Current Perspectives of Mental Illnesses

Four Perspectives on Mental Health

• Biological: Focuses on genes and the brain.
• Psychodynamic: Emphasizes the influence of childhood experiences.
• Cognitive/Behavioral: Highlights the role of thoughts and actions.
• Humanistic: Focuses on finding the good in everyone.
• Cultural Factors: Acknowledges the influence of culture.
• Current Models: Integrates different perspectives.

Perspective

• A conceptual framework used by scientists.
• A lens through which scientists view mental health.
• No perspective is entirely objective or complete.
• Multiple perspectives are needed for a full understanding of mental illness.

Biological Perspective - Tenets

• Human characteristics are determined by genes.
• Human development is dictated by neurochemistry.
• Abnormal behavior reflects neurobiological imbalance.
• Mental illnesses are often due to biological imbalances.

Genes and Heredity

• Genes are the smallest unit or carrier of genetic information.
• Genes are small segments of our DNA.
• They are nature’s instruction manual.
• Genes can be influenced by the environment (nature vs. nurture), such as stress, pollution, and diet.
• Behavior is a combination of nature and nurture.

Gene Expression

• Transcription: DNA is snipped into a single-stranded RNA molecule.
• Translation: RNA is used to create an amino acid chain.
• Protein folding: The amino acid molecule is folded into the shape needed for the particular protein.

Important Genetic Terms

• Gene expression: When genes get to work.
• Proteins influence whether the action of a specific gene will occur.
• Polygenic transmission: Multiple genes influence illness.
• Heritability: Extent to which variability in behavior is due to genetic factors (0.00 – 1.00).
  • A group rather than individual indicator.

Environmental Effects

• Shared environment: Events and experiences common to family members.
• Nonshared environment: Events and experiences unique to each family member.

Heritability studies

• Examine the extent to which nature (genes) or nurture (environment) determines a trait or behavior.
• Twin studies compare identical and fraternal twins.
  • Identical twins: 100% gene match.
  • Fraternal twins: 50% gene match.
• Environment can be divided into shared and nonshared environment.

Behavior Genetics

• Study of the degree to which genes and environmental factors influence behavior.
• Genotype: Genetic material inherited by an individual (unobservable).
• Phenotype: Expressed genetic material (observable behavior and characteristics).
  • Depends on interaction of genotype and environment.

Reciprocal Gene-Environment Interaction

• One’s response to a specific environmental event is influenced by genes.
• Genes predispose individuals to seek out situations that change the likelihood of developing a disorder.
• Example: Adolescent girls with a genetic vulnerability for depression are more likely to experience events that can trigger depression.

Neuroscience Overview

• Neurons and neurotransmitters: The brain’s gossip network.
• Brain structure and function: Different regions have different roles.
• Neuroendocrine system: The connection between the brain and hormones.

The Neuron: Basic Unit of the Nervous System

• Four major parts:
  • Dendrites: Information receptors (receive signals from other neurons).
  • Cell body: Neuron’s command center (integrates signals, if excitatory signals exceed inhibitory signals over a minimum threshold, the neuron will fire).
  • Axons: Information superhighway (transfers nerve impulse to terminal buttons).
  • Terminal buttons: Chemical message bottles (where signal is transferred to the next neuron).
• Synapse: Gap between the terminal button and the next neuron.

Overview of Neuronal Communication

• Dendrites receive the latest news.
• Cell body decides if it’s worth spreading.
• If yes, the message races down the axon.
• Terminal buttons release the news (neurotransmitters) to the next neuron.
• The brain has 100,000,000,000 neurons.
• Communication within a cell is electrical.
• Communication between cells is chemical.

Neurons and Neurotransmitters

• Neurotransmitter: Chemicals that allow neurons to send a signal across the synapse to another neuron.
  • Some excite, some inhibit.
• Receptor sites on the postsynaptic neuron absorb neurotransmitters.
• Reuptake: Reabsorption of leftover neurotransmitters by the presynaptic neuron.

