Introduction
Scientists use different perspectives to understand and explain occurrences and events. These perspectives used in the interpretation of events are known as paradigms or models. Models have a fundamental influence on what investigators view and the questions they ask, information sort after, and how information obtained is perceived. Until recently, many scientists and psychologists tended to agree on a single model of abnormality, which was greatly influenced by cultural beliefs known as “The Demonological model”. This model was mainly used to interpret abnormal functioning during the middle ages. Most of its concepts and assumptions were borrowed from medieval society and were mainly concerned with religion, superstition, and warfare.
In the modern world, several models have been advanced to explain and treat abnormal functioning. These models emanated from a change in thought, values, beliefs, and improvement in scientific and clinical research over the past five decades. These models include biological, psychodynamic, behavioral, and social-cultural models among others. The models are sometimes in conflict due with respect to different concepts, assumptions, and beliefs.
Models and paradigms used in diagnosis
Scholars, who subscribe to the biological school of thought hold that physical processes are fundamental to human behavior. Proponents of this model argue that abnormal functioning is a disorder brought about by the malfunctioning of body parts of an individual. Disorders in the brain anatomy are the major causes of abnormal behavior. The brain is comprised of billions of nerve cells known as neurons, which control important brain functions. Medical research has shown relationships between certain psychological disorders and problems in the brain. For instance, the Huntington disease is associated with violent, emotional outbursts; loss of memory; tendency to commit suicide; inability to control body movements and absurd beliefs. This is often linked to loss of cells in the basal ganglia. Researchers have also observed that psychological disorders can emanate from problems in transmission of messages between neurons (Comer, 2011).
The psychodynamic model is the earliest and most famous among the modern models. Proponents of this school of thought believe that an individual’s behavior is greatly determined by underlying dynamic psychological factors that are unconscious. These forces interact with each other resulting into behavior, thoughts and emotions. Psychological conflict stems from past experiences tied to relationships and traumatic events during childhood. The general assumption is deterministic in its approach meaning that no symptom or behavior is accidental; behavior is determined by past experiences. This school of thought was first propounded by Sigmund Freud during the 20th century. He believed that there are three factors that determine personality. This includes instinctual needs, rational thinking, and moral standards that operate at the unconscious level. He further named the forces as id, ego and the super ego. The id works to seek gratification to instinctual needs such as drives and impulses fueled by sexual energy also known as libido. The ego seeks gratification but on the reality principle thus making use of reason and rationale. The super ego develops from the ego. In this case, children learn from their parents that the id impulses are not accepted, and they adopt their parents’ values. A major disadvantage associated with this model is that its concepts are difficult to research (Comer, 2011).
The social cultural school notes that understanding behavior can be approached from a holistic perspective. The society has a broad spectrum of forces that influence the individual’s behavior. The social cultural model has two perspective including family social perspective and multicultural perspective. Social perspective emphasizes on the broad factors that operate on a normal basis such as family relationships, social interactions and community events. These forces determine normal and abnormal behavior focusing on three main factors: social labels and roles, social networks, and family structure and communication. The multicultural perspective holds that human behavior can be understood when viewed from the cultural context (Comer, 2011).
Marla’s diagnosis
Marla is a 42 year old female of Spanish origin. She came to the mental clinic showing several symptoms that included lack of concentration, difficulty in sleeping, and she complained of having persistent feelings of moodiness. She is employed as an accountant and has complained that she is unable to discharge her duties efficiently. She has been diagnosed with major depression.
According to the DSM IV report, major depression is exhibited by several symptoms. These include mood swings, fluctuations in weight with no change in diet, lack of appetite, lack of interest in one’s own hobbies, lack of sleep, sluggish behaviors, feelings of self guilt, suicidal feelings and loss of reasoning ability.
Marla’s initial interview revealed significant information about her personal life and history. She revealed that she regularly visited a medical practitioner. However, it is not clear if her physician diagnosed any medical issues that could have resulted to her symptoms. In addition, it is not clear whether these symptoms are caused by lack of sleep. The options of family and relationships were also evaluated. She was asked questions about how the perceived symptoms affected her. She was also asked about the period or duration that she has been experiencing these symptoms. Additionally, she was asked if she has had prior diagnosis of depression before hand.
Marla’s interview only reveals three symptoms that lead to diagnosis of major depression. However, on further questioning, it was revealed that apart from lack of sleep, loss of thinking abilities, and sluggish and violent behavior, she also encountered other symptoms. This included lack of appetite, drastic change in weight, and loss of interests in her hobbies. Marla went on to state that she has experienced these symptoms for the past four weeks. In addition, she has never had such feelings in her life. It has become a challenge to do her daily activities such as bathing and eating. When questioned on her cultural background, she insists that her culture and religious beliefs do not tolerate suicide. She continues to say that she would never contemplate killing her self. Her interview did not reveal sources of these symptoms. She even denied having experienced a traumatic event over the past six months. She has also not mourned anyone within the past year. She is optimistic and determined to be prepared so as to get well.
For Marla, each day starts and ends in lows. Major depression does not only affect the mood, but also the cognitive ability. It distorts the ability of the brain to think and make decisions. Thoughts are usually negative and clouded, and there is a lack of mood and motivation. In addition, there is change in behavior including, sleep disorders, eating disorders, persistent crying and rejection of family and friends. Depression leads to lack of interest in personal hobbies, friends and family. This may extend to include other activities. Such symptoms may persist for quite some time.
Scientists have not yet identified the causes of depression, but several theories have been advanced to this effect. Studies carried out on twins strongly support the theory of hereditary genes. The genes are said to contribute to depression tendencies. Research has shown a correlation between major depression and insensitivity to neurotransmitters. The use of modern technology such as the PET scan show differences in brain functioning among those with major depression and those without depression. However, the exact cause of these disparities has not been proven. Research suggests that physiological factors, previous life experiences, individual personality, society’s culture and cognitive ability are largely related to genetic make up of individuals who suffer from major depression.
In this case, the social cultural model is highly recommended as a form of treatment. This is because research has revealed that individuals from minority groups abandon therapy earlier than those from other groups. This is mainly due to the inability of the therapist to address unique challenges facing minority groups. Research shows that social cultural models are effective because they are sensitive to cultural morals. The social cultural model addresses certain issues that challenge minority groups (Comer, 2011).
Conclusion
Marla should join a support group that will meet her special cultural needs to enhance her compliance with the therapy. She should access group therapy at least every fortnight. In addition, Marla should attend frequent family therapy sessions together with her family members. The combination of the group and gender sensitive therapy models will produce the best results in Marla’s case.
Reference
Comer, R. J. (2011). Fundamentals of abnormal psychology. New York: Worth Publishers.