Medical or Biological model
The first definition of psychological abnormality is the most commonplace model used in the western world and was developed by member s of the medical profession. This model focuses largely on objectivity. It assumes that abnormality occurs due to organic or functional disorders, possibly as the result or a tumour or a chemical imbalance in the subjects brain such as an excess of dopamine. There are classification systems used for physical and mental signs of disorder. The model also speculates about the relation of abnormality to genetic inheritance. Kendler (1985) stated that mental illness 'runs in the family'. Relatives of schizophrenics are 18 times more likely to develop it. It also relates infection and illness to psychological abnormality. Barr (1990) proved that schizophrenia was more common in children of women who had flu during pregnancy.
One treatment for abnormality under this model is psychotherapeutic drugs. This is also the most widely used treatment. They can be objectively tested unlike other methods and are cheap and easy. Drugs only attack the problem not the cause of the problem and generally only suppress it rather than make it go away.
There are other treatments also, such as electro-convulsive therapy whereby an electric current is sent through the brain in order to induce a small seizure, it intends to reset neurotransmitter levels. This has a 75% success rate in cases of severe depression. It is not easily accessed. In 2001 there were 13,000 treatments in England each week. 10% of these cases were involuntary. Another treatment is psychosurgery, however this is very rare and in 2000 was only used twice. electrodes are inserted in the brain and heated in order to kill 'bad' tissue so good tissue can take over but it is hard to prove this works. There is a claimed 75% success rate.
This model attaches no blame to the patient, and in that respect is humane. However it is highly impersonal, it may be said that it is ignorant to think that one pill can solve the individual problems of a number of people. Animal research conducted by Rosenhan (1973) supports this model, however many argue that we are more cognitively advanced than animals and therefore this doesn't apply. Patients who come off treatment tend to re-develop symptoms, some think the root of the problem needs to be attacked, the diagnosis of illness from this model is based on symptoms, little emphasis is on experiences and feelings.
Psycho-dynamic model
This model is based on behaviour.
Sigmund Freud defined some of the best known examples. He said mental illness is of psychological origin, the model talks of the
unconscious as playing a big role, it is not normally accessible but plays a big part in our behaviour. Freud said there were 3 main parts of the
personality: the
id (our basic human desire), the
superego (society's influence) and our
ego (or conscience, the balance between id and superego). The model also highlights the importance of
childhood experiences and their affect on us as part of the unconscious. Freud also defined
psycho-sexual development stages. He believed conflict at these times affect later behaviour. The phases are:
A) The oral stage (0-1 years), where the primary source of pleasure is the mouth and sucking.
B) The anal stage (1-3 years), where the primary source of pleasure involves the membranes in the anal region.
C) The phallic stage (3-6 years), where the primary source of pleasure comes from the genitals.
D) The latency stage (6-12 years) where there is so much development in other areas that are sexually latent. Your sexuality lies dormant ready to flourish.
E) The genital stage (puberty onwards), where the primary source of pleasure is through heterosexual relationships.
Childhood conflict leads to anxiety, the ego has defence mechanisms to repress these thoughts to the unconscious, repression is the main defence mechanism. Defence mechanisms can help to reduce our anxiety levels, but they don't resolve the deeper problems.
Patients under this model are coached into revealing the repressed thoughts and developing insight. The therapists allows the patient to talk freely and analyses their speech, and also discusses other factors such as dream which Freud believed gave clues to unconscious activity.
Freud said psychological problems created physical illness, this is now widely accepted, along with his theories on the importance of consciousness, although the treatment's effectiveness has been questioned; Eysenk (1952) reviewed 7000 cases and claimed to find it didn't work, and in cases was damaging due to the affect of remembering traumatic events.
Freud put emphasis on childhood and sexual factors, however these are now considered less important than social issues and everyday problems. Also, his theories are hard to prove as it is not objective. Freud's evidence was case study based and it is believed his studies were limited to specific types of people. Some people also don't like the way he places blame on parents by saying childhood is a major influence, however Freud remains the best known psychologist and psycho-analysis is still the most influential theory.
Behavioural model
Our next model concentrates on
observable behaviour. it states that behaviour (normal and abnormal) is learnt through 2 types of
conditioning.
Classical conditioning.
This was proposed by Ivan Pavlov and is learning by association. He noticed his dog would salivate at the sound of his footsteps as he went to get the meat to feed him. He set up an experiment with dogs where a bell was rung when they were given food, when he eventually took the food away, the dogs still salivated.
Watson and Rayner did an experiment that supported this with an 11 month old baby coined Little Albert who was not scared of anything but the sound of a big bar being struck. After the touched a rat at the same time as the sound, he became scared of the rat, the fear was transferred, he even began to get scared of other fluffy white things.
Operant conditioning.
This is learning through the consequences of behaviour. Basically, if a behaviour is rewarded then it will continue. If behaviour is punished it will stop. e.g when people stop eating to reduce weight and develop an eating disorder because they are criticised or ridiculed for being fat. Abnormal behaviour can be unlearnt in this way too. Token economies are an example of this type of modification. This is a reward system for reinforcement of appropriate behaviour, through the use of tokens that can be exchanged for privileges. Systematic desensitisation is another type of this therapy. This often involves confronting a phobia in a relaxed situation leading to association of the calm feelings with it.
The aim of treatment offered is to change bad behaviour to appropriate behaviour.
Behaviourists will treat the symptoms as they believe this is the problem. They think searching for causes is pointless. Solving the problems immediately affecting the patient is the important thing however critics say symptoms must be attacked at the root.
The approach can be tested although there are ambiguities concerning cultural and environmental effects. The approaches are effective for phobias and obsessive compulsive disorders amongst others but not all as it ignores peoples complex thought processes. The principles of this model have been largely tested on animals that don't have these. Some treatments also use punishment or methods that do not ask patient consent. This is sometimes seen as unethical.
Cognitive model
The final model I shall discuss is based on individual thought processes, such as
disturbed thoughts. It says how we process information ourselves and how easily we
jump to conclusions can affect our
mental stability. It is all about
rationality. Most commonly associated with this model are psychologists
Beck and
Ellis.
We make sense of our lives through cognitive processes, this model says abnormality is derived from faulty processes such as over generalisation (reaching a conclusion on the basis of one incident. Abnormal processes also include magnification of failures and barely acknowledging successes. However these processes can be monitored by the patient and altered by talking through the thought processes rationally. This is called cognitive re-structural therapy, where irrational, negative thoughts are reversed, and is believed to lead to a change in behaviour. However the method will not work for more severe mental disorders such as schizophrenia. Beck's therapy is often used for depression. Beck proposed a 'cognitive triad' of the self, the world and the future, that leads to negative thoughts. The therapist discusses with the patient to establish what they are thinking and why, and they work together to change this by challenging the thought processes.
This is currently a popular model as it focuses on stopping immediate problems and not unearthing the past. It is provided by the NHS. Also it allows the individual to take charge and change the irrational thought processes constantly reported by sufferers of anxiety. However some people dislike it as it places blame on the individual and it is believed that not all depression is a result of irrationality, but due to bad life experiences and every day living conditions. Also it is not clear whether it is actually the irrational thoughts that lead to the problem or if it's the other way round, this cannot be tested as the model is subjective and unscientific because thoughts can't be measured, yet.
-DF