Chapter 2 - Integrative Approach to Psychopathology Flashcards
Multi-dimensional Integrative Approach
Biological Dimensions - Casual factors from the fields of genetics and neuroscience
Psychological Dimensions - causal factors from behavioral and cognitive processes, including learned helplessness, social learning, prepared learning,, and unconsciousness processes.
Emotional Influences - contribute in various ways to psychopathology, as do social and interpersonal influences.
Developmental Influences - figure in any discussion of causes of psychological disorders
Genes
Long molecules of deoxyribonucleic acid (DNA) at various locations on chromosomes within the cell nucleus are inherited from your parents and your ancestors.
Nature of Genes
An average human cell has 46 chromosomes arranged in 23 pairs.
Development of the brain and body
The first 22 pairs of chromosomes
Sex Chromosome
The last pair of chromosomes determines an individual’s sex.
X Chromosomes
The last pair of chromosomes are both X chromosomes for females.
Y Chromosomes
The last pair of chromosomes have a Y chromosome from the mother and an X chromosome from the father for males.
Dominant Gene
One pair of genes that strongly influences a particular trait
[We only need one to determine eye or hair color.]
Recessive Gene
It must be paired with another (recessive) gene to determine a trait.
Polygenic
Most of our behavior, our personality, and even our intelligence are influenced by many genes, each contributing only a tiny effect, all of which, in turn, may be influenced by the environment
The same is true for psychiatric disorders
Quantitative Genetics
Basically, it sums up all the tiny effects across many genes without necessarily telling us which genes are responsible for which effects.
Molecular Genetics
It focuses on examining the actual structure of genes with increasingly advanced technologies such as DNA microarrays.
DNA microarrays
Technologies that allow scientists to analyze thousands of genes all at once and identify broad networks of genes that may be contributing to a particular trait.
Gene studies in rat pups
The absence of normal maternal behavior of “licking and grooming” prevents the genetic expression of a glucocorticoid receptor that modulates stress hormones. This means that rats with inadequate maternal care are more sensitive to stress.
The Interaction of Genes and the Environment
Eric Kandel suggested that the very genetic. Cell structure may change due to learning if genes that were inactive or dormant interact with the environment in such a way that they become active.
(In other words, the environment may occasionally turn certain genes)
This type of mechanism may lead to changes in the number of receptors at the end of a neuron, which in turn, would affect biochemical functioning in the brain.
Diathesis-Stress Model
Individuals inherit tendencies to express certain traits or behaviors, which may be activated under stress conditions.
Each inherited tendency is a diathesis, which means, literally, a condition that makes someone susceptible to developing a disorder.
Vulnerability
The tendency of the diathesis that is inherited mixed with such a life event or type of stressor.
Diathesis is genetically based and the stress is environmentally based but they must interact together to produce a disorder
Two versions of a particular gene were studied for depression.
Allele: the long allele (LL) and the short allele (SS)
Long Allele (LL)
With at least two copies of the long allele (LL), animals were able to cope better with stress than individuals with two copies of the short allele (SS)
Recorded stressful life events show in people with two S alleles, the risk for having major depression doubled if they had at least four stressful events, compared to participants experiencing four stressful events who had two L alleles.
Gene-environment correlation model
or
Reciprocal gene-environment model
Some people might have a genetically determined tendency to create the environmental risk factors that trigger a genetic vulnerability.
Example: Someone may tend to seek out difficult relationships or other circumstances that lead to depression.
Epigenetics
Genes may be turned on or off by cellular material that is located just outside of the genome and stress, nutrition, or other factors can affect this epigenome, which is then immediately passed down to the next generation and maybe for several generations.
Human Nervous System
- Central Nervous System - consisting of the brain and spinal cord
- Peripheral Nervous System - consisting of the somatic nervous system and the automatic nervous system
Neurons
Transmit information throughout the nervous system.
On average the brain uses 140 billion neurons to control our thoughts and actions.
Typical neuron
It contains a central cell body with two branches: dendrites and axons.
a.) Dendrites have numerous receptors that receive messages in the form of chemical impulses from other nerve cells, which are converted into electrical impulses
b.) Axon transmits these impulses to other neurons through connections called synapses.
Action Potential
Information that is transmitted through electrical impulses within each neuron along the axon.
Terminal Button
The end of an axon
Synaptic Cleft
The space between the terminal button of one neuron and the dendrite of another
Neurotransmitter
Biochemicals (chemicals stored in the vesicles of the terminal buttons) that are released from the axons of one neuron and transmit the impulse to the dendrite receptors of another neuron
(Excess or insufficiencies in some neurotransmitters are associated with different groups of psychological disorders)
Major neurotransmitters relevant to psychopathology
- Norepinephrine (aka Noradrenaline)
- Serotonin
- Dopamine
- Gamma-aminobutyric acid (GABA)
- Glutamate
Excitatory Neurotransmitters
They increase the likelihood that the connecting neurons will fire.
