Module 2: Models of Abnormal Psychology PDF

MODULE 2: MODELS OF ABNORMAL PSYCHOLOGY Module Overview Module 2 covers three models of abnormal behavior to include the biological, psychological, and sociocultural models. Each is unique in its own right and no one model can account for all aspects of abnormality. Modul...

MODULE 2: MODELS OF ABNORMAL PSYCHOLOGY Module Overview Module 2 covers three models of abnormal behavior to include the biological, psychological, and sociocultural models. Each is unique in its own right and no one model can account for all aspects of abnormality. Module Outline  2.1. Uni- vs. Multi-Dimensional Models of Abnormality  2.2. The Biological Model  2.3. Psychological Perspectives  2.4. The Sociocultural Model Module Learning Outcomes  Differentiate uni- and multi-dimensional models of abnormality.  Describe how the biological; psychological; and sociocultural models explain mental illness. 2.1. Uni- vs. Multi-Dimensional Models of Abnormality Section Learning Objectives  Define the uni-dimensional model.  Explain the need for a multi-dimensional model of abnormality. In a general sense, a model is defined as a representation or imitation of an object (dictionary.com). For mental health professionals, models help them understand mental illness since diseases such as depression cannot be touched or experienced firsthand. To be considered distinct from other conditions, a mental illness must have its own set of symptoms. But as you will see, the individual does not have to present with the entire range of symptoms to be diagnosed as having dysthymia, paranoid schizophrenia, avoidant personality disorder, or illness anxiety disorder. Five out of nine symptoms may be enough to label as having one of the disorders, for example. 2.1.1. Uni-Dimensional  This model of abnormality asserts that in order to effectively treat a mental disorder, its cause needs to be understood. This could be a single factor such as a chemical imbalance in the brain, relationship with a parent, socioeconomic status (SES), a fearful event encountered during middle childhood, or the way in which the individual copes with life’s stressors. This single factor explanation is called a uni- dimensional model. The problem with this approach is that mental disorders are not typically caused by a solitary factor, but multiple causes. Admittedly, single factors do emerge during the course of the person’s life, but as they arise they become part of the individual and in time, the cause of the person’s psychopathology is due to all of these individual factors. 2.1.2. Multi-Dimensional In reality it is better to subscribe to a multi-dimensional model that integrates multiple causes of psychopathology and affirms that each cause comes to affect other causes over time. Uni-dimensional models alone are too simplistic to fully understand the etiology of mental disorders. The following are the models being examined in this module: 1) Biological – Includes genetics, chemical imbalances in the brain, the functioning of the nervous system, etc. 2) Psychological – includes learning, personality, stress, cognition, self-efficacy, and early life experiences. We will examine several perspectives that make up the psychological model to include psychodynamic, behavioral, cognitive, and humanistic-existential. 3) Sociocultural – includes factors such as one’s gender, religious orientation, race, ethnicity, and culture, for example. 2.2. The Biological Model Section Learning Objectives  Clarify how specific areas of the brain are involved in mental illness.  Describe the roles of genes, hormonal imbalances, and viral infections in mental illness. The biological paradigm looks for biological abnormalities that might cause abnormal behavior. The roots of this approach can be traced to the discovery to the cause of general paresis (general paralysis), a syndrome characterized by a steady deterioration of both mental and physical disabilities, including symptoms such as delusions of grandeur and progressive paralysis. This severe physical and mental disorder is caused by syphilis, a sexually transmitted disease. 2.2.1 Brain Structure and Chemistry  Parts of the brain/neurotransmitters implicated for certain mental illnesses:  Low levels of serotonin are partially responsible for depression. New evidence suggests “nerve cell connections, nerve cell growth, and the functioning of nerve circuits have a major impact on depression. The amygdala, the thalamus, and the hippocampus are areas of the brain that play a significant role in depression.  Individuals with borderline personality disorder have been shown to have structural and functional changes in brain areas associated with impulse control and emotional regulation while imaging studies reveal differences in the frontal cortex and subcortical structures for those suffering from Obsessive Compulsive Disorder.  Parkinson’s disease is a brain disorder which results in a gradual loss of muscle control and arises when cells in the substantia nigra, a long nucleus considered to be part of the basal ganglia, stop making dopamine.  People with Seasonal Affective Disorder (SAD) have difficulty regulating serotonin. 2.2.2 Genes, Hormonal Imbalances, and Viral Infections  “Experts believe many mental illnesses are linked to abnormalities in many genes rather than just one or a few and that how these genes interact with the environment is unique for every person (even identical twins). That is why a person inherits a susceptibility to a mental illness and doesn’t necessarily develop the illness. Mental illness itself occurs from the interaction of multiple genes and other factors — such as stress, abuse, or a traumatic event — which can influence, or trigger, an illness in a person who has an inherited susceptibility to it”  Mental illness may run in families. Heritability of mental illnesses such as schizophrenia, bipolar disorder, and depression was documented.  