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Chapter 2

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University of Toronto Scarborough
Konstantine Zakzanis

Abnormal Psychology - Chapter 2: Current Paradigms & the Role of Cultural Factors The Role of Paradigms  paradigm - the conceptual framework or approach within which the scientist works  a paradigm is a set of assumptions that outline the particular universe of scientific inquiry  they specify what problems scientists will investigate and how they will go about the investigation  the meaning or import given to data may depend to a considerable extent on a paradigm - it injects biases into the definition and collection of data and may also affect the interpretation of facts  4 major types of paradigms are:  biological  cognitive-behavioural  psychoanalytic  humanistic-existential The Biological Paradigm  a biological paradigm of abnormal behaviour is a continuation of the somatogenic hypothesis: mental disorders are caused by aberrant biological process - this paradigm is referred to as the medical model or disease model  the study of abnormal behaviour is linked historically to medicine  the germ theory was the paradigm of medicine - but it soon became apparent that this theory cannot account for all diseases (ex. heart disease - many factors such as smoking, obesity, stress can cause it)  medical illness all share one characteristic: in all of them, some biological process is disrupted or not functioning normally - which is why it is called the biological paradigm  biological paradigm was dominant in Canada from the late 1800s until the middle of the 20th century - removal of ovarian cysts or the entire ovaries was employed as a treatment for mania and delusions back then Contemporary Approaches to the Biological Paradigm  the psychopathology is viewed as caused by the disturbance of some biological process  those working with the biological paradigm assume that answers to puzzles of psychopathology will be found within the body Behavioural Genetics  a zygote has 46 chromosomes - the number of characteristic of human being  each chromosome is made up of thousands of genes - the carriers of the genetic information (DNA) passed from parents to child  behaviour genetics - study of individual differences in behaviour that are attributable in part to differences in genetic makeup  genotype - the total genetic makeup of an individual consisting of inherited genes  genotype is his/her unobservable genetic constitution  phenotype - the totality of his/her observable behaviour characteristics, such as level of anxiety 1 Abnormal Psychology - Chapter 2: Current Paradigms & the Role of Cultural Factors  the phenotype changes over time and is viewed as the product of an interaction between the genotype and environment  it is critical to recognize that various clinical syndromes are disorders of the phenotype not the genotype  a predisposition, also known as diathesis may be inherited, but not the disorder itself  the study of behaviour genetics has relied on 4 basic methods to uncover whether a predisposition for psychopathology is inherited:  comparison of members of family  comparison of pairs of twins  the investigation of adoptees  linkage analysis  the family method can be used to study a genetic predisposition among members of a family because the average number of genes shared by two blood relatives is known  people who share 50% of their genes with a given individual are called first degree relatives of that person  nephews and nieces share 25% of the genetic makeup of an uncle and are called second degree relatives  if a predisposition for a mental disorder is inherited the study of the family should reveal a relationship between the number of shared genes and the prevalence of the disorder in relatives  the starting point in such investigations is the collection of sample of individuals who bear the diagnosis in question - these people are referred to as index cases, or probands  if a genetic predisposition to the disorder being studied is present, first-degree relatives of the index cases should have the disorder at a rate higher than that found in the general population  ex. about 10% of the first degree relatives of index cases with schizophrenia can be diagnosed as having schizophrenia, compared with about 1% of the general population  in the twin method, both monozygotic (MZ) twins and dizygotic (DZ) twins are compared  MZ or identical twins develop from a single fertilized egg and are genetically the same, they are always the same sex  DZ or fraternal, pairs develop from separate eggs and are on average only 50% alike genetically, no more alike than any other 2 siblings- they can be either the same sex or opposite  twin studies begin with diagnosed cases and then search for the presence of the disorder in the other twin - when the twins are similar diagnostically, they are said to be concordant  a predisposition for a mental disorder to be inherited, the concordance for the disorder should be greater in genetically identical MZ pairs than in DZ pairs - when it is higher it is said to be heritable  the methodology of the family and twin studies is clear, the data they yield are not always easy to interpret  ex. the data show that panic disorder runs in families, but that a genetic predisposition is not necessarily involved  the equal environment assumption is that the environmental factors that are partial causes of concordance are equally influential for MZ and DZ pairs - it would assert that both pairs have equivalent numbers of stressful life experiences 2 Abnormal Psychology - Chapter 2: Current Paradigms & the Role of Cultural Factors  other factors can also complicate the results of twin study: violation of the equal environments assumption, the sex of the participant and his/her age when the assessment took place  the adoptees method study children with abnormal disorders who were adopted and reared