models and treatments abnormal behavior

Chapter Two

Abnormal Behavior: Models and Treatments

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Figure 2.1: The Major Models of Psychopathology


Biological Models

• Assume the following:– people are the people that they are and do the things

they do because of biological factors, particularly genes

– changes in thoughts and emotions are associated with biological changes

– Mental disorders are related to biological dysfunction– Effective treatment of mental disorders is biologically

based.


Biological Factors

• Genetics: Physical features, susceptibility to illness, temperament, handling stress

• Nerve cell activities (brain and spinal cord): Thoughts, emotions, behaviors

• Brain Activity & Structure: Changes in thoughts, emotions, behaviors

• Brain Dysfunction: Mental disorders

• Treatment: Drugs or somatic intervention


The Human Brain

• Weighs 3 pounds• comprised of billions of neurons• Forebrain: responsible for thinking, planning, reasoning and

decision making• Midbrain: contains primitive centers for vision and hearing; relays

sensory information to the brain• Hindbrain: responsible for sleep and arousal, muscle tone, cardiac

reflexes, attention and regulation of basic motor activities• The Cerebral Cortex: The brain’s outermost layer; responsible for

our ability to reason, plan, remember and imagine. Comprised of four lobes: Frontal, Parietal, Temporal and Occipital


The Human Brain

• Neurons: Nerve cells that transmit messages throughout the body

• Two Hemispheres: Control opposite sides of the body

• Right Hemisphere: Visual-spatial abilities and emotional behavior

• Left Hemisphere: Language functions


Figure 2.2: The Internal Structure of the Brain


The Forebrain

• Controls higher mental functions: consciousness, learning, speech, thought, memory

• Thalamus: “Relay station” (transmits nerve impulses throughout brain)

• Hypothalamus: Regulates bodily drives

• Limbic system: Experiencing/expressing emotions and motivation


The Midbrain & Hindbrain

• Cerebrum: Largest structure in the brain

• Cerebral Cortex: Covers midbrain & thalamus

• Midbrain: Vision & hearing; sleep, pain, alertness (with hindbrain); produces serotonin, norepinephrine, dopamine


The Midbrain & Hindbrain (Cont’d)

• Hindbrain: Controls heart rate, sleep, respiration; with midbrain also manufactures serotonin

• Reticular formation: Network of nerve fibers controlling sleep, alertness, attention; threads its way from hindbrain up into midbrain


Biochemical Theories

• Chemical imbalances underlie mental disorders

• Dendrites: Receive signals from other neurons

• Axons: Send signals to other neurons• Synapse: Gap between axon of sending

neuron and dendrites of receiving neuron• Neurotransmitters: Chemicals involved in

transmission of neural impulses


Figure 2.3: Synaptic Transmission


Table 2.1: Major Neurotransmitters & Their Effects


Figure 2.4: Neurotransmitter Binding


Evidence for biochemical factors in mental disorders:

• Drugs that alter neurotransmitter levels alleviate symptoms for some people

• Biochemical studies suggest that these drugs work by increasing or decreasing the action of neurotransmitters at receptor sites

• Certain chemical imbalances appear to be disorder-specific


Genetic Explanations

• Biological inheritance transmitted by genes

• Genotype: A person’s genetic makeup

• Phenotype: Observable (expressed) physical & behavioral characteristics

• Genome: all the genetic material in the chromosomes of a particular organism


Genetic Explanations for Abnormal Behavior

• Research suggests that genes play an important role in the development of certain disorders. For example:– Genes may increase reactivity of a person’s

autonomic (involuntary) nervous system– Genes are related to development of alcoholism,

schizophrenia, mood disorders and others.– The Human Genome Project: June, 2000 –

scientists mapped all genes in a human cell and its sequencing (2001).

– However, only 2% of diseases can be traced to a single gene; most are multifactorial.


