abnormal PSYCHOLOGY

Fourth Canadian Edition

Chapter 2Chapter 2Current Paradigms and the Role of Cultural

Factors

Prepared by: Tracy Vaillancourt, Ph.D.

Modified by: Réjeanne Dupuis, M.A.

What is a Paradigm?

• A model of reality: the way reality is or is supposed to be

• It is a set of beliefs that shape our perception of events and help us explain these events

• It is a set of concepts and methods used to collect and interpret data (Kuhn, 1992)

• A paradigm guides the definition, examination, and treatment of mental disorders

Paradigms in Abnormal Psychology

• Biological Paradigm

• Cognitive-Behavioural Paradigm– Behavioural perspective – Cognitive perspective

• Psychoanalytic Paradigm

• Humanistic-Existential Paradigms

• Integrative Paradigm

Biological Paradigm

• Continuation of the somatogenic hypothesis – Mental disorders caused by aberrant or

defective biological processes– Often referred to as the medical model or

disease model– The dominant paradigm in Canada and

elsewhere from the late 1800s until middle of the twentieth century

Behaviour Genetics• Study of individual differences in behaviour attributable

to differences in genetic makeup – Genotype – unobservable genetic constitution

• Fixed at birth, but it should not be viewed as a static entity

– Phenotype – totality of observable, behavioural characteristics• Changes over time; product of an interaction between genotype and

environment

• Methods – Family method

• Index cases, or probands

– Twin method• Concordance rates

– Adoptees method

Molecular GeneticsTries to specify particular gene(s) involved and precise functions of

target genes

Overview• 46 chromosomes (23 pairs); thousands of genes per chromosome • Allele – any one of several DNA codings that occupy the same

position or location on a chromosome– Person’s genotype is his or her set of alleles

• Genetic polymorphism – Involves differences in the DNA sequence that can manifest in different

forms– Entails mutations in a chromosome that can be induced or naturally

occurring• Linkage analysis

– Method in molecular genetics that is used to study people• Typically study families in which a disorder is heavily concentrated; genetic

markers• Gene-environment interactions

The Nervous System • The nervous system is composed of billions of neurons

• Each neuron has four major parts: – (1) the cell body– (2) several dendrites– (3) one or more axons of varying lengths– (4) terminal buttons

• Nerve impulse• Synapse• Neurotransmitters• Reuptake

Synapse

Structure of Brain

• Meninges – 3 layers of nonneural tissue that envelop the brain

• Cerebral hemispheres – constituting most of the cerebrum – “Thinking” centre of the brain– Includes the cortex and subcortical structures

such as the basal ganglia and limbic system

• Corpus collasum – major connection between the two hemispheres

Structure of Brain (cont.) • Cerebral cortex – upper, side, and some of the lower

surfaces of hemispheres – Consists of six layers of neuron cell bodies with many short,

unsheathed interconnecting processes– Grey matter – thin outer covering – Gyri – ridges– Sulci – depression or fissures

• Deep fissures divide the cerebral hemispheres into several distinct areas called lobes

– Frontal lobe – lies in front of the central sulcus– Parietal lobe – behind frontal lobe and above the lateral sulcus– Temporal lobe – located below the lateral sulcus– Occipital lobe – behind the parietal and temporal lobes

Functions of the BrainExamples of Functions • Vision in occipital lobe• Discrimination of sounds in temporal lobe• Reasoning and other higher mental processes, as well

as regulation of fine voluntary movement, in frontal lobe

• Left hemisphere – responsible for speech and perhaps for analytical thinking in right-handed people

• Right hemisphere – discerns spatial relations and patterns, and is involved in emotion and intuition– But keep in mind that the 2 hemispheres communicate

with each other constantly via the corpus collasum

Important Functional Areas

1. Diencephalon (contains thalamus and hypothalamus)– Thalamus- relay station for all sensory pathways except the olfactory – Hypothalamus- highest centre of integration for many visceral

processes, regulating metabolism, temperature, perspiration, blood pressure, sleeping, and appetite

2. Midbrain – Mass of nerve-fibre tracts connecting the cerebral cortex with pons,

medulla oblongata, cerebellum, and spinal cord3. Brain stem

– Comprises pons and medulla oblongata and functions primarily as a neural relay station

4. Cerebellum– Related to balance, posture, equilibrium, and to smooth coordination of

body when in motion5. Limbic system

– Controls visceral and physical expressions of emotion

The Brain

Evaluation of the Biological Paradigm

• Rapid progress is being made in understand brain-behaviour relationships and the role of specific genetic factors