Recent research has discovered that autism, ADHD, bipolar disorder, major depression, and schizophrenia all share genetic roots. They, “were more likely to have suspect genetic variation at the same four chromosomal sites. These included risk versions of two genes that regulate the flow of calcium into cells.”  Twin and family studies have shown that people with first-degree relatives suffering from Obsessive Compulsive Disorder are at higher risks to develop the disorder themselves. The same is true of borderline personality disorder.  Elevated levels of cortisol can cause an increased risk of depression.  Overproduction of the hormone melatonin can lead to Seasonal Affective Disorder.  Infections can cause brain damage and lead to the development of mental illness or an exacerbation of symptoms. For example, evidence suggests that  contracting strep infection can lead to the development of OCD, Tourette’s syndrome, and tic disorder in children.  Influenza epidemics have also been linked to schizophrenia though more recent research suggests this evidence is weak at best. 2.3. Psychological Perspectives Section Learning Objective  Describe how the psychodynamic, behavioral, cognitive, humanistic and existential perspectives explain mental disorders. 2.3.1. Psychodynamic Theory 2.3.1.1. The structure of personality. According to Freud, our personality has three parts – the id, superego, and ego, and from these our behavior arises. The three parts of personality generally work together well and compromise, leading to a healthy personality, but if the conflict is not resolved, intrapsychic conflicts can arise and lead to mental disorders. Both types of instincts, the Eros and the Thanatos, are sources of stimulation in the body and create a state of tension which is unpleasant, thereby motivating us to reduce them. Consider hunger, and the associated rumbling of our stomach, fatigue, lack of energy, etc., that motivates us to find and eat food. If we are angry at someone we may engage in physical or relational aggression to alleviate this stimulation. 2.3.1.2. The development of personality. A person may become fixated at any stage of development, meaning they become stuck, thereby affecting later development and possibly leading to abnormal functioning, or psychopathology. Fixation during the oral stage is linked to a lack of confidence, argumentativeness, and sarcasm. During the anal stage, if parents are too lenient children may become messy or unorganized. If parents are too strict, children may become obstinate, stingy, or orderly. A fixation during the phallic stage may result in low self-esteem, feelings of worthlessness, and shyness. 2.3.1.3. Ego-defense mechanisms are in place to protect us from pain but are considered maladaptive if they are misused and become our primary way of dealing with stress. They protect us from anxiety and operate unconsciously, also distorting reality. 2.3.2. The Behavioral Model Within the context of abnormal behavior or psychopathology, the behavioral perspective is useful because it says that maladaptive behavior occurs when learning goes awry. The good thing is that what is learned can be unlearned or relearned and behavior modification is the process of changing behavior. 2.3.3. The Cognitive Model The work of George Miller, Albert Ellis, Aaron Beck, and Ulrich Neisser demonstrated the importance of cognitive abilities in understanding thoughts, behaviors, and emotions, and in the case of psychopathology, show that people can create their own problems by how they come to interpret events experienced in the world around them. 2.3.3.1 Schemas are sets of beliefs and expectations about a group of people, presumed to apply to all members of the group, and based on experience which can lead us astray or be false. These cognitive errors cause you to make certain assumptions about these individuals and might even affect how you interact with them. 2.3.3.2. Attributions or the idea that people are motivated to explain their own and other people’s behavior by attributing causes of that behavior to personal reasons or dispositional factors or to something outside the person or situational factors can lead us astray too. The fundamental attribution error occurs when we automatically assume a dispositional reason for another person’s actions and ignore situational factors. Then there is the self-serving bias which is when we attribute our success to our own efforts (dispositional) and our failures to outside causes (situational). These two cognitive errors affect how we see the world and our subjective well-being. 2.3.3.3. Maladaptive cognitions. Irrational thought patterns can be the basis of psychopathology. These unwanted, maladaptive cognitions, can be present as an excess such as with paranoia, suicidal ideation, or feelings of worthlessness; or as a deficit such as with self-confidence and self-efficacy. More specifically, cognitive distortions/maladaptive cognitions can take the following forms:  Overgeneralizing – You see a larger pattern of negatives based on one event.  Mind Reading – Assuming others know what you are thinking without any evidence.  What if? – Asking yourself what if? Something happens without being satisfied by any of the answers.  Blaming – You focus on someone else as the source of your negative feelings and do not take any responsibility for changing yourself.  Personalizing – Blaming yourself for negative events rather than seeing the role that others play.  Inability to disconfirm – Ignoring any evidence that may contradict your maladaptive cognition.  Regret orientation – Focusing on what you could have done better in the past rather than on making an improvement now.  