Saturday, August 15, 2009

Models Of Abnormality (Carson and Butcher)


The traditional biological view-point focuses on mental disorders as diseases, many of the primary symptoms of which are cognitive, emotional, or behavioural. Mental disorders are thus viewed as disorders of the central nervous system, autonomic nervous system, and/or the endocrine system that are either inherited or caused by some pathological process.
The disorders first recognized as having biological or organic components were those associated with gross destruction of brain tissue. These disorders are neurological diseases - i.e. they result from the disruption of brain functioning by physical or biochemical means and often involve psychological or behavioural aberrations.
Nevertheless, most mental disorders are not caused by neurological damage. For example, biochemical imbalances in the brain can lead to mental disorders without causing damage to the brain. Moreover, the bizarre content of delusions and other abnormal mental states like hallucinations can never be caused simply or directly by brain damage.
Four categories of biological factors that seem particularly relevant to the development of maladaptive behaviour are:
1. neurotransmitter and hormonal imbalances
2. genetic vulnerabilities
3. temperament
4. brain dysfunction nad neural plasticity.
Each of these categories encompasses a number of conditions that influence the quality and functioning of our bodies and our behaviour. They are often not independent of each other, and they often occur in varying combinations in different people.

Biological discoveries have profoundly affected the way we think about human behaviour. We now recognize the important role of biochemical factors and innate characteristics, many of which are genetically determined, in both normal and abnormal behaviour. Many new developments in the use of drugs can dramatically alter the severity and course of certain mental disorders - particularly the more severe ones such as schizophrenia. Biological treatments seem to have more immediate results that other available therapies.

PSYCHOSOCIAL PERSPECTIVE IN UNDERSTANDING ABNORMAL BEHAVIOUR attempts to understand humans not just as biological organisms, but also as people with motives, desires and perceptions. It emphasizes the importance of early experience, and an awareness of social influences and psychological processes within an individual.
There are 5 major psychosocial perspectives on human nature and behaviour:
1. Psychodynamic
2. Behavioural
3. Cognitive-Behavioural
4. Humanistic
5. The existential perspective.

Freud founded the psychoanalytic school which emphasized the role of unconscious motives and thoughts, and their dynamic inter-relationships in the determination of normal and abnormal behaviour. Psychoanalytic theory emphasizes on the primacy of libidinal energies and inter-psychic conflicts. According to Freud, the conscious part of the mind represents a relatively small area whereas the unconscious part is like the submerged part of an iceberg. In the depths of the unconscious are the hurtful memories, forbidden desires and other experiences which have been repressed. However, unconscious matter continues to seek expression in dreams, slips of the tongue, and when the individual is under hypnosis. Until such unconscious matter is brought to awareness and integrated into the conscious part of the mind, it may lead to maladaptive behaviour.
(Mention the fundamentals of Freud's psychoanalytic theory: the structure of personality - id, ego, and super ego; defence mechanisms; psychosexual stages of development)
Freud was chiefly concerned with the workings of the id. He also paid attention to the super-ego but hardly gave any importance to the ego. Later, many theorists developed some of Freud's basic ideas in three somewhat different directions: Anna Freud was concerned with how the EGO performed its central function as the 'executive' of the personality. According to her and some psychodynamic theorists who constituted the ego psychology school, psychopathology develops when the ego does not function adequately to control or delay impulse gratification or does not make adequate use of defence mechanisms. The second school stressed on the role of an infant's early relationships - especially the mother-infant relationship, on the development of the individual's personality and self-concept. The third group focused on social determinants of behaviour and on the importance of people's interpersonal relationships.
Many theorists like Margaret Mahlet, D.W. Winicott, Melanie Klein, W.R.D. Fairburn developed the object-relations theory - which focuses on individual's interactions with real and imagined other people (external and internal objects) and on the relationships that people experience between their external and internal objects. Object refers to the symbolic representation of another person in the infant's or child's environment, most often the parent.
The inter-personal perspective which began with the defection of Alfred Adler in 1911 states that psychopathology is rooted in the unfortunate tendencies we have developed while dealing with our inter-personal environments. According to Adler, people are social beings motivated primarily by the desire to belong to and participate in a group. Erik Erikson extended the inter-personal aspects of psychoanalytic theory. He elaborated and widened Freud's stages of psychosexual development into more socially oriented concepts, describing crisis or conflicts that occured at 8 stages - each of which could be resolved in a healthy or unhealthy way.
Bowlby's Attachment Theory emphasizes the importance of early experiences, especially early experience with attachment relationships, as laying the foundation for later functioning throughout childhood, adolescence, and adulthood. He stressed the importance of the quality of parental care to the development of secure attachments, but he also saw the infants as playing a more active role in shaping the course of their own development, than had most of the earlier theorists.

