Chapter 2 An Integrative Approach to Psychopathology

1. Chapter 2An Integrative Approach to Psychopathology

2. Models of Approach • One-Dimensional Models • Single cause, operating in isolation • Ignores critical information • Multidimensional Models • Systemic • Several independent inputs that become interdependent • Causes cannot be considered out of context

3. Components of Multidimensional Models • Biological Factors • Behavioral Factors • Cognitive Factors • Emotional Influences • Social Factors • Developmental Factors • All of these interact interdependently

4. Biology: The Influence of Genes • What are genes? • Functional sections of DNA located on chromosomes • How do they influence our risk for psychopathology? • Increase or decrease risk for psychopathology • Polygenetic influences • Multiple genes interact • Often interact with environmental factors • Example: nutrition and height

5. The Study of Genes and Behavior • Quantitative genetics accounts for the effects of several genes on a phenotype • Estimates “heritability,” but does not influence measuring genes • Relies on twin-studies, mostly • Molecular genetics accounts for the influence of specific genes • Involves measuring specific genes and determining their specific influence • DNA collected via saliva, blood, or cheek cells

6. How Else Do Genes Contribute to Psychopathology? Diathesis-Stress model: • Diathesis: • Inherited tendency to express traits/behaviors • Usually genetic • Stress: • Life events or contextual variables • Environmental • Effects of stress (environment) on psychopathology depend on one’s diathesis (genes) • Genes can make a person more or less susceptible to negative effects of environment

7. The Diathesis-Stress Model: Illustration

8. Diathesis-Stress: Serotonin, maltreatment and risk for depression (Caspi et al., 2003)

9. Diathesis-Stress: Cross-fostering • Cross fostering studies of development • Reactive young animals raised by calm mothers overrides genetic risk for “behavioral problems” in adulthood

10. How Else Do Genes Contribute to Psychopathology? Reciprocal Gene-Environment Model • Genes shape how we create our environments • Inherited predispositions or traits • that increase one’s likelihood to engage in activities or seek out situations • Example: divorce

11. How Else Do Genes Contribute to Psychopathology? Epigenetics: Environments affect gene expression • Activation of dormant genes • http://www.youtube.com/watch?v=Fj4d-9Jgl6g

12. Biology: Neuroscience and Psychopathology • The Field of Neuroscience • The role of the nervous system in disease and behavior • Human Nervous System (2 Branches) • CNS • Brain and spinal cord • PNS • Somatic and autonomic branches

13. Overview: Neuroscience and Brain Structure • Two main parts: • Brain stem – basic functions • Forebrain –higher cognition

14. Divisions of the Brain Stem • Hindbrain • Medulla – Heart rate, blood pressure, respiration • Pons – Regulates sleep stages • Cerebellum –physical coordination • Midbrain • Coordinates movement with sensory input • Contains parts of the reticular activating system (RAS)

15. Brain Stem and Forebrain Connections • Thalamus and hypothalamus • Relays between brain stem and forebrain • Behavioral and emotional regulation • Limbic system • Emotions, basic drives, impulse control • Strong links with psychopathology • Basal ganglia • Motor activity • http://www.g2conline.org/?gclid=CIa4pvrL47YCFQNlMgodOG0ACw

16. Divisions of the Forebrain • Forebrain (Cerebral Cortex) • Most sensory, emotional, and cognitive processing • Two specialized hemispheres • Left – verbal, math, logic • Right – perceptual

17. Neuroscience and the Brain Structure • Lobes of the Cerebral Cortex • Frontal • Thinking and reasoning abilities, memory • Temporal • Sight and sound recognition, long-term memory storage • Parietal • Touch recognition • Occipital • Integrates visual input

18. Major Structures of the Brain

19. Neuroscience: The Peripheral Nervous System • PNS - Somatic • Voluntary muscles and movement • PNS - Autonomic • Sympathetic (activating) • E.g., increase heart rate • Parasympathetic (normalizing) • E.g., decrease heart rate • Both divisions regulate: • Cardiovascular system/body temperature • Endocrine system/digestion

21. Neuroscience: The Peripheral Nervous System • The Endocrine System • Hormones • The Hypothalamic-Pituitary-Adrenalcortical Axis (HPA axis) • Integration of endocrine and nervous system • Involved in stress response e.g., fight or flight

22. Neurons • The Neuron (aka nerve cells)- basic building block of nervous system • Soma • Dendrites • Axon • Axon terminals • Synaptic cleft • Function: Electrical • Communication: Chemical • Neurotransmitters

23. Neurotransmitters

24. Neurotransmitters • Gamma aminobutyric acid (GABA) GABA – inhibitory • Implicated in anxiety and its treatment • Benzodiazepines are tranquilizers that act as GABA agonists. • Agonist vs. antagonist. • http://www.youtube.com/watch?v=-pfG6yHAQ5U • Norepinephrine • Respiration, reactions, alarm response • Implicated in panic

25. Neurotransmitters • Serotonin • Regulates behavior, moods, thought processes • Implicated in depression and many other forms of psychopathology • Dopamine • Implicated in schizophrenia • Also associated with reward processing and impulsivity

26. Medication Effects on Serotonin

27. Neuroscience and Psychopathology • Psychosocial influences on the brain • Psychotherapy and functional normalization in OCD

28. Cognitive Approaches • cognitive approaches: identification and modification of maladaptive thoughts • Aaron Beck (cognitive therapy) • Albert Ellis (rational emotive behavior therapy) Thoughts Emotions Situation Behavior

29. Behavioral and Cognitive Sciences • Learned helplessness (Seligman) • Implicated in depression and anxiety • Relates to one’s belief that they are not in control

30. The Role of Emotion in Psychopathology • Emotions and links to psychopathology • Fear – panic • Worry – anxiety • Sadness – depression • Happiness – mania • Anger – aggression • Sometimes considered to be different from mood or affect • Mood: emotional state over long-term • Affect: emotional tone that accompanies what we say or do (e.g. facial expressions)

31. Cultural, Social, and Interpersonal Factors • Social Effects on Health and Behavior • Frequency and quality are critical • Low social contacts • Higher psychopathology • Higher rates of physical health problems • Lower life expectancy • Mediated by perception • Gender differences in psychopathology

32. Cultural, Social, and Interpersonal Factors • Stigma of Psychopathology • Influences the expression of distress • Limits help-seeking behaviors • Helps maintain the cycle of pathology • http://www.youtube.com/watch?v=tZ5l5Npfdsg