1. Chapter 2 An Integrative Approach to Psychopathology

2. Outline One-Dimensional vs. Multidimensional Models
Genetic Contributions to Psychopathology
Neuroscience and its Contributions to Psychopathology
Behavioral and Cognitive Science
Emotions
Cultural, social and interpersonal factors
Life-Span 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. What Caused Judy’s Phobia?
Behavioral factors
Conditioned response to sight of blood
Biological factors
Genetics – inherited tendencies
Physiology (e.g., lightheadedness)
Emotional influences
Fear and anxiety
Social factors
E.g., attention from others
Teaching Tip: This is a reference to the character Judy discussed in Chapter 1, who had a blood-injection-injury phobia. The integrative case concept is discussed in detail on pages
Emphasize the interactive and synergistic effects of these and how it is often impossible to separate out elements from each other or the overall context.

8. What Caused Judy’s Phobia?
FIGURE 2.1 Judy’s case.

9. Genetic Contributions to Psychopathology
Nature of genes
Deoxyribonucleic acid (DNA) – the double helix
46 chromosomes in 23 pairs
Dominant vs. recessive genes
Determine parts of physical and mental characteristics
Phenotype vs. genotype
Genotype = genetic status (e.g. having a certain allele)
Phenotype = how it manifests in the person (e.g., having brown eyes or having the tendency to fear social rejection)
Polygenetic = several genes contribute to the outcome
Technology Tip: The Human Genome Project website provides excellent information about genetics and related research. (
Dominant genes only require one to determine a trait (i.e., only one parent has to pass on the gene)
Recessive genes must be present in pairs to determine a trait (i.e., both parents have to pass on the gene)

10. This is a karyotype for a normal female.

11. Genetic Contributions to Psychopathology
Development and behavior is almost always polygenetic
Rare exceptions: single-gene determinants (e.g., Huntington’s disease, phenylketonuria)
Generally speaking, genes account for less than 50% of variations in psychopathology
Single gene determinants include disorders such as Huntington’s disease and Phenylketonuria (PKU)
Technology Tip: More information about Huntington’s disease is available at the NIH site (
Technology Tip: The Online Mendelian Inheritance in Man database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and colleagues at Hopkins (

12. New Developments in the Study of Genes and Behavior
One study: heritability estimates ranged from ~30-60% for cognitive traits
Adverse life events can trump the influence of genes
Example: If only one identical twin experiences a traumatic life event, the twins’ cognitive abilities may be more discrepant later
Recent research suggests that genetic contributions should not be considered without also considering the environment

13. 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

14. FIGURE 2.3  Interaction of genes and early environment in producing adult major depression. (Reprinted, with permission, from Caspi, A., Sugden, K., Moffitt, T. E., Taylor, A., Craig, I. W., Harrington, H., et al., Influence of life stress on depression: Moderation by a polymorphism in the 5-HTT gene. Science, 301, 386–389,© 2003 AAAS.)

15. The Interaction of Genetic and Environmental Effects
Diathesis-stress model: Disorders are the result of underlying risk factors combining with life stressors that cause a disorder to emerge
Example: Risk factors (e.g., intolerance of distress, sensitivity to physical sensations) make it more likely that someone will develop a disorder when dealing with life stressors (e.g., losing a job, getting married).

16. FIGURE 2.2  In the diathesis–stress model, the greater the underlying vulnerability, the less stress is needed to trigger a disorder.

17. 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
Genetics may make people more likely to seek out certain environments, thus affecting their experiences
Epigenetics is discussed in greater detail on pages

18. Gene-Environment Correlation model
FIGURE 2.4 Gene-Environment Correlation Model

19. Epigenetics and the Nongenomic “Inheritance” of Behavior
Environmental influences (e.g., stress, nutrition) actually affect the expression of certain genes both for the individual and decendents
Cross fostering studies of development
Rats who were born to anxious moms (i.e. genetic influence = anxiety) but raised by calm moms (i.e. environmental influence = calm) grew up calm
i.e., environment “overrides” genes

20. Neuroscience and its Contributions to Psychopathology
The field of neuroscience
The role of the nervous system in disease and behavior
The central nervous system
CNS
Brain and spinal cord
PNS
Somatic and autonomic branches
Technology Tip: Check out for the history of neuroscience and additional neuroscience links.
Technology Tip: The Society for Neuroscience website includes reference materials as well as information on upcoming conferences (

21. The Central Nervous System
Figure 2.5 Divisions of the nervous
system. (Reprinted from Kalat, J. W. (2009).
Biological Psychology, 10th edition, © 2009
Wadsworth.)

