Psychology: Alternatives to the Medical Model

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  • Created by: Madisonxo
  • Created on: 18-04-19 17:57
Behavioural model of abnormality
Focuses on observable behaviour and the role of the environment in determining human behaviour. Based on the idea that all behaviour is learnt.
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Classical conditioning
Unconditioned stimulus (e.g. loud noise), triggers a natural reflex (e.g. fear). UCS presented with another stimulus (neutral stimulus, e.g. a rat) triggers fears. Overtime, conditioned stimulus (rat) triggers fear (conditioned response).
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Watson and Rayner (1920)
11 month old boy, Little Albert. Metal bar struck loudly behind his head as he reached out for a white rat placed in front of him. When he was shown a rat and any other fluffy objects, he would start to cry. Shows abnormal behaviour can be learnt.
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Evaluation of Watson and Rayner
Unethical. Not everyone goes on to develop a fear or phobia after a negative situation (so the theory that behaviour is learnt cannot be the only explanation)
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Taste Aversions
If you're ill after a certain food/drink, its taste becomes a CS, producing a CR of nausea. E.g Chemotherapy (UCS) triggeres nausea (UCR), Chemo + food (NS) triggers nausea (UCR), food (CS) triggers nausea (CR).
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Operant conditioning
Operant conditioning is learning through the consequences of actions. Actions resulting in positive reinforcement (reward), negative reinforcement (removal of something bad) will be repeated. Actions resulting in punishment will not be repeated.
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Examples of operant conditioning
Maintaining phobias: Anxious around phobic stimuli (e.g. spider) and avoid them. This prevents anxiety, negative reinforcement. Anorexics desire to lose weight so not eating is positively reinforced.
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Social learning
Belief that abnormal behaviour is learned through vicarious learning, process of observation and imitation of a role model exhibiting the behaviour.
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Becker (1999)
Studied women living on Fiji. TV arrived in 1995 + by 1998 74% of women surveyed said they were 'too big'. Eating disorders began to appear (unheard of before introduction of TV)
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Flooding
Phobias are a learned fear + need to be unlearned via exposure to the thing you fear. Patients have to face their fears for an extended period of time until they do not fear it anymore, phobia should then disappear.
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Flooding - eval
Can be effective but if patient decides to leave before the feeling of fear has completely gone, the phobia may be made worse.
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Wolpe (1960)
Forced a girl with a fear of cars into the back of the car and drove her around until her fear disappeared.
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Marks et al (1981)
Found that flooding provided continued improvement for up to 9 years after the treatment.
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Paul and Lentz (1977) - method
Independent measures, token economy set up for schizophrenic patients at local hospital. One group - token, one group - control. Tokens were given as rewards when patients were 'well-behaved' and were taken away if they acted 'strange' or 'bizarre'.
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Paul and Lentz (1977) - results
Those in the token economy group showed fewer abnormal behaviour than those in the control group. Only 50% of the control group were able to be released compared to just under 100% of the group that took part in the token economy system.
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Paul and Lentz (1997) - conclusion and evaluation
Concl: Token economy systems are effective in shaping behaviours. Eval - ethics, based on denying people items such as chocolate and cigarettes.
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Aversion therapy
Stops an undesired behaviour by associating it with unpleasant feelings, e.g. nail varnish created that tastes horrible so that nail biters learn to associate biting their nails with a horrible taste.
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Systematic desensitisation
Treatment for phobias: Fear hierarchy created, put into least feared event and encouraged to do a relaxation technique so that they're no longer anxious, repeated until the fear is only linked with relaxation. Repeated for each stage.
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Wolpe (1961)
Carried out systematic desensitisation on 39 people, took each patient through 3 stages (muscle relaxation, devel of fear hierarchy, unlearning anxiety). Cured 35/39 partially/wholly. Concl: systematic desensitisation can be effective phobiaTreatment
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Strenghts of the behavioural model
Scientific approach, testable concepts, can be v effective for treating phobias etc.
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Weaknesses of the behavioural model
Cannot explain all behaviours because it neglects: 1) the influence of genetics + biology 2) the influence of cognitions (how thought processes contribute to disorders). Not effective for all disorders. Ethical issues. Treats behaviour, not cause.
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Cognitive model of abnormality
Abnormal behaviour = result of faulty thinking. Thinking processes that occur between a stimulus and a response are responsible for the feeling that forms part of the response.
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Ellis (1962) Irrational thinking
Everyone's thoughts are rational or irrational at times, psychological problems occur only if people engage in faulty thinking to the extent that it becomes maladaptive for them and others around them.
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Ellis (1962) and Beck (1967)
Polarised thinking (black + white), Overgeneralisation (sweeping from one single event), tyranny of 'should' 'ought to' and 'must', Catastrophising (mountain out of a molehill)
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Ellis's (1962) ABC model
a) Activating event, leads to B) belief about why this happened, leads to C) consequence. Rational belief = adaptive consequence. Irrational belief = maladaptive consequence.
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Beck's (1963) cognitive triad
