An Integrative Approach to Psychopathology

1. An Integrative Approach to Psychopathology

2. What is a “Mental Disorder?” • Any suggestions, ideas??

3. What is a “Mental Disorder?” • Any suggestions, ideas?? • The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (the DSM-IV) is used in the United States as the current authoritative listing of mental disorders. It broadly defines mental disorder as: • “a clinically significant behavioral or psychological symptom or pattern . . . associated with either a painful symptom or impairment in one or more important areas of functioning” (DSM-IV-TR)

4. Other Ways to Define Abnormal? • Statistical Deviance • Biological Disadvantage • Unexpected Distress or Disability • Harmful Dysfunction

5. Option 1: Statistical Deviance • Considers only those conditions that are rare or uncommon (e.g. schizophrenia) • Problems with this definition??

6. Option 1: Statistical Deviance • Considers only those conditions that are rare or uncommon (e.g. schizophrenia) • Problems with this definition?? • Not all abnormal conditions are rare or uncommon • e.g. Suicide is 1/3 leading cause of death for young people • Does that mean it is normal? • Not all rare or uncommon conditions are abnormal • e.g. High intelligence is uncommon • Does that mean it is abnormal?

7. Option 2: Biological Disadvantage • Considers only those conditions that seriously impact an individual’s ability to reproduce • Approaches the definition of “disorder” from a evolutionary or Darwinian perspective • Problems with this definition??

8. Option 2: Biological Disadvantage • Considers only those conditions that seriously impact an individual’s ability to reproduce • Approaches the definition of “disorder” from a evolutionary or Darwinian perspective • Problems with this definition?? • Disorders vary in their impact on reproductive capacities

9. Option 3: Unexpected Disability or Disadvantage • Considers conditions if your behavior causes you distress or disability that is not expected • Problems with this one??

10. Option 3: Unexpected Disability or Disadvantage • Considers conditions if your behavior causes you distress or disability that is not expected • Problems with this one?? • Lots of conditions cause distress or disability, but are not considered disorders • e.g. Poverty or discrimination

11. Option 4: Harmful Dysfunction • Considers conditions that are both: • Harmful according to society standards • Involves a mental dysfunction • Comes the closest to the current DSM definition • Problems with this one??

12. Option 4: Harmful Dysfunction • Considers conditions that are both: • Harmful according to society standards • Involves a mental dysfunction • Comes the closest to the current DSM definition • Problems with this one?? • Societal standards of “harmful” may change

13. Models of Psychopathology

14. Unidimensional Etiological Models of Psychopathology Advocate single causes of psychopathology • Biological • Psychological • Systems

15. Diathesis-Stress Etiological Model of Psychopathology • Biological vulnerability • Environmental stress

16. Multidimensional Model of the Etiology of Psychopathology • Biological (genetic, brain structures, neurotransmitters) • Behavior and cognition • Emotion • Social and cultural factors • Developmental factors

17. Genetics: Limitations of Unidimensional and Diathesis-Stress Models Genetics alone does not predict the development of psychopathology • Genetic factors make some contribution to all disorders but account for less than half of the explanation. • No individual genes for disorders have been identified

18. Genetics: Multidimensional Model • Cognitions, emotions, social, cultural and developmental factors also determine whether genetic vulnerability to abnormal behavior is expressed. • For example: children of schizophrenic parents who were adopted away as babies to families with high quality parenting, did not develop the disorder

19. Environment Mitigates Genetics • Francis et. al. (1999) • Newly born rat pups of fearful and easily stressed mothers • Randomly placed with biological or calm mothers • Rat pups placed with calm mothers, were more calm and supportive as adults

20. Genetics and the Multidimensional Model: Implications • Early environmental manipulation may override genetically influenced tendencies to develop abnormal behavior

21. Neurotransmitters and Psychopathology • Process of Neuron Transmission • Neurotransmitters • Unidimensional and multidimensional models of the etiologic role of neurotransmitters in psychopathology

23. Neurotransmitters • Serotonin • GABA (Gamma aminobutyric acid) • Norepiniphrine • Dopamine

24. Unidimensional Model Excess or deficits in neurotransmitters  abnormal behavior (unidimensional) Multidimensional Model Learning experiences alter the structure of the neurons (e.g. study by William Greenough –see video clip) Early stress exposure  Changes in the HPA axis-increased susceptibility later in life Neurotransmitters and Psychopathology

25. Behavioral and Cognitive Influences to Psychopathology

26. Early Behavioral Paradigms • Classical and operant conditioning • Emphasized a science of observable behavior (removed cognition completely) • Treatments, not causes, were emphasized in terms of psychopathology

27. Classical Conditioning Pairing of a UCS with a CS produces a CR (without any thought on the part of the person: a passive procedure)

28. Conditioning: Later Paradigms Revised conditioning paradigms recognized the role of cognition • Robert Rescorla • Learned Helplessness • Observational learning • Prepared learning

29. Rescorla • Robert Rescorla challenged the simple mechanistic views of learning • Conceptualized classical conditioning as involving the acquisition of information about the relationship among events in the environment. • Two different association patterns produce two different outcomes

30. Consider what it is like on a farm when bells are rung to signal to workers that the meal is on the table. It takes relatively few trials until the farm workers automatically associate the bell with food. Consider what farm workers would do if they heard a bell and sometimes they were fed and other times they weren't. The bell would not be associated with food.

