Chapter 2: Models of Psychopathology

Model/Paradigms:

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

• Guide treatment techniques and principles.

• Often in conflict, it’s best to involve several of these to explain abnormality/psychopathology.

None of these models are?

Complete in itself. Each focuses on one aspect of human functioning, and none can explain all aspects of psychopathology.

Biological Model

Outlines how our thoughts, emotions, and behaviors are all rooted in the biological and medical models.

• Points to problems in brain anatomy or brain chemistry as the cause of such behavior.

Neuron:

A nerve cell.

Synapse:

The tiny space between the nerve ending of one neuron and the dendrite of another.

Neurotransmitter:

A chemical that, released by one neuron, crosses the synaptic space to be received at receptors on the dendrites of neighboring neurons.

• The brain can modify the function of this term based off perception.

Receptor:

A site on a neuron that receives a neurotransmitter.

dendrites → axon →

nerve endings → synapses → neurotransmitters.

Neurotransmitters can also carry what?

An inhibitory message; they tell receiving neurons to stop all firing.

Irregular activity in certain NTs can lead to what?

Specific mental disorders.

• Depression, has been linked in part to low or irregular activity of the neurotransmitters serotonin, norepinephrine, and glutamate.

Psychopathological activity in what system is related to mental disorders?

Endocrine system(hormones)

Secretion above average of the hormone cortisol is linked to what psychopathology?

anxiety and mood disorders such as depression.

Brain Circuit:

A network of particular brain structures that work together, triggering each other into action to produce a distinct kind of behavioral, cognitive, or emotional reaction.

Increasingly, research focuses on what as the key to psychological disorders?

Brain circuits as the key to psychological disorders rather than single brain or brain chemical dysfunction.

• Include brain circuit neurotransmitters, structures, and functions.

Improper interconnectivity among circuit structures can lead to what?

May lead to psychological dysfunction.

• The fear circuit, for example, has interconnecting fiber pathways enable the structures to trigger each other action and to produce our everyday fear.

  • Certain anxiety disorders.

Genes:

Chromosome segments that control the characteristics and traits we inherit.

In most instances, several genes combine to help produce what?

Both functional and dysfunctional actions and reactions.

• Can also make people more prone to heart disease, cancer, or diabetes.

Mutation:

Genes that contribute to mental disorders may be a mistake inheritance. An atypical form of the gene appropriate gene that emerges unexpectedly.

Many genes that contribute to irregular functioning could point to?

The result of normal evolutionary principles.

• However, the capacity to experience fear was and in many instances still is adaptive. However, could leave some with anxiety disorders.

Many genes that contribute to irregular functioning are the result of what?

Normal evolutionary principles.

Drug therapy(most common):

• SSRIS(Selective Serotonin Reuptake Inhibitors)

• Psychotropic Medications

Brain stimulation:

Interventions that directly or indirectly stimulate certain areas of the brain.

• Improve psychological functioning of many whose depressive or related disorders have been unresponsive to other forms of treatment.

Psychosurgery/Neurosurgery:

Brain surgery for mental disorders.

• Typically used only after certain severe disorders have continued for years w/o responding to any treatment.

  • Deep brain stimulation

Psychotropic Medications:

Drugs that primarily affect the brain and reduce many symptoms of mental dysfunction.

Contributions of direct-to-consumer drug ads

• Patient education about available drugs

  • Although imperfectly by directly educating them about drugs that are available in the marketplace.

• Increased involvement of patients in their own care.

Drawbacks of direct-to-consumer drug ads

• Higher drug costs related to advertising expenses

• Patient misinformation

  • Drug does X when in reality it does XYZ.

• Pressure on doctors to prescribe inappropriate DTC-advising drugs.

Electroconvulsive therapy (ECT):

Two electrodes are attached to a patient’s forehead, and an electrical current of 65 to 140 volts is passed through the brain.

• Many patients feel considerably less depressed.

Transcranial Magnetic Stimulation (TMS)

An electromagnetic coil is placed on or above a person’s head, sending a current into certain areas of the brain.

• Stimulated nerve delivers electrical signals to the brain.