• Neuroscience helps improve psychological treatments • Caution against reductionism – the simplification of a

phenomenon to its basics elements• Nervous system dysfunction are not always due to a

neurological defect • At times, a psychological intervention has a similar effect

on the biology as a psychotropic medication would (see p. 46)

Cognitive-Behavioural Paradigm

• The Behavioural Perspective

• The Cognitive Perspective

The Behavioural Perspective

• The behavioural (learning) perspective– Views abnormal behaviour as responses

learned in the same ways other human behaviour is learned

• Classical Conditioning

• Operant Conditioning

• Modelling

Classical Conditioning

• Ian Pavlov (1849-1936)

Operant Conditioning • J. F. Skinner (1904-1990)• Law of effect

– Behaviour that is followed by + consequences will be repeated

– Behaviour that is followed by – consequences will be discouraged

• Positive reinforcement – Strengthening of a tendency to respond by virtue of the

presentation of a pleasant event - Positive reinforcer

• Negative reinforcement– Strengthens a response by the removal of aversive

events• Modelling

Behaviour Therapy• Sometimes called Behaviour Modification• Systematic desensitization– Counterconditioning and Exposure– Aversive conditioning

• Operant Conditioning– Time-out

• Modelling– Assertion training

The Cognitive Perspective

• Focuses on people: – Structure experiences, interpretet experiences, relate

current experiences to past ones – Schemas

• Cognitive Behaviour Therapy– Main focus: Cognitive restructuring

• Beck’s Cognitive Therapy• Ellis’s Rational-Emotive Behaviour Therapy• Meichenbaum’s Cognitive-Behaviour Modification• Behaviour Therapy and CBT in Groups

Evaluation of the Cognitive-Behavioural

Paradigm• Criticism

– Particular learning experiences have yet to be discovered; e.g., showing how some reinforcement history leads to depression (life-time observation)

– Practicing new behaviours (satisfying activities) does not prove that the absence of rewards caused for the abnormal behaviour

– How does observing someone lead to a new behaviour? Cognitive processes must be engaged

– Schemas are not well defined; regarded as causing depression, BUT no explanation of what causes the ‘gloomy’ schemas

– Unclear differences between behaviour and cognitive influences: importance of behaving in new ways for change to occur

Evaluation of the CB Paradigm (cont.)

• Contributions – Integration of 2 perspectives, i.e., CBT, has

shown benefits in psychotherapy– Strong evidence of its benefits in improving

depression, anxiety disorders, eating disorders, autism, and schizophrenia

– Ex.: CBT can be more effective long-term than antidepressants in treating depression

Psychoanalytic ParadigmPsychopathology results from unconscious conflicts in the

individual

Structure of Mind (according to Freud)• ID

– Present at birth – Part of the mind that accounts for all the energy needed to run the

psyche – Comprises the basic urges for food, water, elimination, warmth,

affection, and sex• EGO

– Primarily conscious – Begins to develop from the id during the second six months of life– Task is to deal with reality

• SUPEREGO– Operates roughly as the conscience – Develops throughout childhood

Psychoanalytic Paradigm (cont.)

• Objective anxiety vs.• Neurotic anxiety vs.• Moral anxiety

• Defence Mechanisms– Unconscious

strategies used to protect the ego from anxiety

• Examples– Repression– Denial– Projection – Displacement – Reaction formation – Regression– Rationalization– Sublimation

Psychoanalytic Therapy• The goal is to remove earlier repression, face childhood

conflict, and resolve it from adult reality • Free association• Dream analysis

– Latent content• Some key components of psychoanalytic therapy

– Transference– Countertransference– Interpretation

Modifications in the Psychoanalytic Theory

• Group Psychodynamic Therapy

• Ego Analysis

• Brief Psychodynamic Therapy

• Contemporary Analytic Thought

• Interpersonal Therapy

Evaluation of the Psychoanalytic Paradigm

• Criticism – Theories based on anecdotes during therapy sessions

are not grounded in objectivity, thus, not scientific – Freud’s observations, recollections could be unreliable

• Contributions – Childhood experiences held shape adult personality – There are unconscious influences on behaviour– People use defense mechanisms to control anxiety and

stress– Valid research shows the effectiveness of

psychodynamic therapies

Humanistic-Existential Paradigms

• Similar to psychoanalytic therapies, in that they are insight-focused

• But psychoanalytic paradigm assumes that human nature is something in need of restraint

