abnormal
PSYCHOLOGY
Fourth Canadian Edition
Chapter 2
Current Paradigms and the Role of Cultural
Factors
Prepared by:
Tracy Vaillancourt, Ph.D.
Modified by: Réjeanne Dupuis, M.A.
What is a Paradigm?
• A model of reality: the way reality is or is
supposed to be
• It is a set of beliefs that shape our perception of
events and help us explain these events
• It is a set of concepts and methods used to
collect and interpret data (Kuhn, 1992)
• A paradigm guides the definition, examination,
and treatment of mental disorders
Paradigms in Abnormal Psychology
• Biological Paradigm
• Cognitive-Behavioural Paradigm
– Behavioural perspective
– Cognitive perspective
• Psychoanalytic Paradigm
• Humanistic-Existential Paradigms
• Integrative Paradigm
Biological Paradigm
• Continuation of the somatogenic
hypothesis
– Mental disorders caused by aberrant or
defective biological processes
– Often referred to as the medical model or
disease model
– The dominant paradigm in Canada and
elsewhere from the late 1800s until middle of
the twentieth century
Behaviour Genetics
• Study of individual differences in behaviour attributable
to differences in genetic makeup
– Genotype – unobservable genetic constitution
• Fixed at birth, but it should not be viewed as a static entity
– Phenotype – totality of observable, behavioural characteristics
• Changes over time; product of an interaction between genotype and
environment
• Methods
– Family method
• Index cases, or probands
– Twin method
• Concordance rates
– Adoptees method
Molecular Genetics
Tries to specify particular gene(s) involved and precise functions of
target genes
Overview
• 46 chromosomes (23 pairs); thousands of genes per chromosome
• Allele – any one of several DNA codings that occupy the same
position or location on a chromosome
– Person’s genotype is his or her set of alleles
• Genetic polymorphism
– Involves differences in the DNA sequence that can manifest in different
forms
– Entails mutations in a chromosome that can be induced or naturally
occurring
• Linkage analysis
– Method in molecular genetics that is used to study people
• Typically study families in which a disorder is heavily concentrated; genetic
markers
•
Gene-environment interactions
The Nervous System
• The nervous system is composed of billions of neurons
• Each neuron has four major parts:
–
–
–
–
•
•
•
•
(1) the cell body
(2) several dendrites
(3) one or more axons of varying lengths
(4) terminal buttons
Nerve impulse
Synapse
Neurotransmitters
Reuptake
Synapse
Structure of Brain
• Meninges – 3 layers of nonneural tissue
that envelop the brain
• Cerebral hemispheres – constituting most
of the cerebrum
– “Thinking” centre of the brain
– Includes the cortex and subcortical structures
such as the basal ganglia and limbic system
• Corpus collasum – major connection
between the two hemispheres
Structure of Brain (cont.)
• Cerebral cortex – upper, side, and some of the lower
surfaces of hemispheres
– Consists of six layers of neuron cell bodies with many short,
unsheathed interconnecting processes
– Grey matter – thin outer covering
– Gyri – ridges
– Sulci – depression or fissures
• Deep fissures divide the cerebral hemispheres into several
distinct areas called lobes
– Frontal lobe – lies in front of the central sulcus
– Parietal lobe – behind frontal lobe and above the lateral
sulcus
– Temporal lobe – located below the lateral sulcus
– Occipital lobe – behind the parietal and temporal lobes
Functions of the Brain
Examples of Functions
• Vision in occipital lobe
• Discrimination of sounds in temporal lobe
• Reasoning and other higher mental processes, as well
as regulation of fine voluntary movement, in frontal lobe
• Left hemisphere – responsible for speech and perhaps
for analytical thinking in right-handed people
• Right hemisphere – discerns spatial relations and
patterns, and is involved in emotion and intuition
– But keep in mind that the 2 hemispheres communicate
with each other constantly via the corpus collasum
Important Functional Areas
1. Diencephalon (contains thalamus and hypothalamus)
– Thalamus- relay station for all sensory pathways except the olfactory
– Hypothalamus- highest centre of integration for many visceral
processes, regulating metabolism, temperature, perspiration, blood
pressure, sleeping, and appetite
2. Midbrain
– Mass of nerve-fibre tracts connecting the cerebral cortex with pons,
medulla oblongata, cerebellum, and spinal cord
3. Brain stem
– Comprises pons and medulla oblongata and functions primarily as a
neural relay station
4. Cerebellum
– Related to balance, posture, equilibrium, and to smooth coordination of
body when in motion
5. Limbic system
– Controls visceral and physical expressions of emotion
The Brain
Evaluation of the
Biological Paradigm
• Rapid progress is being made in understand brainbehaviour relationships and the role of specific genetic
factors
• Neuroscience helps improve psychological treatments
• Caution against reductionism – the simplification of a
phenomenon to its basics elements
• Nervous system dysfunction are not always due to a
neurological defect
• At times, a psychological intervention has a similar effect
on the biology as a psychotropic medication would (see
p. 46)
Cognitive-Behavioural Paradigm