22. 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.

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

24. Figure 2.6 The transmission of information from one neuron to another.

25. The Structure of the Brain
Two main parts:
Brain stem
Basic functions
Contains hindbrain, midbrain, thalamus and hypothalamus (between brainstem and forebrain)
Forebrain
Higher-order functions
Contains limbic system, basal ganglia, cerebral cortex (larges part of the brain, the wrinkled outer structure)
NOTE: This is usually one of the most challenging chapters for students. Encourage students to make use of the diagrams and descriptions in their textbook, starting on p. 40.
Technology Tip: The Dana Foundation site provides information and links to sites about brain diseases and disorders (

26. 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.

27. Neuroscience and Brain Structure
Limbic system
Involved in emotional processing, aggression
Thalamus – receives and integrates sensory information
Hypothalamus – eating, drinking, aggression, sexual activity
Basal ganglia: Thought to partially control motor activity

28. 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

29. Neuroscience and Brain Structure
Lobes of the Cerebral Cortex and some of their important functions
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: (

30. FIGURE 2. 7a Three divisions of the brain
FIGURE 2.7a  Three divisions of the brain. (Reprinted, with permission, from Kalat, J. W., Biological Psychology, 10th edition, © 2009 Wadsworth.) 30

31. FIGURE 2. 7b Major structures of the brain
FIGURE 2.7b  Major structures of the brain. (Reprinted, with permission, from Kalat, J. W., Biological Psychology, 10th edition, © 2009 Wadsworth.) 31

32. FIGURE 2. 7c. The limbic system
FIGURE 2.7c. The limbic system. (Reprinted, with permission, from Kalat, J. W., Biological Psychology, 10th edition, © 2009 Wadsworth.) 32

33. FIGURE 2. 7d The basal ganglia
FIGURE 2.7d  The basal ganglia. (Reprinted, with permission, from Kalat, J. W., Biological Psychology, 10th edition, © 2009 Wadsworth.) 33

34. FIGURE 2.8  Some major subdivisions of the human cerebral cortex and a few of their primary functions. (Reprinted, with permission, from Kalat, J. W., Biological Psychology, 10th edition, © 2009 Wadsworth.) 34

35. 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 imagining having a pop quiz on today’s lecture) and then activating the parasympathetic system by breathing or relaxation exercises.

36. FIGURE 2.9  The sympathetic nervous system (red lines) and parasympathetic nervous system (blue lines). (Reprinted, with permission, from Kalat, J. W., Biological Psychology, 10th edition, © 2009 Wadsworth.)

37. Neuroscience: Endocrine Systems
The Endocrine System
Regulates release of hormones
The Hypothalamic-Pituitary-Adrenalcortical axis (HPA axis)
Integration of endocrine and nervous system function
Dysregulated hormones implicated in some forms of psychopathology

38. FIGURE 2. 10 Location of some major endocrine glands
FIGURE 2.10  Location of some major endocrine glands. (Reprinted, with permission, from Kalat, J. W., Biological Psychology, 10th edition, © 2009 Wadsworth.)

39. 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

40. 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

41. 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

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

43. [INSERT Figure 2.12 HERE]
FIGURE 2.12  Manipulating serotonin in the brain.

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

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

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

47. 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.)

48. Implications for Psychopathology
Certain types of brain activity may be associated with abnormal behavior
Example: OCD
Patients have increased activity in part of the frontal lobe (orbital surface)
Man developed OCD after
This overactivity is reduced after effective treatment
Photo 2.14 Brain function is altered in people with obsessive-compulsive disorder, but it normalizes after effective psychosocial treatment

49. Psychosocial Influences on Brain Structure and Function
Psychosocial influences on the brain
Neurological activity may change as a result of psychotherapy > suggests that psychosocial influences affect brain function
Placebos may also change brain function
Psychotherapy
Stress and early development
Interactions of psychosocial factors with brain structure and function
Developmental disorders
Environment and brain structures
Discussion Tip: Have students examine their beliefs about the directionality of effects (e.g., 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?

