Ch. 2 Models of Abnormality

Question 1

Model or Paradigm

Answer 1

MODEL – A set of assumptions and concepts that help scientists explain and interpret observations.

• Gives order and sets guidelines
• It influences what the investigators observe, asks, and interprets

Question 2

Demonological Model

Answer 2

DEMONOLOGICAL MODEL – was used to explain abnormal functioning during the Middle Ages, for example, borrowed heavily from medieval society’s concerns with religion, superstition, and warfare.

• Blamed Evil Spirits for abnormal behavior
• Treatment consisted of prayers, torture, and other acts

Question 3

5 Current Models of Abnormal Functioning

Answer 3

5 CURRENT MODELS of ABNORMAL FUNCTIONING – These range in a spectrum from Biological to Psychological to Sociocultural.

1. BIOLOGICAL MODEL – which sees physical processes as key to human behavior.
2. PSYCHODYNAMIC MODEL – looks at people’s unconscious internal processes and conflicts.
3. COGNITIVE-BEHAVIORAL MODEL – emphasizes behavior, the ways in which it is learned, and the thinking that underlies behavior.
4. HUMANISTIC-EXISTENTIAL MODEL – stresses the role of values and choices.
5. SOCIOCULTURAL MODEL – which looks to social and cultural forces as the keys to human functioning. This model includes two perspectives:
   
   1. FAMILY-SOCIAL PERSPECTIVE – which focuses on an individual’s family and social interactions.
   2. MULTICULTURAL PERSPECTIVE – which emphasizes an individual’s culture and the shared beliefs, values, and history of that culture.

• None can explain all aspects of abnormality and so many of them are often used in combination with others.

Question 4

Biological Model (of Abnormal Behavior)

Answer 4

BIOLOGICAL MODEL – thoughts and feelings are the results of biochemical and bioelectrical processes throughout his brain and body.

• Adopting a medical perspective, view abnormal behavior as an illness.
• The most effective treatment will be medication.
• Linked particular psychological disorders to problems in specific structures of the brain. Ex: Huntington’s disease.

NEUROTRANSMITTERS: How Messages Move From Neuron to Neuron – Information is communicated throughout the brain in the form of electrical impulses that travel from one neuron to one or more others. Abnormal behavior can result from problems in this transmission.

1. ​A message in the form of an ELECTRICAL IMPULSE travels down the sending neuron’s AXON (a long fiber extending from the neuron’s body) to its NERVE ENDING.
2. At the NERVE ENDING, the ​AXON TRANSMITS Electrochemical Signals called NEUROTRANSMITTERS.
3. Because neurons do NOT actually touch each other, the NEUROTRANSMITTER must travel across a tiny space called a SYNAPSE (or SYNAPTIC SPACE).
4. On the other side of the SYNAPSE, the NEUROTRANSMITTER attaches to RECEPTORS on the receiving neuron’s DENDRITES, antenna-like extensions located at one end of the neuron.

• After binding to the receiving neuron’s receptors, some neurotransmitters give a message to the receiving neurons to “FIRE” (that is, to trigger their own electrical impulse). While other neurotransmitters carry an inhibitory message; telling the receiving neurons to “STOP all firing”.
• If any of these steps fail to work properly, abnormal thoughts or behavior can result.

NOTES:

• There are dozens of NEUROTRANSMITTERS and each neuron uses only certain kinds.
• Certain neurotransmitters are sometimes tied to mental disorders.
  
  • Ex: Depression has been linked to low activity of the neurotransmitters SEROTONIN and NOREPINEPHRINE.
• Each neuron has multiple dendrites and a single axon. But that axon can be very long indeed, often extending all the way from one structure of the brain to another.

SUMMARY:

• Sending Neuron’s AXON >> NERVE ENDING >> NEUROTRANSMITTER >> across SYNAPSE >> RECEPTORS on DENDRITES of Receiving Neuron.
• AXONS TRANSMIT Electrochemical Signals
• DENDRITES RECEIVE Electrochemical Signals

HORMONES: Endocrine System – mental disorders are sometimes related to abnormal chemical activity in the body’s endocrine system.

• Endocrine glands, located throughout the body, release chemicals called HORMONES, which propel body organs into action.
  
