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Psychology 3318. Davison and Neale Chapter 2: Current Paradigms in Psychopathology and Therapy. Overview of Davison and Neale Paradigms. Biological (Medical, Disease) Psychoanalytic Humanistic/Existential Learning Cognitive. Biological Paradigm. Types of Disease: Infectious vs. Traumatic

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Psychology 3318

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Psychology 3318 l.jpg

Psychology 3318

Davison and Neale

Chapter 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”)

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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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  • “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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  • 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

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