Chapter 2

An Integrative Approach to Psychopathology

 One-Dimensional vs. Multidimensional
Models
 One-dimensional Models (very dangerous model)
 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
 One-Dimensional vs. Multidimensional
Models
 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
 Multidimensional Models of Abnormal
Behavior
 Major Influences
 Biological
 What can physically be contributing
 Behavioral
 What are you doing
 Emotional
 How are you feeling
 Social & cultural
 Big culture barriers between 1 st and 2nd generations
 Developmental
 Are you having appropriate changes
 Environmental
 What’s going on around you
 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
What Caused Judy’s Phobia?
 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
 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
 If you have a risk factor for panic attacks and have
poorly developed coping mechanisms, you are
more likely to suffer from a panic attack
The Interaction of Genetic and
Environmental Effects
The Central Nervous System
 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
 Connects the brain to limbs and organs
The Central Nervous System
 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 (Reasoning, Planning,
Learning, etc.)
 Contains limbic system, basal ganglia, cerebral
cortex (larges part of the brain, the wrinkled
outer structure)
 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) (i.e., contributes to processes of arousal and
tension whether we are sleep or awake)
 Neuroscience and Brain Structure

 Limbic system
 Involved in emotional processing, aggression
 Thalamus – receives and integrates sensory
information
 Hypothalamus – eating, drinking, aggression,
sexual activity
 Responses for basic everyday activity
 Basal ganglia: Thought to partially control motor
activity
 Parkinson's’ Disease
 Neuroscience and Brain Structure

 Forebrain
 Most sensory, emotional, and cognitive processing
 Cerebral cortex contains two specialized
hemispheres (left and right)
 Left hemisphere (Language) controls the right
side of the body
 Right Hemisphere (Visual) controls the left side
of the body
 Each hemisphere has four lobes with
specialized processes
 Neuroscience and Brain Structure

 Lobes of the Cerebral Cortex and some of their important

functions
 Frontal – thinking and reasoning abilities, memory,
planning, problem solving
 Most sophisticated structure in the brain
 Tells your brain how to organize information in order
to have memories
 Parietal – touch recognition
 Occipital – integrates visual input
 Primary Visual
 Temporal – recognition of sights and sounds, long-term
memory storage
 Primary auditory
 Peripheral Nervous System

 Somatic branch of PNS

 Controls voluntary muscles and movement
 Contains the cranial nerves
 Autonomic branch of the PNS
 Involuntary processes
 Ex: Pupil restriction & dilation, Salivation
 Sympathetic and parasympathetic branches
 Important for development of psychopathology
 Sympathetic: Responsible for Fight-or-Flight response
 Primarily produces epinephrine (also called
adrenaline)
 Parasympathetic: Responsible for relaxation (Rest &
Digest)
 Regulates cardiovascular system & body temperature
 Also regulates the endocrine system and aids in digestion
Sympathetic Nervous System
 Neuroscience: Endocrine Systems

 The Endocrine System

 Regulates release of hormones
 The Hypothalamic-Pituitary-Adrenocortical axis (HPA
axis)
 Integration of endocrine and nervous system
function
 Axis that we think is most responsible for PTSD
(Post Traumatic Stress Disorder)
 Dysregulated hormones implicated in some forms of
psychopathology
 PMS is now considered a psychological disorder
 Neurotransmitters

 Functions of Neurotransmitters
 “Chemical messengers” - transmit messages
between brain cells
 Other chemical substances in the brain
 Agonists
 Promotes production of a neurotransmitter
 Inverse agonists
 Produce effects opposite to those produced by
the neurotransmitter
 Antagonists
 Depletes production of a neurotransmitter
 Most drugs are either agonistic or antagonistic
 Neuroscience: Functions of Main Types
of Neurotransmitters
 Main types of neurotransmitters
 Serotonin (5-HT)
 Glutamate
 Excitatory neurotransmitter
 Involved in learning and memory
 Gamma aminobutyric acid (GABA)
 Inhibitory neurotransmitter
 Primary for things like muscle tone
 Norepinephrine
 Dopamine
 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
 SSRI – Selective Serotonin Re-Uptake Inhibitor
 Norepinephrine

 Also called noradrenaline

 Involved in alarm responses and basic bodily
processes (e.g. breathing)
 Fight-or-Flight drug
 Dopamine

 Implicated in depression and ADHD

 Link between excessive dopamine and schizophrenia
 THEORY: Too much dopamine can cause
schizophrenia
 Link between reduced dopamine and Parkinson’s
disease
 Too little dopamine could cause Parkinson’s
Disease
 Psychosocial Influences on Brain
Structure and Function
 More stimulating environments appear to promote
neurodevelopment
 Stress and early development
 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)
 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
 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
 Anger and Your Heart

 Chronic hostility increases risk for heart disease

 Heart disease is found more in men than in women
because men are found to become angry more
often than women
 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
 Emotions and Psychopathology

 Suppressing negative emotions increases

sympathetic (Fight-or-Flight) nervous system activity
 Dysregulated emotions are key features of many
mental disorders
 Example: Panic attack = fear occurring at the
wrong time
 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
 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
 When you put people in elderly homes, they
decline both cognitively and emotionally
 They either isolate themselves from everyone
else there and pass quickly or they embrace all
of the other people around them
 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
 Ex: Women won’t show anger, Men won’t show
sadness, etc.
 May discourage treatment seeking
 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
 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
 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