  • Ex: During times of stress, adrenal glands secrete the hormone CORTISOL to help the body deal with the stress. Abnormal secretions of this chemical have been tied to anxiety and depression.

BRAIN CIRCUITS – a network of particular brain structures that work together, triggering each other into action to produce a distinct behavioral reaction.

• There is increased focus on BRAIN CIRCUITS as the key to psychological disorders rather than on dysfunction within a single brain structure or by a single brain chemical.
• Ex: One of the brain’s most important circuits is the “fear circuit” which consists of a number of specific structures (including the amygdala and prefrontal cortex). This circuit functions improperly (that is, displays flawed interconnectivity) in people suffering from anxiety disorders.

SOURCES of BIOLOGICAL ABNORMALITIES – Why might the brain structures, neurotransmitters, or brain circuits of some people function differently from the norm?

• Prenatal Events
• Brain Injuries
• Viral Infections
• Environmental Experience
• Stress
• Genetics – Inheritance can play a part in certain mental disorders
• Evolution – many of the genes that contribute to abnormal functioning are actually the result of normal evolutionary principles of mutation.
  
  • Ex: In the past, fear alerted our ancestors to danger. Those with the greatest fear responses were more likely to survive. The very genes that helped our ancestors to survive and reproduce might now leave us particularly prone to fear reactions, anxiety disorders, or related psychological patterns.
• Genetics and Evolution have received particular attention in the Biological Model.

BIOLOGICAL TREATMENTS – three leading kinds: Drug Therapy, Brain Stimulation, and Psychosurgery.

• DRUG THERAPY – In the 1950s, researchers discovered several effective PSYCHOTROPIC MEDICATIONS, drugs that mainly affect emotions and thought processes, of which there are 4 major groups.
  
  1. Antianxiety drugs – help reduce tension and anxiety.
  2. Antidepressant drugs – help improve the functioning of people with depression and certain other disorders.
  3. Antibipolar drugs – also called mood stabilizers, help steady the moods of those with a bipolar disorder, a condition marked by mood swings from mania to depression.
  4. Antipsychotic drugs – help reduce the confusion, hallucinations, and delusions that often accompany psychosis.

NOTES:

• Only 3% of newly discovered chemical compounds make it to animal testing.
• Only 2% of animal-tested compounds reach human testing.
• Only 21% of human-tested drugs are eventually approved.
• BRAIN STIMULATION – refers to interventions that directly or indirectly stimulate certain areas of the brain.
  
  • The oldest (and most controversial) such approach, used primarily on severely depressed people, is ELECTROCONVULSIVE THERAPY (ECT), a biological treatment in which a brain seizure is triggered when an electric current passes through electrodes attached to the patient’s forehead.
  • Newer Techniques are able to improve the psychological functioning of many people whose depressive or related disorders have been unresponsive to other forms of treatment including:
    
    1. Transcranial Magnetic Stimulation (TMS), sends a current into certain areas of the brain.
    2. Vagus Nerve Stimulation (VNS), a pulse stimulates the vagus nerve, which then delivers electrical signals to the brain.
    3. Deep Brain Stimulation, electrodes send a steady stream of low-voltage electricity to the targeted brain areas

1. PSYCHOSURGERY – the act of surgery on the brain to manipulate behavior.
   
   • TREPHINATION – the prehistoric practice of chipping a hole in the skull of a person who behaved strangely, believing that would let the ‘badness’ out.
   • LOBOTOMY – a surgeon would cut the connections between the brain’s frontal lobes and the lower regions of the brain.
     
     • Today’s psychosurgery procedures are much more precise than the lobotomies of the past and are only used as a last resort.

ASSESSING the BIOLOGICAL MODEL – Today, this model commands considerable respect and is typically a part of any treatment plan.

• A Shortcoming is that not all human behavior can be explained in biological terms and treated with biological methods.

Question 5

Psychodynamic Model (of Abnormal Behavior)

Answer 5

PSYCHODYNAMIC MODEL – says that a person’s behavior is determined by underlying psychological forces of which he or she is not consciously aware.

• Abnormal symptoms are viewed as the result of conflicts between these forces – the CONFLICT BETWEEN the CONSCIOUS and the UNCONSCIOUS.
• These conflicts are tied to early relationships and to traumatic experiences that occurred during childhood.
• Psychodynamic theories rest on the DETERMINISTIC assumption that no symptom or behavior is “accidental”: all behavior is determined by past experiences.