Negative thoughts linked to depression, they have negative views about 1) themselves 2) the world 3) the future
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Beck (1967) cognitive triad and errors in logic
Errors in logic: depressed people tend to draw illogical conclusions when they evaluate themselves 2) Cognitive triad - the 3 components interact and interfere with normal cognitive processing.
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CBT - aims
Cognitive Behavioural therapy: Aimed at encouraging people to examine their beliefs and replace irrational thoughts with a positive, adaptive way of thinking.
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Procedures in Cognitive Behavioural Therapy
Cognitive element: Therapist encourages client to become aware of their beliefs. Behavioural element: Client + therapist decide together how the client's beliefs can be reality-tested through experimentation.
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Examples of CBT (Ellis 1962)
REBT: Rational-Emotive Behaviour Therapy, uses ABC model. Claimed that REBT helps people 'cure' themselves as they become less anxious over a long period of time. Should be incorporated into a person's life.
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Examples of CBT (Beck et al. 1985)
Beck's cognitive therapy: Aimed at training clients to monitor situations where they make negative assumptions. Encourages them to challenge these thoughts, help them see that such thoughts unfounded. (Beck Depression Inventory)
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Examples of CBT (Meichenbaum 1972)
Meichenbaum's stress inoculation therapy (SIT) - used widely in stress management training.
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Examples of CBT - Schizophrenia (Hole 1979)
Encouraged patients to reality test their delusions, found that half of patients could reduce the pervasive nature of their delusions (doesn't offer a cure, rather a way of 'normalising' their symptoms)
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Kobasa and Maddi (1977)
Hardiness Training: 3 stages - 1) Focusing (recognise physical symptoms of stress) 2) Reliving stressful encounters (analyse situations) 3) Self-improvement (take on challenges and gain control)
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Fletcher (2005)
Used hardiness training on olympic swimmers, found they improve their performance following training.
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Meichenbaum (1985)
Stress Inoculation Therapy: 1) Conceptualisation (identify fears + concerns w/therapist) 2) Skill acquisition + rehearsal (e.g. +ve thinking) 3) Application and follow through (practice skills IRL). While SIT has been successful, it is time consuming
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Fava et al (1998) - Aim
To see if using drug therapy followed CBT reduced relapse rates for patients with depression compared with using drugs only
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Fava et al (1998) - Procedure
40 patients (who had experienced at least 3 episodes of depression) were randomly assigned to one condition: 1) drugs followed by CBT 2) drugs + standard clinical management
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Fava et al (1998) - Results
During a 2 yr follow up: 25% of patients who had drug therapy followed by CBT had relapses. 80% of patients who had only drug therapy and standard clinical management had relapses.
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Fava et al (1998) - Conclusions
For some patients, CBT offers a successful alternative to long-term drug treatment for preventing relapse.
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Evaluation of the cognitive model - research support
Suggests that everyone should be self sufficient - lays the blame for psychological problems w/the individual rather than the social environment.
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Evaluation of the cognitive model - irrational thinking
Research has shown that many people suffering from mental disorders do exhibit maladaptive thinking: Gustafson (1992) found that maladaptive thinking processes were displayed by many people with psychological disorders such as anxiety, depression etc
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Evaluation of the cognitive model - Individual is responsible
Model does not attempt to examine the origins of irrational thinking. Beck (1991) pointed out that although cognitive processes are involved in many psychological disorders, they may be a consequence rather than cause of the problem.
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Strengths of the cognitive model
Useful approach to disorders like depression + anorexia because it considers the role of thoughts, cognitive therapies can treat disorders, allows person to take control +make a +ve change, research supports approach.
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Weaknesses of cognitive approach
Faulty cognitions may be a consequence of a disorder rather than its cause, cognitive therapies may take a long time + can be costly, may be more effective when combined with other approaches, work better for some conditions than others, blamesPerson
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Psychodynamic approach
Views abnormal behaviour as being caused by unconscious, underlying psychological forces.
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3 parts of the personality according to Freud
1) id 2) ego 3) superego
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Id
The id is the 'pleasure principle', innate drive to do what we want to satisfy ourselves. Exists at birth.
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Ego
The ego exists in both the conscious and unconscious parts of the mind and acts as a rational part known as the 'reality principle'. Balances the id and superego to keep our behaviour in line.
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Superego
Exists in both the conscious and unconscious parts of our mind. This is the part of the mind that takes our morals into consideration.
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Strong ego?
Well-adjusted person develops a strong ego that is able to cope with the demands of both the id and the superego by allowing each expression at appropriate times.
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Unchecked id impulses?
They are expressed in destructiveness and immorality, which may result in conduct disorders in childhood and psychopathic behaviour in adulthood.
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Too powerful superego?
Restricts the id to such an extent that the person will be deprived of even socially acceptable pleasures (results in anxiety disorders e.g. phobias)