- Research showed increased levels of dopamine activity linked to schizophrenia
- Research found correlations between depression and higher levels of norepinephrine
Inhibitory Neurotransmitters
They decrease the likelihood that the connecting neurons will fire.
- Research found reduced levels of GABA associated with excessive anxiety
- Research found correlations between depression and low levels of serotonin.
Overview of the brain in two parts
- Brain stem - a lower and more ancient part of the brain handling essential functions like breathing, sleeping, and moving in a coordinated way, containing the hindbrain, midbrain, thalamus, and hypothalamus.
- Forebrain - The largest part of the forebrain is the cerebral cortex, which allows us to look to the future and plan, reason, and create. Contains the Limbic system with the hippocampus (sea horse), cingulate gyrus (girdle), septum (partition), amygdala (almond), basal ganglia, and caudate (tailed) nucleus.
Hindbrain
Regulates many automatic activities like breathing, heart pumping (heartbeat), and digestion.
It contains the medulla, pons, and cerebellum.
*Cerebellum - controls motor coordination, and recent research suggests that abnormalities in the cerebellum may be associated with autism, although the connection with motor coordination is unclear.
Midbrain
Coordinates movement with sensory input and contains parts of the reticular activating system, which contributes to processes of arousal and tension, such as whether we are awake or asleep.
Thalamus and Hypothalamus
Involved broadly with regulating behavior and emotion
Primarily functions as a relay between the forebrain and the remaining lower areas of the brain stem.
Limbic system
Regulate our emotional experiences and expressions and, to some extent, our ability to learn and to control our impulses. (also involved with the basic drives of sex, aggression, hunger, and thirst)
Limbic means border, so named because it is located around the edge of the brain’s center.
Basal Ganglia and the Caudate (tailed) nucleus
Because damage to these structures is involved in changing our posture or twitching or shaking, they are believed to control motor activity.
Cerebral cortex division
Two hemispheres:
a.) Right hemisphere
b.) Left hemisphere
The hemispheres may look alike structurally and operate relatively independently (both are capable of perceiving, thinking, and remembering) however, recent research indicates that each has different specialties.
Left Hemisphere
Chiefly responsible for verbal and other cognitive processes.
Right Hemisphere
Seems to be better at perceiving the world around us and creating images.
Each hemisphere is divided into four separate areas.
- Temporal Lobe- Associated with recognizing various sights and sounds and with long-term memory storage.
2.) Parietal Lobe - Associated with recognizing various sensations of touch and monitoring body positioning
- Occipital Lobe - Associated with integrating and making sense of various visual inputs
- Frontal Lobe - Most interesting from the point of view of psychopathology. The frontal (or anterior) of the frontal lobe is called the prefrontal cortex and is the area responsible for higher cognitive functions like thinking and reasoning, planning for the future, and long-term memory.
This area of the brain synthesizes all information received from other parts of the brain and decides how to respond.
Peripheral Nervous System
Coordinates the brain stem to make sure the body is working properly.
Two major components:
- Somatic Nervous System
- Automatic Nervous System
Somatic Nervous System
Controls the muscles, so damage in this area might make it difficult for us to engage in any voluntary movement, including talking.
Automatic Nervous System
The primary duties of this system are to regulate the cardiovascular system (heart and blood vessels) and the endocrine system (pituitary gland, adrenal, thyroid, and gonadal glands) and to perform various other functions, including aiding digestion and regulating body temperature.
Includes:
a.) Sympathetic Nervous System
b.) Parasympathetic Nervous System
Endocrine System
It is closely related to the immune system and is also implicated in a variety of disorders. Contributes to stress-related physical disorders and endocrine regulation may also play a role in depression, anxiety, and schizophrenia.
Each endocrine gland produces its own chemical messenger, called a hormone, and releases it directly into the bloodstream.
Adrenal glands produce epinephrine (also called adrenaline) in response to stress as well as salt-regulating hormones; the thyroid gland produces thyroxine, which facilitates energy metabolism and growth; the pituitary is a master gland that produces a variety of regulatory hormones, and the gonadal glands produce sex hormones such as estrogen and testosterone.
An interdisciplinary area of research is termed psychoneuroendocrinology.
Sympathetic Nervous System
Responsible for mobilizing the body during times of stress or danger by rapidly activating the organs or glands under its control.
Three things happen the sympathetic division went on alert:
- Heart beats faster, thereby increasing the flow of blood to the muscles
- Respiration increases, allowing more oxygen to get into the blood and brain
- Adrenal glands are stimulated
Parasympathetic Nervous System
One of the functions of the parasympathetic nervous system is to balance the sympathetic system.
