Chapter 2 - Understanding and Treating Mental Disorders

Most contemporary explanations of mental disorders fall into four distinct camps

Most contemporary explanations of mental disorders fall into four distinct camps

(a)biological views, including genetics and other physiological explanations; (b)psychological issues, rooted in the invisible complexities of the human mind; (c)dysfunctional social relationships, including stressful interactions with family members and peers; and (d)sociocultural influences, including the effects of discrimination and stressors related to race, gender, and poverty.

models

an analogy used by scientists, usually to describe or explain a phenomenon or process they cannot directly observe

Scientists now recognize that one-dimensional perspectives are overly simplistic because they

• (a)

  set up a false “either–or” dichotomy between accepting one explanation or another (e.g., nature vs. nurture),

• (b)

  neglect the possibility that a variety of circumstances contribute to the development of mental disorders, and

• (c)

  fail to recognize the reciprocal interactions of the various contributing factors.

biopsychosocial model

the perspective suggesting that interactions between biological, psychological, and social factors cause mental disorders

sociocultural influences

factors such as gender, sexual orientation, spirituality, religion, socioeconomic status, race/ethnicity, and culture that can exert an effect on mental health

multipath model

a model that provides an organizational framework for understanding the numerous influences on the development of mental disorders, the complexity of their interacting components, and the need to view disorders from a holistic framework

The multipath model is _____and _____.

interactive and intergrative

implusivity

a tendency to act quickly without careful thought

heterogeneous

different or diverse

protective factors

conditions or attributes that lessen or eliminate the risk of a negative psychological or social outcome

the forebrain

responsible for higher-level mental processes

the midbrain

involved with basic functions such as hearing and vision, motor movement, alertness and sleep–wake cycles, and temperature regulation

the hindbrain

responsible for instinctive behavior related to self-preservation and survival as well as basic bodily functions involving physiological equilibrium such as heartbeat, respiration, and digestion.

the left hemisphere of the brain is associated with?

many language functions

the right hemisphere of the brain is associated with?

visual-spatial abilities and has stronger connections to structures associated with emotion

forebrain

contains brain structures associated with characteristics that make us human—thoughts, perceptions, intelligence, language, personality, imagination, planning, organization, and decision making

cerebrum

the largest part of the brain, consisting of the right and left hemisphere

cerebral cortex

the outermost layers of brain tissue; covers the cerebrum

neurons

a nerve cell that transmits messages throughout the body

prefrontal cortex

the outer layer of the prefrontal lobe responsible for inhibiting instinctive responses and performing complex cognitive behavior such as managing attention, behavior, and emotions

executive functioning

mental processes that involve the planning, organizing, and attention required to meet short-term and long-term goals

limbic system

a group of deep brain structures associated with emotions, decision making, and memory formation

amygdala

the brain structure involved with physiological reactivity and emotional memories

hippocampus

the part of the brain involved in forming, organizing, and storing memories

autonomic nervous system (ANS)

a system that coordinates basic physiological functions and regulates physical responses associated with emotional reactions

hypothalamus

the brain structure that regulates bodily drives, such as hunger, thirst, and sexual response, and body conditions, such as body temperature and circadian rhythms

hypothalamic-pituitary-adrenal (HPA) axis

a system activated under conditions of stress or emotional arousal

pituitary glandthe gland that stimulates hormones associated with growth, sexual and reproductive development, metabolism, and stress responses

the gland that stimulates hormones associated with growth, sexual and reproductive development, metabolism, and stress responses

hormones

regulatory chemicals that influence various physiological activities, such as metabolism, digestion, growth, and mood

adrenal gland

a gland that releases sex hormones and other hormones, such as cortisol, in response to stress

gila

the cells that support and protect neurons

neural circuits

a signal-relaying network of interconnected neurons

dendrites

a short, rootlike structure on the neuron cell body that receives signals from other neurons

axon

an extension on the neuron cell body that sends signals to other neurons, muscles, and glands

axon terminals

bulblike swellings

Thus, dendrites bring information __ the body of the cell and axons carry information _____ from the cell.

to, away

myelination

the process by which myelin sheaths increase the efficiency of signal transmission between nerve cells

gray matter

brain tissue comprised of the cell bodies of neurons and glia

Effective communication between neurons relies on both ______ impulses and ______ signals

electrical, chemical

neurotransmitters

any of a group of chemicals that help transmit messages between neurons

synapse

a tiny gap that exists between the axon of the sending neuron and the dendrites of the receiving neuron

reuptake

the reabsorption of a neurotransmitter after an impulse has been transmitted across the synapse

enteric nervous system (ENS)

an independent neural system involved with digestion; capable of signaling the brain regarding stress and other emotions

homeostasis

the ability to maintain internal equilibrium by adjusting physiological processes

neuropeptides

small molecules that can directly and indirectly influence a variety of hormones and neurotransmitters

neuroplasticity

the ability of the brain to change its structure and function in response to experience

neurogenesis

the birth and growth of new neurons

neural stem cells

uncommitted cells that can be stimulated to form new neurons and glia

heredity

the genetic transmission of personal characteristics

traits

a distinguishing quality or characteristic of a person, including a tendency to feel, perceive, behave, or think in a relatively consistent manner

