AP slide 2

Understanding Paradigms of Abnormal Behavior

Why do we behave the way we do?

Understanding etiology

• Two major questions:

1.) do we behave the way we do because of genetics, Nature or

2.) do we behave the way we do because of environment, Nurture?

Figure 2.1: The Major Models of Psychopathology

Dimensions/ Multipath Model

• Dimension One: Biological Factors

• Dimension Two: Psychological Factors

• Dimension Three: Social Factors

• Dimension Four: Sociocultural Factors

The Case of Steven

• Biological?

• Psychological?

• Social?

• Sociocultural?

The Case of John

• biological/genetic

• psychodynamic

• Behaviorist/learning theory

• Cognitive

• Family systems model

How Much of Mental Disorder Is Explained by Our Biological Makeup?

• Genetics: Physical features, susceptibility to illness, temperament, handling stress( resiliency)

• Nerve cell activities (brain and spinal cord): Thoughts, emotions, behaviors

• Brain activity and structure: Changes in thoughts, emotions, behaviors

• Brain dysfunction: Mental disorders• Treatment: Drugs or somatic intervention

The Human Brain

• Neurons: Nerve cells that transmit messages throughout the body

• Two hemispheres control opposite sides of the body:– Right hemisphere: Visual-spatial abilities and

emotional behavior– Left hemisphere: Language functions

Figure 2.2: The Internal Structure of the Brain

The Forebrain

• Controls higher mental functions: Consciousness, learning, speech, thought, memory

• Thalamus: “Relay station,” transmits nerve impulses throughout brain

• Hypothalamus: Regulates bodily drives

• Limbic system: Experiencing/expressing emotions and motivation

The Midbrain and Hindbrain

• Midbrain: Vision and hearing– Sleep, pain, alertness (with hindbrain)– Produces serotonin, norepinephrine, dopamine

• Hindbrain: Controls heart rate, sleep, respiration– With midbrain, also manufactures serotonin

• Reticular formation: Network of nerve fibers controlling sleep, alertness, attention– Threads its way from hindbrain up into midbrain

Biochemical Theories

• Chemical imbalances underlie mental disorders.

• Dendrites: Receive signals from other neurons

• Axons: Send signals to other neurons• Synapse: Gap between axon of sending

neuron and dendrites of receiving neuron• Neurotransmitters: Chemicals involved in

transmission of neural impulses

Figure 2.3: Major Parts of a Neuron

Figure 2.4: Synaptic Transmission

Figure 2.5: Neurotransmitter Binding

Genetic explanations

• Genetic predisposition toward illness

• Diathesis-stress model

Are Early Childhood Experiences and Unconscious Motivations Important in

Determining Mental Health?• Psychodynamic models:

– Adult disorders arise from childhood traumas or anxieties.

– Childhood-based anxieties are unconscious and are repressed through defense mechanisms because they are too threatening to face.

Are Early Childhood Experiences and Unconscious Motivations Important in Determining Mental Health? (cont’d)

• Psychoanalysis: Therapy based on Freudian view that unconscious conflicts must be aired and understood by the patient if abnormal behavior is to be eliminated

Personality Structure

• Id: Present from birth,it operates on the pleasure principle: Impulsive, pleasure-seeking aspect of being; immediate gratification of instinctual needs

• Ego: Realistic, rational part of mind, it operates on reality principle: Awareness of environmental demands, plus need to adjust behavior to meet these demands

• Superego: Moral judgments/moralistic considerations involve conscience & ego ideal

Anxiety and Psychopathology

• Anxiety is at the root of psychopathology– Realistic anxiety: There is potential danger

from external environment– Moralistic anxiety: Someone does not live up

to his/her moral standards or engages in unethical conduct.

– Neurotic anxiety: Id impulses get out of hand and burst through ego control

Defense Mechanisms

• Protect the individual from anxiety

• Operate unconsciously

• Distort reality

• It’s normal to use some strategies to reduce anxiety, but maladaptive when overused.

Table 2.2: Defense Mechanisms

What Is the Role of Learning in the

Development of Behavior Disorders?• Behavioral Models: Concerned with the

role of learning in abnormal behavior

• Three models:– Classical conditioning (Ivan Pavlov)– Operant conditioning (B. F. Skinner)– Observational learning (Albert Bandura)

Classical Conditioning Model

• Classical conditioning: Learning principle in which involuntary responses to stimuli are learned through association

• Unconditioned stimulus (UCS): Elicits an unconditioned response

• Unconditioned response (UCR): The unlearned response made to an unconditioned stimulus

Figure 2.7: A Basic Classical Conditioning Process

The Operant Conditioning Model

• Operant behavior: A voluntary and controllable behavior that “operates” on an individual’s environment

• Operant conditioning: Voluntary behaviors are controlled by the consequences that follow them.

• Law of effect: Edward Thorndike noticed that behaviors followed by positive consequences are repeated.

• B. F. Skinner called this “reinforcement.”

The Observational Learning Model

• Behaviors are acquired by watching someone else perform those behaviors.

• Modeling: Learning by observing models and later imitating them (also called vicarious conditioning)

Observational Learning in Psychopathology

• Four effects of observational learning:– New behaviors may be acquired by watching a

model.– A model may elicit behaviors in an observer by

providing cues.– Behaviors formerly inhibited due to negative

reactions may occur after observing a model.– If observer sees a behavior by a model result in

aversive consequences, the behavior may become inhibited.

