Psychology 3318 Davison and Neale Chapter 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 JungEarly Humanist, stressed collective unconscious Alfred AdlerPower is basic motive, individual psychology Karen Horney Early feminist Erich FrommEarly 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