Dr.

Gema Simbee
Psychiatirst
Mirembe Hospital
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definition

 Psychopathology is the
systematic study of abnormal
experiences, cognition and
behavior-in other words
abnormal states of the mind

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MODELS (PARADIGMS) OF HUMAN BEHAVIOR TO EXPLAIN
NORMAL AND ABNORMAL BEHAVIOR
 Many attempts have been made for centuries to
answer the basic question: Why do we as humans
behave the way we do both normal and abnormal
o Each MODEL/PARADIGM of human behavior has its
own basic philosophical assumptions regarding:
 the nature of man,
 mental health
 psychopathology,
 personality development
 Treatment-Strategies/techniques for interventions
The patient-doctor relationships also vary with the
psychological perspective employed

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MODELS OF ABNORMALITY # 1
What is a model or paradigm?
 A set of assumptions and concepts that help
us explain and interpret observations
 A school of thought

 Helpful because it spells out basic

assumptions and sets guidelines for
investigation

 It influences what investigators observe, the

questions they ask, the information they seek,
and their interpretation of that information

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MODELS OF ABNORMALITY # 2
Historically, clinical scientists of a given
time and place agreed on a single model
of abnormality – a model strongly
influenced by cultural beliefs

Currently, there are several competing

models of abnormality
Why? Each model focuses on one
aspect of human functioning and no
single model can explain all aspects of
abnormality

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 MODELS OF ABNORMALITY # 3
 Strategies/techniques for interventions have
been developed based on these different
perspectives.

 The patient-doctor relationships also vary with

the psychological perspective employed.

 Each perspective offers some understanding

of:
 Why do we behave the way we do?
 What is considered normal behavior?
 What is considered abnormal behavior?
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MODELS OF ABNORMALITY # 3
 However no one perspective ALONE CAN
ADEQUATELY EXPLAIN the complexity of
human behavior, health, psychopathology.

 Models include:
 Biological
 Socio-cultural
 Psychodynamic,
 Behavioral
 Cognitive -behavioral
 Humanistic

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BIOLOGICAL MODEL/PARADIGM
The biological paradigm considers disease as a
process independent of the person who suffers it
and of the social context.
 Is based on the collection of sciences known
collectively as Neuroscience and the focus are on
the biological explanation basis of behavior.
 The neurobiological/neurochemical approach
seeks to specify the neurobiological processes that
underlie normal behavior and psychopathology.
 Neuropsychology focuses on the neural
transmission and the psychoactive (behavior-
influencing) action of medication on
neurotransmitters. 9
HOW DO BIOLOGICAL THEORISTS EXPLAIN
ABNORMAL BEHAVIOR? #1

Takes a medical perspective

The main focus is that psychological
abnormality is an illness brought about by
malfunctioning parts of the organism
Typically focused on the BRAIN
Brain anatomy
The brain is composed of ~100 billion nerve
cells (called neurons) and thousands of
billions of support cells (called glia)
Within the brain, large groups of neurons
form distinct areas called brain regions

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HOW DO BIOLOGICAL THEORISTS EXPLAIN
ABNORMAL BEHAVIOR? #2

Brain anatomy and abnormal behavior

Clinical researchers have found
connections between certain
psychological disorders and problems in
specific brain areas

Example: Huntington’s disease and basal

ganglia (forebrain)

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HOW DO BIOLOGICAL THEORISTS EXPLAIN
ABNORMAL BEHAVIOR? #3

Brain chemistry
Information spreads throughout the brain in the form
of electrical impulses that travel from one neuron to
one or more others
An impulse is first received at a neuron’s dendrites,
travels down the axon and is transmitted to other
neurons through the nerve endings
Neurons don’t touch: they are separated by a space
(the synapse), across which a message moves
When an electrical impulse reaches a nerve ending,
the nerve ending is stimulated to release a chemical
neurotransmitter or “NT”)
Some NTs tell receiving neurons to”fire” other NTs
tell receiving neurons to stop firing