SIGMUND FREUD (1856 - 1939) – After studying hypnosis, Freud developed the theory of psychoanalysis to explain behavior as well as a corresponding method of treatment, a conversational approach also called PSYCHOANALYSIS.

• ID – Instinctual needs, drives, and impulses. The id operates in accordance with the PLEASURE PRINCIPLE; that is, it always seeks gratification.
  
  • Freud also believed that all id instincts tend to be sexual, noting that from the very earliest stages of life a child’s pleasure is obtained from nursing, defecating, masturbating, or engaging in other activities that he considered to have sexual ties.
• EGO – Like the Id, the ego also unconsciously seeks gratification, but it does so in accordance with the REALITY PRINCIPLE, the knowledge we get through experience that tells us it is UNacceptable to express our id impulses outright. The ego, employing reason, guides us to know when we can and cannot express those impulses.
  
  • DEFENSE MECHANISMS – strategies to control unacceptable id impulses and avoid or reduce the anxiety they arouse.
  • Ex: The most basic defense mechanism, REPRESSION, prevents unacceptable impulses from ever reaching consciousness. Others include:
    
    • DENIAL – The unconscious refusal to acknowledge unconscious content. Ex: Terrible contestants on American Idol are in DENIAL.
    • REACTION FORMATION – involves not just denying your feelings, but acting as if you feel the opposite. Ex: If you are a repressed homosexual, you would NOT ONLY be in DENIAL that you are gay, but you would also hate gays.
    • PROJECTION – Seeing one’s own unconscious content in others rather than yourself. Ex: If you are a repressed homosexual, you would NOT ONLY be in DENIAL that you are gay, but you would also SEE others as being gay (whether they are or not).
    • DISPLACEMENT – Moving a threatening impulse onto a different, less threatening object. Ex: Displaced anger is common. If Hayley has a bad day at work, she might come home and punch a hole in the wall. She actually wanted to punch her boss, but the wall was less threatening as it could not retaliate (though it could have broken her hand, I guess).
    • SUBLIMATION – channeling unconscious impulses into work.
    • HUMOR – Releases the tension between the unconscious and the conscious.
    • DEFENSE PESSIMISM – Thinking negative thoughts to prepare for a possible negative outcome
• SUPEREGO – the personality force that operates by the MORALITY PRINCIPLE, a sense of what is right and what is wrong.
  
  • As we learn from our parents that many of our id impulses are unacceptable, we unconsciously adopt our parents’ values – feeling good when we uphold their values; guilty when we don’t.
  • In short, we develop a conscience.
• According to Freud, If the id, ego, and superego are in excessive conflict, the person’s behavior may show signs of dysfunction.
• DEVELOPMENTAL STAGES – Freud proposed that at each stage of development, from infancy to maturity, new events challenge individuals and require adjustments in their id, ego, and superego. If the adjustments are successful, they lead to personal growth. If not, the person may become FIXATED, or stuck, at an early stage of development. Then all subsequent development suffers, and the individual may well be headed for abnormal functioning in the future. Because parents are the key figures during the early years of life, they are often seen as the cause of improper development.
• Freud named each stage of development after the body area that he considered most important to the child at that time.
  
  • ORAL STAGE – (0-18 months)
    
    • Ex: During this stage, children fear that the mother who feeds and comforts them will disappear. Children whose mothers consistently fail to gratify their oral needs may become fixated at the oral stage and display an “oral character” throughout their lives, one marked by extreme dependence or extreme mistrust. Such persons are particularly prone to develop depression.
  • ANAL – (18 months to 3 years of age)
  • PHALLIC – (3 to 5 years)
  • LATENCY – (5 to 12 years)
  • GENITAL – (12 years to adulthood)
• OTHER PSYCHODYNAMIC THEORIES – Although subsequent theories departed from Freud in important ways, each held on to Freud’s belief that dynamic (interacting) psychological forces shape human functioning. Today’s most influential psychodynamic theories are:
  
  • SELF THEORY – emphasizes the role of the self – the unified personality. They believe that the basic human motive is to strengthen the wholeness of the self.
  • OBJECT RELATIONS THEORY – proposes that people are motivated mainly by a need to have relationships with others and that severe problems in the relationships between children and their caregivers may lead to abnormal development.

