1. An Integrative Approach to Psychopathology
Chapter 2
An Integrative Approach to Psychopathology

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

3. Focus Questions
What are the features of unidimensional and multidimensional models of psychopathology?
How do genes interact with environment to influence behavior?
How do different brain regions and neurotransmitters influence psychopathology?
How to behavioral, emotional and cognitive science influence explanations of mental illness?
How do cultural factors affect psychopathology?

4. 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

5. One-Dimensional vs. 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
Discussion Tip: Have students brainstorm all of the possible dimensions that could constitute a one-dimensional model and use this as a platform to discuss their integration in multidimensional models.
Examples of dimensions: (as discussed on next slide) Genetic, biological, social, learning/behavioral, cultural, environmental

6. Multidimensional Models of Abnormal Behavior
Major Influences
Biological
Behavioral
Emotional
Social & cultural
Developmental
Environmental

7. EXAMPLE of multidimensional influences contributing to a blood-injection-injury phobia
FIGURE 2.1  EXAMPLE of multidimensional influences contributing to a blood-injection-injury phobia . The original case description is found on page 3 of Chapter 1.

8. Genetic Contributions to Psychopathology
Phenotype vs. genotype
Nature of genes
Deoxyribonucleic acid (DNA) – the double helix
23 pairs of chromosomes
Dominant vs. recessive genes
Development and behavior is often polygenetic
Genetic contribution to psychopathology
Less than 50%
Genotype = genetic status (e.g. having a certain allele)
Phenotype = how it manifests in the person (e.g., having brown eyes)
Polygenetic = several genes contribute to the outcome
Technology Tip: The Human Genome Project website provides excellent information about genetics and related research. (

9. Chromosomes

10. The Interaction of Genetic and Environmental Effects
Eric Kandel and 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
Examples: Blood-injury-injection phobia, alcoholism
Diathesis stress model: Disorders are the result of underlying risk factors (e.g., intolerance of distress, sensitivity to physical sensations) and life stressors (e.g., losing a job, getting married).

11. The Interaction of Genetic and Environmental Effects
Reciprocal gene-environment model
Outcomes are a result of interactions between genetic vulnerabilities and experience
Examples: depression, impulsivity
Epigenetics and the Non-genomic inheritance of behavior
Genes are not the whole story
Environmental influences (e.g., parenting style) may override genetics
Discussion Tip: Have students discuss the potential pros, cons, and ethical issues related to genetic testing for disorders. You may want to start with physical disorders and then include psychological disorders.

12. Neuroscience Contributions to Psychopathology
The field of neuroscience
The role of the nervous system in disease and behavior
Branches of human nervous system
The central nervous system (CNS)
Brain and spinal cord
The peripheral nervous system (PNS)
Somatic and autonomic branches

13. Neuroscience and the Central Nervous System
The Neuron
Soma – cell body
Dendrites – branches that receive messages from other neurons
Axon – trunk of neuron that sends messages to other neurons
Axon terminals – buds at end of axon from which chemical messages are sent
Synapses – small gaps that separate neurons
Soma is the central cell body.
Dendrites extend from the cell body to receive chemical messages from other nerve cells that are converted into electrical impulses.
Axon transmits these impulses to other neurons.
Synaptic cleft is a small space that exists between the axon of one neuron and the dendrites of another.

14. Neuroscience and the Central Nervous System
Neurons operate electrically, but communicate chemically
Neurotransmitters are the chemical messengers

15. Overview: Neuroscience and Brain Structure
Two main parts
Brainstem
Contains hindbrain, midbrain, thalamus and hypothalamus (between brainstem and forebrain)
Forebrain
Contains limbic system, basal ganglia, cerebral cortex (larges part of the brain, the wrinkled outer structure)
Structures of the brain and nervous system are often some of the hardest material for students to grasp. Encourage students to come back to this chapter later in the course when these brain structures start to be referenced in the context of specific disorders.

