Week 2 - Models of Psychopathology Flashcards
The Scientist-Practitioner Approach
Psychologists use research findings to guide assessment, dialogue treatment of people with mental health disorders
- Empirically supported assessment & treatment strategies
What are models used to explain?
Models are used to explain:
- Origins of abnormal behaviour
- How to treat it
- How to prevent it
They provide a representation of the real world
Research tests hypothesises derived from models
Biological Models
Aetiological models: * Genetics * Biochemistry
* Neuroanatomy
* Endocrine system
Genetics: Studies of gene-environment interactions
1. The pedigree method
2. Classical twin design
3. Adoption studies
4. Molecular genetics
The Pedigree Method
Biological Model - Proband Identified
Tracking within a particular family across the generations if there is a heritable disorder
Natural Vs Nurture
Environment is important to be taken into account as well
The Classical Twin Design
- Compares concordance rates for Monozygotic (MZ) and Dizygotic (DZ) twins. * Differ in genetic similarity, but likely not different environmental experiences
- If MZ > DZ: genetic contributions * If MZ = DZ and both show high concordance; shared environmental contributions
- E.g., growing up in poverty
- If MZ = DZ, and both show low concordance; non-shared environment contributions
- E.g., Experiences unique to one twin
Adoption Studies
- Compares the concordance of a disorder in adopted children: * To their biological relatives
- To their adoptive relatives
Molecular Genetics
Genetic Association Studies
Candidate gene studies
- Is one allele more frequently seen in people with the disorder than in people without the disorder?
ApoE-e4: 37 with Alzeimers disease vs 14% in general population,
Genome wide association studies
- Assess common variation across the entire genome
No single gene has been found to be entirely responsible disorders
Biochemsity as Aetiology
- The anatomic structure of the neuron, or nerve cell:
Biochemsity as Aetiology
- The anatomic structure of the neuron, or nerve cell:
Synaptic Transmission
Neurotransmitters: Chemicals released into the synapse
between two neurons that carry signals from the terminal of one
neuron to the receptors of another
How the synaptic transmission effects the abnormal psychological disorder
Biochemistry as Aetiology
Most druge therapies increase or decrease the activity of specific neurotransmitter systems have very broad effects
BUT: Neurotransmitter systems have very broad effects
The four neurotransmitter systems
There are four that are important to take into account when focusing on modelling for biological disorders
- Serotonin
Regulates behaviour, mood & thought processes
- Low seratonin actiity associated with
- Aggression, Suicide, Impulsive overeating, Hyper-sexual behaviour
Drugs that primarily affect the seratonin system
- Tricuclic antidepressants
- Seratonin specific reuptake inhibitors (e.g Prozac)
Gamma Aminobutyric Acid
- Inhibits a variety of behaviour & emotions
Seems to reduce arousal, anxiolytic effects
Benzodiazpines make it easier for GABA molecules to attach themselves to the receptors of specialized neurons
Noradrenalin
Secreted by adrenal glands
Noradrenalin circuits in CNS:
1. Hindbrain, in an area that consols basic bodily functions such as respiration
2. Another circuit influences the emergency reaction that occur when we suddenly find ourselves in a very dangerous situation
Dopamine
Dopamine circuits merge and cross with seratonin circuits - influence many of the same behaviour
Relays messages to control movements, mood and thought processes
Parkinson’s disease: dopamine-producing cells damaged
Hindbrain
Function involved in sustaining life, regulation of sleep
Midbrain
Regulation of some motor activies (fighting & sex) and sleep
Forebrain
Site of most sensory, emotional & cognitive functioning
Limbic system
Links to the forebrain with the midbrain with and the hindbrain
Regulate emotion and learning
Make note: Specific disturbances may result from damage to specific areas of the brain
.
Endocrine System as Aetiology
The endocrine organs produce hormones
- Route of message transmission is the bloodstream
Functions of hormones
Help regulate physiological processes
Co-ordinate internal bodily processes with external events
* Prolonged stressed can cause dysfunction
Hypothalamic-Pituiraty-Adrenal (HPA) Axis
HPA axis is here the endocrine system and CNS interact and controls reactions to stress
Hypothalamus connects to adjacents pituitary gland - which is the co-ordinator of the endocrine system
The pituitary gland, in turn, may stimulate the cortical (outer part) of the adrenal gland to produce: Surges of adrenaline, cortisol (the stress hormone)
Psychodynamic Model
Developed primarily by Freud - Five overlapping stages of psychosexual development
Psychodynamic model - Sexual energy changes
- Oral: 0-1 ½ - the mouth sucking, swallowing etc.
- Anal: 1-3 - The anus witholding or expelling faeces
- Phallic: 3-4 - The penis or clitoris mast
- Latency: 5-12 - Little or no sexual motivation present
- Genital:11-20 - The penis or vagina, sexual intercourse
Fixation + Adult Personality
Oral - Forceful feeding, deprivation, early weaning > Oral activities (e.g smoking, dependency, aggression)
Anal - Toilet training: too harsh, too lax > Obsessivness, tidiness, meanness, untidiness, generosity
Phallic - Abonormal family set-up leading to unusual relationship with mother/father > Vanity, self-obsession, sexual anxiety, inadequacy, inferiority, envy.