Biology-Based Treatment Techniques

• Electroconvulsive therapy (ECT): Apply electric voltage to the brain to induce convulsions; used to reduce depression

• Psychosurgery: Brain surgery performed to correct severe mental disorder

• Psychopharmacology: Study of the effects of drugs on mind & behavior (medication/drug therapy)


Table 2.2: Drugs Most Commonly Used in Drug Therapy


Drugs Commonly Used for Treating Mental Disorders

• Antianxiety drugs: Minor tranquilizers used for anxiety, nervousness, tension (Librium, Valium)

• Antipsychotic drugs: Major tranquilizers used to control hallucinations (Thorazine, Stelazine, Prolixin)

• Antidepressant drugs: Relieve depression by correcting neurotransmitter imbalance (Prozac, Paxil, Zoloft)


Criticisms of Biological Models

• Do not account for abnormal behavior if no biological cause is found (e.g., phobias, eating disorders)

• Ignore role of environmental, social, cultural influences

• Diathesis-Stress Theory: A diathesis (predisposition to develop illness) is inherited and may or may not be activated by environmental factors


Psychodynamic Models

• Adult disorders arise from childhood traumas or anxieties and are later repressed because they are too threatening to face

• Psychoanalysis: Therapy based on Freudian view that unconscious conflicts must be aired and understood by the patient if abnormal behavior is to be eliminated


Personality Structure

• Id: Present from birth – Operates on the pleasure principle: Impulsive,

pleasure-seeking aspect of being; immediate gratification of instinctual needs

• Ego: Realistic, rational part of mind – Operates on reality principle: Awareness of

environmental demands + need to adjust behavior to meet these demands

• Superego: Moral judgments & moralistic considerations:– Conscience: instills guilt feelings– Ego ideal: rewards altruistic or moral behavior


Personality Structure (Cont’d)

• Instincts give rise to thoughts & actions and fuel their expression

• Dominant human instincts: sex and aggression

• Freud: Although most impulses are hidden from consciousness, they determine human actions


Psychosexual Stages

• Sequence of stages through which personality develops:– Oral (first year of life)– Anal (second year of life)– Phallic (approximately age 3-6)– Latency (approximately age 6-12)– Genital (puberty and older)

• Fixation: Emotional development gets stuck at a particular psychosexual stage


Table 2.3: Defense Mechanisms


Criticisms of Psychodynamic Models

• Freud used uncontrolled research methods including case studies and his own self-study to generate his psychological theory.

• Freud’s writings are unfavorable to women.• Psychodynamic Therapy is not appropriate for

seriously disturbed, inarticulate, very young or very old individuals.

• Research suggests that psychodynamic therapies are only minimally more effective than placebo treatments or no treatment


Behavioral Models

• Assume abnormal behavioral is learned.• Assume rewards and consequences shape behavior.• Classical conditioning: Involves learning to associate one

stimulus with another stimulus.– Pavlov, 1849-1936– Watson, 1920– Therapy involves changing associations between stimuli

• Operant Conditioning: involves learning to associate behavior with rewards and consequences.– Thorndike, 1874-1949– B. F. Skinner, 1904-1990– Therapy involves changing rewards and consequences for

behavior.


Figure 2.5: A Basic Classical Conditioning Process


Behavioral Therapies

• Systematic Desensitization: Reduce anxiety by overcoming it with an antagonistic response

• Flooding: Extinguish fear by placing client in full intensity, real-life anxiety producing situation

• Implosion: Extinguish fear by having client imagine full intensity anxiety-provoking situation

• Aversive Conditioning: Suppress undesirable behavior by pairing it with unpleasant stimulus

• Token Economy: Reward desired behavior with tokens that are exchanged for food, privileges

• Punishment: Shock


Observational Learning Model

• A 3rd type of behavioral model• Suggests we can learn and acquire new behaviors by watching

others.– This type of learning is called vicarious conditioning or modeling.– Direct and tangible reinforcement is not necessary for learning to

occur.– Abnormal behavior is learned by watching others and can be

changed by observing models who:• do not exhibit abnormal behavior• are rewarded for normal behavior or punished for abnormal

behavior• or who give subtle cues for normal behavior.