16. Neuroscience and Brain Structure
Hindbrain – regulates automatic processes
Medulla – heart rate, blood pressure, respiration
Pons – regulates sleep stages
Cerebellum – involved in physical coordination
Midbrain
Coordinates movement with sensory input
Contains parts of the reticular activating system (RAS)
RAS contributes to arousal and tension, which influences sleep and wakefulness.

17. Neuroscience and Brain Structure
Limbic system
includes amygdala, hippocampus, cingulate gyrus, and septum
regulates emotional experiences and expressions
regulates, to a degree, ability to learn and control impulses
involved in basic drives of sex, aggression, hunger, and thirst

18. Neuroscience and Brain Structure
Forebrain
Most sensory, emotional, and cognitive processing
Cerebral cortex contains two specialized hemispheres (left and right)
Each hemisphere has four lobes with specialized processes

19. Neuroscience and Brain Structure
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
Technology Tip: Accessible, basic site regarding brain lateralization: (

20. Neuroscience: Peripheral Nervous System
Somatic branch of PNS
Controls voluntary muscles and movement
Autonomic branch of the PNS
Involuntary processes
Sympathetic and parasympathetic branches
Regulates cardiovascular system & body temperature
Also regulates the endocrine system and aids in digestion
Teaching Tip: Have students activate their sympathetic nervous system by in vivo or covert means (i.e., running in place while breathing through a straw or imaging having a pop quiz on today’s lecture) and then activating the parasympathetic system by breathing or relaxation exercises.

21. Neuroscience: Endocrine Systems
The Endocrine System
Regulates release of hormones
The Hypothalamic-Pituitary-Adrenalcortical axis (HPA axis)
Integration of endocrine and nervous system function

22. Neurotransmitters Functions of Neurotransmitters
“Chemical messengers” - transmit messages between brain cells
Other chemical substances in the brain
Agonists
Inverse agonists
Antagonists
Most drugs are either agonistic or antagonistic
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.
Inverse Agonists produce effects opposite to a given neurotransmitter

23. Neuroscience: Functions of Main Types of Neurotransmitters
Serotonin (5-HT)
Glutamate
Gamma aminobutyric acid (GABA)
Norepinephrine
Dopamine
GABA – main inhibitory neurotransmitter
Glutamate – main excitatory neurotransmitter
Norepinephrine = noradrenaline, epinephrine = adrenaline

24. Serotonin Also known as 5-hydroxytryptamine (5-HT)
Influences information processing, behavior, mood and thoughts
Dysregulated serotonin may contribute to depression
Very low serotonin linked to instability and impulsivity

25. Serotonin Pathways in the Brain
FIGURE 2.11  Major serotonin pathways in the brain.

26. Norepinephrine Also called noradrenaline
Involved in alarm responses and basic bodily processes (e.g. breathing)

27. Norepinephrine Pathways
FIGURE 2.13  Major norepinephrine pathways in the human brain. (Adapted from Kalat, J. W., Biological Psychology, 10th edition, © 2009 Wadsworth.)

28. Dopamine Implicated in depression and ADHD
Link between excessive dopamine and schizophrenia
Link between reduced dopamine and Parkinson’s disease

29. Dopamine Pathways
FIGURE 2.14  Two major dopamine pathways. The mesolimbic system is apparently implicated in schizophrenia; the path to the basal ganglia contributes to problems in the locomotor system, such as tardive dyskinesia, which sometimes results from use of neuroleptic drugs. (Adapted from Kalat, J. W., Biological Psychology, 10th edition, © 2009 Wadsworth.)

30. Implications of Neuroscience for Psychopathology
Relations between brain and abnormal behavior
Example: Obsessive Compulsive Disorder (OCD)
Man developed OCD after part of his frontal cortex was damaged during brain surgery
Psychosocial influences
Can change brain structure and function
Discussion Tip: Have students examine their beliefs about the directionality of effects (i.e., how much does the brain influence behavior or mood, versus behavior or mood influencing the brain). What implications does this have for treatments? The role of the patient?

