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Models of abnormality are general hypotheses as to the nature of psychological abnormalities. The four main models to explain psychological abnormality are the biological, behavioural, cognitive, and psychodynamic models. They all attempt to explain the causes and treatments for all psychological illnesses, and all from a different approach.
The biological model of abnormality (the only model not based on psychological principles) is based on the assumptions that if the brain, neuroanatomy and related biochemicals are all physical entities and work together to mediate psychological processes, then treating any mental abnormality must be physical/biological. Part of this theory stems from much research into the major neurotransmitter, serotonin, which seems to show that major psychological illnesses such as bipolar disorder and anorexia nervosa are caused by abnormally reduced levels of Serotonin in the brain.(1) The model also suggests that psychological illness could and should be treated like any physical illness (being caused by chemical imbalance, microbes or physical stress) and hence can be treated with surgery or drugs. Electroconvulsive therapy has also proved to be a successful short-term treatment for depressive symptoms of bipolar disorder and related illnesses, although the reasons for its success are almost completely unknown. There is also evidence for a genetic factor in causing psychological illness.(2) (3). The main cures for psychological illness under this model: electroconvulsive therapy, drugs, and surgery at times can have very good results in restoring "normality" as biology has been shown to play some sort of role in psychological illness. However they can also have consequences, whether biology is responsible or not, as drugs always have a chance of causing allergic reactions or addiction. Electrotherapy can cause unnecessary stress and surgery can dull the personality, as the part of the brain responsible for emotion (hypothalamus) is often altered or even completely removed.
A diagnosis of mental 'illness' implies that a person is in no way responsible for the abnormality of functioning and as such is not to blame. The concept of 'no blame' is generally thought to be more humane and likely to elicit a much more sympathetic response from others.
However, Zarate (1972), pointed out that even more than physical illness, mental illness is something that people fear – largely because it is something they do not understand. In general, people do not know how to respond to someone diagnosed as mentally ill. There may also be fears that the person's behaviour might be unpredictable or potentially dangerous. Therefore, sympathy is more likely to give way to the avoidance of the person, which in turn leads to the person feeling shunned.
A huge amount of research has been carried out within the framework of the medical model and this has greatly increased our understanding of the possible biological factors underpinning psychological disorders. However, much of the evidence is inconclusive and findings can be difficult to interpret. For example, in family studies, it is difficult to disentangle the effects of genetics from the effects of the environment. It can also be difficult to establish cause and effect. For example, raised levels of dopamine may be a consequence rather than a cause of schizophrenia.
Many psychologists criticise psychiatry for focusing its attention primarily on symptoms and for assuming that relieving symptoms with drugs cures the problem. Unfortunately, in many cases when the drug treatment is ceased the symptoms recur. This suggests that drugs are not addressing the true cause of the problem. [1]
The behavioural model assumes that all maladaptive behaviour is essentially acquired through one's environment. Therefore, psychiatrists practising the beliefs of this model would prioritise changing behaviour over identifying the cause of the dysfunctional behaviour. The main solution to psychological illness under this model is aversion therapy, where the stimulus that provokes the dysfunctional behaviour is coupled with a second stimulus, with aims to produce a new reaction to the first stimulus based on the experiences of the second. Also, systematic desensitisation can be used, especially where phobias are involved by using the phobia that currently causes the dysfunctional behaviour and coupling it with a phobia that produces a more intense reaction. This is meant to make the first phobia seem less fearsome etc. as it has been put in comparison with the second phobia. This model seems to have been quite successful, where phobias and compulsive disorders are concerned, but it doesn't focus on the cause of the illness or problem, and so risks recurrence of the problem.