How Powerful Are Thoughts in Causing Mental Disorders?

• Cognitive Models:– Conscious thought mediates or modifies a

person’s emotional state and/or behavior in response to a stimulus

– Schemas: Sets of underlying assumptions influenced by experiences, values, and perceived capabilities

– Beck’s Irrational Beliefs

Figure 2.8: Ellis’s A-B-C- Theory of Personality

Cognitive Approaches to Therapy

• Highly specific learning experiences to teach clients to:– Monitor negative, automatic thoughts– Recognize connections between cognition,

affect, and behavior– Examine evidence for or against distorted

automatic thoughts– Substitute reality-oriented interpretations– Identify and alter beliefs that predispose them

to distort their experiences

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What Tools Are Used to Evaluate a Person’s Mental

Health?• Assessment: Process of gathering

information and drawing conclusions about an individual’s traits, skills, abilities, emotional functioning, and psychological problems

• Principal means of assessment:– Observations– Interviews– Psychological tests and inventories– Neurological tests


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Table 3.1: Assessment Techniques


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Observations

• Controlled (analogue) observations: Made in laboratory, clinic, other contrived setting

• Naturalistic observations: Made in natural setting (schoolroom, office, hospital ward, home)

• Usually in conjunction with an interview• Observe appearance and behavior as well as

responses• Reactivity: When aware of being observed or

assessed, we may change our usual way of responding


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Interviews

• Collect data about a person’s life and personality

• Analyze:– Verbal behavior– Nonverbal behavior– Content– Process

• Frame of reference and emphasis vary, depending on interviewer’s background


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Interviews: Standardization and Structure

• Common rules and procedures

• Varying degrees of structure and freedom of response– Formal standardized interview: highly

structured– Mental status examination: determine an

individual’s cognitive, psychological, and behavioral functioning

• Fallible and subject to error


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Psychological Tests and Inventories

• Standardized instruments used to assess:– Personality – Maladaptive behavior – Development of social skills – Intellectual abilities – Vocational interests – Cognitive impairment– Personality dynamics and conflicts


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Projective Personality Tests

• Test taker is presented with ambiguous stimuli and is asked to respond to them in some way– Rorschach Technique– Thematic Apperception Test (TAT)– Sentence-Completion Test– Draw-a-Person

• Problems: – Reliability – Validity – Subjectivity


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Tests for Cognitive Impairment

• Detect and assess organicity (damage or deterioration in the central nervous system)

• Bender-Gestalt Visual-Motor Test

• Halstead-Reitan Neuropsychological Test Battery

• Luria-Nebraska Neuropsychological Battery


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Figure 3.3: The Nine Bender Designs

Assessment of Abnormal Behavior (cont’d.)

• Neurological tests:– Increase diagnostic accuracy when coupled

with psychological tests• Electroencephalograph (EEG)• X-ray studies• Computerized axial tomography (CT) scan• Positron emission tomography (PET) scan• Magnetic resonance imaging (MRI)

Sue/Sue/Sue Understanding Abnormal Behavior, 10th edition

© 2013 Cengage Learning

Classification of Abnormal Behavior

• Classification system: – Provides distinct categories, indicators, and

nomenclature for different patterns of behavior, thought processes, and emotional disturbances




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Diagnostic and Statistical Manual of Mental Disorders

• Early studies of DSM: Low reliability and validity– Did not help with etiology, process, treatment, or

prognosis of mental disorders

• DSM-I: Intended to define and categorize mental disorders

• Revisions (DSM-II, DSM-III, DSM-III-R, DSM-IV) increased reliability, validity, usefulness of classification scheme

• Current System: DSM-IV-TR (Text Revision) – Places diagnosis within cultural context and includes culture-bound syndromes


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DSM-IV-TR: The Five Axes

• Axis I: Clinical syndromes• Axis II: Personality disorders and mental

retardation• Axis III: General medical conditions• Axis IV: Psychosocial and environmental

problems– Prognosis: predict future course of disorder

• Axis V: Global assessment of functioning– Comorbidity: Co-occurrence of different disorders

Classification of Abnormal Behavior (cont’d.)

• DSM-V:– Dimensional system: disorders lie on a

continuum with “normality” at one end – “Risk syndromes”: milder forms of disorders– Ratings: “none,” “slight,” “mild,” “moderate,”

“severe”– Clear diagnostic and categorizing guidelines– Comorbidity: the concurrence of different

disorders suffered by a patient at one time



Case Study: Mark

• 50 year old machine operator• Referred to treatment by supervisor due to

deteriorating work performance over the past four months

• Absenteeism; alcohol use at work• Mark is heavy drinker• Daily user; binge drinker on weekends



• heavy drinker for 30 years

• Drinking has increased since wife left him six months ago

• Mark showed signs of jealousy and suspiciousness

• Coworkers find him cold, distrusting of others, unemotional



• Mark has no close friends, no support• Medical exam: cirrhosis of the liver• Mark drinking for many years, though blames others

for this• Mark’s father was an alcoholic who had fits of rage• Mark was physically and emotionally abused as a

child



Mark’s diagnosis, using DSM-V Dimensional System• Alcohol Use Disorder (previously axis I)• Personality Disorder with paranoid traits

(previously Axis II)• Physical Disorder: Cirrhosis of the Liver

(Previously Axis III)• Causal Specifiers (previously Axis IV):

biological/genetic; environmental; developmental; social; cultural; behavioral



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