• The Behavioural Perspective
• The Cognitive Perspective
The Behavioural Perspective
• The behavioural (learning) perspective
– Views abnormal behaviour as responses
learned in the same ways other human
behaviour is learned
• Classical Conditioning
• Operant Conditioning
• Modelling
Classical Conditioning
• Ian Pavlov
(1849-1936)
Operant Conditioning
• J. F. Skinner (1904-1990)
• Law of effect
– Behaviour that is followed by + consequences will be
repeated
– Behaviour that is followed by – consequences will be
discouraged
• Positive reinforcement
– Strengthening of a tendency to respond by virtue of
the presentation of a pleasant event - Positive reinforcer
• Negative reinforcement
– Strengthens a response by the removal of aversive
events
• Modelling
Behaviour Therapy
• Sometimes called Behaviour Modification
• Systematic desensitization
– Counterconditioning and Exposure
– Aversive conditioning
• Operant Conditioning
– Time-out
• Modelling
– Assertion training
The Cognitive Perspective
• Focuses on people:
– Structure experiences, interpretet experiences, relate
current experiences to past ones
– Schemas
• Cognitive Behaviour Therapy
– Main focus: Cognitive restructuring
•
•
•
•
Beck’s Cognitive Therapy
Ellis’s Rational-Emotive Behaviour Therapy
Meichenbaum’s Cognitive-Behaviour Modification
Behaviour Therapy and CBT in Groups
Evaluation of the
Cognitive-Behavioural Paradigm
• Criticism
– Particular learning experiences have yet to be discovered;
e.g., showing how some reinforcement history leads to
depression (life-time observation)
– Practicing new behaviours (satisfying activities) does not
prove that the absence of rewards caused for the abnormal
behaviour
– How does observing someone lead to a new behaviour?
Cognitive processes must be engaged
– Schemas are not well defined; regarded as causing
depression, BUT no explanation of what causes the ‘gloomy’
schemas
– Unclear differences between behaviour and cognitive
influences: importance of behaving in new ways for change to
occur
Evaluation of the CB Paradigm
(cont.)
• Contributions
– Integration of 2 perspectives, i.e., CBT, has
shown benefits in psychotherapy
– Strong evidence of its benefits in improving
depression, anxiety disorders, eating
disorders, autism, and schizophrenia
– Ex.: CBT can be more effective long-term than
antidepressants in treating depression
Psychoanalytic Paradigm
Psychopathology results from unconscious conflicts in the
individual
Structure of Mind (according to Freud)
• ID
– Present at birth
– Part of the mind that accounts for all the energy needed to run the
psyche
– Comprises the basic urges for food, water, elimination, warmth,
affection, and sex
• EGO
– Primarily conscious
– Begins to develop from the id during the second six months of life
– Task is to deal with reality
• SUPEREGO
– Operates roughly as the conscience
– Develops throughout childhood
Psychoanalytic Paradigm (cont.)
• Objective anxiety vs.
• Neurotic anxiety vs.
• Moral anxiety
• Defence Mechanisms
– Unconscious
strategies used to
protect the ego from
anxiety
• Examples
–
–
–
–
–
–
–
–
Repression
Denial
Projection
Displacement
Reaction formation
Regression
Rationalization
Sublimation
Psychoanalytic Therapy
• The goal is to remove earlier repression, face childhood
conflict, and resolve it from adult reality
• Free association
• Dream analysis
– Latent content
• Some key components of psychoanalytic therapy
– Transference
– Countertransference
– Interpretation
Modifications in the
Psychoanalytic Theory
•
•
•
•
•
Group Psychodynamic Therapy
Ego Analysis
Brief Psychodynamic Therapy
Contemporary Analytic Thought
Interpersonal Therapy
Evaluation of the
Psychoanalytic Paradigm
• Criticism
– Theories based on anecdotes during therapy sessions
are not grounded in objectivity, thus, not scientific
– Freud’s observations, recollections could be unreliable
• Contributions
– Childhood experiences held shape adult personality
– There are unconscious influences on behaviour
– People use defense mechanisms to control anxiety
and stress
– Valid research shows the effectiveness of
psychodynamic therapies
Humanistic-Existential Paradigms
• Similar to psychoanalytic therapies, in that they are
insight-focused
• But psychoanalytic paradigm assumes that human
nature is something in need of restraint
• Humanistic and existential paradigms
– Place greater emphasis on the person’s freedom of
choice
– Free will as the person’s most important characteristic
– Exercising one’s freedom of choice take courage and
can generate pain and suffering
– Seldom focus on cause of problems
Carl Roger’s Client-Centred Therapy
• Also known as person-centred therapy
• Our lives are guided by an innate tendency toward selfactualization, thus focusing on positive factors
• Based on following assumptions:
– People can be understood only from the vantage point of
their own perceptions and feelings (phenomenological
world)
– Healthy people are aware of their behaviour, are innately
good and effective, and are purposive and goal-directed
– Therapists should not attempt to manipulate events for the
individual
• Create conditions that will facilitate independent decisionmaking by the client
• Features – unconditional positive regard & empathy
Humanistic-Existential Paradigm
(cont.)