Criticisms of the Behavioral Models

• Neglect inner determinants of behavior

• Many studies conducted on animals rather than humans

• Too mechanistic and inflexible


Cognitive Models

• Assume thinking and mental processes affect behavior• Our cognitive interpretation of a situation affects our emotional

response to it.• Irrational and maladaptive thoughts and ways of thinking contribute

to abnormal behavior.• Teaching more rational thoughts and ways of thinking can decrease

abnormal behavior.– Beck suggests three levels of thinking:

• Voluntary thoughts, that we have the greatest control over• Automatic thoughts, that occur spontaneously or are

triggered by external events• Underlying assumptions about ourselves and the external

world


Table 2.4: Beck’s Six Types of Faulty Thinking


Cognitive Models: Ellis

• Psychological problems are produced by irrational thought patterns that stem from one’s individual belief system– Unpleasant emotional responses result from one’s

unrealistic and irrational thoughts about an event, not the event itself

• A-B-C- Theory of Personality– A= Activating Event, B= Beliefs about the Event, C=

Consequence• It is the “B” (Beliefs about the event) that we may be able to

change.


Criticisms of Cognitive Models

• Skinner (1990) suggests cognitions are not observable phenomena and can’t be empirically studied.

• Too mechanistic – behavioral motivation is more complicated than the cognitive models represent.

• Cognitive therapists are too direct and authoritative. – Therapist, as teacher, expert, authority figure is direct

& confrontational and may intimidate client and misidentify the disorder


Humanistic and Existential Approaches

• Assume each person has his or her own reality that is the product of his or her experiences.

• In order to be effective, the therapist must understand the client from his or her perspective.

• Individuals have the ability to make their own choices and are responsible for those choices.

• Believe in the “whole” person rather than focusing on simples formulas.

• Believe people have the capability to fulfill their potential and live the lives they desire.


The Humanistic Perspective

• Carl Rogers (1902-1987)• All people are basically good.• People have a natural tendency to self-actualize, (to

reach their full potential).• Abnormal Behavior results from incongruence between a

person’s inherent potential and his or her self-concept.– This incongruence occurs when conditions of worth are

imposed by significant others in the person’s life.

• Treatment of abnormal behavior involves allowing the person to experience a caring relationship of trust with someone who has unconditional positive regard for him, and views the client from his point of view.


The Existential Perspective

• Human beings need to be understood from their perspective

• In confronting the possibility of their non-being, individuals can find meaning in their lives.

• Self-fulfillment is not enough; individuals have ethical responsibilities to others as well.

• The individuals positive attributes will be expressed unless they are distorted by the environment.


Criticisms of Humanistic & Existential Approaches

• “Fuzzy,” ambiguous, nebulous nature• Applied to a restricted population • Creative in describing human condition, but not

in constructing theory• Not suited to scientific or experimental

investigation• Subjective, intuitive, & empathic, not empirically

based• Effective with intelligent, well-educated, relatively

“normal” clients, not severely disturbed clients


The Family Systems Model

• Emphasizes the family’s influence on individual behavior

• Characteristics:– Personality development ruled by family

attributes– Abnormal behavior is a reflection of unhealthy

family dynamics and poor communication– Therapist must focus on family system, not

just the individual


Criticisms of Family Systems Model

• Definition of family may be culture bound

• Exclusive emphasis on the family systems model may have negative consequences:– Parental influence may not be a factor in an

individual’s disorder– Parents are burdened with unnecessary guilt

over a situation they may be unable to control


Culturally Diverse Populations & Psychotherapy

• European American perspectives see problems located within the person

• Multicultural model suggests problems may be located in social system

• Surgeon General’s Report: – European American standards may result in denying

appropriate treatment to minority groups– European American standards may oppress, not help,

culturally different clients– Cultural concerns of minority group members must be

recognized and responded to

models and treatments abnormal behavior

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