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HOW DO BIOLOGICAL THEORISTS EXPLAIN
ABNORMAL BEHAVIOR? #5

Role of brain chemistry in abnormal

behavior
Researchers have defined dozens of NTs
Examples: serotonin, dopamine and
GABA

Studies indicate that abnormal activity in

certain NTs can lead to specific mental
disorders
Examples: depression (serotonin and
norepinephrine) and anxiety (GABA)

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HOW DO BIOLOGICAL THEORISTS EXPLAIN
ABNORMAL BEHAVIOR? #6

Role of brain chemistry

Additionally, researchers have learned that mental
disorders are sometimes related to abnormal
chemical activity in the endocrine system

Endocrine glands work along with neurons and

release chemicals called hormones into the
bloodstream

Abnormal secretions have been linked to

psychological disorders
• Example: cortisol release is related to anxiety and
mood disorders
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HOW DO BIOLOGICAL THEORISTS EXPLAIN
ABNORMAL BEHAVIOR #7

Biological abnormalities – genetics

Humans have 23 pairs of chromosomes, each with
numerous genes that control the characteristics and
traits a person inherits

Studies suggest that inheritance plays a part in

mood disorders, schizophrenia, mental retardation,
Alzheimer’s disease, and other mental disorder
specific genes have been identified for some
disorders
Don’t know the extent to which genetic factors
contribute to disorders
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HOW DO BIOLOGICAL THEORISTS EXPLAIN
ABNORMAL BEHAVIOR #8
Biological abnormalities – evolution
Genes that contribute to mental disorders
are viewed as unfortunate occurrences:
May be mutations
May be inherited after a mutation in the
family line
Evolutionary theorists argue that we can best
understand abnormality by examining the
millions of years of human evolution
Looking at a combination of genes, adaptive
behaviors of the past, and the interaction
between genes and current environmental
events

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HOW DO BIOLOGICAL THEORISTS EXPLAIN
ABNORMAL BEHAVIOR #9

Biological abnormalities – viral infections

Infection provides another possible
source of abnormal brain structure or
biochemical dysfunction
Example: schizophrenia and prenatal
viral exposure

Interest in viral explanations of

psychological disorders has been
growing in the past decade

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BIOLOGICAL TREATMENTS
Biological practitioners attempt to pinpoint
the physical source of dysfunction to
determine the course of treatment

Three types of biological treatment:

Drug therapy
Electroconvulsive therapy (ECT)
Psycho-surgery

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BIOLOGICAL TREATMENTS

Drug therapy – in 1950s: Advent of

psychotropic medications
Changed outlook for a number of mental
disorders

Four groups of drugs:

Anti-anxiety drugs (anxiolytics,
tranquilizers)
Antidepressant drugs
Anti-bipolar drugs (mood stabilizers)
Antipsychotic drugs

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Biological Treatments

Electroconvulsive therapy (ECT)

With ECT, electrodes are attached to the
patient’s forehead and an electrical
current is passed through, causing a
seizure

Used for severe depression when drugs

and other therapies have failed

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Biological Treatments

Psychosurgery
Historical roots in trephination
1930s: First lobotomy
Much more precise than in the past
Considered experimental and used only
in
extreme cases

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 Assessing the Biological Model

Weaknesses: Can limit rather than enhance our

understanding
 Too simplistic
 Evidence is incomplete or inconclusive
 Treatments produce significant undesirable
(negative) effects

Strengths : Earns considerable respect in the field

 Fruitful
 Creates new therapies
 Suggests new avenues of research
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BIOLOGICAL MODEL/PERSPECTIVE
 Behaviour is merely the outward expression of
biological processes and that behavior is created out
of the working of the nervous system and is purely a
physiological process.
 Assumes that through the study of the brain and its
functioning all secrets of human behavior will be
revealed
 Does not attempt to rule out the effects of
environment over heredity. Both are understood to
influence physiological makeup and functioning of
the brain
 However, because of the complexity of the brain and
the fact that live human brains are seldom available
for study tremendous gaps exist in our knowledge of
neuronal functioning. A psychological conception of
ourselves based solely on neurobiology would be
inadequate. So for this reason other methods are
used to investigate psychological phenomena