PSYCHODYNAMIC THEORIES – Psychodynamic therapists seek to uncover past traumas and the inner conflicts that have resulted from them. Therapists must subtly guide therapy discussions so that the patients discover their underlying problems for themselves. To aid in the process, the therapists rely on such techniques as:

• FREE ASSOCIATION – the patient is responsible for starting and leading each discussion. The therapist tells the patient to describe any thought, feeling, or image that comes to mind, even if it seems unimportant
• THERAPIST INTERPRETATION – Psychodynamic therapists listen carefully as patients talk, looking for clues, drawing tentative conclusions, and sharing interpretations when they think the patient is ready to hear them. Interpretations of three phenomena are particularly important:
  
  • RESISTANCE – an unconscious refusal to participate fully in therapy.
  • TRANSFERENCE – when they suddenly cannot free-associate or when they change a subject to avoid a painful discussion.
  • DREAMS – therapists try to help patients interpret their dreams, which Freud (1924) called the “royal road to the unconscious.” There are two types of dream content:
    
    • MANIFEST CONTENT – the consciously remembered dream.
    • LATENT CONTENT – the symbolic meaning of the dream.
    • To interpret a dream, therapists must translate its manifest content into its latent content.
• CATHARSIS – The reliving of past repressed feelings in order to settle internal conflicts and overcome problems believing that Insight must be an emotional as well as an intellectual process.
• WORKING THROUGH – A single episode of interpretation and catharsis will not change the way a person functions. The patient and therapist must examine the same issues over and over in the course of many sessions, each time with greater clarity.
• MODERN PSYCHODYNAMIC THEORY – An increased demand for focused, time-limited psychotherapies has resulted in efforts to make psychodynamic therapy more efficient and affordable, Including:
  
  • SHORT-TERM PSYCHODYNAMIC THERAPIES – Patients choose a single problem to work on, such as difficulty getting along with other people. The therapist and patient focus on this problem throughout the treatment and work only on the psychodynamic issues that relate to it. They are quite helpful to patients.
  • RELATIONAL PSYCHOANALYTIC THERAPY – Argues that therapists are key figures in the lives of patients—figures whose reactions and beliefs should be included in the therapy process. Thus, a key principle of relational therapy is that therapists should also disclose things about themselves, particularly their own reactions to patients, and try to establish more equal relationships with patients.

NOTES:

• Psychodynamic theorists say that abnormal functioning may be rooted in the same processes as normal functioning.
  
  • Psychological conflict is a common experience; it leads to abnormal functioning only if the conflict becomes excessive.
• Freud and his followers were the first to:
  
  • …apply theory systematically to treatment.
  • …demonstrate the potential of psychological, as opposed to biological, treatment.
  • Their ideas have served as starting points for many other psychological treatments.

SHORTCOMINGS of the PSYCHODYNAMIC MODEL – Because id, ego, and fixation are abstract, there is no way of knowing for certain if they are occurring, which means there is little research support.

• Psychodynamic theorists rely largely on evidence from individual case studies. Nevertheless, recent research evidence suggests that long-term psychodynamic therapy may be helpful for many people with long-term complex disorders.
• 18% of today’s clinical psychologists identify themselves as psychodynamic therapists.

Question 6

Cognitive-Behavioral Model (of Abnormal Behavior)

Answer 6

COGNITIVE BEHAVIORAL MODEL – focuses on the interplay between behaviors and thoughts – how behavior affects thinking and how thinking affects behavior.

• Essentially, it takes BEHAVIORISM and adds a dimension of COGNITION (thoughts and interpretations) to come up with this model which allows a thinking person to be influenced through conditioning, but is also empowered to think, interpret, and react in order to create their behavior.
  
  • The idea was that ways of thinking can result in abnormal behavior. Change the thinking and you change the behavior.
• Believed that behaviors can be EXTERNAL (going to work, say) or INTERNAL (having a feeling).
• Saw BEHAVIOR as something that is LEARNED, not a result of internal conflict, like psychoanalysts.
• Looks at two dimensions:

BEHAVIORAL DIMENSION – Both normal and abnormal behaviors can be learned. There are several forms of learning:

• CLASSICAL CONDITIONING – people learn to respond to one stimulus the same way they respond to another as a result of the two stimuli repeatedly occurring together close in time.
  
