THEORIES AND MODELS OF

MENTAL ILLNESS
 What is a Theory?
• A theory is a set of interrelated concepts, definitions
and propositions that present a systematic view of
events or situations by specifying relations among
variables, in order to explain and predict the events or
situations” (Kerlinger, 1986, p. 9).
• “A theory is a set of ideas that provides a framework
for asking questions about a phenomenon and for
gathering and interpreting information about that
phenomeon”(Nolen-Hoeksema, 2011, p.27).
 What is a Model?
• Models draw on a number of theories
to help understand a specific problem
in a particular setting or context”
(Glanz et al., 2008, p.29)
• A set of related theories that helps in
explaining a phenomenon
 Models of Mental Illness
• Biological Model
• Psychological Model
• Socio-cultural Model
• Diathesis-Stress Model
• Bio-psychosocial(s) Model
 Biological Model
• Biological theories of psychopathology typically attribute
symptoms to structural abnormalities in the brain,
disordered biochemistry, or faulty genes.
• Structural abnormalities in the brain can be caused by faulty
genes, by disease, or by injury. Which particular area of the
brain is damaged influences the symptoms individuals show.
• Many biological theories attribute psychopathology to
imbalances in neurotransmitters or to the functioning of
receptors for neurotransmitters.
• Genetic theories of abnormality usually suggest that it takes
an accumulation of faulty genes to cause a psychopathology.
 Biological Model cont’d
• Genes can influence the environments people
choose, which then influence the expression of
genetic tendencies. Epigenetics is the study of how
environmental conditions can influence the
expression of genes.
• Biological therapies most often involve drugs
intended to regulate the functioning of the brain
neurotransmitters associated with a psychological
disorder or to compensate for structural brain
abnormalities or the effects of genetics.
 Biological Model cont’d
• Antipsychotic medications help reduce unreal
perceptual experiences, unreal beliefs, and other
symptoms of psychosis. Antidepressant drugs help
reduce symptoms of depression. Lithium and
anticonvulsants help reduce mania. Barbiturates
and benzodiazepines help reduce anxiety.
• Electroconvulsive therapy is used to treat severe
depression. Psychosurgery is used in rare
circumstances.
 Psychological Model
• Psychodynamic theories
• Behavioural theories
• Cognitive theories
• Humanistic theories
 Psychological Model
• Psychodynamic theories
• Behavioural theories
• Cognitive theories
• Humanistic theories
 Psychological Model cont’d
• Psychodynamic theories of psychopathology focus on
unconscious conflicts that cause anxiety in the
individual and result in maladaptive behavior.
• Freud argued that these conflicts arise when the
libidinal impulses of the id clash with the constraints on
behavior imposed by the ego and superego. People use
various types of defense mechanisms to handle their
internal conflicts.
• How caregivers handle children’s transitions through
the psychosexual stages determines the concerns or
issues the children may become fixated on.
 Psychological model cont’d
• More recent psychodynamic theorists focus less on the
role of unconscious impulses and more on the
development of the individual’s self concept in the
context of interpersonal relationships. They see a greater
role for the environment in shaping personality and have
more hope for change during adulthood than Freud had.
• Psychodynamic therapy focuses on unconscious conflicts
that lead to maladaptive behaviors and emotions.
Interpersonal therapies are based on psychodynamic
theories but focus more on current relationships and
concerns.
 Psychological model cont’d
• The behavioral theories of mental illness reject notions of
unconscious conflicts and focus only on the rewards and
punishments in the environment that shape and maintain behavior.
• Classical conditioning takes place when a previously neutral stimulus
is paired with a stimulus that naturally creates a certain response;
eventually, the neutral stimulus also will elicit the response.
• Operant conditioning involves rewarding desired behaviors and
punishing undesired behaviors.
• People also learn by imitating the behaviors modeled by others and
by observing the rewards and punishments others receive for their
behaviors.
• Behavior therapies focus on changing specific maladaptive behaviors
and emotions by changing the reinforcements for them.
 Psychological model cont’d
• Cognitive theories suggest that people’s
cognitions (e.g., attributions for events, global
assumptions) influence the behaviors and
emotions with which they react to situations.
• Remember the 15styles of distorted thinking?
• Cognitive therapies focus on changing the way
a client thinks about important situations. This
is referred to as cognitive restructuring.
 Psychological model cont’d
• Humanistic theories suggest that all humans strive to
fulfill their potential for good and to self - actualize.
The inability to fulfill one’s potential arises from the
pressures of society to conform to others’
expectations and values.
• Its emphasis is thus, on growth and self-actualization
rather than on curing diseases or alleviating
disorders. The humanistic theorists do not believe in
labeling people. Humanistic therapies seek to help a
client realize his or her potential for self-actualization.
 Socio-cultural Model
• Sociocultural theories suggest that socioeconomic stress,
discrimination, and social upheaval can lead to mental
health problems in individuals.
• Cultures also have implicit and explicit rules regarding the
types of abnormal behavior they permit. Some clients may
wish to work with therapists of the same culture or gender,
but it is unclear whether matching therapist and client in
terms of culture and gender is necessary for therapy to be
effective.
• It is important that therapists be sensitive to the influences
of culture and gender on a client’s attitudes toward therapy
and toward various solutions to problems.
 Contemporary Models
• Biopsychosocial model
• Diathesis-stress model
• Many contemporary theorists, however, take a bio-psychosocial
approach to disorders, recognizing that it often takes a combination
of biological, psychological, and sociocultural factors to result in the
development of a specific disorder.
• People may carry a diathesis , or vulnerability, for a particular
disorder. This vulnerability can be a biological one, such as a genetic
predisposition to the disorder. It may also be a psychological one,
such as a personality trait that increases the person’s risk of
developing the disorder. Or it may be a sociocultural one, such as
growing up with the stress of discrimination based on ethnicity or
race.
 Contemporary Models cont’d
But in many cases, the vulnerability or diathesis may
not be enough to lead to a disorder. For the person to
actually develop the disorder, he or she has to
experience some type of stress, or trigger.
Again, this trigger can be a biological one, such as an
illness that changes the person’s balance of certain
hormones. Or the trigger can be a psychological or
social one, such as a traumatic event. Only when the
diathesis and the stress come together in the same
individual does the full-blown disorder emerge. These
are known as diathesis-stress models
 Critical Thinking
Read the following case study about Ama. Then explain the causes of her symptoms
according to three different approaches: the biological approach, at least one of the
psychological approaches, and the sociocultural approach. Ama was born to a 16-year-
old mother who was addicted to alcohol and multiple illegal drugs. While Ama’s
mother tried to stop using alcohol and drugs after Ama was born, the addiction proved
too powerful. She lost custody of Ama because of her continued substance abuse and
her neglect and abuse of her daughter. While her mother returned to the streets, Ama
went from foster home to foster home. Some of the families were loving people who
did their best to calm Ama during her frequent temper tantrums, while other families
became abusive when she acted out. Ama did very poorly in school. She was always
daydreaming and seldom did any of her homework, finding it impossible to
concentrate long enough to read and retain material. On top of that, Ama was
constantly in trouble for being aggressive toward other students or skipping classes to
smoke cigarettes with some of the other students. When Ama reached puberty, she
became self-destructive, sometimes cutting herself with razors and twice attempting
to kill herself. She was forced to see therapists, and she told them that she was “no
good” and “defective” and that she wanted to die.