Clinical Psychology

Stigma is also a major reason people do not seek
treatment for mental distress (Corrigan, 2004). Too
often, diagnosis seems to obscure the real person;
observers see labels, not the real people behind
them. Thus, labels can damage relationships, prevent
people from being hired or promoted or from seek-
ing treatment, and in extreme cases, result in a loss of
civil rights. Labels can even encourage some people
to capitulate and assume the role of a“sick”person.

Causes of Abnormal Behavior and Mental Illness

Up to this point, we have discussed issues regarding
the description and definition of abnormal behavior
as well as the implications of diagnosing and classi-
fying individuals. However, very little has been said
about what factors may cause abnormal behavior
and mental illness. Although we will discuss various
etiological models of psychopathologyin the chapters on
intervention, it is useful to present these models
briefly here to give you some idea of the predomi-
nant viewpoints.

Major Models of Psychopathology

Table 5-8 presents a brief overview of major mod-

els of psychopathology and the explanation of

abnormal behavior offered by each. As can be

seen, some of the etiological models are quite dif-

ferent in their perspective on abnormal behavior.

We will discuss these models in more detail later

in the book, in the context of clinical interventions

(Chapters 11–15) and specialties in clinical psychol-

ogy (Chapters 16–19). As we will see, differences

among the models have implications for how a cli-

nician adhering to one of these viewpoints will

conduct assessment and treatment. For example, a

clinical psychologist subscribing to a cognitive the-

ory of depression will probably use cognitively

based assessment instruments to identify maladap-

tive cognitions as well as cognitive-behavioral inter-

ventions to treat depression (see Chapter 14).

Diathesis-Stress Model

A more general model of etiology that can accom-

modate a variety of theoretical viewpoints (e.g.,

those in Table 5-8) is the diathesis-stress model of

psychopathology. The diathesis-stress model is not

T A B L E 5-8 Brief Description of Several Models of Psychopathology

Model Explanation Example of Abnormal Behavior

Biological Processes in central nervous system (CNS) have
gone awry

Schizophrenia is caused by an excess of

dopaminergic activity.

Developmental
Psychopathology

Maladjustment arises from a distortion in the

path or trajectory in healthy adaptation;

maladjustment is due to interactions between

the individual and their environment

Depression is caused by interpersonal stressors

that make it hard to learn appropriate coping

skills, and depression cyclically leads to later

additional interpersonal stressors

Psychodynamic Intrapsychic conflict Specific phobia is due to the displacement of an
intrapsychic conflict onto an external object that
can then be avoided.

Learning Learned the same way normal behavior is
learned

Specific phobia is learned via classical

conditioning.

Cognitive Due to maladaptive cognitions Depression results from negative views about
oneself, the world, and the future.

Humanistic Relative neglect of one’s own self-view and
overreliance on the appraisals of others when
the two are incongruous

Generalized anxiety disorder reflects this over-

reliance and incongruity.

DIAGNOSIS AND CLASSIFICATION OF PSYCHOLOGICAL PROBLEMS 153