  • Ex: Pavlov’s Dog with the food (UNCONDITIONED STIMULUS), the bell (before conditioning the NEUTRAL STIMULUS, and after the conditioning, the CONDITIONED STIMULUS), and the salivating to the food (UNCONDITIONED RESPONSE) and after conditioning salivating to the bell (CONDITIONED RESPONSE) with the CONDITIONING itself consisting of a pairing of the food presented with the bell ringing.
  • Ex: If, say, a physician wears a white lab coat whenever she gives painful allergy shots to a little boy, the child may learn to fear not only injection needles but also white lab coats.
• MODELING – another form of conditioning, individuals learn responses simply by observing other individuals and then repeating their behaviors.
  
  • Ex: Bobo the Clown (Albert Bandura) – After watching a video of a woman beating a clown doll, kids did the same, but those who did not watch the video did not act that way to the doll.
• OPERANT CONDITIONING – individuals learn to behave in certain ways as a result of experiencing consequences of one kind or another—reinforcements (for example, rewards) or punishments—whenever they perform the behavior.
  
  • POSITIVE REINFORCEMENT – ADDITION of a GOOD thing (REWARD) for GOOD BEHAVIOR.
  • NEGATIVE REINFORCEMENT – REMOVAL of a BAD thing (Ex: Decreasing Chores) for GOOD BEHAVIOR.
  • POSITIVE PUNISHMENT – ADDING something BAD (Spanking, or extra chores) after MISBEHAVIOR.
  • NEGATIVE PUNISHMENT – REMOVING something GOOD (Ex: a “Timeout” – taking them out of the activity) after misbehavior.
  • In treatment, behavior-focused therapists seek to replace a person’s problematic behaviors with more appropriate ones, applying the principles of operant conditioning, classical conditioning, or modeling.

COGNITIVE DIMENSION – Albert Ellis (1962) and Aaron Beck (1967), proposed that clinicians must ask questions about the assumptions and attitudes that color a client’s perceptions in addition to observing their behaviors.

• They believed that abnormal functioning can result from several kinds of cognitive problems.
  
  1. Making incorrect assumptions
  2. Adopting disturbing or inaccurate attitudes
  3. Thinking Illogically
  • Ex: Depressed people consistently think in illogical ways and keep arriving at self-defeating conclusions like drawing broad negative conclusions on the basis of single insignificant events.
• For Treatment, therapists guide depressed clients to identify and challenge any negative thoughts, biased interpretations, and errors in logic that dominate their thinking and contribute to their disorder.
  
  • Ex: People with SOCIAL ANXIETY DISORDER have severe anxiety about social situations in which they may face scrutiny by other people.
    
    • Cognitive-behavioral theorists contend that people with this disorder hold a group of social beliefs and expectations (thoughts) that consistently work against them (Ex: underestimating their attractiveness or expecting a terrible outcome no matter what).
    • As a result of these warped thoughts, the person has abnormal behaviors, including:
    • AVOIDANCE BEHAVIORS – include, for example, talking only to people they already know well at gatherings or parties, or avoiding social gatherings altogether.
    • SAFETY BEHAVIORS – include wearing makeup to cover up blushing.
      
      • Such behaviors are reinforced by eliminating or reducing the individuals’ feelings of anxiety and the number of unpleasant events they encounter.
    • EXPOSURE THERAPY – a behavior-focused intervention in which fearful people are repeatedly exposed to the objects or situations they dread – used to break this cycle of problematic beliefs and behaviors.

IMPORTANT:Thecognitive-behavioral modelhas become apowerful force in the clinical field.

• Nearly half of today’s clinical psychologists report that their approach is cognitive-behavioral!
• Supporting Research is STRONG.

SHORTCOMINGS Include:

• COGNITIVE-BEHAVIORAL MODEL assumes that the thoughts are CAUSAL to the BEHAVIOR (bad/wrong thoughts lead to abnormal behavior) but it can also be true that the problematic behaviors and cognitions seen in psychologically troubled people could well be a result rather than a cause of their difficulties.
• It’s not always possible for clients to rid themselves fully of their negative thoughts and biased interpretations.
• A final drawback of the cognitive-behavioral model is that it is narrow in certain ways. Although behavior and cognition obviously are key dimensions in life, they don’t take other things into consideration like environment, culture, situation, and genetics.