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PSYCHOANALYTIC/MODEL/PARADIGM
 Philosophical assumptions (major principles;
nature of man; what is health/pathology?)
 Human beings are determined by psychic
energy and early childhood experiences
 Basic biological drives (sexual and aggressive)
press for immediate release and bring man
into conflict with social reality.
 Unconscious motives and conflicts are central
in determining present behavior.
 Psychic energy originates in the body in the
form of DRIVES and seeks expression through
erotogenic zones.
 Mind and body duel/struggle over how mind
will permit body to express these desires.
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PSYCHOANALYTIC/MODEL/PARADIGM #2
Theory of Personality: (Development and Pathology)
 Normal personality development is based on successful
resolution and integration of psychosexual stages of development
(oral, anal, phallic and genital).
 Faulty Development/psychopathology: Inadequate resolution
of a conflict at a
particular stage Id, ego and superego constitute basis for
personality structure.
 The id seeks the pleasure principle and needs to be immediately
expressed and gratified.
 The ego that develops out of the id is also charged with
drive gratification but it must operate in accordance with the
reality principle.
 Ego assists id in delaying gratification by meeting needs for
gratification
in accordance with reality. Ego also mediates between id and
superego.

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PSYCHOANALYTIC/MODEL/PARADIGM #3
 Concept of health: Resolution of underlying
conflicts/victory of ego over id.
 Concept of Pathology: View illness as cause by
some traumatic event in childhood or considerable
gratification at some stage.
 Fixation or regression to that stage is likely to occur
at times of stress. When defensive mechanisms
become ineffective in dealing with anxiety neurotic
symptomatology develops.
 Anxiety result of repressed conflict.
 Unconscious/unacceptable thoughts out of
awareness = heart of pathology. Energy used to
keep conflictual material unconscious reduces
psychic efficiency.
 Bringing unconscious conflicts to conscious
awareness makes conflicts available for modification
– should decrease symptomatic behavior.

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Defense mechanisms
 Refers to an unconscious process that defends
a person against anxiety by distorting reality in
some way. These emotion-focused strategies
do not alter the stressful situation; they simply
change the way the person perceives or thinks
about it. Thus all defense mechanisms involve
an element of self-deception.

 Defense mechanisms can be adaptive for a

while but when overused become maladaptive
when they become the dominant manner of
responding to problems.

 We all use defense mechanisms at times and

they help us cope with emotional rough spots
until we can deal more directly with the stressful
situation.
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THE PSYCHODYNAMIC MODEL

 Oldest and most famous psychological

model

 Based on the belief that a person’s behavior

is determined largely by underlying dynamic
psychological forces of which she or he is not
aware
Abnormal symptoms are the result of
conflict among these forces

 Father of psychodynamic theory and

psychoanalytic therapy: Sigmund Freud
(1856 – 1939)
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 HOW DID FREUD EXPLAIN NORMAL AND ABNORMAL
BEHAVIOR?
 Determined (shaped/caused) by three
UNCONSCIOUS forces:
1. Id – guided by the “pleasure principle”
Instinctual needs, drives, and impulses
Sexual; fueled by libido (sexual energy)

2. Ego – guided by the “reality principle”

 Seeks gratification but guides us to know
when we can and can’t get and express our
wishes
 Ego defense mechanisms protect us from
anxiety
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HOW DID FREUD EXPLAIN NORMAL AND ABNORMAL
BEHAVIOR?
3. Superego – guided by the “morality principle”
Conscience; unconsciously adopted from our
parents

 These three parts of the personality are often

in conflict.

 A healthy personality is one in which

compromise exists between the parts

 If the id, ego, and superego are in excessive

conflict, the person’s behavior may show signs
of dysfunction
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HOW DID FREUD EXPLAIN NORMAL AND ABNORMAL BEHAVIOR?