Psychodynamic Model - 3 parts to personality
3 parts to personality: The Id
* Motivated by biologically driven instincts * Operates at unconscious level according
to pleasure principle and wish fulfilment The Ego
* Motivated by the reality principle
* Uses defence mechanisms to ward off unpleasant feelings (repression, projection etc) The Super Ego
* Conscience and ego ideal Often in conflict
Contributions of Psychodynamic Theory
- Impact of childhood experiences on later development
- The impact of the unconscious on behaviour
- The continuity of normality and abnormality
- Demystified mental illness
- Defence mechanisms
- Transference and counter-transference
Limitations of Psychodynamic
- Resistance to empirical investigation
* How to study unconscious processes? - Emphasises abnormality rather than psychological health
- Hasn’t contributed to prevention or early intervention methods
Humanistic Model
- Explicitly positive view of human nature
- Humans born with natural inclination to be friendly, co-operative
and constructive and are driven to self-actualise - Free will: we control, choose, and are responsible for our actions
Origins: 1940s; Carl Rogers - Client Centred Therapy
Huministic model - explanation of abnormal behaviour
Basic need to receive positive regard from significant others to accept our authentic selves unconditionally
- if not received: distress
Client Centred Therapy
Acceptance, Congruence, Understanding
Behavioural Model (1940s & 1950s)
- John B. Watson (1878-1958) founder of behavioural movement
- Rejection of introspection
- Focus on behaviour which could be observed & measured * Learning has the key role in the development of behaviour
Models of Learning
- Classical Conditioning - Pavlov (1849 - 1936)
- Operant Conditioning - Skinner (1904 - 1990)
Classic Conditioning (Pavlovs dog)
Classical conditioning was first studied in detail by Ivan Pavlov, who conducted experiments with dogs and published his findings in 1897. During the Russian physiologist’s study of digestion, Pavlov observed that the dogs serving as his subjects drooled when they were being served meat.
Operant Conditioning: Skinner
- The best way to understand behaviour is to look at the causes of
an action and its consequences - Reinforcers: responses from the environment that increase the
probability of a behaviour being repeated - Punishment: designed to weaken or eliminate a response
- Extinction: suppressing behaviour by removing the reinforcers
- Discriminative stimulus: external events that tell the organism
that if it performs a certain behaviour a certain consequence will
follow
Classical Conditioning techniques
Systematic Desensitisation
Aversion Therapy
Exposure therapy - relearning connections
Operant Conditioning techniques
Positive reinforcement
Extinction
Token economies
Behavioural activation: re-engagement with rewards
Strengths of Behavioural Model
- Theory and treatments can be tested in the laboratory
- Laboratory research supports the behavioural model
- Many of the techniques remain useful
Weaknesses of Behavioural Model
- No indisputable evidence that abnormal behaviour is due to improper
conditioning - Too simplistic
- Over-emphasis on learning and environmental determinants of behaviour
- Human cognition could not be accounted for
Cognitive Model
1960s - 1970s cognitive revolution
1980s CBT with cognitive model at its core A+B+C model
A = Antecedent/ event
B = Belief
C = Consequence
The Cognitive Principle
- Emotional reactions & behaviour are strongly influenced by
cognitions (thoughts, beliefs, interpretations, etc.) - Different cognitions give rise to different emotions
- By changing cognitions one can change the way that they feel
Strengths of Cognitive Model
- Amenable to empirical enquiry
- Complements behavioural strategies
Weaknesses of Cognitive Model
- Precise mechanism role of cognitions in psychopathology not
clearly known - Lack of evidence for hypothesized mediators of change in CBT
- Lack of evidence that cognitive therapy added to behavior therapy
Other emerging therapies
1990s
* Dialectical Behavior Therapy (DBT; Linehan)
* Mindfulness Based Stress Reduction (Kabat-Zinn)
2000s
* Adaptations of MBSR eg. Mindfulness-Based Cognitive Therapy (MBCT)
1999
* Acceptance & Commitment Therapy (ACT); Hayes, Strosahl & Wilson 1999; 2011
What is Mindfulness?
- “The awareness that emerges through paying attention on purpose,
in the present moment, and non-judgmentally to the unfolding of
experience, moment by moment” (Kabat-Zinn, 2003) - Psychological problems arise when we dwell in the past or become
stuck on thoughts about what might happen in the future
Mindfulness-Based Stress Reduction (MBSR)
Originally developed for chronic pain & stress-related illnesses
Mindfulness-Based Cognitive THerpay (MBCT)
Originally developed for prevention of depressive relapse but has since been expanded to a variety of other populations, including chronic pain.
What is ACT?
“ACT is a therapy approach that uses acceptance and
mindfulness processes to produce greater psychological
flexibility.” (Hayes & Stroshal, 2004)
* Psychological problems originate from thought and language
* Language and cognition can trigger intense emotional pain and
psychological discomfort, and associated behaviours
What is the goal for ACT?
- The goal is psychological flexibility which involves contact with
the present moment and changing or persisting in behaviour in
the service of chosen values
Strengths of Emerging Treatments CBT focused
- CBT does not work for everyone, so we need alternative evidencebased options such as MBSR, MBCT, ACT.
Weaknesses of Emerging Treatments CBT focused
- Currently there is not the breadth and depth of highest level evidence
(e.g., fully powered RCTs) across a range of disorders; - Many of the same criticisms as CBT (i.e., it is not clear if theorised
mechanisms underlie treatment gains etc.)
Daithesis-Stress Perspective
The diathesis-stress model posits that psychological disorders result from an interaction between inherent vulnerability and environmental stressors. Such interactions between dispositional and environmental factors have been demonstrated in psychopathology research.
Diatheses - Genes, Biological characteristics, psychological traits
Stressors - Environmental trauma, economic adversity, loss of loved ones, harsh family backgroun
…All these together leading to a Mental disorder..
