An Integrative Approach to Psychopathology

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An Integrative Approach to Psychopathology
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What is a Mental Disorder?

• Any suggestions, ideas??

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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)

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Other Ways to Define Abnormal?

• Statistical Deviance
• Biological Disadvantage
• Unexpected Distress or Disability
• Harmful Dysfunction

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Option 1 Statistical Deviance

• Considers only those conditions that are rare or
  uncommon (e.g. schizophrenia)
• Problems with this definition??

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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?

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Option 2 Biological Disadvantage

• Considers only those conditions that seriously
  impact an individuals ability to reproduce
• Approaches the definition of disorder from a
  evolutionary or Darwinian perspective
• Problems with this definition??

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Option 2 Biological Disadvantage

• Considers only those conditions that seriously
  impact an individuals 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

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Option 3 Unexpected Disability or Disadvantage

• Considers conditions if your behavior causes you
  distress or disability that is not expected
• Problems with this one??

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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

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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??

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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

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Models of Psychopathology
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Unidimensional Etiological Models of
Psychopathology

• Advocate single causes of psychopathology
• Biological
• Psychological
• Systems

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Diathesis-Stress Etiological Model of
Psychopathology

• Biological vulnerability
• Environmental stress

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Multidimensional Model of the Etiology of
Psychopathology

• Biological (genetic, brain structures,
  neurotransmitters)
• Behavior and cognition
• Emotion
• Social and cultural factors
• Developmental factors

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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

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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

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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

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Genetics and the Multidimensional Model
Implications

• Early environmental manipulation may override
  genetically influenced tendencies to develop
  abnormal behavior

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Neurotransmitters and Psychopathology

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

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Neurotransmitters

• Serotonin
• GABA (Gamma aminobutyric acid)
• Norepiniphrine
• Dopamine

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Neurotransmitters and Psychopathology

• 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

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Behavioral and Cognitive Influences to
Psychopathology
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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

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Classical Conditioning

• Pairing of a UCS with a CS produces a CR (without
  any thought on the part of the person a passive
  procedure)

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Conditioning Later Paradigms

• Revised conditioning paradigms recognized the
  role of cognition
• Robert Rescorla
• Learned Helplessness
• Observational learning
• Prepared learning

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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

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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.  
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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

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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)

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Observational Learning

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

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Banduras 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
• Childs behavior is observed

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Banduras Results

• Experimental-group children mimicked aggressive
  action
• Control-group children were less likely to treat
  doll aggressively

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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 toys
  tricks

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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.

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Conditioning, Cognitive Processes and
Psychopathology

• Question
• What do these conditioning paradigms that include
  cognition have to do with the etiology of
  psychopathology?
• Orwhy 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

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Cognitive Behavioral Therapy

• Maladaptive behavior results from maladaptive
  thinking process.
• Changing maladaptive thinking will result in
  improved behavior
• Note more later in the semester

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Emotion and Psychopathology

• Emotion can contribute in significant ways to the
  development of psychopathology

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Emotion Definition

• A subjective feeling that is accompanied by
  changes in physiological reactions, cognitions,
  and behavior.

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Emotion

• Three components
• Behavior
• Physiology
• Cognition

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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
?
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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)

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Mood

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

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Emotions and Cognition

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

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Isen, Daubmen Nowicki (1987)
Manipulation Check Creative Problem Solving Task
Percentage w/ Correct Solution
Affect Manipulation Condition
Comedy Film
58
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Math Film
16
No Film
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Emotion and Psychopathology

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

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Imagine the different emotional reactions of
mothers to their infants crying
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Culture, Social, Development

• 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

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Multidimensional Model of the Etiology of
Psychopathology

• Biological (genetic, brain structures,
  neurotransmitters)
• Behavior and cognition
• Emotion
• Social and cultural factors
• Developmental factors