apart from their parents - this situation has he benefit of eliminating the effects of being raised by disordered parents Molecular Genetics  molecular genetics is an approach that attempts to show whether a disorder has a genetic component; it tries to specify the particular gene or genes involved and the precise function of them  the term allele refers to any one of several DNA codings that occupy the same position or location on a chromosome - a person's genotype is his/her set of alleles  genetic polymorphism refers to variability among members of the species - it involves differences in the DNA sequence that can manifest in very different forms among members in the same habitat  it entails mutations in a chromosome that can be induced or naturally occurring  linkage analysis is a method used to study people  researchers use this method to typically study families in which a disorder is heavily concentrated  they collect diagnostic information and blood samples from affected individuals and their relatives and use the blood samples to study the inheritance pattern of characteristics whose genetics are fully understood - genetic markers  researchers in this area often hypothesize gene-environment interactions - the notion that a disorder or related symptoms are the joint product of a genetic vulnerability and specific environmental experiences or conditions  exclusive focus on genetic factors promotes the notion that illness and mental illness are predetermined Neuroscience and Biochemistry in the Nervous System  neuroscience is the study of the brain and 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 (the short & thick extensions) 3. one or more axons of varying lengths 4. terminal buttons on the many end branches of the axon  when a neuron is stimulated through its dendrites or at its cell body - a nerve impulse - which is a change in the electric potential of the cell, travels down the axon to the terminal endings  between the terminal endings of the sending axon and the cell membrane of the receiving neuron, there is a small gap, called the synapse  for a nerve impulse to pass from one neuron to another and for communication to occur, the impulse must have a way of bridging the synaptic gap 3 Abnormal Psychology - Chapter 2: Current Paradigms & the Role of Cultural Factors  the terminal buttons of each axon contain synaptic vesicles, small structures that are filled with neurotransmitters - a chemical substances that allow a nerve impulse to cross the synapse  nerve impulses cause the synaptic vesicles to release molecules of their transmitter substances and these molecules flood the synapse and diffuse toward the postsynaptic neuron  the cell membrane of the postsynaptic cell contains proteins, called receptor sites that are configured so that specific neurotransmitters can fit into them  when a neurotransmitter fits into a receptor site, a message can be sent to the postsynaptic cell  sometimes these messages are excitatory, leading to the creation of a nerve impulse in the postsynaptic cell, at other times the messages can be inhibitory, making the postsynaptic cell less likely to fire  not all the released neurotransmitter has found its way to postsynaptic receptors - some of what remains is broken down by enzymes and some is pumped back into the presynaptic cell through a process called reuptake  norepinephrine, a neurotransmitter of the peripheral sympathetic nervous system is involved in producing states of high arousal and may be involved in anxiety disorders  serotonin (in brain) may be involved in depression and dopamine (in brain) in schizophrenia  GABA inhibits some nerve impulses and may be involved in anxiety disorders  maturational changes influence neurotransmitter levels  theories linking neurotransmitters to psychopathology have proposed that a given disorder is caused by either too much or too little of a particular transmitter  neurotransmitters are synthesized in the neuron through a series of metabolic steps - each reaction along the way to producing an actual transmitter is catalyzed by an enzyme, speeding up the metabolic process  too much or too little of a particular transmitter could result from an error in these metabolic pathways  when a new nerve impulse caused further neurotransmitter substances to be released into the synapse, the postsynaptic neuron would get a double dose of neurotransmitter, making it more likely for a new nerve impulse to be created  if the receptors on the postsynaptic neuron were too numerous or too easily excited, the result would be having too much transmitter released - there would simply be more sites available with which the neurotransmitter could interact, increasing the chances that the postsynaptic neuron would be stimulated Biological Approaches to Treatment  tranquilizers such as Valium can be effective in reducing the tension associated with anxiety disorders  stimulating GABA neurons to inhibit other neural systems that create the physical symptoms of anxiety  antidepressants (Prozac) increase neural transmission in neurons that use serotonin as a neurotransmitter by inhibiting the reuptake of serotonin 4 Abnormal Psychology - Chapter 2: Current Paradigms & the Role of Cultural Factors  antipsychotic drugs such as Clozaril, (used for treatment in schizophrenia) reduce the activity of neurons that use dopamine as a neurotransmitter by blocking their receptors  drugs can efficiently and often provide symptomatic improvement relatively quickly  ex. selective serotonin reuptake inhibitors (SSRIs) are frequently described as having a delayed onset  contemporary approaches to biological assessment attempts to make inferences about the functioning of the nervous system or to "see" the actual structure and functioning of the brain and other parts of the nervous system  a clinical scientist can believe in a biological basis for a mental problem yet recommend psychological intervention Evaluating the Biological