31. Learned Helplessness • High frequency noncontingent punishment • Seligman classic study • Experimental dogs given inescapable shock • Experimental dogs never learned to jump to other compartment • Control dogs learned to jump to other compartment

32. Learned Helplessness and Depression • Uncontrollable events • Cognitive: responding is futile-motivation is reduced • Self-conceptualization: person feels like a passive recipient rather than active agent • Attribution: (internal, stable, global)

33. Observational Learning • Consequences influence probability of a behavior • Humans can learn by observing • Individuals will model behavior if they identify with another person

34. Bandura’s Early Studies • Child coloring in room • Adult brutalizes a bobo doll and makes aggressive comments for about 10 minutes • Child led to second room with enticing toys • Frustration induced • Child led to third room with several toys and a bobo doll • Child’s behavior is observed

35. Bandura’s Results • Experimental-group children mimicked aggressive action • Control-group children were less likely to treat doll aggressively

36. Observational Learning in Infants • Observation learning begins in infancy • Study by Hanna & Meltzoff (1993) • Trained one-year olds to be “experts” at a novel toy with “tricks” • “Expert” babies demonstrate how to solve the tricks to fellow toddlers • “Trained toddlers” were able to solve the puzzle within 20 seconds • “Untrained toddlers” could not solve the toy’s tricks

37. Prepared Learning • Biology and genetics influence readiness to learn • We are (biologically) prepared to more readily associate fear with some objects or situations (e.g. snakes, heights) over others (e.g., pajamas, electrical outlets) even though both may be associated with panic or trauma.

38. Question: What do these conditioning paradigms that include cognition have to do with the etiology of psychopathology? Or…why are we reviewing this information? Answers: These early models recognized the importance of thought (cognition) in understanding learned behavior. Basic research about the critical role of cognition in determining behavior informed the development of cognitive behavioral therapies Conditioning, Cognitive Processes and Psychopathology

39. Cognitive Behavioral Therapy • Maladaptive behavior results from maladaptive thinking process. • Changing maladaptive thinking will result in improved behavior Note: more later in the semester

40. Emotion and Psychopathology • Emotion can contribute in significant ways to the development of psychopathology

41. Emotion: Definition A subjective feeling that is accompanied by changes in physiological reactions, cognitions, and behavior.

42. Emotion Three components: • Behavior • Physiology • Cognition

43. Theories of Emotion James -Lange Emotional event  Physiological changes  Emotion Schacter -Singer Physiological arousal  Emotion Emotional event  Cognitive label from external cues Izard Emotion Subcortical brain structures   Emotional event Cortex Emotion 

44. Facial Expression: Expressions of Emotion • Nonverbal facial cues are associated with specific emotions • Extensively studied by Izard • Ability increases with age • However even very young children can decipher facial meaning (social referencing video example)

45. Mood • While emotions are short lived temporary states, moods are a persistent period of affect

46. Emotions and Cognition • Emotions affective cognitive processes • For example, good mood increases memory performance and creative problem solving (Isen)

47. Isen, Daubmen & Nowicki (1987) Affect Manipulation Condition Manipulation Check Creative Problem Solving Task Percentage w/ Correct Solution Comedy Film 58% 11% Math Film 16% No Film

48. Emotion and Psychopathology Emotions are principal factor in many psychological disorders • Fear • Anger • Sadness • Excitement Why? Emotions and interpretations are related.

49. “Oh no not again -if “I wonder what’s wrong “I’m doing something “Ah- poor thing - it someone doesn’t help, must be wind! She’s wrong. Its my fault. - is my baby ill? I’ll throw this baby out got great lungs! She’s I’m a useless mother Maybe I’ve not fed her of the window. She’s telling me she’s still she doesn’t like me. properly… should I deliberately winding here and needs I’ve no energy to do take her to the me up!” something!” anything else.” doctor?” Imagine the different emotional reactions of mother’s to their infant’s crying

50. Cultural Gender Interpersonal Developmental Fright disorders (Voodoo, evil eye) Females-phobias and eating disorders Few social relationships is associated with psychopathology Developmental periods may differentially influence vulnerability to psychopathology Culture, Social, & Development