Approaches to Clinical Psychology

Past and Present

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.

Paradigms used to study Clinical Psychology:

Biological Psychodynamic (Psychoanalytical) Behavioral Cognitive Humanistic

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.

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).

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

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.

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

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.

  How do we study behavior genetics?

1. Family members 2. Twin studies 3. Adoption studies 4. Linkage analysis

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).

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

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.

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.

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.

Linkage Analysis: Uses DNA blood testing to examine the

influence of genetics inmental disorders.  

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.

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.

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.

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

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.

Freud’s therapy

Premise—we have repressed information in unconscious that needs to come out.

How??? Free-association, dream analysis, hypnosis.

III. Behavior paradigm

Focuses on observable behaviors.

Premise—abnormal behavior is learned!!

Learning (classical & operant conditioning, modeling)

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)

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).

Operant conditioning: Desired behaviors are reinforced (positive,

negative), whereas undesirable behaviors are extinguished (punishment).

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)

Behavioral therapies

Systematic desensitization (phobias, anxiety)

Flooding (phobias, anxiety) Aversion conditioning (pedophiles)

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.

Criticisms of theory contd:2. Simplistic circular reasoning (Description as

explanation).

3. Useful for treatment, but not as cause for most mental disorders.

Mark must be aggressive

Why is Mark Aggressive?Because he hit John

Mark hits John

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.

 

Therapy

Cognitive-Behavioral therapy Rational Emotive therapy

V. Humanistic Paradigm: Theorists argue we are driven to self-

actualize, that is, to fulfill our potential for goodness and growth.

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.