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Models of

Abnormality
Chapter 3

Slides & Handouts by Karen Clay Rhines, Ph.D.


American Public University System

Comer, Abnormal Psychology, 8e, DSM-5


Update

Models of Abnormality

In science, the perspectives used to


explain events are known as models or
paradigms

Each model spells out basic assumptions,


gives order to the field under study, and sets
guidelines for investigation

Models influence what investigators observe,


the questions they ask, the information they
seek, and how they interpret this information
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Models of Abnormality

Until recently, clinical scientists of a given


place and time tended to agree on a single
model of abnormality a model greatly
influenced by the beliefs of their culture

Today several models are used to explain


and treat abnormal functioning

Sometimes in conflict, 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

Adopts a medical perspective

Main focus is that psychological


abnormality is an illness brought
about by malfunctioning parts of the
organism

Typically point to problems in brain


anatomy or brain chemistry
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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 discovered


connections between certain
psychological disorders and problems in
specific brain areas

Example: Huntingtons disease and basal


ganglia and cortex

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How Do Biological Theorists


Explain Abnormal Behavior?

Brain chemistry

Information is communicated
throughout the brain in the form of
electrical impulses that travel from one
neuron to one or more others

An impulse is first received by a


neurons dendrites, travels down the
axon, and is transmitted through the
nerve endings to other neurons
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Comer, Abnormal Psychology, 8e,


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How Do Biological Theorists


Explain Abnormal Behavior?

Brain chemistry

Neurons do not actually touch each other;


they are separated by a space (the synapse),
across which a message moves

When an electrical impulse reaches a nerve


ending, the ending is stimulated to release a
chemical, called a neurotransmitter (NT), that
travels across the synaptic space to receptors
on the dendrites of neighboring neurons

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 and 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

For example: depression has been linked to


low activity of serotonin and norepinephrine
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How Do Biological Theorists


Explain Abnormal Behavior?

Brain chemistry and abnormal behavior

Additionally, researchers have learned that


mental disorders are sometimes related to
abnormal chemical activity in the endocrine
system

Endocrine glands release hormones which


propel 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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Sources of Biological
Abnormalities Genetics

Abnormalities in brain anatomy or chemistry


are sometimes the result of genetic
inheritance

Each cell in the human body contains 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, and other mental
disorders

Appears that in most cases several genes combine to


produce our actions and reactions
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Sources of Biological
Abnormalities Genetics

Genes that contribute to mental


disorders are viewed as unfortunate
occurrences:

May be mutations

May be inherited after a mutation in the


family line

May be the result of normal evolutionary


principles
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Sources of Biological
Abnormalities Evolution

Evolutionary theorists argue that human


reactions and the genes responsible for
them have survived over the course of
time because they have helped
individuals thrive and adapt

Example: The fear response

In todays world, however, those genes


and reactions may not be so adapative
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Sources of Biological
Abnormalities Evolution

This model has been criticized and


remains controversial, yet it receives
considerable attention

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Sources of Biological
Abnormalities Viral
Infections

Another possible source of abnormal brain


structure or biochemical dysfunction is
viral infections

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

Greatly changed the outlook for a number of mental


disorders

Four major drug groups:

Antianxiety drugs (anxiolytics; minor tranquilizers)

Antidepressant drugs

Antibipolar drugs (mood stabilizers)

Antipsychotic drugs
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Biological Treatments

Electroconvulsive therapy (ECT):

Used primarily for depression,


particularly when drugs and other
therapies have failed

This treatment is used on tens of thousands


of depressed persons annually

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Biological Treatments

Psychosurgery (or neurosurgery):

Historical roots in trephination

1930s = first lobotomy

Much more precise today than in the


past

Considered experimental and used only


in extreme cases
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Assessing the
Biological Model

Strengths:

Enjoys considerable
respect in the field

Constantly
produces valuable
new information

Treatments bring
great relief

Weaknesses:

Can limit, rather than


enhance, our
understanding

Too simplistic

Treatments produce
significant undesirable
(negative) effects

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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 - that is, interacting psychological forces of which she or he is not
consciously aware

Abnormal symptoms are the result of conflict among


these forces

Father of psychodynamic theory and


psychoanalytic therapy:

Sigmund Freud (18561939)


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How Did Freud Explain


Normal and Abnormal
Functioning?

