Approaches to Clinical Psychology

1. Approaches to Clinical Psychology Past and Present

2. Several approaches have been applied in the field of Clinical Psychology. • These approaches are based on theoretical views or perspectives within the field of psychology. • Each of these approaches uses a different conceptual framework or paradigm to examine behavior & mental processes. • Furthermore, within each paradigm there are certain assumptions that influence the methods employed to examine the phenomenon.

3. Paradigms used to study Clinical Psychology: • Biological • Psychodynamic (Psychoanalytical) • Behavioral • Cognitive • Humanistic

4. I. Biological Paradigm: assumes behavior & mental processes can be explained by organic events. • Assumptions of paradigm: • A. Biology plays a role in pathological behavior. B. Psychopathology is caused by disease.

5. Problems with Biological model • 1. Factors unrelated to biology may influence the onset of psychopathology. E.g., environmental factors (life-style, abuse) may play role in some mental disorders (depression). • 2. Multiple factors may influence onset of psychopathology. • 3. Some forms of psychopathology are learned (e.g., phobias).

6. Is there evidence to support the Biological Paradigm?? • Yes!!! There is evidence from two sources . • 1. Behavioral Genetics – examines how much of individual differences in behavior are due to genetic makeup. • 2. Biochemistry in the nervous system

7. Behavioral Genetics: Theory • Genotype – the physiological genetic constitution of a person. (fixed at birth, but not static) • Phenotype- the observable expression of our genes (changes over time & is product of interaction with genotype & environment). • E.g., A child may be hard-wired for high intellectual achievement, but will need environmental stimulation to produce development.

8. Can we possess a biological predisposition for certain mental illnesses or behavioral problems? • Yes!! This is called a Diathesis. • Many individuals have psychopathology in their family backgrounds that have a genetic link. Examples include depression, schizophrenia, ADHD, autism, antisocial behaviors

9. Does having a diathesis automatically mean you will develop the mental disorder? • Not necessarily!!! A lot depends on the interaction of your biology with environmental factors (parents, peers). • (E.g., while monozygotic twins share 100% of each others genes, if one twin has schizophrenia, the other twin only have a 44% chance of developing the disorder. • So genetics alone don’t account for the diagnosis of schizophrenia.

10. How do we study behavior genetics? • 1. Family members • 2. Twin studies • 3. Adoption studies • 4. Linkage analysis

11. Family Members: • Studies the 1st & 2nd degree relatives of individual with a given mental disorder. • 1st-degree relatives-parents & siblings (50%-shared genes) • 2nd-degree relatives-aunts, uncles (25%-shared genes) • Are compared with index cases (probands).

12. If there is a genetic predisposition: • 1st degree relatives of the index case(s), should have the disorder at a higher rate than in the general pop. • E.g., 10% of 1st degree relatives of index cases with schizophrenia can be diagnosed with schizophrenia

13. Twin studies • Monozygotic (100% shared genes) & dizygotic twins (50% shared genes) are compared. • Start with diagnosis of one twin & see if other twin develops same disorder. • When twins are similarly diagnosed, they are said to be concordant.

14. If disorder is heritable-- concordance rate will be higher for MZ than for DZ twins. • However, since most twins are reared together in the same environment, the shared influence of environment cannot be ruled out.

15. Adoption studies • Examine children who were adopted & reared apart from their “abnormal” parents. • This method reduces the influence of shared environmental influences on behavior and should reflect influence of genetics.

16. Linkage Analysis: • Uses DNA blood testing to examine the influence of genetics inmental disorders.  

17. II. Psychodynamic Paradigm: • Argues that our behavior results from unconscious conflicts. • Conflicts occur outside of overt awareness. This is referred to as the iceberg theory.

18. Structures of mind: • 1. Id (unconscious) “wants” to satisfy basic urges (thirst, hunger, sex). • 2. Ego (primarily conscious) tries to satisfy id impulses without breaking societal norms. • 3. Super-ego (conscious) our morality center which tells us right from wrong.

19. Psychosexual stages of development • 1. Oral (birth to 1 yr)- needs gratified orally (sucking). 2. Anal (2yr)-needs met- through elimination of waste. • 3. Phallic (3-5 yrs)-needs met through genital stimulation. • 4. Latency (6-12 yrs)-impulses dormant. • 5. Genital (13+)-needs met through intercourse.

20. Defense mechanisms- unconscious & protect ego from anxiety. • Repression • Projection • Reaction formation • Displacement • Denial • rationalization

21. Problems with Freudian theory: • 1.   Freud had no scientific data to support his theories. • 2.   Freud’s theories (unconscious, libido, etc.) cannot be observed. • 3.   Theory explains behavior (post-hoc) after the fact. • 4.    Observations not representative of population.

22. Freud’s therapy • Premise—we have repressed information in unconscious that needs to come out. • How??? • Free-association, dream analysis, hypnosis.

23. III. Behavior paradigm • Focuses on observable behaviors. • Premise—abnormal behavior is learned!! • Learning (classical & operant conditioning, modeling)

24. Classical conditioning • Pavlov’s study: • Step 1: Meat Powder (UCS)---Salivation (UCR) • Step 2: Bell (CS) ---- Salivation (UCR) • -Meat Powder (UCS)---- • Step 3: Bell (CS)---------Salivation (CR)

25. Conditioning emotional responses: Watson & Raynor • Classically conditioned 11-month-old infant to fear white rats (Santa beard, cotton). • Presented infant with cute white rat—child showed interest in rat, was then presented with a loud noise (startle response).

26. Operant conditioning: • Desired behaviors are reinforced (positive, negative), whereas undesirable behaviors are extinguished (punishment).

27. Modeling (Albert Bandura) • We learn how to behavior, by watching others. • Whether we will produce a given behavior is determined by whether we have seen it reinforced or punished.(Famous Bobo Doll study)

28. Behavioral therapies • Systematic desensitization (phobias, anxiety) • Flooding (phobias, anxiety) • Aversion conditioning (pedophiles)

29. Criticisms of theory: • 1. Abnormal behavior is not always associated with learned behavior. E.g., Schizophrenia, Bipolar disorder, & autism are largely related to organic causes.

30. Criticisms of theory contd: 2. Simplistic circular reasoning (Description as explanation). • 3. Useful for treatment, but not as cause for most mental disorders.

31. IV. Cognitive Paradigm: • Premise- Psychopathology develops from faulty perceptions and thinking. • Criticism of Cognitive Paradigm • 1. Concepts are slippery, not well defined. • 2. Cognitive explanations do not explain much. E.g., depressed person has negative cognition--I am worthless.

32. Therapy • Cognitive-Behavioral therapy • Rational Emotive therapy

33. V. Humanistic Paradigm: • Theorists argue we are driven to self-actualize, that is, to fulfill our potential for goodness and growth.

34. Roger’s Humanistic therapy • We all have a basic need to receive positive regard from the important people in our lives (parents). • Those who receive unconditional positive regard early in life are likely to develop unconditional self-regard. • That is, they come to recognize their worth as persons, even while recognizing that they are not perfect. Such people are in good shape to actualize their positive potential.