Abnormal Psychology

1. Abnormal Psychology Lecture 2

2. An Integrative Approach to Psychopathology Chapter 2

3. Outline • One-Dimensional Versus Multidimensional Models • Biological Contributions to Psychopathology • Psychological Contributions to Psychopathology • Cultural, Social and Developmental Factors

4. 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

5. 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

6. One-Dimensional Versus Multidimensional Models

7. 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%

8. 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

9. Biological Contributions to Psychopathology • Neuroscience and its contributions to psychopathology • The Central Nervous System • Structures contributing to psychopathology • Neurotransmiters

10. Biological Contributions to Psychopathology

11. Biological Contributions to Psychopathology

12. Biological Contributions to Psychopathology

13. Biological Contributions to Psychopathology

14. Biological Contributions to Psychopathology

15. 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)

16. 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)

17. How neurotrasmitters and drugs influencing them work

18. 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

19. 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)

20. 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)

21. 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)

22. 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

23. 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

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

25. Clinical Assessment and Diagnosis Chapter 3

26. 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)

27. 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

28. 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)

29. 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

30. 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)

31. Rorschach inkblot test

32. 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))

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

34. 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)

35. 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