The behavioural model overcomes the ethical issues raised by the medical model of labeling someone as 'ill' or 'abnormal'. Instead, the model concentrates on behaviour and whether it is 'adaptive' or 'maladaptive'. The model also allows individual and cultural differences to be taken into account. Provided the behaviour is presenting no problems to the individual or to other people, then there is no need to regard the behaviour as a mental disorder. Those who support the psychodynamic model, however, claim the behavioural model focuses only on symptoms and ignores the causes of abnormal behaviour. They claim that the symptoms are merely the outward expression of deeper underlying emotional problems. Whenever symptoms are treated without any attempt to ascertain the deeper underlying problems, then the problem will only manifest itself in another way, through different symptoms. This is known as symptom substitution. Behaviourists reject this criticism and claim that we need not look beyond the behavioural symptoms as the symptoms are the disorder. Thus, there is nothing to be gained from searching for internal causes, either psychological or physical. Behaviourists point to the success of behavioural therapies in treating certain disorders. Others note the effects of such treatments are not always long-lasting. Another criticism of the behavioural model is the ethical issues it raises. Some claim the therapies are dehumanising and unethical. For example, aversion therapy has been imposed on people without consent.
The cognitive model of abnormality focuses on the cognitive distortions or the dysfunctions in the thought processes and the cognitive deficiencies, particularly the absence of sufficient thinking and planning. [2] This model holds that these variables are the cause of many psychological disorders and that psychologists following this outlook explain abnormality in terms of irrational and negative thinking [2] with the main position that thinking determines all behaviour. [3]
The cognitive model of abnormality is one of the dominant forces in academic psychology beginning in the 1970s and its appeal is partly attributed to the way it emphasizes the evaluation of internal mental processes such as perception, attention, memory, and problem-solving. The process allows psychologists to explain the development of mental disorders and the link between cognition and brain function especially to develop therapeutic techniques and interventions. [4]
When it comes to the treatment of abnormal behavior or mental disorder, the cognitive model is quite similar to the behavioural model but with the main difference that, instead of teaching the patient to behave differently, it teaches the patient to think differently. It is hoped that if the patient's feelings and emotions towards something are influenced to change, it will induce external behavioural change. Though similar in ways to the behavioural model, therapists working with this model use differing methods for cures. One key assumption in cognitive therapy is that treatment should include helping people restructure their thoughts so that they think more positively about themselves, their life, and their future. [3]
One of the main treatments is rational emotive therapy (RET), which is based on the principle that an "activating" emotional event will cause a change in thoughts toward that situation, even if it is an illogical thought. So with this therapy, it is the therapist's job to question and change the irrational thoughts. It is similar to the behavioural model where its success is concerned, as it has also proved to be quite successful in the treatment of compulsive disorders and phobias. Although it does not deal with the cause of the problem directly, it does attempt to change the situation more broadly than the behavioural model. Due to their respective characteristics and similarities, there are instances when psychologists combine cognitive and behavioural models to treat mental disorders. [4]
The psychodynamic model is the fourth psychological model of abnormality and is based on the work of Sigmund Freud. It is based on the principles that psychological illnesses come about from repressed emotions and thoughts from experiences in the past (usually childhood), and as a result of this repression, alternative behaviour replaces what is being repressed. The patient is believed to be cured when they can admit that which is currently being repressed (4). The main cure for illnesses under this model is free association where the patient is free to speak while the psychiatrist notes down and tries to interpret where the trouble areas are. This model can be successful, especially where the patient feels comfortable to speak freely and about issues that are relevant to a cure.
Anxiety is an emotion which is characterised by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different from fear in that fear is defined as the emotional response to a present threat, whereas anxiety is the anticipation of a future one. It is often accompanied by nervous behavior such as pacing back and forth, somatic complaints, and rumination.
Psychoanalysis is a set of theories and therapeutic techniques that deal in part with the unconscious mind, and which together form a method of treatment for mental disorders. The discipline was established in the early 1890s by Sigmund Freud, whose work stemmed partly from the clinical work of Josef Breuer and others. Freud developed and refined the theory and practice of psychoanalysis until his death in 1939. In an encyclopedic article, he identified the cornerstones of psychoanalysis as "the assumption that there are unconscious mental processes, the recognition of the theory of repression and resistance, the appreciation of the importance of sexuality and of the Oedipus complex." Freud's colleagues Alfred Adler and Carl Gustav Jung developed offshoots of psychoanalysis which they called individual psychology (Adler) and analytical psychology (Jung), although Freud himself wrote a number of criticisms of them and emphatically denied that they were forms of psychoanalysis. Psychoanalysis was later developed in different directions by neo-Freudian thinkers, such as Erich Fromm, Karen Horney, and Harry Stack Sullivan.
