Psychology 3318 Davison and Neale Chapter 2: Current Paradigms in Psychopathology and Therapy.
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Transcript of Psychology 3318 Davison and Neale Chapter 2: Current Paradigms in Psychopathology and Therapy.
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Psychology 3318
Davison and NealeChapter 2: Current Paradigms in Psychopathology and Therapy
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Overview of Davison and Neale Paradigms
• Biological (Medical, Disease)• Psychoanalytic• Humanistic/Existential• Learning• Cognitive
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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)
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Representation of Biological Model
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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
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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
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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)
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Freudian Disease Model
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Other Early Psychoanalysts (“NeoFreudians”)
Carl Jung Early Humanist, stressed collective unconscious
Alfred Adler Power is basic motive, individual psychology
Karen Horney
Early feminist
Erich Fromm
Early existentialist, stressed role of society
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Traditional Therapeutic Concepts
• Free Association• Resistance• Dream analysis (latent vs. manifest
content)• Transference and countertransference• Interpretation• Analyst sits in background; patient is
prone
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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
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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
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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)
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Humanistic/Existential: Existential
• Based (perhaps loosely) on philosophic movement
• Stresses the present and responsibility for choice
• Goal is to change behavior
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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)
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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)
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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
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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
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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
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Modeling
• Role Playing• Rehearsal• Self-efficacy
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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
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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