Chapter 2

An Integrative Approach to Psychopathology

 One-Dimensional versus
Multidimensional Models

 One-Dimensional Models

 Multidimensional Models
▪ The Role of Genes
▪ Neuroscience
▪ Behavioral and Cognitive Sciences
▪ Emotions
▪ Cultural, Social, and Interpersonal Factors
▪ Life-Span Development

 How do we put it all together?

 One-Dimensional versus
Multidimensional Models

 One-Dimensional Models
▪ Single cause, operating in isolation
▪ Linear causal model
▪ Ignores critical information

 Multidimensional Models
▪ Systemic
▪ Several independent inputs that become
interdependent
▪ Causes cannot be considered out of context
 What Caused Judy’s Phobia?

 Behavioral factors

 Biological factors
▪ Genetics
▪ Physiology
▪ Neurobiology

 Emotional influences
 What Caused Judy’s Phobia?

 Social factors

 Developmental factors

 All of these interact interdependently

What Caused Judy’s Phobia?
 The Nature of Genes

 The nature of genes

 What are genes?
▪ Long molecules of DNA
▪ Double Helix structure
▪ Located on chromosomes
 46 chromosomes in 23 pairs
 Pairs 1 – 22 = body and brain development
 Pair 23 = gender
 The Nature of Genes

 What are genes?

▪ Determine physical characteristics
 (e.g., weight)
▪ Importance of contextual factors
▪ Dominant vs. recessive genes
▪ Single-gene determinants
▪ Polygenetic influences
 Rule, not the exception
 Genetic Contributions to
Psychopathology

 Evidence of the complexity and the contextual nature

of genetics:
▪ Quantitative genetics accounts for the small,
individual effects of several genes
▪ Gene expression and gene-environment
interactions
 New Developments in the Study of Genes
and Behavior

• Behavioral genetics
• Role of genes and psychological disorders
 The Interaction of Genes and the
Environment

 Eric Kandel—learning affects genetic structure of cells

▪ Activation of dormant genes
▪ Continued development in the brain
 Plasticity vs. hardwired
▪ Diathesis-Stress model
 The Interaction of Genes and the
Environment

 Diathesis:
▪ Inherited tendency to express traits/behaviors
▪ Genetic

 Stress:
▪ Life events or contextual variables
▪ Environmental

 Combining both yields activation under the right

conditions
The Diathesis-Stress Model
 The Interaction of Genes and the
Environment

• Gene-environment correlation model

• Genes shape how we create our environments

 Inherited predispositions or traits that increase

one’s likelihood to engage in activities or seek out
situations

 Example: divorce
Gene-Environment Correlation Model
 Epigenetics and the Nongenomic
“Inheritance” of Behavior

 Overemphasis on the role of genes?

 Environment and early learning

▪ Cross fostering studies of development
▪ Critical vs. sensitive periods
 Genetic Contributions to
Psychopathology

 ~50% of variance in personality or cognitive

characteristics

 Complex gene-environment relationships

 Genes:
▪ Behavior, Cognition, Emotions
▪ “Bounds” of environmental impact

 Environment:
▪ Genetic structure and activation
▪ May override genetic diathesis
 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
The Central Nervous System
 The Central Nervous System

 The neuron-basic building block

▪ Soma
▪ Dendrites
▪ Axon
▪ Axon terminals
▪ Synaptic cleft

 Function: electrical

 Communication: chemical
▪ Neurotransmitters
Synaptic Transmission
The Structure of the Brain
 The Structure of the Brain

 Two main parts:

▪ Brain stem
 Basic functions
▪ Forebrain
 Higher cognition
 The Structure of the Brain

 Hindbrain
▪ Medulla—Heart rate, blood pressure, respiration
▪ Pons—Regulates sleep stages
▪ Cerebellum—Physical coordination

 Midbrain
▪ Coordinates movement with sensory input
▪ Contains parts of the reticular activating system
(RAS)
The Structure of the Brain
 The Structure of the Brain

 Thalamus and hypothalamus

▪ Relays between brain stem and forebrain
▪ Behavioral and emotional regulation

 Limbic system
▪ Emotions, basic drives, impulse control
▪ Associated structures and psychopathology

 Basal ganglia
▪ Caudate nucleus
▪ Motor activity
The Structure of the Brain
The Structure of the Brain
The Structure of the Brain
 The Structure of the Brain

 Forebrain (cerebral cortex)

▪ Most sensory, emotional, and cognitive processing
▪ Two specialized hemispheres
 Left
▪ Verbal, math, logic
 Right
▪ Perceptual
The Structure of the Brain
 The Structure of the Brain

 Lobes of the cerebral cortex

▪ Frontal
 Thinking and reasoning abilities, memory
▪ Temporal
 Sight and sound recognition, long-term memory
storage
▪ Parietal
 Touch recognition
▪ Occipital
 Integrates visual input
 The Peripheral Nervous System

 Somatic system
▪ Voluntary muscles and movement

 Autonomic system
▪ Sympathetic (activating)
▪ parasympathetic (normalizing)
▪ Both divisions regulate:
 Cardiovascular system/body temperature
 Endocrine system/digestion
The Peripheral Nervous System
 The Peripheral Nervous System

