Psychology 3318

Davison and NealeChapter 2: Current Paradigms in Psychopathology and Therapy

Overview of Davison and Neale Paradigms

• Biological (Medical, Disease)• Psychoanalytic• Humanistic/Existential• Learning• Cognitive

Biological Paradigm

• Types of Disease: Infectious vs. Traumatic

• Basic Model– Predisposition (resistance) and

exposure (germs, trauma, etc.) interact to produce disease

– Disease causes symptoms and signs• Symptoms: what is reported• Signs: what is observable (more

important)

Representation of Biological Model

Behavior Genetics

• Key concepts: Genes, genotype, phenotype – Family method: index case (probands), – Twin method: monozygotic (MZ) vs.

dizygotic (DZ) twins, concordance, – Adoptee method– Linkage analysis: looks for particular

gene based upon genetic markers

Central Nervous System Biochemistry

• Key concepts; Neurons, nerve impulses, synapse, neurotransmitters (see Figs. 2.1 and 2.2)

• Some key neurotransmitters: – Norepinephrine (noradrenalin)– Gamma-aminobutyric acid (GABA)– Dopamine (schizophrenia?)– Serotonin (depression?)

• Very important to drug therapy

Classical Freudian Concepts

• Strongly Darwinian• Sex is a basic motive• Structures: Id (motives), ego (executive), superego (morality)• Levels of consciousness: Conscious, preconscious, unconscious• Principles: Pleasure vs. reality• Processes: Primary vs. secondary• Psychosexual stages: Polymorphous perverse, oral-passive, oral-

biting, anal, phallic, latent, genital• Fixations and regressions• Oedipus (Electra) complex• Anxiety: Objective (realistic), neurotic, moral• Defense mechanisms: Repression, denial, projection, displacement,

rationalization, reaction formation, sublimation (see Table 2.1)

Freudian Disease Model

Other Early Psychoanalysts (“NeoFreudians”)

Carl Jung Early Humanist, stressed collective unconscious

Alfred Adler Power is basic motive, individual psychology

Karen Horney

Early feminist

Erich Fromm

Early existentialist, stressed role of society

Traditional Therapeutic Concepts

• Free Association• Resistance• Dream analysis (latent vs. manifest

content)• Transference and countertransference• Interpretation• Analyst sits in background; patient is

prone

Newer Concepts

• Ego analysis (many, including Freud): Ability of person to control environment

• Brief therapy: Ferenczi; Alexander and French

• Interpersonal therapy (Klerman and Weissman): concenrates on person’s current difficulties; active teaching

Evaluation

• “Blame your parents” and rejection of responsibility

• Child is “father” to the “man”.• Unconscious influences on behavior• Role of defense mechanisms• Causes of behavior may not be

apparent

Humanistic/Existential: Rogers Client-Centered Therapy

• Importance of phenomenology• Healthy people are aware of behavior• Healthy people are good• Healthy people are purposive and goal-

directed• Importance of self-actualization• Therapeutic techniques

– Reflection– Unconditional positive regard– Empathy: primary (understanding) vs. advanced

(inferential)

Humanistic/Existential: Existential

• Based (perhaps loosely) on philosophic movement

• Stresses the present and responsibility for choice

• Goal is to change behavior

Humanistic/Existential: Gestalt Therapy (Fritz Perls)

• Existential in orientation• Techniques

– I-language– Empty chair– Projection of feelings– Attending to nonverbal cues– Use of metaphor

• (For comparison of the three approaches, see Table 2.3)

Learning Paradigms

• Basic model: psychopathology is learned

• Important early names– Pavlov– Watson– Thorndike

• Major types of learning– Classical (Pavlovian) conditioning– Operant (instrumental) conditioning– Modeling (vicarious learning)

Pavlovian Concepts

• Unconditioned stimulus: US or UCS• Conditioned stimulus: CS• Unconditioned response: UR or UCR• Conditioned response: CR• Many prefer “conditional” and

“unconditional” to “conditioned” and “unconditioned”

• Extinction

Operant Concepts

• Law of effect• Discriminative stimulus• Positive and negative reinforcement• Shaping• Avoidance conditioning• Mediational vs. Skinnerian approaches• Skinner: There is no difference between

disease and symptoms

Behavior Therapy and Modification

• Use of behavioral techniques to modify pathological behavior

• Behavior therapy is more mediational• Behavioral modification is more Skinnerian• Counterconditioning• Systematic desensitization• Flooding (implosion)• Aversive conditioning• Time-out• Token economy

Modeling

• Role Playing• Rehearsal• Self-efficacy

Cognitive Paradigm

• Although Skinner denied the importance of cognition (thought) many of his followers became cognitive.

• Schema• Cognitive behavior therapy

– Beck– Ellis and Rational-emotional Behavior

Therpy (REBT)– Group therapies– Self-efficacy

General Considerations

• See Table 2.4 for a comparison of psychoanalytic and cognitive-behavioral approaches.

• Diathesis-stress is unifying concept• Importance of eclecticism: Good

therapists are seen as more alike one another, despite paradigm, than bad ones