31. Implications of Neuroscience for Psychopathology
Treatments for mental health problems may now focus on the brain regions found to be relevant for these problems
Psychotherapy
Also can change brain structure and function
Medications and psychotherapy are often used together

32. The Contributions of Behavioral and Cognitive Science
Conditioning and cognitive processes
Early research on classical conditioning: Simple associations are learned between two things that tend to occur together
Later research indicated that it is not that simple – this sort of learning is influenced by higher-order cognitive processes.

33. The Contributions of Behavioral and Cognitive Science
Other types of learning
Respondent and operant learning
Learned helplessness
Social learning
Modeling and observational learning
Prepared learning
Respondent/operant learning = Repeat behaviors that are followed by good consequences. Perform behaviors less that are followed by bad consequences.
Prepared learning = it is easier to learn associations that were adaptive for our ancestors to have in the past. For example, it is easier to acquire a fear of spiders because it was useful for our ancestors to fear (possibly poisonous) creatures like that in the past. (In contrast, it is less easy to acquire a fear of rabbits because there has been no evolutionary advantage to avoiding rabbits).
Technology Tip: This Psychology Today article presents Susan Mineka’s work on prepared learning related to fear of snakes and other threatening animals (
Learned helplessness = When you try to exert influence over a challenging situation and you’re repeatedly unable to, you stop trying – even when the circumstances change such that you COULD make a difference. Demonstrated by Martin Seligman.

34. Cognitive Science and the Unconscious
There may be a dissociation between behavior and consciousness
Implicit memory
Acting on the basis of experiences that are not recalled
Blind sight
Some people who are blind can still sense objects that would be in their visual field even if they do not experience sight
Some experimental tests reveal implicit processing
Example of implicit processing: Stroop paradigm, p. 54. Participants are slowed down in their performance by words that have emotional significance, even if they are not aware of this

35. The Role of Emotion in Psychopathology
The nature of emotion
To elicit or evoke action
Action tendency different from affect and mood
Intimately tied with several forms of psychopathology
Many types of psychopathology can be boiled down to problematic reactions to our own emotions. For example, people with social anxiety don’t like the way they feel in social situations, so they attempt to avoid these situations in order to not feel that uncomfortable emotion.

36. The Role of Emotion in Psychopathology
Components of emotion
Behavior, physiology, and cognition
Example of fear: Anxious thoughts, 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

37. Cultural, Social, and Interpersonal Factors in Psychopathology
Cultural factors
Influence the form and expression of behavior
Gender effects
Men and women may differ in emotional experience and expression
Social support effects on health and behavior
Frequency and quality important
Related to mortality, disease, and psychopathology
Discussion Tip: Have students break into groups or split up by gender and discuss how men and women typically display and cope with depression, anxiety, and stress. It may be helpful to first have each group discuss how the other group experiences these before talking about their own group.

38. 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

39. 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
Some things that are normal at a certain age or stage, are not normal at another.
EXAMPLE OF EQUIFINALITY: Delirium can be caused by a number of separate or related underlying conditions, including post-operative states, drugs and alcohol, urinary tract infections, fever, and organ failure. Elderly individuals and children are also at a higher risk for delirium than are adults.
Equifinality = the same outcome can be arrived at from different origins
Multifinality = the same origin can end up at different outcomes

40. Summary of the Multidimensional Perspective of Psychopathology
Multiple causation
The rule, not the exception
Take a broad, comprehensive, systemic perspective
Biological and neuroscientific
Cognitive and emotional
Social, cultural, and developmental factors

41. Summary of the Multidimensional Perspective of Psychopathology
A multidimensional, comprehensive approach puts us in the best position to:
Understand the causes of psychopathology
Alleviate and prevent psychopathology