Chapter 2: Theories and Treatment of Abnormality

Sociocultural approach

Views psychological disorders as the result of environmental conditions and cultural norms

Biological approach

Views disorders as the result of abnormal genes or neurobiological dysfunction

Psychological approach

Views disorders as the result of thinking processes, personality styles, emotions, and conditioning

Theory

Set of ideas that provides a framework for questioning, gathering, and interpreting information about a phenomenon

Therapy

• treatment usually based on a theory of a phenomenon

• adresses those factors the theory says cause the phenomenon

Biopsychosocial approach

Recognizing that the development of psychological symptoms often results from the interaction of biological, psychological, and social factors

risk factors

increase the risk of psychological problems

Transdiagnostic risk factors

Increase the risk of multiple types of psychological problems

Diathesis-stress model

When risk factor and trigger/stress come together in the same individual, a full- blown disorder emerges

what does each approach prescribe

bio- medication

psychological and some sociocultural- psychotherapy

sociocultural- work to change social policies/condition

Neuroplasticity

• ability of neuronal circuits to adapt and modify connections on both a structural and functional level

• Ranges from molecular, synaptic, and cellular changes to more global network changes

brain sections

hindbrain, midbrain,, forebrain

hindbrain

• includes all the structures located in the hind (posterior) part of the brain, closest to the spinal cord

• on top of spinal cord for crucial basic life functions

  • medulla- breathing

  • pons- attentiveness and sleep

  • reticular formation- network of neurons that control arousal

  • cerebellum- coordination of movement

midbrain

• contains superior colliculus and inferior colliculus which relay sensory info and control movement

• Substantia nigra- crucial part of pathway that regulars responses reward

forebrain

• relatively large and developed

• cerebral cortex

cerebral cortex

area of brain involved in most advanced thinking processes

• 2 hemispheres connected by corpus collosum

• each hemisphere divided into 4 lobes

  • frontal

  • parietal

  • occipital

  • temporal

subcortical structures

• thalamus

• hypothalamus

• limbic system

• amygdala

• hippocampus

thalamus

directs incoming info from sense receptors to cerebrum

hypothalamus

regulates eating, drinking, and sexual behaviors and processes basic emotions

limbic system

set of structures that regulates many instincive behaviors such as reactions to stressful events and eating

• located around central core of brain and interconnected with hypothalamus

Amygdala

Structure of the limbic system that is critical in emotions such as fear

Hippocampus

Part of the limbic system that plays a role in memory

Brain dysfunction can result from

injury, disease that can cause brain deterioration

Neurotransmitters

Biochemicals that act as messengers carrying impulses from one neuron, or nerve cell, to another in the brain and in other parts of the nervous system

• dentrites

• axon

• synaptic terminals

• cell body

dendrites

Each neuron has a cell body and a number of short branches

axon

slender, tubelike extension

synaptic terminals

small swellings where the impulse stimulates the release of neurotransmitters

how neurotransmitters travel

• Dendrites and cell body receive impulses from adjacent neurons

• Impulse then travels down axon

• synaptic cleft

synapse

Slight gap between the synaptic terminal of one neuron and the dendrite of another neuron

Receptors

Molecules on the membrane of an adjacent neuron

Reuptake

Occurs when the neuron that initially released the neurotransmitter into the synapse reabsorbs the neurotransmitter

• Decreases the amount of neurotransmitter left in the synapse

Degradation

Occurs when the receiving neuron releases an enzyme into the synapse that breaks down the neurotransmitter into other biochemicals.

Psychological symptoms in biological apporach

• too many or few receptors

• increase or decrease amt of neurotransmits

Serotonin

• Travels through many key areas of the brain, affecting the function of those areas

• Implicated in depression, anxiety, aggressive impulses.

dopamine

• found in areas of brain associated with experience of reinforcements or rewards

• affected by substances and behaviors that are pleasurable

Norepinephrine

• produced mainly by neurons in brain stem

• role in development of anxiety and depressive disorder associated with decreased concentration of it in both

GABA

• inhibits action of other neurotransmits

• underlying mechanism responsible for anxiety and depression is a multifactorial process but research suggest GABA plays integral role

endocrine system

system of glands that produce hormones into blood

hormones

carries messages throughout body and affects

• mood, energy, reaction to stress

pituitary gland

master gland, controls secretions of hormones from others endocrine glands

• works with hypothalamus and adrenal glands to regulate response to stress

• chronic stress cause dysregulation in neruotrans and endocrine system

malfunctioning of hypothalamic-pituitary-adrenal axis (HPA axis)

cause anxiety and depression

behavioral genetics

study of genetics of personality and abnormality is concerned with

• to what extent are behaviors/tendencies inherited

• what are the processes by which genes affect behavior

chromosomes contain…

individual genes, segments of long molecules of dna

• abnormalities in genes are more common than major abnormalities in structure/# of chromosomes

polygenic process

multiple genetic abnormalities coming together in other in one person to create specific disorder

