Models of mental disorder

In the present context a ‘model’ means a view, or system of beliefs, about what causes mental disorders. Within psychology in general there are several different schools of thought, such as the behaviourist school and the psychodynamic or Freudian school, which offer competing explanations for most forms of behaviour.2 Given the complexity of human behaviour, it is quite likely that several different views will be valid, even if one is more useful in a particular case.

The same is true of mental disorders, but the models can be particularly influential in this area because not only do they offer competing explanations, they also suggest that different types of treatment will be suitable. We will expand on this in the next section. Historically, the main conflict has been between the religious and the medical approaches to mental disorder. For example, in the Middle Ages the religious movements of the time were responsible for many abnormal individuals being regarded as victims of demonic possession who were consequently burnt at the stake. Physicians, however, still adhered to the view of Hippocrates in the fourth century BC, who held that the origins of such problems were medical. It was not until the early part of the nineteenth century that the terms ‘madness’ and ‘lunacy’ began to be replaced by the term ‘mental disease’. ‘Lunatics’ became ‘patients’, and the asylum system became medicalised, aiming to cure rather than simply to confine.

The medical (or biomedical) model was therefore the first of the modern approaches to emerge. The main assumption of this model is that the behavioural symptoms of mental illness reflect an underlying disease process, in the same way that the symptoms of a physical illness do. The model is supported by three kinds of evidence: research into the effects of brain damage on behaviour; research into genetic influences on behaviour; and research into the links between abnormal behaviour and disordered communication systems in the nervous system.

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