The system takes over after the sympathetic nervous system has been active for a while, normalizing our arousal and facilitating energy storage by helping the digestive process.
Hypothalamic-pituitary-adrenocortical axis (HPA axis)
- The hypothalamus is connected to the adjacent pituitary gland, which is the master or coordinator of the endocrine system.
- The pituitary, in turn, may stimulate the cortical part of the adrenal glands on top of the kidneys.
- Epinephrine Surges tend to energize, arouse, and prepare our bodies for threats or challenges. (When athletes say their adrenaline was really flowing, they mean they were highly aroused and up for the competition)
- The cortical part of the adrenal glands also produces the stress hormone cortisol.
Good evidence that dysregulation of the HPA axis is linked to depression
Telomeres
Certain structures that cap the ends of chromosomes to protect the chromosome from deteriorating or getting entangled with neighboring chromosomes.
** A recent study by Gotlib and colleagues suggests that telomere appears to moderate the effect of depression and cortisol. **
Neurotransmitters
Carry messages from one neuron to another
[Narrow currents flowing through the ocean of the brain. Sometimes they run parallel with other currents, only to separate again. Often, they seem to meander aimlessly, looping back on themselves before moving on. Neurons that are sensitive to one type of neurotransmitter cluster together and form paths from one part of the brain to the other]
Estimate suggest that more than 100 different neurotransmitters, each with multiple receptors, are functioning in various parts of the nervous system
Brain Circuits
Paths that may overlap with the paths of other neurotransmitters but somehow end up going their separate ways. [There are thousands, perhaps tens of thousands of these brain circuits]
Agonists
A substance that effectively increases the activity of a neurotransmitter by mimicking its effects.
Antagonists
Substances that decrease or block, a neurotransmitter
Inverse Agonists
Substances that produce effects opposite to those produced by the neurotransmitter
Reuptake
Some drugs that do not affect neurotransmitters directly but prevent the chemical from reaching the next neuron by closing down or occupying the receptors in that neuron.
After the neurotransmitter is released, it is quickly broken down and brought from the synaptic cleft into the same neuron that released it.
Two types of neurotransmitters are most relevant to psychopathology.
a.) Monoamines: norepinephrine (aka noradrenaline), serotonin, and dopamine.
b.) Amino-acids: gamma-aminobutyric acid (GABA) and glutamate
[Referred to as “Chemical Brothers” because they work in concert to balance functioning in the brain.]
These are considered “classic” neurotransmitters because they are synthesized in the nerve.
Glutamate
An excitatory transmitter that “turns on” many different neurons, leading to action.
Gamma-aminobutyric acid (GABA)
An inhibitory transmitter that regulates the transmission of information and action potentials.
Effects of MSG in Chinese food
People sensitive to glutamate may experience adverse effects of MSG (monosodium glutamate.)
MSG can increase the amount of glutamate in the body causing headaches, ringing in ears, or other physical symptoms in people.
Effects of the class of drugs: Benzodiazepines (or minor tranquilizers)
Make it easier for GABA molecules to attach themselves to the receptors of specialized neurons. Thus, the higher the level of benzodiazepines, the more GABA becomes attached to the neuron receptors and the calmer we become (to a point)
Serotonin aka 5-Hydroxtryptamine (5HT)
It influences a great deal of our behavior, mainly how we process information. This is because six major serotonin circuits spread from the midbrain, looping around its various parts, which primarily end up in the cortex.
Low activity levels have been associated with aggression, suicide, impulsive overeating, and excessive sexual behavior
This may make us more vulnerable to certain problematic behaviors without directly causing them.
Norepinephrine (aka noradrenaline)
Stimulates two groups of receptors:
a.) alpha-adrenergic
b.) beta-adrenergic
Circuits in the central nervous system:
1.) Begins in the hindbrain that controls basic bodily functions such as respiration
1. Another appears to influence the emergency reactions or alarm responses.
Dopamine
A major transmitter that had been linked to schizophrenia, disorders of addiction, depression, and attention deficit hyperactivity disorder.
Reserpine (wonder drug for schizophrenia) blocks specific dopamine receptors, thus lowering dopamine activity.
Dopamine and Serotonin Merged and Crossed Circuits
Their circuits merge and cross each other at many points, therefore influencing many of the same behaviors.
For example:
Dopamine activity is associated with exploratory, outgoing, pleasure-seeking behaviors. Whereas, serotonin is associated with inhibition and constraint, thus, in a sense they balance each other out.
Brain Images of Patients with OCD
a.) The size and structures of the brain are the same as those of other people
b.) Increased activity in the part of the frontal lobe of the cerebral cortex called the orbital surface, the cingulate gyrus, and, to a lesser extent, in the caudate nucleus, which is a circuit that extends from the orbital section of the frontal area of the cortex to the thalamus.