• most disorders are polygenic

• do not need all genes to have a disorder (more=higher risk)

genes influence…

type of environment and experiences people choose

• people with identical genes cause them to choose similar environments

• environments at as catalyst for genetic tendency

epigenetics

environmental conditions affect the expression of genes

• enviro instructs genes to turn off/on

drug therapies

standard first line treatments for psychiatric disorders

• overlap among psychiatric disorder and medications

  • suggest disorder likely involve widespread and shared circuitry/neurotrans

antipsychotic drugs

help reduce symptoms of psychosis

antidepressant drugs

reduce symptoms of depression (SNRIs)

snris

designed to target both serotonin and norepinephrine

lithium

widely used as mood stabilizer effective in treatment for bipolar disorder

anticonvulsants

drug used to treat mania and depression

anti-anxiety drugs

First group was the barbiturates

Electroconvulsive Therapy (ECT)

convulsive therapy commonly used for treating severe mood disorders

Repetitive transcranial magnetic stimulation (rTMS)

non-invasively exposes patients to repeated high intensity magnetic impulses focuses on particular brain structures

Deep brain stimulation

Electrodes are surgically implanted in specific areas of the brain, then connected to a pulse generator placed under the skin that delivers stimulation to the specific brain areas

Vagus nerve stimulation (VNS)

invasive brain stimulation method where electrodes are surgically implanted at the vagus nerve.

Psychosurgery

• A neurosurgeon attempts to destroy small areas of the brain thought to be involved in a patient’s symptoms

• rarely used and only used when do not respond to treatment

Behavioral approaches

Focus on how our environment influences and shapes human behavior through experiences of reinforcement and punishment.

Classical conditioning

unconditioned stim/response

conditioned stim/response

Unconditioned stimulus and response

stimulus that produces natural response

responses created by the US

conditioned stimulus and response

previously neutral stimulus

response elicited by the CS

Operant conditioning

Shaping of behaviors by providing rewards for desired behaviors and providing punishments for undesired behaviors

• extinction, partial/continuous reinforcement schedule

modeling

New behaviors are learned by imitating the behaviors modeled by important people

Observational learning

Person observes the rewards and punishments that another person receives and then behaves accordingly

Behavioral therapies

Focus on identifying those reinforcements and punishments that contributed to maladaptive behavior and changing specific behaviors

Systematic desensitization therapy

Gradual method for extinguishing anxiety responses to stimuli and the maladaptive behavior that accompanies this anxiety

Assessing Behavioral Approaches

• Set the standard for scientifically testing hypothesis about how normal and abnormal behaviors develop

• could account for certain symptoms and behaviors in some disorder

Cognitive theories

Argue that it is not simply rewards and punishments motivate behavior, also cognitions

Cognitions

Thoughts and beliefs affect emotions and behavior

Causal attributions

The meaning given to an event affects how people feel about it and respond to it.

Global assumptions

Broad beliefs about oneself, relationships and the world affect moment-to-moment interpretations of events

Cognitive therapies

Help clients identify and challenge their negative thoughts and dysfunctional belief systems

Cognitive-behavioral therapy (CBT)

focused on changing negative patterns of thinking and solving concrete problems through brief sessions in which a therapist helps a client challenge negative thoughts, consider alternative perspectives, and take effective action

Assessing Cognitive Approaches

proven useful in mood, anxiety, sexual, eating disorder

greatest limitation- difficult to prove maladaptive conditions precede and cause disorder

Psychodynamic theories

suggest that all behaviors, thoughts, and emotions, both normal and abnormal, are influenced to a large extent by unconscious processes

Catharsis

Expression of emotions connected to memories and conflicts, leads to release of energy used to keep these memories in the unconscious

Repression

Defense mechanism in which ego pushes anxiety-provoking material back into the unconscious

Ego psychology

Emphasizes ego and a person’s ability to regulate defense mechanisms in a way that promotes adaptive functioning

Object relations

Early relationships with caregivers and important others affect how people view and experience all future relationships

Self-psychology

Emphasizes how people’s self-concept affects the way they relate to others

Relational psychoanalysis

Emphasizes real and imagined relationships with others and their role in abnormality

Collective unconscious

Wisdom accumulated by a society over hundreds of years of human existence is stored in the memories of individuals

Psychodynamic therapies help clients recognize

• Maladaptive coping strategies.

• Unconscious conflicts.

Free association

Client talks about whatever comes to mind, without censoring any thoughts

Resistance

When a client finds it difficult or impossible to address certain material

Transference

Occurs when the client reacts to the therapist as if the therapist were an important person from the client’s past.

Working through

Repeatedly going over painful memories and difficult issues in order to emotionally resolve them

interpersonal therapy (IPT)

Shifted focus from the unconscious conflicts of the individual to the client’s pattern of relationships with important people in their life

Assessing Psychodynamic Approaches

• Most comprehensive theories of human behavior.

• Difficult to test its assumptions scientifically.

• unaffordable bc long

• telehealth

• IPDT effective in nontradtional treatmeant

Humanistic theories

Based on the assumption that humans have an innate capacity for goodness and for living a full life

Carl Rogers’ approach

individuals naturally move toward personal growth, self-acceptance, and self- actualization

Self-actualization

Fulfillment of one's potential for love, creativity, and meaning

Humanistic therap

Helps clients discover their potential through self-exploration

Client-centered therapy

Therapist communicates a genuineness in their role as helper.

Reflection

therapist expresses an attempt to understand what client is experiencing and trying to communicate

Family systems theories

See the family as a complex interpersonal system, with its own hierarchy and rules that govern family members’ behavior

Family systems therapy

Treating the family as a system will resolve an individual’s problematic symptoms

Behavioral family systems therapy (BFST)

targets family communication and problem solving, those beliefs of parents and adolescents that impede communication and systemic barriers to problem solving