Shaped by three unconscious forces:


1.

2.

Id guided by the Pleasure Principle

Instinctual needs, drives, and impulses

Sexual; fueled by libido (sexual energy)

Ego guided by the Reality Principle

Seeks gratification, but guides us to know when we


can and cannot 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:


3.

Superego guided by the Morality Principle

Conscience; unconsciously adopted from our parents

These three parts of the personality are often


in some degree of conflict

A healthy personality is one in which an effective


working relationship 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 new theories depart from Freuds


ideas in important ways, each retains the
belief that human functioning is shaped by
dynamic (interacting) forces:

Ego theorists

Self theorists

Emphasize the role of the ego; consider it independent


and powerful
Emphasize the unified personality

Object-relations theorists

Emphasize the human need for relationships, especially


between children and caregivers
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Psychodynamic Therapies

Range from Freudian psychoanalysis


to modern therapies

All seek to uncover past trauma and


inner conflicts

Therapist acts as a 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
and treatment

Saw abnormal
functioning as rooted in
the same processes as
normal functioning

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 psychodynamic theorists,


behavioral theorists believe that our
actions are determined largely by our
experiences in life

Concentrates wholly on behaviors


and environmental factors

Bases explanations and treatments


on principles of learning
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The Behavioral Model

The model began in laboratories where


conditioning studies were conducted

Several forms of conditioning:

Operant conditioning

Modeling

Classical conditioning

All may produce normal or abnormal


behavior
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How Do Behaviorists
Explain Abnormal
Functioning?

Operant conditioning

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 responses by observing


and repeating behavior

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How Do Behaviorists
Explain Abnormal
Functioning?

Classical conditioning

Learning by temporal association

Father of classical conditioning: Ivan Pavlov


(1849 1936)

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

Classic study using dogs and meat powder

Explains many familiar behaviors (both normal


and abnormal)
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Classical Conditioning
US

UR

Meat

Salivat
e
UR

US
Meat

Tone

Salivat
e

CS

CR

Tone

Salivat
e
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Behavioral Therapies

Aim 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
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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

Construct a fear hierarchy

Confront feared situations


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Assessing the Behavioral


Model

Strengths:

Powerful force in
the field

Can be tested in
the laboratory

Significant
research support
for behavioral
therapies

Weaknesses:

No evidence that
symptoms are
ordinarily acquired
through conditioning
Behavior therapy is
limited
Too simplistic

New focus on
self-efficacy, social
cognition, and
cognitive-behavioral
theories

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The Cognitive Model

This model proposes that we can best


understand abnormal functioning by
looking at cognitive processes the center
of behaviors, thoughts, and emotions

Argues that clinicians must ask questions


about assumptions, attitudes, and
thoughts of a client

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How Do Cognitive Theorists


Explain Abnormal
Functioning?

Abnormal functioning can result from


several kinds of cognitive problems:

Faulty assumptions and attitudes

Illogical thinking processes

Example: overgeneralization

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Cognitive Therapies

People can overcome their problems by


developing new ways of thinking

Main model: Becks Cognitive Therapy

The goal of therapy is to help clients recognize


and restructure their thinking

Therapists also guide clients to challenge their


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 and


effective

Focuses on a uniquely
human process
Theories lend
themselves to research
Therapies effective in
treating several
disorders

Weaknesses:

Precise role of cognition in


abnormality has yet to be
determined

Therapies do not help


everyone

Some changes may not


be possible to achieve

In response, a new wave of


therapies has emerged,
including Acceptance and
Commitment Therapy and
mindfulness-based
techniques

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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 selfactualize through honest recognition of
strengths and weaknesses

The existentialist view

Emphasis on self-determination, choice, and


individual responsibility; focus on authenticity
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Rogers Humanistic
Theory and Therapy

Believes in the 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 do not


know what they really need, etc.

