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Theoretic Basis of Nursing Practice. Chapter 7. Biologic Theories. General Adaptation Syndrome - Selye Linked stressful events and illness Some support, but not specific enough Diathesis-Stress Model Genetic vulnerability and environmental stressors

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biologic theories
Biologic Theories
  • General Adaptation Syndrome - Selye
    • Linked stressful events and illness
    • Some support, but not specific enough
  • Diathesis-Stress Model
    • Genetic vulnerability and environmental stressors
    • “A Diathesis” , a constitutional predisposition towards a disorder must be challenged by a stressor
psychodynamic theories psychoanalytic
Psychodynamic Theories:Psychoanalytic
  • Sigmund Freud - founder
  • Study of unconscious
  • Personality and its development
    • Ego, id and superego
    • Sexuality is an end product of a complex process.
  • Psychoanalysis
    • A therapeutic process of accessing the unconscious and resolving conflicts that originated in childhood
    • Not effective treatment for mental disorders, but respected for enhancing maturity and growth
neo freudian models
Neo-Freudian Models
  • Adler – Individual Psychology
    • Inferiority
    • Birth order
  • Jung – Analytical Psychology
    • Extroverted vs. introverted
  • Horney – Feminine Psychology
    • Rejected “penis envy”
    • Rejected “oedipal complex”
other psychodynamic theories
Other Psychodynamic Theories
  • Sullivan - Interpersonal relations
    • Great influence on psychiatric nursing
    • Interaction patterns and parataxic distortions
humanistic existentialtheories
Humanistic/ ExistentialTheories
  • Roger’s Client-centered Theory
  • Frederik Perls/Gestalt Theory
  • Maslow’s Heirarchy of Needs
  • Albert Ellis/ Rational Emotive Therapy
applicability to nursing psychodynamic theories
Applicability to Nursing: Psychodynamic Theories
  • Defense mechanisms
    • Now coping mechanisms in DSM-IV (explained in Chapter 10)
  • Transference and countertransference
  • Object relations and identification
  • Empathy
  • Levels of consciousness
    • awareness
    • unconscious
behavioral theories
Behavioral Theories
  • Stimulus-response Theories
    • Pavlov and his dog
    • Behaviorism and John B. Watson
  • Reinforcement Theories
    • Edward L. Thorndike and “stamping in”
    • B.F. Skinner and operant conditioning
  • Cognitive Theories
    • Bandura’s social cognitive theory and modeling, self-efficacy
    • Aaron Beck - thinking and feeling
applicability of behavior theories to pmhn
Applicability of Behavior Theories to PMHN
  • Wide-spread use of behavioral theories in practice
  • Patient education interventions
  • Changing an entrenched habit
  • Privilege systems and token economies
developmental theories
Developmental Theories
  • Erik Erikson – Psychosocial development
  • Jean Piaget – Learning in children
  • Moral Development
    • Kohlberg
    • Carol Gilligan – Gender differentiation (attachment important for female identity)
applicability of developmental theories to pmhn
Applicability of Developmental Theories to PMHN
  • Research on models is ongoing.
  • Evidence suggests that girls do not follow a staged developmental path.
  • There are gender and cultural differences in development.
social theorists
Social Theorists
  • Social conditions are largely responsible for deviant behavior
  • Deviance is culturally defined
  • Social conditions can “pre-dispose” a person to mental illness.
social theories familydynamics
Social Theories:FamilyDynamics
  • Family dynamics: patterned interpersonal and social interactions
    • Interactional view: Bateson
    • Problem-solving approach: Haley
    • Multigenerational system: Bowen
    • Structural family theory - Minuchin
  • Applicability of family theories to PMHN
    • Assessment of family dynamics
    • Planning interventions for families
social theories social distance
Social Theories:Social Distance
  • Balance theory: A balance is maintained between formal and informal support system (Litvak,1966).
      • Formal support systems: large organizations (hospital , etc.)
      • Informal support systems: family, friends, neighbors
      • Individuals with strong informal support networks live longer than those without that type of support.
  • Social distance:
      • Degree to which values formal organization and primary group members differ
      • When formal and informal systems begin performing the same function, the formal system increases social distance.
  • Applicability:
      • Practical model for understanding relationship between formal and informal systems
other social theories
Other Social Theories
  • Role Theories
      • Explains individual’s social position and function within the environment
      • Applies role concepts in understanding group interaction and role of patient within family and community.
  • Sociocultural Perspectives
      • Culture and gender – Mead
      • Transcultural health care – Leininger
      • Uses theories as a basis for assessing and intervening within social domain
medical model
Medical Model
  • All mental processes derive from operations of the brain, and deviant behavior is a symptom of a brain disorder
  • Genes and combinations of genes exert significant control over behavior.
  • Physician as “healer” prescribes the plan
nursing theories interpersonal relations model
Nursing Theories Interpersonal Relations Model
  • Hildegarde Peplau
      • Empathic linkage
      • Self-system
      • Anxiety
  • Ida Jean Orlando
      • Nurse-patient relationship
      • Acute care setting
other nursing theories
Other Nursing Theories
  • Existential and Humanistic
      • Joyce Travelbee
      • Jean Watson
  • Systems Models
      • Imogene King
      • Betty Newman
      • Dorothea Orem
  • Others
      • Martha Rogers
      • Calista Roy

Psychoanalysts believe that behavior problems in adulthood are caused by__________________.

Interpersonal theorists believe that behavior problems arise from ______________________.

The drives for ________________________and________________ are critical to a person’s psychological health according to the interpersonal model.

Social theorists believe that deviant behavior is caused by____________________.

The existential therapeutic process focuses on the_______________.

In supportive therapy a therapist plays an ___________role and regards the client as a _____in the treatment process.


Which model of psychiatric treatment do you think is most culture-bound? Which is the most culture-free? Defend your answer.