PSYC379-23S1 Readings Notes
PSYCHOPATHOLOGY: An Integrative Approach
to Mental Disorders
D. Barlow, et al. (2022, 9th edition)
Key
 Italicized: Definition | Highlight: Important
 Blue bold: Chapter Header | Bold: Section Header
 Blue underlined: Sub-header | Black underlined: Sub-
sub-section Header (black bold if important)
 Pink: Example
Wk. 1 - Perspectives on Psychopathology
Chap. 2: An Integrative Approach to
Psychopathology (pgs. 30-71)
Psychosocial Influences
Psychosocial Influences on Brain Structure
 The effects of treatments for disorders (with
multiple causes) can tell us more about the nature
of psychopathology
 ‘the reasons a problem develops (initiating factors)
are not always the same reasons a problem persists
(maintaining factors); To treat a problem, must
know the maintaining factors
 Psychological treatment is powerful enough to
affect brain circuits directly (w/o surgery/ drugs)
 CBT for OCD (‘exposure and response
prevention’) resulted in brain circuit changes
(normalized) after the intervention
 this idea for psychological treatments on brain
function was also found true for depression, PTSD,
panic/ social anxiety disorders, phobias, and
schizophrenia – depending on the disorder
psychotherapy resulted in normalization of
abnormal activity patterns, activation of other area,
or both; as little as 2 hrs. of intensive exposure-
therapy for a phobia changed brain function
dramatically (lasted >= 6 months)
Placebo Effect: a + effect produced by a placebo drug/
treatment which can’t be attributed to the properties of
the placebo itself
- Research backs the + effects of the placebo effect
– even in brain imaging; presumably a result of
psychological factors (i.e. increasing hope and
expectations or conditioning effects)
- Major depressive disorder patients were treated
with either antidepressants or placebo medication;
measures of brain function show BOTH to have
change. Different parts of the brain were impacted,
suggest different mechanisms of actions were used
with the interventions – at least for depression
- Pain study found both treatments (opioid and
placebo) were effective and activated overlapping
regions in the brain
‘top down’ change: Brain circuit changes originate in
the cortex and work their way down into the lower
brain; often found for CBT/ psychotherapy
1
‘bottom up’ change: Brain circuit changes originate in
the lower brain and reach higher areas of the cortex
last; drugs often work in this manner
Precision medicine: tailoring the treatment plan to the
individual patient to optimize therapy outcomes
Psychosocial Factors and Neurotransmitters
 Research states natural and lab experiments both
show neurotransmitters to react differently
dependent on previous psychosocial experiences.
Directly affect the structure of neurons at the
synapse by altering the sensitivity of neuron
receptors; the effects of serotonin have been found
to be reversible if the losers again become
dominant
o crayfish to establish dominance had neurons
more likely to fire serotonin – loss of
dominance w same neurons less likely to fire
o primates with early stressful experiences
produced deficits in serotonin that did not occur
in those w/ no absence of early stress
o small mouse bullied produced changes in
mesolimbic dopamine  became recluse
Psychosocial Effects on Development
 Early psychological experiences affects the
development of the nervous system  determines
vulnerability to psychological disorders later in life
 The structure of neurons (+ # of receptors) can be
changed by learning & experiences during
development – these effects continue throughout
our life
o The nervous system of rats in a rich
environment (more learning and motor
development) had more nerve cell connections
(+ dendrites) than rats that were lazy – similar
study with stress lead to major changes in HPA
axis
Brain-Gut Connection
Microbiota: Entirety of microorganisms populating
our intestine; combined genome of these organisms is
the microbiome (~20 million genes)
Brain-gut connection: Our emotional well-being
influenced by our gut  some gut bacteria seem
important for physical and mental health
Psycho-biome: The influence of the microbiome of the
gut on the psychological well-being
 Healthy gut bacteria are essential for the immune
system, wrong combo. can produce inflammation
 Microbiota influence some cells in gut lining that
release transmitters  travel to brain
 Depressed people show deficits in bacterial species
involved in dopamine production; serotonin,
common in digestive system, likely important gut-
brain link
**The exact mechanism which the gut influences on
our mental health is not fully understood
Conclusions
***Brain circuits suggest structure and function of the
nervous system play major roles – other research
suggests circuits are strongly influenced by
psychological and social factors. Both biological /
psychological interventions are capable of altering
circuits  we can’t consider nature/ cause of
psychological disorders without examining both
biological and psychological factors (pgs. 52-56)
Behavioral and Cognitive Science
Cognitive Science: how we acquire and process info.;
how we store and retrieve it (i.e. memory)
- Classical and operant conditioning paradigms
show the learning between events in the enviro.