NEW THERAPY – In addition to the traditional cognitive-behavioral approaches, there is a new wave of cognitive-behavioral therapies, such as ACCEPTANCE AND COMMITMENT THERAPY (ACT) – which is based on MINDFULNESS and is very effective – It helps clients to accept many of their problematic thoughts rather than judge them, act on them, or try fruitlessly to change them. The hope is that by recognizing such thoughts for what they are—just thoughts—clients will eventually be able to let them pass through their awareness without being particularly troubled by them.

Question 7

Humanistic-Existential Model (of Abnormal Behavior)

Answer 7

HUMANISTIC-EXISTENTIAL MODEL – Focuses on the human need to successfully deal with philosophical issues such as self-awareness, values, meaning, and choice.

HUMANISTS – believe that human beings are born with a natural tendency to be friendly, cooperative, and constructive and are driven to SELF-ACTUALIZE – to fulfill their potential for goodness and growth.

• They can do so only if they recognize and accept their weaknesses as well as their strengths and establish satisfying personal values to live by.
• When this drive to self-actualize is interfered with, abnormal behavior may result.
• Believe that self-actualization leads naturally to a concern for others.
• Humanistic principles are apparent throughout positive psychology
• EXISTENTIALIST – believe that from birth we have total freedom, either to face up to our existence and give meaning to our lives or to shrink from that responsibility.
  
  • Those who choose to “hide” from responsibility and choice will view themselves as helpless and may live empty, inauthentic, and dysfunctional lives as a result.

CARL ROGERS (1902 - 1987) – considered the pioneer of the humanistic perspective, developed CLIENT-CENTERED THERAPY, which tries to create a very supportive therapy climate in which people can look at themselves honestly and acceptingly, thus opening the door to self-actualization.

• ROGER’S HUMANISTIC THEORY and THERAPY – From infancy, we all have a basic need to receive positive regard from the important people in our lives (primarily our parents).
  
  • Those who receive UNCONDITIONAL POSITIVE REGARD (nonjudgmental) 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 a good position to actualize their positive potential.
  • Those who do not suffer damaged self-regard, leading to problems in functioning.
  • Clinicians try to create a supportive climate in which clients feel able to look at themselves honestly and acceptingly. The therapist must display three important qualities:
    
    1. unconditional positive regard (full and warm acceptance for the client)
    2. accurate empathy (skillful listening and restating)
    3. genuineness (sincere communication).
  • Client-Centered Therapy has NOT fared well in research.

GESTALT THEORY and THERAPY (Humanistic Approach) – Gestalt therapists, like client-centered therapists, guide their clients toward self-recognition and self-acceptance. But unlike client-centered therapists, they try to achieve this goal by challenging and even frustrating the clients, demanding that they stay in the here and now, and pushing them to embrace their real emotions.

• Ex: Gestalt therapists often use the technique of role-playing, instructing clients to act out various roles. Through this experience, they may come to “own” (accept) feelings that previously made them uncomfortable.
• Due to the subjective nature of this approach, there is almost no research.

SPIRITUAL VIEWS and INTERVENTIONS – Researchers have learned that spirituality correlates with psychological health.

• Though spirituality may cause mental health, it is also possible that mental help facilitates spiritualism or that some other factor causes both things separately.
  
  • ​That said, clients are now encouraged to use their spiritual resources to help them cope with current stressors.

EXISTENTIAL THEORIES and THERAPY – Like humanists, existentialists believe that psychological dysfunction is caused by self-deception. To be healthy means to embrace life’s responsibilities and create your own path.

• Essentially, abnormal behavior results from hiding from life’s responsibilities.​
  
  • IF they fail to accept life’s responsibilities and to recognize that it is up to them to give their lives meaning, then they will become overwhelmed by daily pressures, forever looking to others for explanations, guidance, and authority. They forfeit their personal freedom of choice and suffer from empty, inauthentic lives, filled with anxiety, frustration, boredom, alienation, and depression.
• In EXISTENTIAL THERAPY, people are encouraged to accept responsibility for their lives and for their problems. Therapists try to help clients recognize their freedom so that they may choose a different course and live with greater meaning.
• Little research has been done on this approach.