Vagus nerve Stimulation (VNS)

Pulse generator is implanted in a person’s neck helping to stimulate their vagus nerve(a nerve that extends from the brain down through the neck on the abodmen.)

• Stimulated nerve delivers electrical signals to the brain.

Deep brain stimulation

Electrodes are surgically implanted in specific areas of a person’s brain and connected to a battery(pacemaker) in the chest.

• The battery sends electrodes.

Antianxiety drugs

Anxiolytics; minor tranquilizers

• Help reduce tension and anxiety

Antidepressants drugs

Help improve the functioning of people with depression and certain other disorders.

Antibipolar drugs(mood stabilizers)

Help steady the moods of those with bipolar disorder, a condition marked by mood swings from mania to depression.

Antipsychotic drugs

Help reduce the confusion, hallucinations, and delusions that often accompany psychosis.

• A loss of contact with reality found in schizophrenia and other disorders.

The Psychodynamic Model

Proposed person’s behavior determined largely by underlying dynamic psychological forces outside of conscious awareness.

• Conscious, preconscious(sub), and unconscious

The psychodynamic model suggests abnormal symptoms are the result of what?

Conflict/interaction among these forces outside of conscious awareness.

Psychoanalysis Theory:

Explain psychological functioning as well as conversational method of treatment.

Deterministic View:

Assume that no symptom or behavior is “accidental”. All behavior is determined by past experience.

Id:

Pleasure principle

• Instinctual needs, drives, and impulses.

• Believed it tended to be sexual starting from the earliest stages of life.

Ego:

Reality principle

• The knowledge we acquire through experience that it can be unacceptable to express our id impulses outright.

Ego defense mechanisms:

Controls unacceptable id impulses and avoid or reduce the anxiety they arouse.

Superego:

What is right and wrong.

• We learn from our parents that many of our id impulses are unacceptable, we adopt our parents values and ideals.

  • Conscience

The id, ego, and supergo are in some degree of what?

Healthy conflict

If the id, ego, and supergo are in excessive conflict it can produce what?

Dysfunction in someone’s behavior.

If development through infancy to maturity is successful then what and if the opposite?

Leads to personal growth and if not they could become stuck at an early stage of development.

• Could be headed to maladaptation and psychopathology.

Self Theory:

The psychodynamic theory that emphasizes the role of the self— our unified personality.

Object Relations Theory:

The psychodynamic theory that views the desire for relationships as the key motivating force in human behavior.

• Severe issues in the relationship between children and caregivers could lead to dysfunctional development.

Free association

A psychodynamic technique in which the client describes any thought, feeling, or image that comes to mind, even if it seems unimportant.

Therapist interpretation:

Listening while clients talk, looking for clues, drawing tentative conclusions, and sharing interpretations

Resistance:

Unconscious refusal to participate fully in therapy, when they suddenly can’t free associate or when they change a subject to avoid a painful discussion.

Transference:

When they act and feel toward the therapist as they did or do toward important persons in their lives(partner(s), siblings, etc.,)

Dream interpretation:

Considered a rich source of info about unconscious instincts, needs, and wishes.

Catharsis:

If they’re to settle internal conflicts of past repressed feelings, if they’re to settle internal conflicts and overcome their issues.

Short-term psychodynamic therapies:

Focus on a single problem and any other issues related to it.

• Such as getting along with others and unresolved oral needs.

Relational psychoanalytic therapy:

Therapists should also disclose things about themselves, particularly their own reactions to clients, and try to establish more equal relationships.

The Cognitive-Behavioral Model:

Focuses on maladaptive behaviors and/or cognitions in understanding and treating psychopathologies.

• The model is concerned with the impact the behavior-cognition interplay often has on feelings and emotions.

Self Theory:

The psychodynamic theory that emphasizes the role of the self— our unified personality.

Fixation:

According to Freud, a condition in which the id, ego, or superego don’t mature properly and are frozen at an early stage of development.

Psychodynamic Therapies

Seek to uncover past trauma and inner conflicts with the therapist subtly acting as a guide so that the clients themselves discover their underlying problems.

Classical conditioning

two events that repeatedly occur close together in time become fused in a person’s mind and produce the same response.