Learned Helplessness: Occurs when animals
encounter conditions over which they have no control
(Martin Seligman, 1976)
- If an animal learns their behavior has no effect on
their environment, they become helpless = they
give up attempting to cope  depression
- Theorized: ‘same phenomenon with people faced
with uncontrollable stress factors – shows true
under condition: people become depressed if they
‘decide/think’ they can do little about the stress in
their lives. People make an attribution they have
no control.
- Illustrates necessity to recognize different ppl.
Process info. About events in the environment in
many different ways
Learned Optimism: If people faced with considerable
stress and difficulty display an optimistic, upbeat
attitude, they are likely to function better
psychologically and physically
- Study (age 50-95) w/ + views of themselves and +
attitudes lived ~7.5 yrs. Longer than those w/o a
positive, optimistic attitude; even after controlling
age, sex, income, loneliness, physical capability,
social activities
- Effect very powerful. 1-4 yrs. Added life,
associated with low blood pressure, low
cholesterol, no obesity, or smoking.
Social Learning/ Modeling/ Observational Learning:
We do not have to experience certain events in our
environment to learn effectively – we can learn
2
through observation of others’ actions/ effects (Albert
Bandura, 1973, 1986) 
- ‘analysis of cognitive processes may produce
accurate scientific predictions of behavior’
Prepared Learning: We’ve become highly prepared for
learning about certain objects/ situations due to
evolution
- Women are particularly sensitive to this learning
compared to men (as early <1yr.
The Unconscious
Implicit Memory: apparent when someone clearly acts
on the basis of things that happened but can’t be
remembered (selective for certain events)
Black Box: Method to identify unconscious,
unobservable feelings inferred from an individual –
possible through advances in technology
i.e. Stroop Color-naming paradigm
- Through this we can now uncover patterns of
emotional significance even if participant can’t
verbalize them/ isn’t aware of them
Emotions
Emotion: Often linked to an action tendency, by an
external event (i.e. threat), feeling state (terror), and a
physiological response (not always)
- Purpose is motivation to carry out behavior: if we
escape, our terror (unpleasant) will ↓
- Emotions are short-lived, temporary states lasting
minutes to hours, in response to an external event
Composed of three related components:
1.) Behavior
2.) Physiology
3.) cognition
Fight or Flight: alarm reaction that activates during
potential emergencies – physical adrenaline rush to
help mobilize us to escape the danger or fend it off
- Fear activates cardiovascular system – blood
vessels constrict  raise arteries pressure,
decrease blood flow to extremities, excess blood to
skeletal muscles
Circumplex Model: temperamental differences in
positive and negative affectivity likely arise from
variations in the bias and reactivity of the valence
system within the CNS.
- Based on a 2-dimensional arousal system: high
arousal and low arousal). 3rd dimension (time)
could be added to specify experience
Mood: More persistent period of affect or emotion
Affective Style: summarize commonalities among
emotional states characteristic of an individual
- i.e. Someone often fearful, anxious, & depressed
 negative affective style
**’Your facial communication increases chance of
survival b/c you can respond faster to threat – this may
be why emotions are contagious (pgs.57-62)
** Emotion is primitive in brain functioning –
therefore you may experience emotions directly w/o
necessarily thinking about them/ being aware
Anger
 Anger affects the heart: decreased pumping
efficiency; the ability for the heart to pump blood
through the body dropped significantly during
anger but not during stress or exercise
 Adopting a forgiving attitude can neutralize the
toxic effects of anger on cardiovascular activity
Dalai Lama: “Harboring anger is like swallowing
poison and expecting the other person to die” –
Antidote to anger is forgiveness;Backed by science!