Damage interrupting serotonin circuits
Seem to impair the ability to ignore irrelevant external cues, thus finding ourselves acting on every thought or impulse that enters our heads.
Initiating factors
Reasons why a problem developed in the first place
Maintaining Factors
Reasons why problems persist
(particular experiences from the past that might have initiated the problem)
Cognitive Behavioral Therapy Practice
Exposure and Response prevention is known to be effective for depression, PTSD, OCD, panic disorder, social anxiety disorder, specific phobias, and schizophrenia.
Placebo
Placebos alone are not usually as effective as active medication, but every time clinicians prescribe pills, they are also treating the patient psychologically by inducing positive expectations for change, and thus intervention changes brain function.
Top Down
Changes that originate in the cortex and work their way down into the lower brain.
Example: CBT facilitates changes in thinking patterns in the cortex, which, in turn, affects the emotional brain.
Bottom Up
Reaching higher areas of the cortex (where thinking occurs) last.
Example: Drugs seem to go straight to the lower brain and work their way up to the cortex.
Precision Medicine
Tailoring the treatment to the individual patient in order to optimize therapy outcomes
Cognitive Science
Concerned with how we acquire and process information and how we store and ultimately retrieve it (one of the processes involved with memory)
Learned Helplessness
Occurs when rats or other animals encounter conditions over which they have no control
Example: If animals learn that their behavior has no effect on their environment - sometimes they get shocked and sometimes they don’t, no matter what they do - they become “helpless”: in other words, they don’t give up attempting to cope and seem to develop the animal equivalent to depression
Attribution
People become depressed if they “decide” or “think” they can do little about the stress in their lives, even if it seems to others that there is something they could do.
People make an attribution that they have no control, and they become depressed.
Learned optimism
A different set of attributions
If people faced with considerable stress and difficulty in their lives nevertheless display an optimistic, upbeat attitude, they are likely to function better psychologically and physically.
Positive Psychology
Investigators explore factors that account for positive attitudes and happiness.
Modeling or Observational learning
Learning by observing what happens to someone else in a situation
Prepared Learning
We have become highly prepared to learn about certain types of objects or situations over the course of evolution because this knowledge contributes to the survival of the species.
Implicit memory
It is apparent when someone clearly acts on the basis of things that have happened in the past but can’t remember the events.
Explicit Memory
A conscious memory of events
Black Box
Refers to unobservable feelings and cognition inferred from an individual’s self-report or behaviors.
Example: Stroop color naming paradigm
Fight or Flight Response
The alarm reaction activates during potentially life-threatening emergencies.
The whole purpose of the physical rush of adrenaline that we feel in extreme danger is to mobilize us to escape the danger (flight) or to fend it off (fight)
Emotion of Fear
A Subjective feeling of terror, a strong motivation for behavior (escaping or fighting), and a complex physiological or arousal response.
Emotion is linked to an action tendency, that is, a tendency to behave in a certain way (for example, escape), elicited by an external event (a threat) and a feeling state (terror) and accompanied by a (possibly) characteristic physiological response.
Usually short-lived, temporary states lasting from several minutes to several hours, occurring in response to an external event.
Mood
More persistent periods of affect or emotionally
a.) Mood disorders - enduring or recurring states of depression or excitement (mania)
Affect
Often refers to the valance dimensions (pleasant or positive vs. unpleasant or negative) of an emotion.
For example: Postive affect is experienced during joy, whereas negative affect is experienced during anger and fear.
Together with arousal dimensions (activated of high arousal vs. deactivated and low arousal), any emotional experience can be assigned to a point on this two-dimensional system.
Circumplex model of emotions
The two-dimensional system
Emotion is composed of three components:
a.) Behavior
b.) Physiology
c.) Cognition
Fright Disorder
Characterized by exaggerrated startle responses and other observable fear and anxiety reactions.
Fear
What we fear is strongly influenced by our social environment.
Phobia
The likelihood of you having a particular phobia is powerfully influenced by your gender.
Cultural expectations of men and women and our gender roles
Tend and Befriend
A unique way that females respond to stress in their lives.
Refers to protecting themselves and their young through nurturing behavior (tend) and forming alliances with larger social groups, particularly other females (befriend)
Social Effects on Health & Behavior
Many studies have demonstrated that the greater the number and frequency of social relationships and contacts, the longer you are likely to live.
Social and Interpersonal Influences on the Elderly
The effect of social and interpersonal factors on the expression of psychical and psychological disorders may differ with age.
The principle of equifinality
Used in developmental and psychopathology to indicate that we must consider a number of paths to a given outcome.
