• Emphasizes the individual
• Taps into domains missing from other theories
• Non-deterministic
• Optimistic
• Emphasizes health

• Weaknesses
• Focuses on abstract issues
• Difficult to research
• Not much influence
• Weakened by disapproval of scientific approach
• Changing somewhat

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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 persons social
  surroundings to understand their (abnormal)
  behavior

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How Do Sociocultural Theorists Explain Abnormal
Functioning?

• Focus on
• Societal labels roles
• Diagnostic labels (example Rosenhan study)
• Sick role
• Social networks and support

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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

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How Do Sociocultural Theorists Explain Abnormal
Functioning?

• Focus on
• Culture
• Set of values, attitudes, beliefs, history, and
  behaviors shared by a group of people and
  communicated from one generation to the next
• Multicultural psychology is a growing field of
  study

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How Do Sociocultural Theorists Explain Abnormal
Functioning?

• Focus on
• Religion and spirituality
• For most of the twentieth century, clinical
  scientists viewed religion as a negative factor
  in mental health but this alienation now seems to
  be ending
• 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

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Sociocultural Treatments

• May include traditional individual therapy
• Broadened therapy to include
• Culturally sensitive therapy
• Group therapy
• Family therapy
• Couple therapy
• Community treatment
• Includes prevention work

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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

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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,
  and also allows for specification of the factors
  that are especially pertinent to particular
  disorders

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Integration of the Models

• Many theorists, clinicians, and practitioners
  adhere to a biopsychosocial model
• Abnormality results from the interaction of
  genetic, biological, developmental, emotional,
  behavioral, cognitive, social, and societal
  influences
• Also popular
• Diathesis-stress approach
• Diathesis predisposition (bio, psycho, or
  social)
• Reciprocal effects explanation

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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