Developmental stages
 Freud proposed that at each stage of development,
new events and pressures require adjustment in
the id, ego, and superego
 If successful = personal growth

 If unsuccessful = fixation at an early developmental

stage, leading to psychological abnormality

 Because parents are the key figures in early life,

they are often seen as the cause of improper
development
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HOW DID FREUD EXPLAIN NORMAL AND ABNORMAL
BEHAVIOR?

 Developmental stages

 Oral (0 to 18 months of age)

 Anal (18 months to 3 years of age)
 Phallic (3 to 5 years of age)
 Latency (5 to 12 years of age)
 Genital (12 years of age to adulthood)

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 HOW DID FREUD EXPLAIN
NORMAL AND ABNORMAL BEHAVIOR?
Although current models deviate from Freud’s in
fundamental ways, each retains the belief that
human functioning is shaped by interacting forces:
Ego theorists
 Emphasize the role of the ego; consider it
independent

Self theorists
 Emphasize the unified personality over any one
component

Object-relations theorists
 Emphasize the human need for interpersonal
relationships
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PSYCHODYNAMIC THERAPIES

 Range from Freudian psychoanalysis to

more modern therapies

 All seek to uncover past trauma and inner

conflicts

 Understanding early life experience is

critically important

 Therapist acts as a “subtle guide”

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PSYCHODYNAMIC THERAPIES

Utilize various techniques:

 Free association
 Therapist interpretation
 Resistance
 Transference
 Dream interpretation
 Catharsis
 Working through
 Short-term dynamic therapies

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ASSESSING THE PSYCHODYNAMIC MODEL

 First to recognize importance of psychological

theories and treatment
 Saw internal conflict as an important source of
psychological health and abnormality
 First to apply theory and techniques
systematically to treatment –monumental impact
on the field
 Weaknesses:
 Unsupported ideas difficult to research
 Non-observable
 Inaccessible to human subject (unconscious)

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Sociocultural Theorists

 Argues that abnormal behavior is best

understood in light of the social and cultural
forces that influence an individual

 Addresses norms and roles in society

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How Do Sociocultural Theorists
Explain Abnormal Functioning?
Focus on: Family structure and communication
 Family systems theory posits that abnormal
functioning within a family leads to abnormal
behavior

 Some family systems are particularly likely to

produce abnormal functioning in individual
members
 Examples: enmeshed, disengaged
structures
 Role of culture
 Role of social networks and supports
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HOW DO SOCIOCULTURAL THEORISTS
EXPLAIN ABNORMAL FUNCTIONING?

Focus on:
 Societal conditions
 Abnormality more common in lower classes.
Why?
 Societal labels and roles
 Diagnostic labels
 Sick role

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Sociocultural Treatments
May include traditional individual therapy;
broadened therapy to include:
 Culturally-sensitive therapy
 Group therapy
 Family therapy
 Couples therapy
 Community treatment
 Includes prevention work

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Assessing the Sociocultural Model

Strengths:
Adds greatly to the clinical understanding of
abnormality

Increases awareness of labeling

Clinically successful when other treatments have

failed

Weaknesses: Research is difficult to interpret

correlation causation

Model is unable to predict abnormality in specific

individuals
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Conclusion:Assessing the Sociocultural Model

Given the limitations of the socio-

cultural model, most clinicians
view these explanations as
operating in conjunction with
biological or psychological
explanations

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BEHAVIORIST MODEL OF HUMAN BEHAVIOR
Philosophical assumptions: Major principles:
 Behavior a product of learning and conditioning
Classic and operant conditioning).
 Behavior determined by sociocultural conditioning.
 Man is passive and his behavior is
shaped/determined by classical and operant
conditioning.
 Theory of Personality:
 Man has the capacity to learn and learning seen as
an additive process (from simple to complex ideas).
Man believes what he has been habitually shaped
to believe. Man born without any inborn frame
 Concept of health: What is normal/health?
Learned behavior that is adaptive.
 Psychopathology = result of faulty or maladaptive
learning/conditioning.

