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Abnormal Psychology. Lecture 2. An Integrative Approach to Psychopathology. Chapter 2. Outline. One-Dimensional Versus Multidimensional Models Biological Contributions to Psychopathology Psychological Contributions to Psychopathology Cultural, Social and Developmental Factors.

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outline
Outline
  • One-Dimensional Versus Multidimensional Models
  • Biological Contributions to Psychopathology
  • Psychological Contributions to Psychopathology
  • Cultural, Social and Developmental Factors
one dimensional versus multidimensional models
One-Dimensional Versus Multidimensional Models
  • Factors contributing to psychological disorder
    • Biological
      • Genetics, brain and neural systems
    • Psychological
      • Behavioral and cognitive factors, unconscious processes, learned helplessness
    • Social
      • Friends and family, social learning
    • Developmental
      • More or less reactivity, critical period
one dimensional versus multidimensional models5
One-Dimensional Versus Multidimensional Models
  •  Judy – each of the four groups should pick one of the four factors and develop arguments about what could have caused Judy’s illness
  • Try to persuade your classmates in the other group that your factors are the right explanation of Judy’s disorder
biological contributions to psychopathology
Biological Contributions to Psychopathology
  • Genetic contributions to psychopathology
    • Genes are very long molecules of DNA at various locations on chromosomes (23 pairs), within the cell nucleus
    • Most of our behavior and personality is probably polygenic (influenced by many genes)
    • There are no individual genes for mental disorders
    • In general – our psychological make-up is heritable up to 50%
biological contributions to psychopathology8
Biological Contributions to Psychopathology
  • The Interaction of Genetics and Environmental Effects
    • The Diathesis-Stress Model
      • The diathesis (inherited tendency) interacts with stress we encounter; the more diathesis the less stress needed to initiate the illness
    • The Reciprocal Gene-Environment Model
      • Genetic endowment may increase the probability that an individual will experience stressful life events
biological contributions to psychopathology9
Biological Contributions to Psychopathology
  • Neuroscience and its contributions to psychopathology
    • The Central Nervous System
    • Structures contributing to psychopathology
    • Neurotransmiters
biological contributions to psychopathology15
Biological Contributions to Psychopathology
  • Neuron structure
      • Cell body, dendrites, axon, synaptic cleft
  • Neurotransmitters
      • Chemicals released from axon of one nerve cell that transmit the impulse to the receptors of another nerve cell
      • There are multiple neurotransmitter currents (brain circuits) in the brain
      • Drugs can influence neurotransmitters as agonists (increase the activity of a neurotrasmitter), antagonists (decrease or block) or inverse agonists (effects opposite to effects of a neurotrasmitter)
biological contributions to psychopathology16
Biological Contributions to Psychopathology
  • Neurotransmitters
    • Serotonin
      • regulates moods, thought processes, regulation of eating, sexual and aggressive behavior
      • Redux (antiobezity)and Prozac (antidepressant)
    • Gamma Aminobutyric Acid (GABA)
      • Reduces anxiety, overall arousal and emotional responses (aggressive behavior, hostility)
biological contributions to psychopathology18
Biological Contributions to Psychopathology
  • Neurotransmitters
    • Norepinephrine
      • Controls heart rate, blood pressure, and respiration; contributes to panic attacks, anxiety and mood disorders (beta-blockers)
    • Dopamine
      • Activates other neurotransmitters and aids in exploratory and pleasure-seeking behaviors
      • Excess is implicated in schizophrenia and deficit in Parkinson’s disease
biological contributions to psychopathology19
Biological Contributions to Psychopathology
  • genetic contributions may lead to patterns of neurotransmitter activity that influence personality
  • psychological treatment can influence neural circuits directly (e.g. OCD)
  • extreme abuse severely impedes intellectual, emotional, and social growth
  • psychosocial factors changes activity levels of neurotransmitters (e.g. sense of control and reaction to GABA antagonist)
psychological contributions to psychopathology
Psychological Contributions to Psychopathology
  • Learned helplessness
    • Martin Seligman
    • if people believe that they have no control over the stress in their lives, they give up attempting to cope and develop depression
  • Social learning
    • people can learn a lot by observing what happens to someone else in a given situation (modeling or observational learning)
psychological contributions to psychopathology21
Psychological Contributions to Psychopathology
  • Prepared learning
    • we became highly prepared for learning about certain types of objects or situations over the course of evolution
  • Cognitive science and the unconscious
    • we are not aware of much of what goes on inside our heads
    • dissociation between consciousness and behavior (blind sight and implicit memory)
psychological contributions to psychopathology22
Psychological Contributions to Psychopathology
  • emotions
    • components of emotions (physiological reactions, motor expression, action tendency, appraisal (CBT), subjective feeling)
    • emotions (last from several minutes to several hours), mood (more persistent affect), affect (momentary emotional tone)
    • influence of anger and hostility on heart is much stronger than stress alone
    • suppressing emotional reactions has significant physiological consequences
cultural social and developmental factors
Cultural, social and developmental factors
  • voodoo and other disorders
    • voodoo death -intolerable autonomic arousal combined with lack of social support
  • gender differences
    • women – an insect or small animal phobia
    • men – alcoholism
  • social effects
    • social relationships seem to protect individuals against many physical and psychological disorders
  • the principle of equifinality
    • developmental psychopathology says that a behavior or disorder may have several different causes
integrative approach
Integrative approach
  • applying contributions from all the factors to explain causes of a mental disorder in a specific individual
  • integrative approach
outline26
Outline
  • Assessing Psychological Disorder (systematic evaluation and measurement of psychological, biological, and social factors)
  • Diagnosing Psychological Disorders