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Freud's stages of psychosexual development
1) Oral (0-18 months) 2) Anal (18months-3 years) 3) Phallic (3-6 years) 4) Latency (6 years to puberty) 5) Genital (Puberty to adult)
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Characteristics of each stage?
1) Oral - sucking behaviour 2) Anal - Keeping or discarding faeces 3) Phallic - Genital fixation (Oedipus complex) 4) Latency - Repressed sexual urges 5) Genital - Awakened sexual urges
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Little Hans
Phobia of horses - thought they might bite him - mum threatened castration - had dream he was married to his mum + dad was his granddad - According to Freud: Dad = horse, Oedipus complex (jealous of dad)
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Mechanisms to deal with conflict?
Repression, projection, denial, regression, displacement, sublimation.
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Repression?
Prevents unacceptable desires, motivations or emotions from becoming conscious, the repressed drives remain in the unconscious where they influence behaviour.
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Projection?
When people's own unacceptable faults or wishes are attributed to someone else.
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Denial?
People sometimes refuse to believe events or to admit they are experiencing certain emotions that provoke anxiety.
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Regression?
Sometimes people respond to anxiety by behaving in childish ways. People may regress to an earlier type of behaviour when they suffer a traumatic experience.
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Displacement?
Diverting emotions on to someone else because the emotions cannot be expressed to the person concerned.
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Sublimation?
Diverting emotions onto something else (rather than someone else).
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Freud's hydraulic theory?
The theory suggests that mental energy behaves in the same way as physical energy i.e. it can be stored, transformed, discharged, but never expressed. -ve emotions being repressed result in a build up of this psychic energy which develops disorders.
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Psychodynamic explanation of schizophrenia? - Fromm-Reichmann (1948)
Fromm-Reichmann suggested that in families who were characterised by high emotional tension+Secrecy, and with mothers who were domineering and cold in their attitude, children had a high risk of developing schizophrenia.
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Evaluation of the psychodynamic model?
Influential, untestable, retrospective data, determinist, ethical implications.
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Psychodynamic therapy - psychoanalysis
'talking cure' - Aim was to allow the patient to access repressed thoughts and unconscious conflicts
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3 aims of psychoanalysis
1) Bring repressed impulses + traumatic memories into conscious awareness 2) Facilitate insight into the conflicts and anxieties that are the underlying causes of abnormal behaviour 3) cure neurotic symptoms e.g. phobias
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4 main methods of psychoanalysis
1) Hypnosis 2) Free association 3) Dream analysis 4) Transference
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Hypnosis?
Deep relaxation. Freud gradually lost interest in hypnosis because he found it difficult to hypnotise people and found that people became very suggestible when hypnotised.
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Free association?
The patient is given a cue word and is asked to say any ideas or memories that come into their mind. Clients are encouraged to let their thought wonder and say whatever comes into their heads. The client then offers an interpretation of the words.
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Dream analysis?
The unconscious mind is revealed in dreams, so a treatment is analysing dreams. Freud believed that repressed thoughts are likely to appear in dreams.
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Transference?
The client projects on to the analyst the characteristics that are unconsciously associated with important people e.g. parents. Analyst stands in for them. Repeated experiences of this sort reveal repressed feelings. The analyst MUST remain neutral.
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Why must the analyst remain neutral during transference?
So that they do not get drawn into countertransference - showing their unconscious feelings towards their client.
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Fonagy (2000)
Reviewed several studies looking at people before + after psychoanalysis, found that treatment consistently helped those who had mild neurotic disorders (e.g. mild anxiety). Results less consistent for more serious disorders.
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Eysenck (1952)
Suggested that psychodynamic therapies incl. psychoanalysis were a waste of time and money.
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Bergin (1971)
Re-analysed Eysenck's data using different outcome criteria (for what counted as success or failure), results showed that 83% of those receiving psychanalysis improved compared 30% of those in control groups (waiting list).
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Corsini + Wedding (1995)
Success of psychotherapy ranges from 30-60% depending on the outcome criteria involved.
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Strengths of the psychodynamic approach
First theory to focus on psychological causes of disorders, offers methods of therapy which may also uncover unconscious conflicts which allows client to resolve them, unique approach to abnormality.
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Weaknesses of the psychodynamic approach
Subjective interpretations, hard to test scientifically, uncovered conflicts rely on patient memory (unreliable, inaccurate), distressing, focus is on client's past rather than present problems.
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Card 2

Front

Classical conditioning

Back

Unconditioned stimulus (e.g. loud noise), triggers a natural reflex (e.g. fear). UCS presented with another stimulus (neutral stimulus, e.g. a rat) triggers fears. Overtime, conditioned stimulus (rat) triggers fear (conditioned response).

Card 3

Front

Watson and Rayner (1920)

Back

Preview of the front of card 3

Card 4

Front

Evaluation of Watson and Rayner

Back

Preview of the front of card 4

Card 5

Front

Taste Aversions

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