CHAPTER 2
CHAPTER OUTLINE
I.
One-Dimensional models of mental disorders Models are analogies that scientists use to
describe things they cannot directly observe. Among the models that psychologists use is
the medical model, which portrays psychological disorders as diseases or the psychosocial
model. This chapter will introduce the multi-path model. The case of Steven V. is presented,
which describes a college student suffering from depression and violent fantasies. The
biological model suggests that abnormal behavior is caused by biological factors, especially
involving genetic material and the brain. Psychological explanations such as Sigmund
Freud’s psychodynamic model emphasizes early childhood experiences. Behavioral
explanations can be traced to inappropriate learning. Social explanations look at the social
environment. Sociocultural explanations look at cultural factors to explain behavior.
II. A multi-path model of mental disorders. What, then, is the “best” way to conceptualize
the causes of mental disorders? An integrative and interacting multi-path model is a way of
viewing disorders and their causes. The multi-path model is not a theory, but a way of
looking at the variety and complexity of contributors to mental disorders. The etiology of
mental disorders can be subsumed under four dimensions. Dimension One: Biological
Factors This dimension includes genetics, brain anatomy, biochemical imbalances, central
nervous system functioning, autonomic nervous system reactivity, etc. Dimension Two:
Psychological Factors This dimension includes personality, cognition, emotions, learning,
stress-coping, self-esteem, self-efficacy, values, developmental history, etc. Dimension
Three: Social Factors This dimension includes family, relationships, social support,
belonging, love, marital status, community, etc. Dimension Four: Sociocultural Factors This
dimension includes race, gender, sexual orientation, religion, socioeconomic status,
ethnicity, culture, etc.
III. Dimension one: biological factors. Modern biological explanations of normal and
abnormal behavior continue to share certain assumptions: (1) the things that make people
who they are—their physical features, susceptibility to diseases, temperaments, and ways of
dealing with stress—are embedded in the genetic material of their cells; (2) human thoughts,
emotions, and behaviors are associated with nerve cell activities of the brain and spinal
cord; (3) a change in thoughts, emotions, or behaviors will be associated with a change in
activity or structure (or both) of the brain; (4) mental disorders are highly correlated with
some form of brain or other organ dysfunction; and (5) mental disorders can be treated by
drugs or somatic intervention The human brain is composed of billions of neurons (nerve
cells) that receive and transmit information. The brain is divided into two hemispheres, each
controlling the opposite side of the body. The brain structures most relevant to abnormal
behavior include the thalamus, hypothalamus, reticular activating system, limbic system,
and cerebrum. Other structures in the midbrain and hindbrain manufacture chemicals that
are correlated with mental disorders. Biochemical theories suggest that chemical imbalances
underlie mental disorders. Neurons are composed of dendrites, which receive signals from
other neurons, and axons, which send the signals to other neurons. At the end of the axon is
a gap called the synapse, into which chemicals called neurotransmitters are released.
Imbalances in neurotransmitters are associated with many mental disorders. Certain
medications can reduce symptoms of abnormal behavior by blocking or facilitating
neurotransmitter activity. Biochemistry plays an important role in understanding abnormal
behavior. Genetics also plays an important part in explaining the development of disorders.
A person’s genotype (genetic makeup) interacts with the environment to produce physical or
behavioral characteristics (the person’s phenotype). The Human Genome Project has
mapped the location of all genes in the nucleus of a human cell and has completed its
sequencing to provide a basic blueprint of the entire genetic material found in each cell of
the human body. While single cells have been found to be responsible for a few diseases,
most diseases are the result of many genes interacting with hormones, electrical signals and
nutrient supplies internally, plus physical and social environments. Biology-based treatment
techniques include: Psychopharmacology is the study of the effects of drugs on the mind
and on behavior; it is also known as medication or drug therapy. Besides medication,
electroconvulsive therapy (ECT) can be used to treat certain mental disorders.
Psychosurgery is brain surgery performed for the purpose of correcting a severe mental
disorder The treatment was used most often with patients suffering from schizophrenia and
severe depression, although many who had personality and anxiety disorders also
underwent psychosurgery. Diathesis-stress theory argues that people can inherit a
vulnerability to developing an illness, but this tendency must be activated by environmental
forces for the disorder to occur.