(the process of determining whether the particular problem afflicting the individual meets all the criteria for a psychological disorder according to the DSM-IV-TR)

assessing psychological disorder
Assessing Psychological Disorder
  • Key Concepts in Assessment
    • Reliability
      • The degree to which a measurement is consistent across people (inter-rater reliability) or across time (test-retest reliability)
    • Validity
      • Whether something measures what it is designed to measure (e.g. concurrent validity of IQ tests)
    • Standardization
      • Process of establishing specific norms and requirements for a measurement technique
assessing psychological disorder28
Assessing Psychological Disorder
  • The Clinical Interview
    • Unstructured interviews
    • Semistructured interviews
    • The Mental Status Exam

(careful observation of behavior)  Y-Steve

      • Appearance and behavior (overt behavior, posture, expressions)
      • Thought processes (rate, continuity and content of speech)
      • Mood and affect (current and predominant feeling of the individual)
      • Intellectual functioning (type of vocabulary, use of metaphors and abstractions)
      • Sensorium (orientation in time, place and person)
assessing psychological disorder29
Assessing Psychological Disorder
  • Physical examination
    • Psychological disorders associated with medical conditions (e.g. thyroid gland – overactive results in anxiety, underactive results in depression)
  • Behavioral assessment
    • To assess formally an individual’s thoughts, feelings, and behavior in specific situations or contexts
assessing psychological disorder30
Assessing Psychological Disorder
  • Psychological testing
    • Projective testing
      • Ambiguous stimuli are presented to a person who is asked to describe what he/she sees
      • Rorschach inkblot test
      • Thematic Apperception Test (TAT)
    • Personality inventories
      • Minnesota Multiphasic Personality Inventory (MMPI) (scales like anxiety, depression etc.)
    • Intelligence testing
      • Stanford-Binet test
      • Wechsler test (verbal scales, performance scales)
assessing psychological disorder32
Assessing Psychological Disorder
  • Neuropsychological testing
    • Measuring language abilities, attention, memory, perception, motor skills, learning and abstraction to detect possible brain dysfunction
    • Luria-Nebraska Neuropsychological Battery
    • Halstead-Reitan Neuropsychological Battery
  • Neuroimaging
    • Structural (computerized axial tomography (CAT), magnetic resonance imaging (MRI))
    • Functional (measuring metabolic changes (PET, fMRI))
assessing psychological disorder33
Assessing Psychological Disorder
  • Psychophysiological assessment
    • Electroencephalogram (EEG)
    • ERP (event-related potentials)
    • Skin conductance response
    • Heart rate
    • Respiration
    • Electromygraphy (EMG)
diagnosing psychological disorders
Diagnosing Psychological Disorders
  • Some concepts
    • classification (assignment into categories)
    • taxonomy (system fo classification in science)
    • nosology (naming system for medical and psychological phenomena)
  • Approaches to classification
    • classical categorical approach (clear-cut differences, different cause)
    • dimensional approach (continuum)
    • prototypical approach (defining, essential characteristics)
diagnosing psychological disorders35
Diagnosing Psychological Disorders
  • Prototypical approach (used in DSM-IV)
    • System for categorizing disorders using both essential, defining characteristics and a range of variation on other characteristics  B-Diagnosis
    • Criteria for Panic Disorder with Agoraphobia
      • recurring unexpected panic attacks
      • one or more of the following during the month after a panic attack: (1) persistent worry about having an additional attack; (2) worry about the implications of an attack; (3) a significant change in behavior related to the attack
      • anxiety about being in places or social situations from which escape might be difficult or embarrassing, such as being in a crowd, travelling on a bus, or waiting in line