Abnormal Psychology

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

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 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

One-Dimensional Versus Multidimensional Models

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 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 Psychopathology • Neuroscience and its contributions to psychopathology • The Central Nervous System • Structures contributing to psychopathology • Neurotransmiters

Biological Contributions to Psychopathology

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 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)

How neurotrasmitters and drugs influencing them work

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 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 • 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 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 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 • 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 • applying contributions from all the factors to explain causes of a mental disorder in a specific individual • integrative approach

Clinical Assessment and Diagnosis Chapter 3

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 • 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 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 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 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)

Rorschach inkblot test

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 Disorder • Psychophysiological assessment • Electroencephalogram (EEG) • ERP (event-related potentials) • Skin conductance response • Heart rate • Respiration • Electromygraphy (EMG)

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 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

Abnormal Psychology