Paradigm  reductionism - refers to the view that whatever is being studied can and should be reduced to its most basic elements or constituents  in an extreme form, reductionism asserts that psychology, psychiatry, and psychopathology will ultimately be nothing more than biology  this has been severely criticized:  for abnormal psychology - delusional beliefs and dysfunctional attitudes will be impossible to explain biologically  psychological interventions can be as effective as drug treatment and produce changes in the functioning of our brains The Cognitive - Behavioural Paradigm The Behavioural Perspective  from a behavioural perspective psychologists view abnormal behaviour as responses learned in the same ways other human behaviour is learned The Rise of Behaviourism  John B. Watson - key figure in this  Watson promoted a focus on behaviourism by extrapolating from the work of psychologists who were investigating learning in animals  because of this, dominant focus of psychology switched from thinking to learning  behaviourism - an approach that focuses on observable behaviour rather than on consciousness Classical Conditioning  in Pavlov's studies of the digestive system, a dog was given meat powder to make it salivate - then they became aware that the dog began salivating when it saw the person who fed it - later it started to salivate earlier, when it heard the footsteps of the person  he decided to study it systematically - in the first experiment: a bell was rung behind the dog and then the meat powder was placed in its mouth - after this procedure had been repeated a number of times, the dog began salivating as soon as it heard the bell 5 Abnormal Psychology - Chapter 2: Current Paradigms & the Role of Cultural Factors  in this experiment, because the meat powder automatically elicits salivation with no prior learning, the powder is termed as an unconditioned stimulus (UCS)  and the response to it, salivation, an unconditioned response (UCR)  when the offering of meat powder is preceded several times by the ringing of the bell, a neutral stimulus, the sound of the bell alone (conditioned stimulus, CS) is able to elicit the salivary response (the conditioned response, CR)  extinction - refers to what happens to the Cr when the repeated soundings of the bell are not followed by meat powder; fewer and fewer salivations are elicited, and the CR gradually disappears  classical conditioning can instill pathological fear Operant Conditioning  B.F Skinner introduced operant conditioning - applies to behaviour that operates on the environment  he formulated the law of effect by shifting the focus from the linking of stimuli and response (S-R connections) to the relationships between responses and their consequences  he introduced the concept of discriminative stimulus - to refer to external events that in effect tell an organism that if it performs a certain behaviour, a certain consequence will follow  positive reinforcement - refer to the strengthening of a tendency to respond by virtue of the presentation of a pleasant event, called a positive reinforcer  ex. a water deprived pigeon will tend to repeat behaviours that are followed by the availability of water  negative reinforcement - strengthens a response, but it does so via the removal of an aversive event such as the cessation of electric shock - such consequences are negative reinforcers  skinner argued that freedom of choice is a myth and that all behaviour is determined by the reinforcers provided by the environment  aggressive responses in children are often rewarded(when one child hits another to get a toy) , which makes such behaviour more likely to occur  operant condition can produce abnormal behaviour Modelling  we all learn by watching and imitating others - a process called modelling  Albert Bandura demonstrated that witnessing someone perform certain activities can increase or decrease diverse kinds of behaviour  Bandura concluded that there are four key processes in observational learning 1. attention - noticing the model's behaviour 2. retention - remembering the model's behaviour 3. reproduction - personally exhibiting the behaviour 4. motivation - repeating imitated behaviours, if it had positive consequences  children of parents with phobias or substance -abuse problems may acquire similar behaviour patterns, in part through modelling 6 Abnormal Psychology - Chapter 2: Current Paradigms & the Role of Cultural Factors Behavioural Therapy  behaviour therapy applies procedures based on classical and operant conditioning to alter clinical problems  behaviour modification - employ operant condition as means of treatment  behaviour therapy is an attempt to change abnormal behaviour, thoughts, and feelings by applying in a clinical context the methods used  three theoretical approaches in behaviour therapy : role of modelling, counterconditioning and exposure, application of operant conditioning Counterconditioning and Exposure  counterconditioning - relearning is achieved by eliciting a new response in the presence of a particular stimulus  a response (R ) 1o a given stimulus (S) [original situation] can be eliminated by eliciting a new response (R ) in the presence of the same stimulus [after therapist intervention] 2  the counterconditioning principle is behind a behaviour therapy technique - systematic desensitization  a person who suffers from anxiety works with a therapist to compile a list of feared situations, starting with those that arouse minimal anxiety and progressing to the most frightening - the person is also taught to relax deeply - the relaxation tends to inhibit any anxiety that might otherwise be elicited by imaginary scenes  another type of counterconditioning - aversive conditioning: a stimulus attractive to the client is paired with an unpleasant event, in the hope of endowing it with negative properties  ex. a problem drinker who wishes to stop drinking might be asked to smell alcohol