Chapter 2 An Integrative Approach to Psychopathology

Outline One-dimensional vs. Multidimensional Models Genetic Contributions Neuroscientific Contributions Behavioral and Cognitive Science Emotions Cultural and Social Factors Lifespan Development

One-Dimensional vs. Multidimensional Models One-dimensional Models – Explain behavior in terms of a single cause – Could mean a paradigm, school, or conceptual approach – Tend to ignore information from other areas – Example: Explaining obsessive-compulsive disorder as the result of family history alone

One-Dimensional vs. Multidimensional Models Multidimensional Models – Interdisciplinary, eclectic, and integrative – “System” of influences that cause and maintain suffering – Draw upon information from several sources – Abnormal behavior results from multiple influences

Multidimensional Models of Abnormal Behavior Major Influences – Biological-Neuroscience – Behavioral – Cognitive – Emotional – Social & cultural – Developmental *No one factor acts on its own to cause a disorder *These factors interact resulting in mental health and mental disorder

Neuroscience Contributions to Psychopathology

Lobes of the Cerebral Cortex Frontal – thinking and reasoning abilities, memory Parietal – touch recognition Occipital – integrates visual input Temporal – recognition of sights and sounds, long-term memory storage

Lobes of the Cerebral Cortex

Neurotransmitters & Main Functions Neurotransmitters – “chemical messengers” that transmit messages between brain cells – Agonists – increase the activity of a neurotransmitter by mimicking its effects – Antagonists – inhibit or block the production of neurotransmitter or function indirectly to prevent the chemical from reaching the next neuron by closing or occupying the receptors – Reuptake – process by which neurotransmitters are taken back into the synaptic vesicles; applies the “breaks” on neurotransmitter action

Common Neurotransmitters Associated with Psychopathology Dopamine Serotonin (5-HT) Norepinephrine Gamma aminobutyric acid (GABA) Glutamate

Common Neurotransmitters Associated with Psychopathology

Reuptake of Serotonin

Implications of Neuroscience for Psychopathology Psychosocial factors – Interact with brain structure and function Psychotherapy – Can change brain structure and function Example: OCD patients w/ CBT – brain imaging showed that neurotransmitter circuits of the brain had been normalized – Medications and psychotherapy Consider: How much does the brain influence behavior or mood, versus behavior or mood influencing the brain? – Directionality of effects can have implications for treatment

The Contributions of Behavioral and Cognitive Science Conditioning and cognitive processes – Modern research indicates that learning is more complicated than classical conditioning (associations between two things that occur together) or operant conditioning (i.e., reinforcement and punishment) These types of learning are influenced by higher-order cognitive processes – Learned helplessness (Martin Seligman) – Modeling and observational learning (Albert Bandura)

The Role of Emotion in Psychopathology The nature of emotion – To elicit or evoke action – Intimately tied with several forms of psychopathology – Thoughts influence our emotions (“perception is everything”) – *Consider: Typically thoughts come first (how an event is perceived), followed by emotions. These thoughts- emotions then result in behaviors that can influence our environment (“good” or “bad”). In turn, our environment can also influence us. Reciprocal Determinism (Albert Bandura)

Reciprocal Determinism

The Role of Emotion in Psychopathology Components of emotion – Cognition, physiology, and behavior – Example of phobia: threatening thoughts, anxious feelings, elevated heart rate, tendency to flee Harmful side of emotional dysregulation – Emotions like anger, hostility, sadness, and anxiety play a key role in psychopathology – Some emotions (e.g., chronic hostile arousal) and emotion suppression can have negative health consequences

Components of Emotion

Cultural, Social, and Interpersonal Factors in Psychopathology Cultural factors – Influence the form and expression of behavior Gender effects – Exert a strong and puzzling effect on psychopathology Consider: How do women and men typically display and cope with depression and anxiety (stress)? – Different or same? Social effects on health and behavior – Frequency and quality important – Related to mortality, disease, and psychopathology

Social Stigma of Psychopathology Culturally, socially, and interpersonally situated Problems with social stigma – May limit the degree to which people express mental health problems e.g., concealing feelings of depression > unable to receive support from friends – May discourage treatment seeking

Life-Span and Developmental Influences Over Psychopathology Life-span developmental perspective – Addresses developmental changes – Influence and constrain what is normal and abnormal The principle of equifinality – From developmental psychopathology – Several paths to a given outcome – Paths vary by developmental stage Multiple causation – The rule, not the exception

An Integrative Model to Psychopathology

Examples of Interactions Brain, Genes, Hormones, Development, and Environment – Infants of depressed mothers (or fathers) – Toddlers with disorganized attachments – Adolescents with PTSD who have been abused – Adults who had anxious parents

The Interaction of Genetic and Environmental Effects Genetic contribution to psychopathology is less than 50% Gene-environment interactions – The genetic structure of cells actually changes as a result of learning experiences e.g., an inactive gene may become active because of environmental influences The diathesis-stress model – Biological predisposition (varies among individuals) interaction with environmental stressors – Examples: Schizophrenia, alcoholism, depression

Diathesis-Stress Model – Alcoholism

Diathesis-Stress Model – Depression

The Interaction of Genetic and Environmental Effects Reciprocal gene-environment model – Inherited predispositions or traits that increase one’s likelihood to engage in activities or seek out situations i.e., genes shape how we create/choose our environments, which then influences our thoughts, feelings, and behaviors (and then affects our environment, etc.) – Example: blood-injury-injection phobia & impulsivity However: – Genes are not the whole story – Environmental influences (e.g. parenting style) may override genetics

Reciprocal Gene-Environment Model – Blood-injury-injection Phobia