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BECK’S COGNITIVE MODEL
 He has developed specific cognitive models
for different diagnostic categories and is firmly
wedded to empiricism.

 According to Beck patients with psychiatric

disorders process information in a biased way
and the nature of the bias differs for different
conditions.

 In depression-there is a pervasive negative

view of the self, the world and the future.
 In anxiety there is a shift in attention leading to
exaggerated awareness of physical and social
danger.
 In paranoid states, the person is primed to find
injustice or prejudice against themselves in the
actions of others.
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BECK’S COGNITIVE MODEL #2
 There is evidence that normal individuals have a
self-serving bias in thinking but there is usually
sufficient reality testing available to allow people
to change their beliefs on the basis of new
information

 In psychiatric disorders biases in thinking and

behavior trap the patient in a particular mind-set.
Beck has identified cognitive distortions or
thinking errors which lead the patient to
selectively attend to information consistent with
faulty beliefs and filter out information which
does not fit.

 Once a particular way of seeing the world is 46

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The Humanistic-Existential Model
Combination model

The humanist view emphasizes on

people as friendly, cooperative, and
constructive; focus on drive to self-
actualization

The existentialist view emphasis on

self-determination, choice, and
individual responsibility; focus on
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ROGERS’ HUMANISTIC THEORY AND THERAPY
 Basic human need for unconditional positive regard
 If received, leads to unconditional self-regard
 If not, leads to “conditions of worth”
 Incapable of self-actualization because of distortion
–don’t know what they really need, etc.

 Rogers’ “client-centered” therapy

 {Therapist provides unconditional positive regard
 Both accurate and genuine in reflection (reflective
listening)
 Little research support
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 GESTALT THEORY AND THERAPY HUMANISTIC APPROACH

 Developed by Fritz Perls

 Goal is to achieve self-recognition through
challenge and frustration

 Techniques:
Skillful frustration
Role playing
Rules, including “Here and Now” and “I”
language

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SPIRITUAL VIEWS AND INTERVENTIONS

For most of the twentieth century, clinical

scientists viewed religion as a negative factor in
mental health

This division now seems to be ending:

Numerous books have been published
Ethical codes now include religion under “diversity”
Researchers have begun to systematically study
the influence of religion and spirituality on mental
health
Many therapists now address spiritual issues when
treating religious clients
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 Existential Theories and Therapy

 Psychological dysfunction is caused by self-

deception:
 people hide from life’s responsibilities and fail to
recognize that it is up to them to give meaning to
their lives
 Therapy is focused on patient acceptance of
personal responsibility and recognition of:
 freedom of action
 Goals more important than technique
 Great emphasis placed on client-therapist relationship
 Existential therapists do not believe that experimental
methods can adequately test the effectiveness of their 52
 Assessing the Humanistic-Existential
Model
Strengths:
 Emphasizes on the individual
 Taps into domains missing from other theories
 Non-deterministic
 Optimistic
 Emphasizes health
Weaknesses:
 Focuses on abstract issues
 Not much influence
 Weakened by disapproval of scientific approach
 Changing somewhat
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Summary of models-
paradigms
Each perspective is valuable to
understanding abnormal behavior

Different perspectives are more appropriate

under differing conditions

 No one model-paradigm is adequate to

explain the complexities of human behavior
normal or abnormal

 To get a better appreciation of the

complexity of human behavior it is 54
Integration of the Models

 An integrative approach provides a

general framework for thinking about
abnormal behavior while also allowing
for specification of the factors that are
especially pertinent to particular
disorders

 Integrative therapists are often called

“eclectic” – they take the strengths from
each model using them in combination
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Integration of the Models
 Many theorists, clinicians, and practitioners
adhere to a bio-psychosocial model
 Abnormality results from the interaction of
genetic, biological, developmental, emotional,
behavioral, cognitive, social, and societal
influences
 Some bio-psychosocial theorists also favor the
diathesis-stress approach
 Diathesis = predisposition (bio, psycho, or social)
 Asserts that a predisposition to a disorder is
triggered
by an environmental stressor
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