Dichotomous thinking – Viewing people or events in all-or-nothing terms. 2.3.4. The Humanistic and Existential Perspectives 2.3.4.1. The humanistic perspective. The humanistic perspective asserts that when people are made to feel that they can only be loved and respected if they meet certain standards, called conditions of worth, they experience conditional positive regard. Their self-concept is now seen as having worth only when these significant others approve and so becomes distorted, leading to a disharmonious state and psychopathology. Individuals in this situation are unsure what they feel, value, or need leading to dysfunction and the need for therapy. 2.3.4.2. The existential perspective. This approach stresses that abnormal behavior arises when we avoid making choices, do not take responsibility, and fail to actualize our full potential. 2.4. The Sociocultural Model Section Learning Objective  Clarify how socioeconomic, gender, environmental and multicultural factors affect mental illness. Outside of biological and psychological factors on mental illness, race, ethnicity, gender, religious orientation, socioeconomic status, sexual orientation, etc. also play a role, and this is the basis of the sociocultural model. 2.4.1. Socioeconomic Factors  Low socioeconomic status has been linked to higher rates of mental and physical illness (Ng, Muntaner, Chung, & Eaton, 2014) due to persistent concern over unemployment or under-employment, low wages, lack of health insurance, no savings, and the inability to put food on the table, which then leads to feeling hopeless, helpless, and dependent on others. This situation places considerable stress on an individual and can lead to higher rates of anxiety disorders and depression.  Borderline personality disorder has also been found to be higher in people in low income brackets (Tomko et al., 2012) and group differences for personality disorders have been found between African and European Americans (Ryder, Sunohara, and Kirmayer, 2015). 2.4.2. Gender Factors Gender plays an important, though at times, unclear role in mental illness. It is important to understand that gender is not the cause of mental illness, though differing demands placed on males and females by society and their culture can influence the development and course of a disorder. Consider the following:  Rates of eating disorders are higher among women than, men, though both genders are affected. In the case of men, muscle dysphoria is of concern and is characterized by extreme concern over being more muscular.  Obsessive Compulsive Disorder has an earlier age of onset in girls than boys, with most people being diagnosed by age 19.  Females are at greater risk for developing an anxiety disorder than men.  ADHD is more common in males than females, though females are more likely to have inattention issues.  Boys are more likely to be diagnosed with Autism Spectrum Disorder.  Depression occurs with greater frequency in women than men.  Women are more likely to develop PTSD compared to men.  Rates of SAD (Seasonal Affective Disorder) are four times greater in women than men. Interestingly younger adults are more likely to develop SAD than older adults. Consider this… In relation to men: “Men and women experience many of the same mental disorders but their willingness to talk about their feelings may be very different. This is one of the reasons that their symptoms may be very different as well. For example, some men with depression or an anxiety disorder hide their emotions and may appear to be angry or aggressive while many women will express sadness. Some men may turn to drugs or alcohol to try to cope with their emotional issues.” In relation to women: “Some women may experience symptoms of mental disorders at times of hormone change, such as perinatal depression, premenstrual dysphoric disorder, and perimenopause-related depression. When it comes to other mental disorders such as schizophrenia and bipolar disorder, research has not found differences in rates that men and women experiences these illnesses. But, women may experience these illnesses differently – certain symptoms may be more common in women than in men, and the course of the illness can be affected by the sex of the individual.” 2.4.3. Environmental Factors Environmental factors also play a role in the development of mental illness.  In the case of borderline personality disorder, many people report experiencing traumatic life events such as abandonment, abuse, unstable relationships or hostility, and adversity during childhood.  Cigarette smoking, alcohol use, and drug use during pregnancy are risk factors for ADHD.  Divorce or the death of a spouse can lead to anxiety disorders.  Trauma, stress, and other extreme stressors are predictive of depression.  Malnutrition before birth, exposure to viruses, and other psychosocial factors are potential causes of schizophrenia.  SAD occurs with greater frequency for those living far north or south from the equator (Melrose, 2015). Horowitz (2008) found that rates of SAD are just 1% for those living in Florida while 9% of Alaskans are diagnosed with the disorder. 2.4.4. Multicultural Factors Racial, ethnic, and cultural factors are also relevant to understanding the development and course of mental illness. Multicultural psychologists assert that both normal behavior and abnormal behavior need to be understood in relation to the individual’s unique culture and the group’s value system. Racial and ethnic minorities must contend with prejudice, discrimination, racism, economic hardships, etc. as part of their daily life and this can lead to disordered behavior (Lo & Cheng, 2014; Jones, Cross, & DeFour, 2007; Satcher, 2001), though some research suggests that ethnic identity can buffer against these stressors and protect mental health (Mossakowski, 2003).