IV. Dimension Two: psychological factors. Especially important for the psychological
dimension are conflicts in the mind, emotions, learned behavior, and cognitions in
personality formation. Personality is a dynamic process resulting from three interacting
components: the id, the ego, and the superego. The id operates on the pleasure principle, a
need for immediate gratification. The ego is influenced by the reality principle. The
superego is composed of the conscience and the ego ideal. Personality develops through five
psychosexual stages (oral, anal, phallic, latency, and genital). Fixation at any of the stages
affects emotional development. Anxiety is at the root of psychoanalytic thinking and takes
three forms: realistic, moralistic, and neurotic. Defense mechanisms protect the individual
from anxiety. These include, among others, repression, reaction formation, projection,
rationalization, displacement, undoing and regression. Psychoanalytic therapy, or
psychoanalysis, has three main goals: (1) uncovering repressed material, (2) having clients
achieve insight into their inner motivations and desires, and (3) resolving childhood
conflicts that affect current relationships. Psychoanalysts traditionally use four methods to
achieve their therapeutic goals: free association, dream analysis, analysis of resistance and
analysis of transference. Psychoanalysis has been criticized for basing its evidence on case
studies, which are subject to distortion. Psychodynamic theory is biased against women and
cannot be applied to a wide range of disturbed people. The behavioral models emphasize
learning. The classical conditioning model involves the pairing of a neutral (conditioned)
stimulus with an unconditioned stimulus that automatically produces certain responses
called the unconditioned response. After repeated pairing, the conditioned stimulus alone
can produce a weakened version of the response, call the conditioned response. Classical
conditioning in psychopathology. These concepts can be said to explain the development of
phobias and deviant sexual behavior. However, the passive nature of associative learning
makes it a limited explanatory tool. Watson and the “little Albert” experiment are a good
example. The operant conditioning model stresses the consequences of voluntary and
controllable behaviors called operant behaviors. According to Thorndike’s law of effect,
these behaviors are more likely when they produce positive consequences and less likely
when they produce negative consequences. Operant conditioning principles help explain
such forms of psychopathology as self-injurious behavior. As in classical conditioning,
operant concepts can be applied to treatment as well. The observational learning model
suggests that an individual can acquire new behaviors simply by watching other people
perform them through the process of vicarious conditioning or modeling. Observational
learning in psychopathology assumes that exposure to disturbed models helps produce
disturbed behavior. Behavioral models have made significant contributions to both the
understanding and treatment of disorders. However, they are criticized for diminishing the
importance of inner determinants of behavior. The cognitive models assume that thoughts
modify our emotional states and behavior. People differ in their mediating processes, which
determine our reactions, behaviors and self-evaluations. Our schemas (how we interpret
events) influence our experiences. Cognitive theorists focus on irrational beliefs (Ellis) or
dysfunctional “automatic thoughts” (Beck). Beck’s work on depression helped him identify
a hierarchy of cognitive content. Ellis describes an A-B-C theory of personality in which A
is an event, B is a belief, and C is a consequent behavior or emotion. Beck describes six
types of faulty or distorted thinking: arbitrary inference, selective abstraction,
overgeneralization, magnification and exaggeration, personalization, and polarized thinking.
Cognitive approaches to therapy have clients monitor their thoughts; recognize the
connections between thoughts, emotions, and behaviors; examine the evidence for their
assumptions; and substitute more reality-oriented interpretations. The humanistic and
existential approaches emphasize the need to appreciate the world form the individual's
vantage point. They also highlight freedom of choice and the wholeness of the individual.
Psychologists Carl Rogers and Abraham Maslow suggested that people are motivated by the
actualizing tendency to enhance the self (self-actualization). Development of abnormal
behavior occurs when society imposes conditions of worth on people so that their selfconcept and actualizing tendency become incongruent. This incongruence produces
behavior disorders. In Rogers’ person-centered therapy, people are free to grow toward their
potential. The therapist uses reflection of feelings and acceptance rather than advice to help
the client actively evaluate his or her experience. The existential perspective is not a
systematized school of thought but a set of attitudes that is less optimistic than humanism. It
views the individual within the human condition and focuses more on responsibility to
others. Both approaches lack scientific grounding, are vague, and apply therapies that are
ineffective with severely disturbed clients. Criticisms of the humanistic and existential
approaches point to their “fuzzy,” ambiguous, and nebulous nature and to the restricted
population in which these approaches can be applied.
V. Dimension Three: social factors. In contrast to traditional psychological models, socialrelational models emphasize how other people, especially significant others, influence our
behavior. This viewpoint holds that all people are enmeshed in a network of interdependent
roles, statuses, values, and norms. One of these, the family systems model, assumes that the
behavior of one family member directly affects the entire family system. Criticisms of the
family systems model include difficulty defining it from different cultural viewpoints and
its confusion of cause and effect over the issue of family abuse.
VI. Dimension Four: sociocultural factors. Gender factors, women are consistently subjected
to greater stressors than their male counterparts. Lower socioeconomic class is related to
lower sense of self-control, poorer physical health, and higher incidence of depression.
Early attempts to explain differences between various minority groups and their white
counterparts tended to adopt one of two models. The first, the inferiority model, contends
that racial and ethnic minorities are inferior in some respect to the majority population. The
second model—the deprivations or deficit model—explained differences as the result of
“cultural deprivation.” It implied that minority groups lacked the “right” culture. Both
models have been severely criticized as inaccurate, biased, and unsupported in the scientific
literature. The Multicultural Model is the new approach emphasizing that being culturally
different does not equal deviancy, pathology, or inferiority. The model recognizes that each
culture has strengths and limitations and that differences are inevitable. Criticisms of the
Multicultural Model include that the multicultural model operates from a relativistic
framework; that is, normal and abnormal behavior must be evaluated from a cultural
perspective. The reasoning is that behavior considered disordered in one context—seeing a
vision of a dead relative, for example—might not be considered disordered in another time
or place.
VII. Implications. Each model—whether biological, psychodynamic, behavioral, cognitive,
existential-humanistic, family systems, or multicultural—represents different views of
pathology. In practice, most clinicians recognize that models of psychopathology do not
completely contradict one another on every point. As the multi-path model suggests,
elements of various perspectives can complement one another to produce a broad and
detailed explanation of a person’s condition