genes

segments of DNA coded with information needed for the biological inheritance of various traits

genome

the complete set of DNA in a cell; the human genome consists of approximately 30,000 genes located in the nucleus of every cell

genotype

a person’s genetic makeup

phenotype

observable physical and behavioral characteristics resulting from the interaction between the genotype and the environment

genetic mutations

an alteration in a gene that changes the instructions within the gene; some mutations result in biological dysfunction

alleles

the gene pair responsible for a specific trait

polymorphisms

a common DNA mutation or variation of a gene

Epigenetics

a field of biological research focused on understanding how environmental factors influence gene expression

gene expression

the process by which heritable information in a gene is translated into a specialized function within a cell; although the DNA within the cell does not change, epigenetic changes can be passed on to new cells during cell division and can be inherited

Epigenetic modifications appear to result from four primary categories of environmental influences:

nutrition, behavior, exposure to stress, and contact with toxins

Psychopharmacology

the study of the effects of psychotropic medications on thoughts, emotions, and behaviors

psychiatric medications correct physiological imbalances by __________ biochemical processes

normalizing

Classes of medication used to treat mental disorders include

• (a)

  antianxiety drugs (or minor tranquilizers),

• (b)

  antipsychotics (or major tranquilizers),

• (c)

  antidepressants (used for both depression and anxiety), and

• (d)

  mood stabilizers (sometimes called antimanic drugs).

used to calm people and to help them sleep

anti anxiety medication

treat the agitation, mental confusion, and loss of contact with reality associated with psychotic symptoms

antipsychotic medications

psychotic symptoms

the loss of contact with reality that may involve disorganized thinking, false beliefs, or seeing or hearing things that are not there

extrapyramidal symptoms

side effects of antipsychotic medications that can affect a person’s gait, movement, or posture

Some atypical antipsychotics reduce ________ transmission by loosely binding to dopamine receptors

dopamine

prescribed to help relieve symptoms of depression and anxiety. There are several well-known classes of antidepressants.

antidepressant medications

The primary difference between SSRIs and other antidepressants is that SSRIs specifically target the neurotransmitter serotonin whereas others target ________ neurotransmitters.

multiple

____________ are now being used for some psychological disorders

probiotics

Electroconvulsive therapy (ECT)

a procedure that can change brain chemistry and reverse symptoms associated with some mental disorders

psychosurgery

performing brain surgery in an attempt to correct a severe mental disorder

deep brain stimulation (DBS)

involves implanting electrodes that produce ongoing stimulation of specific areas of the brain.

vagus nerve stimulation

involves surgically implanting a pacemaker-like device under the skin on the chest; when activated, the device sends signals along a wire connected to the vagus nerve

vagus nerve

a nerve that creates a mind-body pathway from the brain through the digestive tract to the abdomen; regulates autonomic nervous system processes and body reactivity

repetitive transcranial magnetic stimulation (rTMS)

involves stimulation of the prefrontal cortex and regions of the brain involved with mood regulation; this is done by means of magnetic pulses emitted from an electromagnetic coil held against the forehead

Criticisms of Biological Models and Therapies?

Biological models are criticized for their failure to consider an individual’s unique life circumstances or psychological, social, or cultural influences on a person’s symptoms

drug-drug interactions

when the effect of a medication is changed, enhanced, or diminished when taken with another drug, including herbal substances

The psychological dimension focuses on:

emotions, learned behavior, and cognitions

Psychodynamic models

a model of psychopathology concerned with unconscious conflicts

The __ operates from the pleasure principle

id

pleasure principle

the impulsive, pleasure-seeking aspect of our being, from which the id operates

the ___ represents the realistic and rational part of the mind. It is influenced by the reality principle

ego

reality principle

an awareness of the demands of the environment and of the need to adjust behavior to meet these demands, from which the ego operates

Moralistic considerations are the domain of the ________

superego

psychosexual stages

in psychodynamic theory, the sequence of stages—oral, anal, phallic, latency, and genital—through which human personality develops

the oral

first year of life

anal

around the second year of life

phallic

beginning around the third or fourth years of life

latency

approximately 6 to 12 years of age

genital

beginning in puberty

Fixation ______ emotional development at a particular psychosexual stage

halts

defense mechanisms

in psychoanalytic theory, an ego-protection strategy that shelters the individual from anxiety, operates unconsciously, and distorts reality

psychoanalysis

therapy aimed at helping clients uncover repressed material, achieve insight into inner motivations and desires, and resolve childhood conflicts that affect current relationships

free association

a psychoanalytic therapeutic technique in which clients are asked to say whatever comes to mind for the purpose of revealing their unconscious thoughts

Dream analysis

a psychoanalytic technique focused on interpreting the hidden meanings of dreams

resistance

during psychoanalysis, a process in which the client unconsciously attempts to impede the analysis by preventing the exposure of repressed material

transference

the process by which a client undergoing psychoanalysis reenacts early conflicts by applying to the analyst feelings and attitudes that the person has toward significant others

Contemporary psychodynamic therapists view experiences with early attachment figures as having powerful effects on current _____________ difficulties.

interpersonal