50. Psychosocial Influences on Brain Structure and Function
More stimulating environments appear to promote neurodevelopment
Stress and early development
Sense of control over environment appears important

51. Psychosocial Influences on Brain Structure and Function
Monkeys were given neurochemical designed to trigger extreme anxiety
Monkeys raised in uncontrollable environment responded with panic
Monkeys raised in controllable environment responded with aggression

52. 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 always that simple – influenced by higher-order cognitive processes

53. EXAMPLE of research informing our understanding of classical (associative) conditioning.
FIGURE 2.15  Robert Rescorla’s (1940-) experiment that showed contiguity—pairing a neutral stimulus and an unconditioned stimulus—does not result in the same kind of conditioning. The dog in the contiguity-only group (top panel) experiences the usual conditioning procedure: Pairing a tone and meat causes the tone to take on properties of the meat. For the dog in the contiguity-and-random group, the meat appeared away from the tones, as well as with it, making the tone less meaningful.
The point here is that you’re more able to acquire associations between two things if they occur ONLY together. For instance, if your girlfriend wears a certain perfume, you will associate the smell with her more than if your girlfriend AND your mom wear that perfume.

54. The Contributions of Behavioral and Cognitive Science
Other types of learning
Respondent and operant learning
Learn to repeat behaviors followed by desirable consequences and decrease behaviors followed by undesirable consequences

55. The Contributions of Behavioral and Cognitive Science
Other types of learning
Learned helplessness
First demonstrated in animal models, but may contribute to the maintenance of depression
Rats given occasional shocks
Gave up trying to control the shocks if attempts were ineffective (i.e., “learned” not to bother trying)

56. The Contributions of Behavioral and Cognitive Science
Other types of learning
Social learning
Based on research of Albert Bandura
Modeling and observational learning: Learn to copy the behaviors that seem to turn out well for other people

57. The Contributions of Behavioral and Cognitive Science
Other types of learning
Prepared learning
It is easier to learn associations that would have been helpful to our ancestors
Example: Easier to acquire a fear of spiders because it was adaptive for our ancestors to fear (possibly poisonous) spiders
Technology Tip: This Psychology Today article presents Susan Mineka’s work on prepared learning related to fear of snakes and other threatening animals (

58. 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. 56. Participants are slowed down in their performance by words that have emotional significance, even if they are not aware of this

59. The Role of Emotion in Psychopathology
The nature of emotion
To elicit or evoke action
Action tendency different from affect and mood
Components of emotion
Behavior, physiology, and cognition
Example of fear: Anxious thoughts, elevated heart rate, tendency to flee
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.

60. FIGURE 2.16  Emotion has three important and overlapping components: behavior, cognition, and physiology.

61. Anger and Your Heart
Chronic hostility increases risk for heart disease
This effect is stronger than many physiological risk factors
Efficiency of heart pumping is decreased when angry
This effect is reversed when people practice forgiveness toward an offense

62. Emotions and Psychopathology
Suppressing negative emotions increases sympathetic nervous system activity
Dysregulated emotions are key features of many mental disorders
Example: Panic attack = fear occurring at the wrong time
NOTE: Many types of psychopathology are maintained by 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.

63. Cultural, Social, and Interpersonal Factors in Psychopathology
Cultural factors
Influence the form and expression of behavior
Example: Children raised to be autonomous are less fearful
Example: Culturally-bound fears
Susto (Latin America): symptoms of anxiety occurring when an individual believes (s)he has been struck by black magic

64. Cultural, Social, and Interpersonal Factors in Psychopathology
Gender effects
Men and women may differ in emotional experience and expression
Examples:
90% of insect phobia sufferers are female
Most bulimia sufferers are female
Alcohol use disorders are more common in men
May be related to gender roles: Certain ways of coping with emotion are more acceptable for men or women
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.

65. Cultural, Social, and Interpersonal Factors in Psychopathology
Effect of social support
Low social support related to mortality, disease, and psychopathology
Frequency and quality important
Social support especially important in the elderly

66. 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

67. Global Incidence of Psychological Disorders
Mental health accounts for 13% of world disease burden
Mental health care very limited in developing countries
Sub-Saharan Africa: only one psychiatrist per 2 million people
Even in the US, only 1 in 3 people with a mental disorder has received any treatment

68. 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

69. 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

70. 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