etiological models for psychopathology final

Murray's findings on trauma and etiology

o Said we wasted too much time and money trying to find biological basis for disorders and we ignored trauma. Since then, trauma accounts for more variance in psychosis than genetics does.

Miklowitz on family factors

o Peole who are diagnosed with psychosis often come from families where there is a lot of complaining, perfectionism, basically negative expressed emotions.

-Negative Expressed emotional (EE): high levels of criticism, hostility, or emotional over involvement by a key relative likely contribute to exacerbation and maintenance of psychotic symptoms. In families where there is more at risk for psychosis, there is more negative expressed emotion.

-Negative affective style (AS): negative AS is characterized by at least one relative making at least one personal criticism or guilt-inducing statement or six or more intrusive (mind-reading: I assume you know what youre thinking and chastise you for it) statements to the patient during a 10-minute problem-solving discussion. At least one influential individual in the person's life who conveys and establishes a negative affective style. You do this to try and change the person's behavior.

Mystification: when someone does something, and an emotion happens that you think is indicative of the behavior but it isn't. for example, you yawn and someone goes "why are you mad?". Occurs in negative affective style.

-Double bind hypothesis: damned if you do, damned if you don't. You get in trouble for acting one way and get in trouble for fixing it.

Stice's "dual pathway" model of bulimia and binge eating

o Sociocultural pressure/ideal body internalization body dissatisfaction negative affect OR restrained eating eating disorders

o The two pathways are key. Personal and societal pressure. Talks about external and internal factors

o Body internalization is a specific instance of a human behavior of wanting to imitate.

Cognitive model of substance use

o not a stand alone treatment, works best with psychopharmacology and group intervention

o be sensitive to stages of change model to gauge current stage of patient when beginning a session (ex: asking about usage since last session)

o -7 psychological factors that contribute to risk of substance use:

1) high risk situations: internal and external. Identify people places and things they associate with substance use; physiological and mood states are internal high risk (ex: low distress/discomfort tolerance)

2) dysfunctional beliefs: challenging faulty beliefs (ex: that one is fundamentally bad and doesn't deserve to recover)

3) automatic thoughts increase sympathetic arousal and increase craving; prepare rational responses to reduce reflexive drug use (ex: mental image of children)

4) physiological cravings: delay and distract technique; make a list of activities to do instead of acting on urge

5) permission giving beliefs: "its ok to use this time"; develop rational, well rehearsed responses, like " there is no such thing as using a little" have emotional valance to them; have rise in emotional moments

6) rituals: restructure routine so it is more difficult to access drugs, focusing on improving communication and problem solving skills

7) adverse psychological reactions: to a lapse/relapse; challenge erroneous thinking around failure, study lapse and learn from it

how personality disorders differ from other diagnoses

· OCPD and hoarding: 5 and 7 criteria for OCPD match hoarding diagnosis. OCPD is egosyntonic

· Avoidant personality disorder is different than social anxiety is that someone with avoidant disorder does not think there is a chance of social success. Someone with social anxiety wants to fix their social anxiety. They do not want to be afraid

· Schizotypal is included in the psychotic disorders, but schizoid is not.

hayes and hoffman chapter 6

o Human suffering is shaped by our own capacity for language, symbolic cognition, and relational framing

§ Relational frame theory (RFT): how humans use language to relate stimuli, and how those relations transform the functions of behaviors

o We may develop core beliefs and relational webs that will shape our behavior and emotions (how do we develop "rule-governed behaviors")

o Shift from "what disorder does someone have" to "what relational learning processes are maintaining this person's suffering?"

o Challenges the idea that psychological distress is captured by certain symptom clusters

o Need to understand how an individual processes relations and how they respond

o We use language to create understanding

hayes and hoffman chapter 11

o Researchers and practitioners are moving away from "protocols for syndromes."

§ Unexplained comorbidity, unreliable, increased stigma, and no treatment specificity because it is based on the medical model

o Processes-based therapy (PBT)

§ Build on ACT universalism, process-focused, and idographic methods

§ Emphasis of an evolutionary approach (function, history development, proximal mechanisms)

§ Main question: what core biopsychosocial processes should be targeted with this client, for this goal, in this situation, and how can they change effectively

§ Therapeutic processes of change, set of theory based, dynamic, progressive, context-dependent, and multilevel change processes that occur in sequences toward the goal

§ EEMM is one of these

o Extended evolutionary meta model (EEMM)

§ Dimensions are all the things psychotherapists concern themselves with (affect, cognition, attention, self, motivation, overt behavior, biophysiological, and sociocultural)

§ The levels are biophysiological and sociocultural (old model separates these from other dimensions

§ The variations across the top (variation, selection, retention, and context) effect how the domains present; they select the particular variation of any of the dimensions

§ Ex: at home your mood is depressed, but you go out and see your friends and your mood is lifted

§ Context ultimately determines whether what was retained in adaptive or maladaptive (the old model). The new model does not have maladaptive or adaptive, just context

§ As a therapist, you have to see the pattern of variation and retention of chrematistics of disorders.

§ Ex: one fo the main symptoms can be low mood that you have most days but there are still days where there is no low mood and there is another variation. Motivation changes too.