Freud's psychoanalytic theory can be seen as the first systematic approach to showing how human psychological processes can result in mental disorders.
The behavioural perspective arose in the early 20th century in part as a reaction against the unscientific methods of psychoanalysis. Behavioural psychologists believed that the study of subjective experience did not provide acceptable scientific data because such observations were not open to verification by other investigators. In their view, only the study of directly observable behaviours and of the stimuli and reinforcing conditions that control it could serve as a basis for understanding human behaviour, normal or abnormal.
Although this perspective was initially developed through laboratory research rather than clinical practise with disturbed patients, its implications for explaining and treating maladaptive behaviour soon became evident. The roots of behavioual perspective are in Pavlov's study of classical conditioning and in Thorndike's study of instrumental conditioning - later renamed as operant conditioning by Skinner. Learning - the modification of behaviour as a consequence of experience - is the central theme of the behavioural approach. Because most human behaviour is learnt, te behaviourists addressed the question of how learning occurs. Behaviourists focused on the effects of environmental conditions on the acquisition, modification, and possible elimination of various types of response patterns, both adaptive and maladaptive.
(Discuss what is classical conditioning, operant conditioning,the concepts of generalization and discrimination, and observational learning).
The behaviourist perspective attempts to explain the acquisition, modification and extinction of nearly all types of behaviour. Maladaptive behaviour is viewed as the result of: a failure to learn necessary adaptive behaviour or competencies, OR the learning of ineffective or maladaptive responses.
Maladaptive behaviour is thus the result of learning that has gone awry and is defined in terms of specific, observable, undesirable responses. For the behaviour therapist, the focus is on changing specific behaviours and emotional responses.

Albert Bandura developed the cognitive-behavioral persepctive and placed considerable emphasis on the cognitive aspects of learning. Bandura stressed that human beings regulate behaviour by internal symbolic processes - thoughts. According to him, we prepare ourselves for difficult tasks by visualising the consequences. We do not always require external reinforcement to alter behaviour patterns - our cognitive abilities allow us to solve many problems internatlly. He developed a theory of self-efficacy - the belief that one can achieve desired goals.

Today, this perspective focuses on how thoughts and information processesing can become distorted and result in maladaptive behaviour. The central construct for this perspective is SCHEMA - an underlying representation of knowledge that guides the current processing of information and often leads to distortions in attention, memory, and comprehension. People develop different schemas based on their temperament, abilities and experiences.
(Discuss assimilation and attribution)
Different forms of psychopathology are characterized by different maladaptive schemas that have developed as a function of adverse learning experiences. These maladaptive schemas lead to the distortions in thinking that are characteristic of certain disorders such as anxiety, depression, and personality disoders. Cognitive psychologists study non-conscious mental activity which refers to mental processes that are occuring without our being aware of them.
Beck is the founder of cognitive therapy. Following his lead, many clinicians have shifted focus from overt behaviour itself to the underlying cognitions assumed to be producing the maladaptive behaviour.

The humanisitic perspective views human nature as basically good. Paying less attention to unconscious processes and past causes, it emphasized present conscious processes and places strong emphasis on people's inherent capacity for responsible self-direction. Humanistic psychologists think that much of the empirical research designed to investigate causal factors is too simplistic to uncover the complexities of human behaviour. This perspective is concerned with processes of love, hope, creativity, values, meaning, personal growth, and self-fulfillment. Although these abstract processes are not readily subject to empirical investigation, certain underlying themes and principles of humanistic psychology can be identified, including the self as a unifying theme and a focus on values and personal growth.
Humanistic psychologists stress on individuality. Carl Rogers developed the formulation of SELF-CONCEPT i.e. each individual exists in a private world of experience which is I, Me, Myself. The most basic striving of an individual is toward maintenance, enhancement, and actualization of the self, and his or her inner tendencies are towards health and wholeness under normal conditions. A perceived threat to the self is followed by a defence including a tightening of percention and behaviour and the introduction of self-defence mechanisms.
(Discuss Maslow's hierarchy of values)
According to this view, psychopathology is essentially the blocking or distortion of personal growth and the natural tendency toward physical and mental health.

This emphasizes on the uniqueness of the individual, the quest for values and meaning, and the existence of freedom for self-direction and self-fulfilment. It places more emphasis on the irrational tendencies and the difficulties inherent in self-fulfilment - particularly in modern, dehumanising mass society.
Existential psychologists focus on the importance of establishing values and acquiring a level of spiritual maturity worthy of freedom and dignity bestowed by one's humanness. Avoiding such central issues creates corrupted, meaningless, and wasted lives. Abnormal behaviour is therefore the product of a failure to deal constructively with existential despair and frustration.

is concerned with the impact of culture and other features of the social environment on mental disorders. It is concerned with the contribution of socio-cultural variables to mental disorder. Although many serious mental disorders are fairly universal, the form that some disorders take and their prevalence vary widely among different cultures. Low socio-economic status, unemployment, and being subjected to prejudice and discrimination are associated with greater risk for various disorders.


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