ASSESSMENT of the HUMANISTIC-EXISTENTIAL APPROACH – Theorists who follow the principles of the humanistic-existential model offer great hope when they assert that, despite past and present events, we can make our own choices, determine our own destiny, and accomplish much.

IMPORTANT: “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” – Maya Angelou

Question 8

Sociocultural Model (of Abnormal Behavior)

Answer 8

SOCIOCULTURAL MODEL – believes abnormal behavior is best understood in light of the broad forces that influence an individual, such as the norms of society, culture, and the environment. There are two major perspectives

FAMILY SOCIAL PERSPECTIVE – focuses on broad forces that operate on an individual through life – family relationships, social interactions, and community events, paying particular attention to THREE FACTORS:

1. SOCIAL LABELS and ROLES – Abnormal functioning can be influenced greatly by the labels and roles assigned to troubled people. If society labels them “deviant” or “mentally ill”, such labels tend to stick and become self-fulfilling as the person labeled tends to accept that role.
   
   • A famous study called “On Being Sane in Insane Places” (David Rosenhan (1973))[ – 8 normal people, presented themselves at various mental hospitals, falsely complaining that they had been “hearing voices” say benign words. On the basis of this complaint alone, each was diagnosed as having schizophrenia and admitted. Though they showed no symptoms beyond that claim, they found it incredibly difficult to convince others that they were in fact, sane. The label took over.
2. SOCIAL NETWORKS – Little social contact is related to psychological dysfunction. Isolated people are more likely to become depressed when under stress and to remain depressed longer than are people with strong social support.
3. FAMILY STRUCTURE and COMMUNICATION – According to FAMILY SYSTEMS THEORY, the family is a system of interacting parts who interact with one another in consistent ways and follow rules unique to each family.
   
   • The structure and communication patterns of some messed-up families actually force individual members to behave in a way that otherwise seems abnormal. If the members were to behave normally, they would severely strain the family’s usual manner of operation and would actually increase their own and their family’s turmoil.
   • Family systems likely to produce abnormal functioning in individual members include:
     
     • …those with members grossly overinvolved in one another’s activities, thoughts, and feelings.
       
       • Children from this kind of family may have great difficulty becoming independent in life.
     • …those families display disengagement, which is marked by very rigid boundaries between the members.
       
       • Children from these families may find it hard to function in a group or to give or request support.

• FAMILY-SOCIAL TREATMENTS – Consists of:
  
  • GROUP THERAPY – a therapist meets with a group of clients who have similar problems.
    
    • Research suggests that group therapy is of help to many clients, often as helpful as individual therapy.
    • SELF-HELP GROUP – people who have similar problems (Ex: bereavement, substance abuse) come together to help and support one another without the direct leadership of a professional.
      
      • These exist in person and on the internet.
      • Perhaps 3 million of these groups in the USA with 3-4% of the population attending.
  • FAMILY THERAPY – A therapist meets with all members of a family, points out problem behaviors and interactions, and helps the whole family to change its ways.
    
    • Family Systems therapists often try to change the family power structure, the roles each person plays, and the relationships between members.
    • Research has NOT clarified how helpful this might be.
  • COUPLE THERAPY (MARITAL THERAPY) – focuses on the structure and communication patterns in the relationship.
    
    • A couple approach may also be used when a child’s psychological problems are traced to problems in the parents’ relationship.
    • Couples who live together without marrying tend to have the same problems as married couples.
    • May follow the principles of any of the major therapy orientations.
      
      • Ex: Cognitive behavioral couple therapy helps spouses recognize and change problem behaviors by teaching specific problem-solving and communication skills.
      • Ex: Integrative behavioral couple therapy helps partners accept behaviors that they cannot change, and embrace the whole relationship nevertheless. Partners are asked to see such behaviors as an understandable result of basic differences between them.
    • Research shows Couple Therapy Works.
  • COMMUNITY MENTAL HEALTH TREATMENT – programs allow clients, particularly those with severe psychological difficulties, to receive treatment in familiar social surroundings as they try to recover – seem to be of special value to people with severe mental disorders.
    
    • ​Community workers recognize 3 types of PREVENTION:
      
      1. ​PRIMARY PREVENTION – consists of efforts to improve community attitudes and policies. Its goal is to prevent psychological disorders altogether.
         
