WEEK 1: THEORETICAL MODELS OF PSYCHOPATHOLOGY

Introduction _____________________________________________
• Clinical description and diagnosis of common psychopathology across the lifespan (focus
heavily)
• Epidemiology (health issues and treatment in population level) and individual differences
• Aetiology – the actual cause/issue (including biopsychosocial influences)
• Prominent models and theories of psychological disorders
• Treatment of psychological disorders (limited extent)
• Limitations: a clinical training course – aims to provide theoretical knowledge and
understanding of abnormal psychology but does not provide training or experience in the role
of a professional psychologist

Definitions
• Abnormal Psychology is the study of understanding, explaining and modifying abnormal
behaviour
• More than mental disorders (psychopathology) but often the focus
• Abnormality is dependent on perspective

Elements of ‘abnormal’ behaviour

• Infrequency
• i.e. statistical infrequency
• Normal distribution – quite often a particular presentation of a population lies in a
continuum
• Intelligence is almost normally distributed
• Frequency of abnormal behaviours
• Frequency does not help much in terms of mental disorder
• Deviance
• Contextual deviance defines abnormality based on the social acceptability of
behaviours
• Gender role expectations
• Culture
• Classification system
• Deviance from social norm is not enough to define abnormal behaviour
• Distress
• Subjective psychological distress, such as suffering and a desire to change behaviour
• Individual assessment of their own abnormality, rather than societal
• With some mental disorders, there some variable levels of distress (less/more
distress)
• Person needs to have an insight to understand that something is distressing
• Disability
• Impairment: determined by how adaptive or maladaptive a behaviour is
• Impact on life and social roles, e.g. work, family, friendship, health
• But by whose standards? Flexibility? New work arrangement
• Danger
• Assessment of harm to self or others
• E.g depression and suicidal thoughts
• Not a single criterion is enough to define abnormality -> need to consider different elements

DSM-5 'Mental Disorder'

 • “A mental disorder is a syndrome characterized by clinically significant disturbance in an
individual’s cognition, emotion regulation, or behaviour that reflects a dysfunction in the
psychological, biological, or developmental processes underlying mental functioning.
• Mental disorders are usually associated with significant distress or disability in social,
occupational, or other important activities. An expectable or culturally approved
response to a common stressor or loss, such as the death of a loved one, is not a
mental disorder
• Socially deviant behaviours (e.h. political, religious, or sexual) and conflicts that are
primarlity between the individual and society are not mental disorders unless the
deviance or conflict results from a dysfunction in the individual, as described above”

Models of Abnormal Psychology _________________________________

What is a model/ paradigm?
• Set of assumptions and concepts that provide a framework to help explain and interpret
• No one theory is perfect or complete
• Influences
• What is a disorder?
• What are the disorders?
• What causes the disorders?
• How to treat the disorder?
• Research method
• Major theoretical perspective in Abnormal Psychology
• Biological
• Psychological
• Social/ environmental
• There is no one known cause of mental illness

Biological factors
• Biological (or medical) model established with emergence of medical specialist in mental
illness
• Psychiatry (150 years ago)
• Result of biological diseases afflicting the brain or nervous system
• Alteration in biological processes result in abnormal behaviour
• Biological processes identified include

Genetic
• Focus on the impact of individual differences in genetic makeup on behaviour
• Behaviour genetics -> extent of heritability of behaviours
• E.g. twin study (genotype and phenotype comparisons using
monozygotic and dizygotic twin studies)
• Molecular genetics -> processes through which genes affect behaviour (specific
genetic area that affect a particular behaviour)
• All of the behaviours are polygenic (every genes are involved) and epigenetic
processes (genes are exactly the same but due to environmental factors that
each genes could be expressed differently)
• Case study: Denmark Adoption Study
• All individuals participated were adopted, convicted as criminal in court
• When adoptive parents and biological parents were criminal -> higher likelihood
of criminal behaviour
• When biological parents were criminal but adoptive parents were not -> raised in
a non-crime-related environment -> second highest in likelihood of committing
crime
Trauma-related influences on
 • Brain structure abnormalities
• Cerebrum
• Pre-frontal cortex:
§ Reasoning, organization, behavioural and emotional control
• Limbic system
• Emotion centre
• Hypothalamus
• Regulates hunger, sleep, sexual drive
• Different lobes of the brains are responsible for different cognitive functioning
Biochemistry
• Neurons transmit information throughout the brain and nervous system
• Neurotransmitters cross the connection between neurons to transmit information
• Examples:
• GABA
• Dopamine
• Serotonin and norepinephrine
• Endocrine system
• Hormones are chemicals in the bloodstream released by glands (e.g.
cortisol)

