Lecture 2 - Medical Model & CBT Flashcards
What did the Medical Model introduce?
Shift away from cultural/religious beliefs
Introduced scientific thinking regarding
understanding of psychopathology
– Given rise to large body of scientific knowledge
Based on Medicine – Psychiatry
Primary approach
– Identify biological causes
– Treat with medication/surgery
Biological Explanations of the Medical Model
Many biological explanations
– Brain abnormality
– Biochemical imbalances – neurotransmitter
imbalance
– Genetic Factors
– Physical effects of pathological activities
Problems with Medical Model
Aided development of a scientific view and
influential treatments, but…
Implies cause is always medical or
biological
Reductionist
– Reducing complex psychological and emotional
factors simply to biology
* Struggles to explain dysfunctional beliefs
characteristic of many psychopathologies
Further problems with MM
Problems with the implicit assumption
– Dysfunction vs extreme form of normal
behaviour
* AN, DP
– Impacts our views of individuals with MHPs
adding to stigmatisation
Drug Treatments
Regularly used to alleviate some of the
symptoms of psychopathologies, e.g.:
– Anti-depressant Drugs
– Antipsychotic Drugs
– Anxiolytic Drugs (Tranquilisers)
Antidepressant Drugs
Successfully developed in 1960s
– Tricyclic Antidepressants
* Increase amount of norepinephrine and serotonin available
for synaptic transmission
– Monoamine Oxidase (MAO) Inhibitors
* For those who do not respond to other antidepressants
– Also useful in treating panic disorder and bipolar depression
– Selective Serotonin Reuptake Inhibitors (SSRIs)
* Selectively affect the reuptake of serotonin
Antipsychotic Drugs
Use of effective antipsychotics
common in 1960s and 1970s
– Block dopamine receptors, helping to
reduce high levels of dopamine in the
brain
Reduce symptoms
Side effects
– E.g., blurred vision, muscle spasms,
blood disorders, cardiac problems
– Treatment adherence
Anxiolytic Drugs
Benzodiazepines
– Increasing the level of GABA at synapses in the
brain
– Usually only prescribed for short periods as risk
of dependency over a longer period of use
– Risk of abuse if available in large doses
Problems with Drug Treatments
– Medicalisation of mild psychopathology
– Long-term prescription may lead to perception of
dependence on drugs for psychological and social
functioning
– Can prevent understanding and insight into the
psychopathology
– Some evidence to suggest that may alleviate immediate
symptoms, may worsen long term course (e.g., Fava, 2003)
Can be prescribed in conjunction with
psychological therapies
Behavioural Approach
Psychopathology reflects learned reactions to
life experiences
Learning Theory
– Dysfunctional behaviour (as adaptive behaviour)
can be acquired through learning
Encompasses principles of classical and
operant conditioning
Frequently applied to explaining and treating
psychopathology
Classical Conditioning: Pavlov (1849 - 1936)
UCS food -> UCR salivation
CS + UCS -> UCR
CS -> CR
Classical conditioning applied to mental health
Trauma e.g. car accident -> UCR Fear and
UCS Anxiety
Phobic stimulus -> Fear and anxiety
Travelling in car CS CR
+ UCS
CS -> CR
Operant conditioning: Skinner (1904-1990)
- Consequences of behaviour
important - Positive reinforcement
- Negative reinforcement
- Friendly person has been
reinforced for being friendly and
visa versa
Operant conditioning applied
‘The learning of a specific behaviour or response
because that behaviour has certain
consequences’ (Davey, 2008, p.13)
For example:
– Acquisition of bizarre behaviours in Schizophrenia
(Ullman & Krasner, 1975)
– Stress-reducing or stimulant effects of nicotine, alcohol
and illegal drugs that may lead to substance
dependency (Schachter, 1982)
– Checking behaviours and OCD
Pros and cons of Behavioural Model
+ Has lead to development of
important behavioural
treatment approaches
- Neglects the cognitive
aspect of psychopathologies
E.g., dysfunctional
thinking - Psychopathologies complex,
acquired gradually over
many years
Difficult to trace
reinforcement history