         • Ex: offer public workshops on stress reduction, or construct Web sites on how to cope effectively.
      2. SECONDARY PREVENTION consists of identifying and treating psychological disorders in the early stages, before they become serious.
         
         • Ex: Work with teachers, ministers, or police to help them recognize the early signs of psychological dysfunction.​
      3. TERTIARY PREVENTION – is to provide effective treatment as soon as it is needed so that moderate or severe disorders do not become long-term problems.

MULTICULTURAL PERSPECTIVE – seeks to understand how those of different culture, race, ethnicity, gender differ psychologically and how that affects behavior and thought.

• The poor, perhaps due to the pressures of poverty, suffer psychological abnormality much more than wealthier people.
• Prejudice, and the problems such prejudice poses, may contribute to abnormal patterns of tension, unhappiness, and low self-esteem.
• MULTICULTURAL TREATMENTS – ethnic and racial minority groups tend to show less improvement in clinical treatment, make less use of mental health services, and stop therapy sooner than members of majority groups.
  
  • Two features of treatment can increase a therapist’s effectiveness with minority clients:
    
    1. greater sensitivity to cultural issues
    2. inclusion of cultural morals and models in treatment.
       
       • These can be accomplished using CULTURE-SENSITIVE, GENDER-SENSITIVE, and FEMINIST THERAPIES.

NEW THERAPY – takes advantage of technology:

• VIRTUAL REALITY THERAPY – the use of 3D computer graphics to simulate real-world objects and situations.
  
  • Used for treating people with phobias, PTSD, and other disorders, allowing them to be exposed— through computer simulation—to the objects and memories they dread, thus helping them to confront their fears head-on.
• AVATAR THERAPY – used to alleviate problems such as social anxiety, loneliness, and hallucinations that hinder normal interactions.
• Research has shown these to be very helpful.

ASSESSING THE SOCIOCULTURAL MODEL – finally takes culture and gender into account.

• Research findings are unclear.
• Cannot predict abnormality in specific individuals.
  
  • Ex: If social conditions such as prejudice and discrimination are key causes of anxiety and depression, why do only some of the people subjected to such forces experience psychological disorders?
    
    • A: Because it is only one of many risk factors.

Question 9

Integrating the Models (of Abnormal Behavior)

Developmental Psychopathology Perspective

Answer 9

DEVELOPMENTAL PSYCHOPATHOLOGY PERSPECTIVE – Because no single model of Abnormal Behavior adequately addresses all the risk factors, we must integrate them all.

• Abnormality results from the interaction of genetic, biological, emotional, behavioral, cognitive, social, cultural, and societal influences.
  
  • ​Most therapists combine treatment techniques from several models.
  • Research shows that problems respond best to a multi-pronged approach.
  • Pays particular attention to the TIMING of influential variables. The emergence of particular events, experiences, or biological factors can continue to have enormous impact on later functioning if they occur at vulnerable points in a person’s life.
    
    • Ex: they tend to prioritize PREVENTION and early intervention for vulnerable persons over treatment for individuals who have already developed severe disorders.

HOW DOES DEVELOPMENTAL PSYCHOPATHOLOGY DRAW FROM EACH MAJOR MODEL?

• Biological Model – Determines how certain genetic and brain factors have set the stage for the individual’s important environmental experiences
• Psychodynamic Model – considers how earlier events in a person’s life – including parent-child relationships – have stifled subsequent development
• Cognitive-Behavioral Model – Determines how the individual’s maladaptive behaviors have been reinforced over the years and how he or she has interpreted and processed life experiences.
• Humanistic-Existential Model – Considers the person’s competencies, uniqueness, and resilience, even in the face of overwhelming life stress
• Sociocultural Model – emphasizes the influence of social context and culture – both present and past – on the individual’s functioning.

PATHWAYS to ABNORMALITY – Various developmental routes, or PATHWAYS, can lead to dysfunction. This is based on two principles:

• EQUIFINALITY – says a DIFFERENT developmental pathways can lead to the SAME psychological disorder.
• MULTIFINALITY – says SIMILAR developmental pathways can lead to the DIFFERENT psychological outcomes.
  
  • Persons who have experienced a number of similar developmental variables (Ex: Socioeconomic setting, family, neighborhood) may nevertheless react to comparable current situations in very different ways.