Hypochondriasis or hypochondria also known as syndrome is a condition in which a person is excessively and unduly worried about having a serious illness. Hypochondria is an old concept whose meaning has repeatedly changed over its lifespan. It has been claimed that this debilitating condition results from an inaccurate perception of the condition of body or mind despite the absence of an actual medical diagnosis. An individual with hypochondriasis is known as a hypochondriac. Hypochondriacs become unduly alarmed about any physical or psychological symptoms they detect, no matter how minor the symptom may be, and are convinced that they have, or are about to be diagnosed with, a serious illness.
Abnormal psychology is the branch of psychology that studies unusual patterns of behavior, emotion, and thought, which could possibly be understood as a mental disorder. Although many behaviors could be considered as abnormal, this branch of psychology typically deals with behavior in a clinical context. There is a long history of attempts to understand and control behavior deemed to be aberrant or deviant, and there is often cultural variation in the approach taken. The field of abnormal psychology identifies multiple causes for different conditions, employing diverse theories from the general field of psychology and elsewhere, and much still hinges on what exactly is meant by "abnormal". There has traditionally been a divide between psychological and biological explanations, reflecting a philosophical dualism in regard to the mind–body problem. There have also been different approaches in trying to classify mental disorders. Abnormal includes three different categories; they are subnormal, supernormal and paranormal.
Kleptomania is the inability to resist the urge to steal items, usually for reasons other than personal use or financial gain. First described in 1816, kleptomania is classified in psychiatry as an impulse control disorder. Some of the main characteristics of the disorder suggest that kleptomania could be an obsessive-compulsive spectrum disorder, but also share similarities with addictive and mood disorders.
Psychopathology is the study of abnormal cognition, behaviour, and experiences which differs according to social norms and rests upon a number of constructs that are deemed to be the social norm at any particular era.
Psychodynamic psychotherapy and psychoanalytic psychotherapy are two categories of psychological therapies. Their main purpose is revealing the unconscious content of a client's psyche in an effort to alleviate psychic tension, which is inner conflict within the mind that was created in a situation of extreme stress or emotional hardship, often in the state of distress. The terms "psychoanalytic psychotherapy" and "psychodynamic psychotherapy" are often used interchangeably, but a distinction can be made in practice: though psychodynamic psychotherapy largely relies on psychoanalytical theory, it employs substantially shorter treatment periods than traditional psychoanalytical therapies. Psychodynamic psychotherapy is evidence-based; the effectiveness of psychoanalysis and its relationship to facts is disputed.
Biological psychiatry or biopsychiatry is an approach to psychiatry that aims to understand mental disorder in terms of the biological function of the nervous system. It is interdisciplinary in its approach and draws on sciences such as neuroscience, psychopharmacology, biochemistry, genetics, epigenetics and physiology to investigate the biological bases of behavior and psychopathology. Biopsychiatry is the branch of medicine which deals with the study of the biological function of the nervous system in mental disorders.
Substance dependence, also known as drug dependence, is a biopsychological situation whereby an individual's functionality is dependent on the necessitated re-consumption of a psychoactive substance because of an adaptive state that has developed within the individual from psychoactive substance consumption that results in the experience of withdrawal and that necessitates the re-consumption of the drug. A drug addiction, a distinct concept from substance dependence, is defined as compulsive, out-of-control drug use, despite negative consequences. An addictive drug is a drug which is both rewarding and reinforcing. ΔFosB, a gene transcription factor, is now known to be a critical component and common factor in the development of virtually all forms of behavioral and drug addictions, but not dependence.