Rogers client-centered therapy

Therapist creates a supportive climate

Unconditional positive regard


Accurate empathy
Genuineness

Little research support but positive impact on clinical


practice
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Gestalt Theory and Therapy

Humanistic approach

Developed by Fritz Perls

Goal is to guide clients toward selfrecognition through challenge and frustration

Techniques:

Skillful frustration

Role playing

Rules, including Here and Now and I language

Little research support


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Spiritual Views and


Interventions

For most of the twentieth century, clinical


scientists viewed religion as a negativeor
at best neutralfactor in mental health

This historical alienation between the


clinical field and religion seems to be
ending

Researchers have learned that spirituality


can, in fact, be of psychological benefit to
people
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Existential Theories and


Therapy

Belief that 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

In therapy, people are encouraged to accept


personal responsibility for their problems

Goals more important than technique

Great emphasis placed on client-therapist


relationship
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Existential Theories and


Therapy

Existential therapists do not believe


that experimental methods can
adequately test the effectiveness of
their treatments; as a result, little
controlled research has been
conducted

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Assessing the HumanisticExistential Model

Strengths:

Weaknesses:

Taps into domains


missing from other
theories

Emphasizes the
individual

Optimistic

Emphasizes health

Focuses on abstract
issues

Difficult to research

Weakened by
disapproval of
scientific approach

Changing somewhat

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The Sociocultural Models

Argue that abnormal behavior is best


understood in light of the social and
cultural forces that influence an
individual

Address norms and roles in society

Comprised of two major perspectives:

Family-Social perspective

Multicultural perspective
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How Do Family-Social
Theorists Explain Abnormal
Functioning?

Proponents of this model argue that


theorists should concentrate on
forces that operate directly on an
individual, including:

Social labels and roles

Diagnostic labels (example: Rosenhan study)

Social connections and supports


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How Do Family-Social
Theorists Explain Abnormal
Functioning?

Focus on:

Family structure and communication

Family systems theory argues that abnormal


functioning within a family leads to
abnormal behavior (insane behavior
becomes sane in an insane environment)

Examples: enmeshed, disengaged structures

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Family-Social Treatments

This perspective has helped spur the


growth of several treatment
approaches, including:

Group therapy

Family therapy

Couple therapy

Community treatment

Includes prevention work


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How Do Multicultural Theorists


Explain Abnormal Functioning?

Culture refers to the set of values, attitudes,


beliefs, history, and behaviors shared by a
group of people and communicated from one
generation to the next

The multicultural, or culturally diverse,


perspective has emerged as a growing field of
study

Multicultural psychologists seek to understand


how culture, race, ethnicity, gender, and similar
factors affect behavior and thought, as well as
how people of different cultures, races, and
genders differ psychologically
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How Do Multicultural Theorists


Explain Abnormal Functioning?

The model holds that an individuals


behavior is best understood when examined
in the light of that individuals unique
cultural context

They also have noticed that the prejudice


and discrimination faced by many minority
groups may contribute to certain forms of
abnormal functioning

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Multicultural Treatments

Studies have found that members of


ethnic and racial minority groups tend to
show less improvement in clinical
treatment than members of majority
groups

Two features of treatment can increase a


therapists effectiveness with minority clients:

Greater sensitivity to cultural issues

Inclusion of cultural models in treatment, especially


in therapies for children and adolescents
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Multicultural Treatments

Given such findings, some clinicians


have developed culture-sensitive
therapies as well as gender-sensitive,
or feminist, therapies

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Assessing the
Sociocultural Models

Strengths:

Added greatly to the


clinical understanding
and treatment of
abnormality

Increased awareness
of clinical and social
roles

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

Todays leading models vary widely


and none of the models has proved
consistently superior

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Comparing the Models

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Integration of the Models

A growing number of clinicians favor


explanations of abnormal behavior that
consider more than one cause at a time

These are sometimes called


biopsychosocial theories

Abnormality results from the interaction of


genetic, biological, developmental, emotional,
behavioral, cognitive, social, and societal
influences
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Integration of the Models

Some biopsychosocial theorists favor


a diathesis-stress approach

Diathesis = predisposition (bio, psycho, or


social)

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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

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Theoretical Orientations of
Todays Clinical
Psychologists

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Integration of the Models

Integrative therapists are often called


_______________ taking the strengths
from each model and using them in
combination

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