• NS(neutral) + US(unconditioned) = UR

Modeling:

A process of learning in which an individual acquires responses by observing and imitating others.

• Phobias can also be acquired.

Operant conditioning:

One comes to behave in certain ways as a result of experiencing consequences of one kind or another whenever they perform the behavior.

• Positive and negative reinforcement

Exposure Therapy:

A behavior-focused intervention which fearful people are repeatedly exposed to the objects or situations they dread.

Inaccurate or disturbing assumptions and attitudes

Believing you’re past history will be your fate in the present.

• Believing xyz will happen because of x happened in the past.

Illogical thinking processes

Source of psychopathological functioning.

• Those with depression think in illogical ways and arrive at self-defeating conclusions.

In the cog-beh model therapists help clients do what?

Recognize, challenge, and change problematic thinking.

• Guide clients to new ways of thinking in daily life.

The Cognitive-Behavioral Interplay

Behavioral and cognitive components are interwoven in most contemporary theories and therapies.

• Social anxiety disorder

Anxiety levels increase how in social anxiety?

clients enter social situations; avoidance and safety behaviors appear.

• Challenging assumptions and expectations

  • Therefore, clients come to adopt more accurate social beliefs and experience less fear.

Acceptance and commitment therapy(ACT)

Helps clients to accept many of their problematic thoughts rather than judge them, act on them, or try fruitlessly to change them.

• Clients will eventually be able to let them pass.

Mindfulness-based techniques; mindfulness meditation.

Teaches individuals to pay attention to the thoughts and feelings during meditation in a nonjudgemental way.

Humanist View

Emphasis on people as friendly, cooperative, and constructive.

• Self-actualize

Existentialist View

Emphasis on accurate self-awareness and meaningful life(authentic).

• Total freedom from birth can result in negative or positive behaviors/outcomes.

• Psychopathology is caused by self-deception

Self-Actualization:

The humanistic process by which people fulfill their potential for goodness and growth through honest recognition of strengths and weaknesses.

Rogers’ Humanistic Theory:

Basic human need for unconditional positive regard.

• If received → unconditional self-regard.

• If not → conditions of worth.

Client-Centered Therapy:

The humanistic therapy in which clinicians try to help clients by conveying acceptance, accurate empathy, and genuineness.

• Clients are expected to feel accepted and understood by their therapists.

In the existential theory, self-deception arises when?

When a client uses self-deception to hide from responsbilities.

• Quitting becomes the norm and overlooking their freedom.

Existential Therapy:

A therapy that encourages clients to accept responsibility for their lives and to live with greater meaning and value.

The Sociocultural Model:

Psychopathology includes social and cultural forces that influence and individual.

• Family-social perspective

• Multicultural perspective

Social labels and roles

The behavior and of people with psychological problems can be influenced greatly by the labels and roles assigned to them by others.

• Positive and negative impact

People who are isolated and lack social support or intimacy are more likely to be what?

Depressed and become depressed when under stress and remain depressed longer than those with supportive friends and partners.

Family Systems Theory:

A theory that views the family as a system of interacting parts whose interactions exhibit consistent patterns and unstated rules.

• Could produce psychological dysfunction if the family is overinvolved/enmeshed or disengaged.

Family Therapy:

A treatment in which a therapist meets with all members of a family and helps them change in therapeutic ways.

Couple Therapy:

A treatment in which the therapist works with two people who share a long-term relationship.

• Therapists help partners recognize and change problem behaviors largely by teaching problem-solving and communication skills.

Group therapy:

Develop important insights, build social skills, strengthen feelings of self-worth, and share useful info or advice often with a therapist.

Community Treatment:

Programs, clients, particularly those with severe psychological difficulties, receive treatment in familiar social surroundings as they try to recover.

• Prevention and reaches out to at-risk individuals.

What therapies would the biomodel use?

• Drug therapy(most common)

• Brain stimulation

• Psychosurgery

What would be involved in psychodynamic therapy?

• Resistance

• Transference

• Dream interpretation

• Catharsis

What would be involved in Cog-Beh therapy?

• Classical conditioning

• Modeling

• Operant conditioning