Biological treatments
Continually developing, e.g.
• Psychosurgery
• Electroconvulsive therapy (ECT) – not first line treatment but works well
• Shock therapy (heavy shock)
• Patients were anaesthetized prior to treatment
• Still do not quite know how it works
• Psychotropic medication (1960s) – still don’t quite know how it works
• Anxiolytics – anxiety disorders
• Antidepressants
• Mood stabilizers – bipolar disorders
• Antipsychotics – hallucinations etc
• Where are these treatments prominent?
• Depression, bipolar disorders and psychotic disorders

Strengths
• Constant evolution and efficacy of psycho-pharmacology
Limitations
• Beliefs, values, interpretation – how is it related to biology?
• Causation unclear – nature/nurture
• Side effects, relapse and long-term use
• Therapy can alter brain structure/chemicals

Psychological variables
• Abnormal behaviour explained by psychological processes
• Interpretations of the world
• Beliefs and motivations (conscious/subconscious)
• Learning history
• Established 1892/1919
• Increasing recognition in the assessment and treatment of mental illness through rise of
psychoanalysis

Psychological models include :

• Psychoanalytic and psychodynamic
• Sigmund Freud
• Mental illness expanded from severe psychotic states e.g. neurosis
• Key concepts
 • Unconscious
• Psychosexual development
• Defence mechanism
• Strategies (used by the Ego) to repress or change impulses or wishes
(of the Id) that are unwanted
• Projection
• Unfaithful husband suspects of his wife of infidelity
• Reaction formation
• Someone who is angry with a person actually ends up
being particularly friendly
• Distress if unsuccessful or creation of other difficulties
• Psychoanalytic treatment (passive treatment from therapist side)
• Developed by Freud
• Uncover the conflict kept unconscious by defence mechanisms of the Ego
• Dreams
• Free association (talk about anything you like)
• Transference (patients listen to therapist’s approach) and countertransference
(some problems from the therapist could transfer to patients)
• Lengthy treatment with no specific goal or symptom reduction
• Strengths
• Expansions of mental health field
• Importance of childhood experience, unconscious influences, defence
mechanisms
• Limitations
• Sexual instincts as basis of all behaviour
• Limited evidence base and tests
• Efficacy of treatment

Psychodynamic models (derived from Freud’s psychoanalytic principle)

o Behaviour governed by dynamic internal forces and unconscious processes
influencing behaviour, thoughts and emotions
o Contemporary psychodynamic models
• Ego psychology
• Object relations
• Interpersonal therapy
• Attachment theory

Behavioural
• Abnormal behaviour caused by observable and identifiable stimuli in immediate
environment which elicit, reinforce or punish
• Behaviourism and learning theory
o Classical conditioning (Pavlov/Watson)
• Pairing of stimuli with response can lead to involuntary behaviour
• There are US and UR
• Pair with a NR (NR -> no CR)
• Pair NR with US -> response (UR)
• NR becomes CS -> CR
o Operant conditioning (Skinner)
• Behaviours are increase or decreased through consequences
• Reinforcement
• Punishment
• Positive
• Negative
• Note: this can be adaptive but is often generalized and maladaptive
o Modeling/observational learning (Bandura)
 • Social behavioural learning can occur in absence of reinforcement
(show people something, they observe the behaviour and then model
the behaviour without reinforcement )
• Modeling
• Learning by watching and imitating behaviours of others
• Eg. learned aggression in Bobo Doll study
• Bobo Doll Study (1961)
• Learned aggression in the absence of reinforcement for the
children
• See adult play with the doll, observe and then when moved to a
different room with the doll, act like what the adult did

Behavioural treatment
• Functional analysis and alter environmental contingencies to learn new responses,
extinguish old ones, or habituate to avoided stimuli
o Exposure/systematic desensitization
o Aversion (punishment)
o Token economies (reinforcement)
• Where are they prominent?
o Disorders with strong behavioural components
• Anxiety
• Behaviour problems/children
• Depression
• Addiction
• Strengths
• Methodologically robust and experimental evidence
• Limitations
• Over simplistic

Cognitive
• Abnormal emotions and behaviour caused by dysfunctional cognitive processes
• Based on clinical observations by Albert Ellis and Aeron Beck
• Rational emotive therapy (RET;Ellis)
o Response to events based on interpretations of events
o ABC model (event-beliefs-response)
o Beck’s cognitive model (functional thinking patterns)
• Psychological disorders caused by thinking patterns
• Themes in thoughts in depression
• Errors in thinking across numerous disorders
• Interpretations of negative events as global, internal and stable
• Self, future and the world
• Multiple levels of cognitive processes
• Cognitive treatment
1. Identify distorted cognitive patterns (automatic and core/schemas) -> people
don’t generally realize why their beliefs are like that
2. Change these to more rational thought processes
3. Increase adaptive behaviours

Cognitive behaviour
• Contemporary theory combining cognitive and behavioural theories in treatment
• Prominent across
o Anxiety disorders
o Mood disorders
o Eating disorders
o Adjunct to medication in severe disorders
• Strengths
o Strong evidence base