• Humanistic and existential paradigms – Place greater emphasis on the person’s freedom of

choice– Free will as the person’s most important characteristic – Exercising one’s freedom of choice take courage and

can generate pain and suffering– Seldom focus on cause of problems

Carl Roger’s Client-Centred Therapy

• Also known as person-centred therapy • Our lives are guided by an innate tendency toward self-

actualization, thus focusing on positive factors

• Based on following assumptions:– People can be understood only from the vantage point of

their own perceptions and feelings (phenomenological world)

– Healthy people are aware of their behaviour, are innately good and effective, and are purposive and goal-directed

– Therapists should not attempt to manipulate events for the individual

• Create conditions that will facilitate independent decision-making by the client

• Features – unconditional positive regard & empathy

Humanistic-Existential Paradigm (cont.)

• Humanistic Paradigm– All people are striving to reach self-actualization;

– Anxiety occurs when there is a discrepancy between one’s self-perceptions and one’s ideal self;

– Carl Rogers – Client-Centred Therapy

– Gestalt Therapy – Fritz Pearl

• Existential Paradigm – Anxiety arises when what individuals does not bring

meaning in their lives (Viktor Frankl)

– Learning to relate authentically, spontaneously to others

Evaluation of the Humanistic-Existential

Paradigms• Criticism

– Therapists inferences of the client’s phenomenology (world) may not be valid

– Assumption not demonstrated: People are innately good and would behave in satisfactory and fulfilling ways if faulty experiences did not interfere

– Self-awareness does not necessarily lead to change

• Contributions – Rogers insisted that therapy outcomes be empirically

evaluated

Consequences of Adopting a Paradigm

• Eclecticism / integration in psychotherapy

• Guides the data that will be collected and how they will be interpreted

• Leads to ignoring possibilities and overlook other information

• Most therapist use a Prescriptive Eclectic Theory, a combination of ideas and therapeutic techniques – CBT therapists show empathy; Learning therapists

inquire about clients’ thoughts; Freud was directive and encourage behaviour change

Integrative Paradigm

• Diathesis-Stress Paradigm

• Biopsychosocial Paradigm

• Both paradigms emphasize the interplay among the biological, psychological, and social / environmental perspectives

Diathesis-Stress Paradigm

• Focuses on interaction between predisposition toward disease (diathesis) and environmental, or life, disturbances (stress)

• Diathesis – Constitutional predisposition toward illness

• Any characteristic or set of characteristics that increases a person’s chance of developing a disorder

• That is: genetic, psychological, environmental factors can be predisposing to the development of a mental disorder

Biopsychosocial Paradigm

Risk Factors

Protective Factors

Cultural Considerations

• Canada, A Multicultural Country– Acculturation and ‘Cultural Mosaic’ vs. – Assimilation and ‘Melting Pot’ in U.S.

• Canada and U.S. differ on the following aspects:– Language – Foreign birth – Visible racial differences

Cultural Considerations (cont.)

• Mental Health Implications of Diversity in Canada– Extremely low rates of mental disorder in Hutterites, MA– ‘Healthy Immigrant Effect’ – Similar levels of behavioural problems among

French/English-Canadians and Caribbean/Filipino-Canadian adolescents

– Under-usage of mainstream mental health services by members of minority groups:

• Asians in Canada (Chinese, Indian, Filipino, Vietnamese) and West Indian

Cultural Considerations (cont.)

• Aboriginals and Mental Health Problems – Depression, drug abuse, suicide, low self-esteem, PTSD

symptoms, violence, obesity, and diabetes are widespread

– Institutional discrimination over 300 • Inuit people moved to the Far North • Indian Residential Schools for 100 years

• Moving Aboriginals in reserves

– Aboriginal children are raised by relatives, thus moving between households, which is not a sign of trouble

– Treatment, due to importance of family, may be conducted in the home with all members involved

Cultural Considerations (cont.)

• Diagnosing and Assessment– Most assume that clients to best when matched w/

clinician of similar cultural background, however,– Similarity in values or cognitive match may be more

relevant for clients’ improvement – The use of professional interpreters needs to become

universal across Canada – Mental health professionals need to be trained in cultural

and ethnic particularities– Clinicians must be aware that members of many minority

groups are angry at a sometimes insensitive majority culture

Copyright

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