• Humanistic Paradigm
– All people are striving to reach self-actualization;
– Anxiety occurs when there is a discrepancy between
one’s self-perceptions and one’s ideal self;
– Carl Rogers – Client-Centred Therapy
– Gestalt Therapy – Fritz Pearl
• Existential Paradigm
– Anxiety arises when what individuals does not bring
meaning in their lives (Viktor Frankl)
– Learning to relate authentically, spontaneously to
others
Evaluation of the
Humanistic-Existential Paradigms
• Criticism
– Therapists inferences of the client’s phenomenology
(world) may not be valid
– Assumption not demonstrated: People are innately
good and would behave in satisfactory and fulfilling
ways if faulty experiences did not interfere
– Self-awareness does not necessarily lead to change
• Contributions
– Rogers insisted that therapy outcomes be empirically
evaluated
Consequences of
Adopting a Paradigm
• Eclecticism / integration in psychotherapy
• Guides the data that will be collected and how they will
be interpreted
• Leads to ignoring possibilities and overlook other
information
• Most therapist use a Prescriptive Eclectic Theory, a
combination of ideas and therapeutic techniques
– CBT therapists show empathy; Learning therapists
inquire about clients’ thoughts; Freud was directive
and encourage behaviour change
Integrative Paradigm
• Diathesis-Stress Paradigm
• Biopsychosocial Paradigm
• Both paradigms emphasize the interplay
among the biological, psychological, and
social / environmental perspectives
Diathesis-Stress Paradigm
• Focuses on interaction between predisposition
toward disease (diathesis) and environmental, or
life, disturbances (stress)
• Diathesis
– Constitutional predisposition toward illness
• Any characteristic or set of characteristics that
increases a person’s chance of developing a disorder
• That is: genetic, psychological, environmental factors
can be predisposing to the development of a mental
disorder
Biopsychosocial Paradigm
Risk Factors
Protective Factors
Cultural Considerations
• Canada, A Multicultural Country
– Acculturation and ‘Cultural Mosaic’ vs.
– Assimilation and ‘Melting Pot’ in U.S.
• Canada and U.S. differ on the following aspects:
– Language
– Foreign birth
– Visible racial differences
Cultural Considerations (cont.)
• Mental Health Implications of Diversity in Canada
– Extremely low rates of mental disorder in Hutterites, MA
– ‘Healthy Immigrant Effect’
– Similar levels of behavioural problems among
French/English-Canadians and Caribbean/FilipinoCanadian adolescents
– Under-usage of mainstream mental health services by
members of minority groups:
• Asians in Canada (Chinese, Indian, Filipino, Vietnamese) and
West Indian
Cultural Considerations (cont.)
• Aboriginals and Mental Health Problems
– Depression, drug abuse, suicide, low self-esteem,
PTSD symptoms, violence, obesity, and diabetes are
widespread
– Institutional discrimination over 300
• Inuit people moved to the Far North
• Indian Residential Schools for 100 years
• Moving Aboriginals in reserves
– Aboriginal children are raised by relatives, thus moving
between households, which is not a sign of trouble
– Treatment, due to importance of family, may be
conducted in the home with all members involved
Cultural Considerations (cont.)
• Diagnosing and Assessment
– Most assume that clients to best when matched w/
clinician of similar cultural background, however,
– Similarity in values or cognitive match may be more
relevant for clients’ improvement
– The use of professional interpreters needs to become
universal across Canada
– Mental health professionals need to be trained in
cultural and ethnic particularities
– Clinicians must be aware that members of many
minority groups are angry at a sometimes insensitive
majority culture
Copyright
Copyright © 2011 John Wiley & Sons Canada, Ltd. All rights
reserved. Reproduction or translation of this work beyond that
permitted by Access Copyright (The Canadian Copyright Licensing
Agency) is unlawful. Requests for further information should be
addressed to the Permissions Department, John Wiley & Sons
Canada, Ltd. The purchaser may make back-up copies for his or her
own use only and not for distribution or resale. The author and the
publisher assume no responsibility for errors, omissions, or damages
caused by the use of these programs or from the use of the
information contained herein.