 The endocrine system

▪ Hormones

 The hypothalamic-pituitary-adrenalcortical axis (HPA

axis)
▪ Integration of endocrine and nervous system
The Peripheral Nervous System
 Neurotransmitters

 Production

 Uptake and reuptake

 Functions
▪ Agonists
 Inverse agonists
▪ Antagonists
 Neurotransmitters

 Glutamate and GABA

▪ Glutamate
 Excitatory
▪ GABA
 Inhibitory
▪ Fast acting
▪ Complex subsystems
▪ Implicated in anxiety
 Benzodiazepines
 Neurotransmitters

 Serotonin (5HT)
▪ Monamine class
▪ Widespread, complex circuits
▪ Regulates behavior, moods, thought processes
▪ Low levels and vulnerabilities
▪ Implicated in several psychopathologies
Neurotransmitters
Neurotransmitters
 Neurotransmitters

 Norepinephrine
▪ Stimulation of alpha- and beta-adrenergic
receptors
▪ Respiration, reactions, alarm response
▪ Implicated in panic
Neurotransmitters
 Neurotransmitters

 Dopamine
▪ “Switch” function in brain circuits
▪ Interacts with other neurotransmitters
▪ Implicated in schizophrenia
▪ Parkinson’s disease
Neurotransmitters
 Implications for Psychopathology

 The brain and abnormal behavior

▪ Studying images
 Obsessive-compulsive disorder
 Psychosocial Influences on Brain
Structure and Function

 Psychosocial influences on the brain

▪ Functional normalization in OCD
▪ Placebo
▪ Psychotherapy
▪ Stress and early development
 Interactions of psychosocial factors with brain
structure and function
▪ Developmental disorders
▪ Environment and brain structures
 Interactions of Psychosocial Factors
and Neurotransmitter Systems

 Some research indicates that psychosocial factors

directly affect levels of neurotransmitters
 Psychosocial Effects on the Development of
Brain Structure and Function

 The structure of neurons themselves, including the

number of receptors on a cell, can be changed by
learning and experience during development
 Behavioral and Cognitive Sciences

 Conditioning and cognitive processes

▪ Respondent and operant learning
▪ Environmental relationships
Behavioral and Cognitive Sciences
Emotional Responses
 Behavioral and Cognitive Sciences

 Learned helplessness
▪ Perceptions of control
▪ Implicated in depression
 Negative attributions
▪ “Learned optimism”
 Behavioral and Cognitive Sciences

 Social learning
▪ Albert Bandura
▪ Modeling
▪ Observational learning
▪ Interactive and contingent on perceptions of
similarity
 Behavioral and Cognitive Sciences

 Prepared learning
▪ Evolutionary basis
▪ Increases survival
▪ “One-trial” learning
 Cognitive Science and the Unconscious

 Blind sight
 Stroop paradigm
 Emotions

 The nature of emotion

▪ Fight or flight response
▪ Fear response
 Cardiovascular
 Cortical
 Emotional response is terror, motivation for
action
▪ Short-lived, temporary states
▪ Different from mood or affect
 Emotional Phenomena

 Emotion
 Mood
 Affect
 The Components of Emotion

 Emotion has three important and overlapping

components: behavior, cognition, and physiology
Emotions
 Anger and Your Heart

• Hostility and anger are risk factors for heart disease

• Cardiovascular efficiency

• Interactions with genetic risks

 Emotion and Psychopathology

• Timing of emotional responses

• Degree of response

• Environmental and social interactions

 Voodoo, the evil eye, and other fears

 Cultural factors
▪ Influence form and expression of behavior
▪ Culturally-bound “fright disorders”
▪ Influence on objects of fear
▪ Interaction with physiology
 Gender

 Gender effects and roles

▪ Related to cultural imperatives
▪ Influence across several dimensions
 Type and prevalence of fears
 Fear behaviors
 Responses
 Coping strategies
 Social Effects on Health and Behavior

 Social effects on health and behavior

▪ Frequency and quality are critical
▪ Low social contacts
 Higher mortality
 Higher psychopathology
 Lower life expectancy

▪ Mediated by meaning and perception

Health and Stress
 Social Effects on Health and Behavior

 “Drift”
 Social and interpersonal influences on the elderly
 Stigma of psychopathology
▪ Influences the expression of distress
▪ Limits help-seeking behaviors
▪ Helps maintain the cycle of pathology
 Global Incidence of Psychological
Disorders

 Global incidence of psychological disorders

▪ Disorders are common across cultures accounting
for 13% of the global burden of disease
▪ Rates and expression varies
▪ Prevalence and incidence influenced by:
 Poverty
 Political unrest
 Technological disparities
▪ Treatment depends on views and provider
availability
 Life-Span Developmental

 Change over time

▪ Biological maturation
▪ Psychological development
▪ Social complexity
▪ Roles and demands
▪ Expression of disorders
▪ Treatment response
 “The end of history” illusion
 Life-Span Developmental

 The principle of equifinality

▪ Chicchetti, 1991
▪ Several paths to a given outcome
▪ Paths vary by developmental stage
 Example: Delirium
▪ Interaction with other dimensions
 Social support