while he/she is being made nauseous by a drug Operant Conditioning as an Intervention  making positive reinforcers contingent on behaviour is used to increase the frequency of desirable behaviour  the main premise is that the same learning conditions and processes that created maladaptive behaviour can also be used to change maladaptive behaviour (ie. unlearning the behaviour) The Cognitive Perspective  cognitive - term that groups together the mental processes of perceiving, recognizing, conceiving, judging and reasoning  cognitive paradigm - focuses on how people structure their experiences, how they make sense of them and how they relate their current experiences to past ones that have been stored in memory The Basics of Cognitive Theory  cognitive psychologists regard the learner as an active interpreter of a situation, with the learner's past knowledge imposing a perceptual funnel on the experience  the learner fits new information into an organized network of already accumulated knowledge, referred to as a schema or cognitive set 7 Abnormal Psychology - Chapter 2: Current Paradigms & the Role of Cultural Factors  the new information may fit the schema, but if it doesn't, the learner reorganizes the schema to fit the information Beck's Cognitive Therapy  psychiatrist Aaron Beck developed a cognitive therapy (CT) for depression based on the idea that a depressed mood is caused by distortions in the way people perceive life experiences  Beck's therapy tries to persuade clients to change their opinions of themselves and the way in which they interpret life events  the general goal of Beck's therapy is to provide clients with experiences, both inside and outside the consulting room, that will alter their negative schemas and dysfunctional beliefs and attitudes Rational-Emotive Behaviour Therapy  Albert Ellis's thesis was that sustained emotional reactions are caused by internal sentences that people repeat to themselves, and these self-statements reflect sometimes unspoken assumptions - irrational beliefs - about what is necessary to lead a meaningful life  in Ellis's rational-emotive therapy (RET), subsequently renamed rational-emotive behaviour therapy (REBT) - the aim is to eliminate self-defeating beliefs through a rational examination of them  Ellis proposes that people interpret what is happening around them, that sometimes these interpretations can cause emotional turmoil and that a therapist's attention should be on that  Ellis emphasizes the importance of getting the client to behave differently, both to test out new beliefs and to learn to cope with life's disappointments - this is how it becomes both cognitive and behavioural Cognitive Behaviour Therapy  cognitive behaviour therapy (CBT) - does incorporate theory and research on cognitive and behavioural processes and represents a blend of cognitive and learned principles  cognitive behaviour therapists pay attention to private events, thoughts perceptions, judgements, self-statements and unconscious assumptions  cognitive restructuring - general term for changing a pattern of thought that is presumed to be causing a disturbed emotion or behaviour Meichenbaum's Cognitive - Behaviour Modification  two illustrative procedures are:  self-instructional training: the therapist helps the client prepare to make specific coping statements when confronted with difficult situations  stress-inoculation training: emphasizes systematic acquisition of coping skills through learning to cope with small but manageable amounts of stress  cognitive behaviour therapists who adopt Meichenbaum's approach help clients understand the narratives they create and learn ways to alter how they appraise events and their abilities to handle stressful events 8 Abnormal Psychology - Chapter 2: Current Paradigms & the Role of Cultural Factors The Psychoanalytic Paradigm  psychoanalytic paradigm - developed by Sigmund Freud and that psychopathology results from unconscious conflicts in the individual Structure of the Mind  divided mind into 3 parts: id, ego and superego  id - present at birth and is part of the mind that accounts for all the energy needed to run the psyche - it comprises the basic urges for food, water, elimination, warmth, affection and sex  saw the source of id's energy was all biological  as infant develops this energy called libido converted into psychic energy  the id seeks immediate gratification and operates according to the pleasure principle - when id is not satisfied, tension is produced and if strives to eliminate the tension  primary process thinking - another means of obtaining gratification, generating images (fantasies) of what is desired  ego - primarily conscious and begins to develop from the id during the second 6 months of life - task is to deal with reality  through secondary process thinking- planning and decisions making functions, ego realizes living through the pleasure principle is not the effective way of maintaining life  the ego operates on the reality principle as it mediates between the demands of reality and immediate gratification desired by the id  superego - operates roughly as the conscience develops throughout childhood  the interplay of these forces is referred to as the psychodynamics of the personality  the id's instincts as well as many of the superego's activities are not known to the conscious mind Neurotic Anxiety  objective (realistic) anxiety - the ego's reaction to danger in the external world  a person's personality that hasn't been fully developed may experience neurotic anxiety - a feeling of fear that is not connected to reality or any real threat  moral anxiety - arises when the impulses of the superego punish an individual for not meeting expectations and thereby satisfying the principle that drives the superego - perfection principle Defence Mechanisms: Coping with Anxiety  objective anxiety can be handled by removing or avoiding the
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