Psychology 3318

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Psychology 3318

• Davison and Neale
• Chapter 2 Current Paradigms in Psychopathology
  and Therapy

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Overview of Davison and Neale Paradigms

• Biological (Medical, Disease)
• Psychoanalytic
• Humanistic/Existential
• Learning
• Cognitive

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Biological Paradigm

• Types of Disease Infectious vs. Traumatic
• Basic Model
• Predisposition (resistance) and exposure (germs,
  trauma, etc.) interact to produce disease
• Disease causes symptoms and signs
• Symptoms what is reported
• Signs what is observable (more important)

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Representation of Biological Model
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Behavior Genetics

• Key concepts Genes, genotype, phenotype
• Family method index case (probands),
• Twin method monozygotic (MZ) vs. dizygotic (DZ)
  twins, concordance,
• Adoptee method
• Linkage analysis looks for particular gene based
  upon genetic markers

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Central Nervous System Biochemistry

• Key concepts Neurons, nerve impulses, synapse,
  neurotransmitters (see Figs. 2.1 and 2.2)
• Some key neurotransmitters
• Norepinephrine (noradrenalin)
• Gamma-aminobutyric acid (GABA)
• Dopamine (schizophrenia?)
• Serotonin (depression?)
• Very important to drug therapy

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Classical Freudian Concepts

• Strongly Darwinian
• Sex is a basic motive
• Structures Id (motives), ego (executive),
  superego (morality)
• Levels of consciousness Conscious, preconscious,
  unconscious
• Principles Pleasure vs. reality
• Processes Primary vs. secondary
• Psychosexual stages Polymorphous perverse,
  oral-passive, oral-biting, anal, phallic, latent,
  genital
• Fixations and regressions
• Oedipus (Electra) complex
• Anxiety Objective (realistic), neurotic, moral
• Defense mechanisms Repression, denial,
  projection, displacement, rationalization,
  reaction formation, sublimation (see Table 2.1)

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Freudian Disease Model
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Other Early Psychoanalysts (NeoFreudians)
Carl Jung Early Humanist, stressed collective unconscious
Alfred Adler Power is basic motive, individual psychology
Karen Horney Early feminist
Erich Fromm Early existentialist, stressed role of society
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Traditional Therapeutic Concepts

• Free Association
• Resistance
• Dream analysis (latent vs. manifest content)
• Transference and countertransference
• Interpretation
• Analyst sits in background patient is prone

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Newer Concepts

• Ego analysis (many, including Freud) Ability of
  person to control environment
• Brief therapy Ferenczi Alexander and French
• Interpersonal therapy (Klerman and Weissman)
  concenrates on persons current difficulties
  active teaching

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Evaluation

• Blame your parents and rejection of
  responsibility
• Child is father to the man.
• Unconscious influences on behavior
• Role of defense mechanisms
• Causes of behavior may not be apparent

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Humanistic/Existential Rogers Client-Centered
Therapy

• Importance of phenomenology
• Healthy people are aware of behavior
• Healthy people are good
• Healthy people are purposive and goal-directed
• Importance of self-actualization
• Therapeutic techniques
• Reflection
• Unconditional positive regard
• Empathy primary (understanding) vs. advanced
  (inferential)

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Humanistic/Existential Existential

• Based (perhaps loosely) on philosophic movement
• Stresses the present and responsibility for
  choice
• Goal is to change behavior

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Humanistic/Existential Gestalt Therapy (Fritz
Perls)

• Existential in orientation
• Techniques
• I-language
• Empty chair
• Projection of feelings
• Attending to nonverbal cues
• Use of metaphor
• (For comparison of the three approaches, see
  Table 2.3)

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Learning Paradigms

• Basic model psychopathology is learned
• Important early names
• Pavlov
• Watson
• Thorndike
• Major types of learning
• Classical (Pavlovian) conditioning
• Operant (instrumental) conditioning
• Modeling (vicarious learning)

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Pavlovian Concepts

• Unconditioned stimulus US or UCS
• Conditioned stimulus CS
• Unconditioned response UR or UCR
• Conditioned response CR
• Many prefer conditional and unconditional to
  conditioned and unconditioned
• Extinction

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Operant Concepts

• Law of effect
• Discriminative stimulus
• Positive and negative reinforcement
• Shaping
• Avoidance conditioning
• Mediational vs. Skinnerian approaches
• Skinner There is no difference between disease
  and symptoms

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Behavior Therapy and Modification

• Use of behavioral techniques to modify
  pathological behavior
• Behavior therapy is more mediational
• Behavioral modification is more Skinnerian
• Counterconditioning
• Systematic desensitization
• Flooding (implosion)
• Aversive conditioning
• Time-out
• Token economy

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Modeling

• Role Playing
• Rehearsal
• Self-efficacy

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Cognitive Paradigm

• Although Skinner denied the importance of
  cognition (thought) many of his followers became
  cognitive.
• Schema
• Cognitive behavior therapy
• Beck
• Ellis and Rational-emotional Behavior Therpy
  (REBT)
• Group therapies
• Self-efficacy

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General Considerations

• See Table 2.4 for a comparison of psychoanalytic
  and cognitive-behavioral approaches.
• Diathesis-stress is unifying concept
• Importance of eclecticism Good therapists are
  seen as more alike one another, despite paradigm,
  than bad ones