Pain disorder is chronic pain experienced by a patient in one or more areas, and is thought to be caused by psychological stress. The pain is often so severe that it disables the patient from proper functioning. Duration may be as short as a few days or as long as many years. The disorder may begin at any age, and occurs more frequently in girls than boys. This disorder often occurs after an accident, during an illness that has caused pain, or after withdrawing from use during drug addiction, which then takes on a 'life' of its own.
Behavioral medicine is concerned with the integration of knowledge in the biological, behavioral, psychological, and social sciences relevant to health and illness. These sciences include epidemiology, anthropology, sociology, psychology, physiology, pharmacology, nutrition, neuroanatomy, endocrinology, and immunology. The term is often used interchangeably, but incorrectly, with health psychology. The practice of behavioral medicine encompasses health psychology, but also includes applied psychophysiological therapies such as biofeedback, hypnosis, and bio-behavioral therapy of physical disorders, aspects of occupational therapy, rehabilitation medicine, and physiatry, as well as preventive medicine. In contrast, health psychology represents a stronger emphasis specifically on psychology's role in both behavioral medicine and behavioral health.
Mental disorders are classified as a psychological condition marked primarily by sufficient disorganization of personality, mind, and emotions to seriously impair the normal psychological and often social functioning of the individual. Individuals diagnosed with certain mental disorders can be unable to function normally in society. Mental disorders may consist of several affective, behavioral, cognitive and perceptual components. The acknowledgement and understanding of mental health conditions has changed over time and across cultures. There are still variations in the definition, classification, and treatment of mental disorders.
Medical model is the term coined by psychiatrist R. D. Laing in his The Politics of the Family and Other Essays (1971), for the "set of procedures in which all doctors are trained". It includes complaint, history, physical examination, ancillary tests if needed, diagnosis, treatment, and prognosis with and without treatment.
Mysophobia, also known as verminophobia, germophobia, germaphobia, bacillophobia and bacteriophobia, is a pathological fear of contamination and germs. It is classified as a type of specific phobia, meaning it is evaluated and diagnosed based on the experience of high levels of fear and anxiety beyond what is reasonable when exposed to or in anticipation of exposure to stimuli related to the particular concept. William A. Hammond first coined the term in 1879 when describing a case of obsessive–compulsive disorder (OCD) exhibited in repeatedly washing one's hands.
In applied psychology, interventions are actions performed to bring about change in people. A wide range of intervention strategies exist and they are directed towards various types of issues. Most generally, it means any activities used to modify behavior, emotional state, or feelings. Psychological interventions have many different applications and the most common use is for the treatment of mental disorders, most commonly using psychotherapy. The ultimate goal behind these interventions is not only to alleviate symptoms but also to target the root cause of mental disorders.
Exposure therapy is a technique in behavior therapy to treat anxiety disorders.
Panic disorder is a mental and behavioral disorder, specifically an anxiety disorder characterized by reoccurring unexpected panic attacks. Panic attacks are sudden periods of intense fear that may include palpitations, sweating, shaking, shortness of breath, numbness, or a feeling that something terrible is going to happen. The maximum degree of symptoms occurs within minutes. There may be ongoing worries about having further attacks and avoidance of places where attacks have occurred in the past.
Somatic symptom disorder, also known as somatoform disorder, is defined by one or more chronic physical symptoms that coincide with excessive and maladaptive thoughts, emotions, and behaviors connected to those symptoms. The symptoms are not deliberately produced or feigned, and they may or may not coexist with a known medical ailment.
Chronophobia, also known as prison neurosis, is considered an anxiety disorder describing the fear of time and time moving forward, which is commonly seen in prison inmates. Next to prison inmates, chronophobia is also identified in individuals experiencing quarantine due to COVID-19. As time is understood as a specific concept, chronophobia is categorized as a specific phobia.
Metacognitive therapy (MCT) is a psychotherapy focused on modifying metacognitive beliefs that perpetuate states of worry, rumination and attention fixation. It was created by Adrian Wells based on an information processing model by Wells and Gerald Matthews. It is supported by scientific evidence from a large number of studies.