**Suggests that anger and hostility contribute to heart
disease but as do many other factors, including a
genetically determined biological vulnerability
Conclusions.
 Suppressing an emotional response (i.e. fear/
anger) increases sympathetic nervous system
 Basic emotions/ moods may contribute to many
psychological disorders and may even define
them; emotions and mood also affect our cognitive
processes: positive mood  associations,
interpretations, and impressions tend to be +. A
person’s first impressions and memories are
defined to great extent by their current mood
Cultural, Social, and Interpersonal Factors
Fright Disorders: exaggerated startle responses &
other observable fear and anxious reactions (i.e. susto,
voodoo doll, evil eye, black magic)
- Can be completely culturally shaped
Gender
- Gender roles and culture can greatly impact
phobias and disorders
- severe small-animal phobia ~90% female; assume
differences are to do with cultural expectations/
culture-specific gender-roles, it is more acceptable
for women to acknowledge fearfulness phobia
develops (also potential evolutionary function)
3
- social phobias ~equal among gender; it is more
acceptable for men to be shy than show fear &
may be more likely to admit social discomfort
- Gender Differences in same treatments: PTSD
exposure therapy  women maintain gains
significantly better during follow-up
- Eating disorder (bulimia) almost entirely young
women or gay men  cultural emphasis on
feminine thinness in society; proportion of queer
men with eating disorder was 10x higher than
hetero men
‘Tend and Befriend’ response: Primary female stress-
response: protect themselves through nurturing
behavior (tend) and forming alliances with larger
social groups, mostly other females (befriend
Social Effects on Health and Behavior
 The greater number & frequency of social relations
 the longer you are likely to live. It’s not the
absolute number of social contacts but the
perception of loneliness of importance
 ^lower social index score  shorter life
expectancy; social relations seem to protect
individuals from many physical & psychological
disorders. Risk of depression for those living alone
80% higher than those with others
 Social isolation ↑ risk of death as much as smoking
cigs and more than obesity
 Amphetamine ↑ dominant behaviors in primates ↑
in social hierarchy; ↑ submissive behaviors in
those low in social hierarchy – The effects of a
biological factor (drug) on psychological
characteristics (behavior) were unexplained unless
we consider social context
**Social relations could facilitate health-promoting
behaviors (i.e. restraint from drugs, proper sleep)
- Meta-analysis est. risk for schizophrenia 2.37x
higher in urban environment vs. rural
Social Influences on Elderly
 Those with fewer meaningful contacts & less
social support from relatives had consistently
higher levels of depression – more reports of
unsatisfactory quality of life  idea that it may be
advantageous for elders to be physically ill,
allowing them to reestablishing the social support
making life worth living
Social Stigma
‘Psychological disorders still carry a substantial stigma
in our society’ – with less social support than physical
illness there’s less chance of full recovery and greater
risk of suicide
Global Incidence of Psychological Disorders
Life-Span Development
Erik Erikson (1982): suggest we go through 8 major
crises during our life – ‘important developmental
changes occur at all points in our life’
- Stimulating environments can + affect brain at any
age, even prenatally; disease progression of old
 age disorders can be delayed through enriched
environments
- Gender distribution in depression is ~equal until
puberty – becomes more common in girls
Equifinality: indicate we must consider a number of
paths to a given outcome (causes for disorder)
- The presence of a caring guardian/ adult can offset
negative stresses of an environment; as well as
child’s ability to understand + coping
- New research: Strong biological differences in
response to trauma  protective factors (i.e. social
support, strong purpose/ meaning of life)
Conclusions: comments (pgs.62-71)