Specific Neurotransmitters in Psychopathology

• Neurotransmitter theories of psychopathology hypothesize that mental illness results from problems with neurotransmitters.
• Serotonin and Dopamine: The mood and motivation duo.
• Norepinephrine: The stress responder.
• GABA: The brain’s calming center.
• Possible mechanisms:
  • Excessive or inadequate levels.
  • Insufficient reuptake.
  • Excessive number or sensitivity of postsynaptic receptors.
  • Just because medications influence these and often work does NOT mean the NT dysfunction caused the disorder.

Neurotransmitters and Psychopathology

• Serotonin and Dopamine are implicated in depression, mania, and schizophrenia.
• Norepinephrine is implicated in anxiety and other stress-related disorders.
• Gamma-Aminobutyric Acid (GABA) inhibits nerve impulses and is implicated in anxiety.

Organization of the Nervous System

• The nervous system has two major divisions:
  • Central nervous system: Includes the brain and the spinal cord, which connects the brain to the rest of the body.
  • Peripheral nervous system: Carries messages to and from the body to the central nervous system.

The Brain

• The brain is divided into two cerebral hemispheres: left and right.
  • Connected by the corpus collosum.
• Lobes:
  • Frontal: The boss.
  • Occipital: The visionary.
  • Parietal: The sensor.
  • Temporal: The feelings and speech expert.

The Limbic System

• Thalamus: Relay system between lower and higher structures.
• Hypothalamus: Controls biological urges (fight, flight, food, sex).
• Amygdala: Attends to emotionally salient stimuli and emotionally relevant memories.
• Hippocampus: Memory center.
• Prefrontal cortex: Your inner adult.

The Peripheral Nervous System

• The body’s communication network:
  • Autonomic nervous system: Automatically controls involuntary body functions.
  • Somatic nervous system: Sends signals to the body to control voluntary muscles and carries messages from the body about sensory information.

PNS: Autonomic system

• Helps prepare the body for the environment.
• Sympathetic: Activates the body, energy is released, feelings of anxiety.
• Parasympathetic: Relaxes the body, energy is stored, feeling of relaxation.
• Work in tandem to promote homeostasis.
• Many mental disorders are characterized by overactivity, some by underactivity.

The HPA Axis

• The body’s stress response team:
  • Hypothalamus sounds the alarm by releasing corticotropin-releasing hormone (CRF).
  • Pituitary gland releases adrenocorticotropic hormone to spread the word.
  • Adrenal cortex triggers the release of cortisol, the stress hormone.

Psychodynamic Perspective - Tenets

• Humans are born animalistic, aggressive, and sexual.
• Personality is molded by early childhood experiences.
• Mental illness is caused by unconscious anxiety.

Sigmund Freud (1856 – 1939)

• Originally trained as a medical scientist.
• Became interested in mental illness after working with Jean Charcot using hypnosis to cure psychosomatic symptoms.
• Major contribution is discovering the power of the unconscious mind.

Freud’s Model of the Mind

• Id: the party animal (pleasure principle).
• Ego: the responsible friend (reality principle).
• Superego: the inner critic (moral principle).

Psychodynamic Perspective

• Unconscious anxiety: Conflict between the intrapsychic parts.
  • ID “I am hungry – eat”
  • SuperEgo “One doesn’t eat in class”
  • Ego “I will distract myself by listening to the lecture”
• Neurotic Anxiety
• Moral Anxiety

Freud's Defense Mechanisms

• Repression: Keeping unacceptable impulses from conscious awareness.
• Denial: Keeping objective events from conscious awareness.
• Projection: Attributing to someone else one's own unacceptable thoughts or feelings.
• Displacement: Redirecting emotional responses from their real target to someone else.
• Reaction formation: Converting an unacceptable feeling into its opposite.
• Regression: Retreating to the behavioral patterns of an earlier stage of development.
• Rationalization: Offering acceptable reasons for an unacceptable action or attitude.
• Sublimation: Converting unacceptable aggressive or sexual impulses into socially valued behaviors.

Freud’s Legacy

• Pioneered ideas like defense mechanisms.
• Emphasized the importance of childhood.
• Context is key!

Movement Away From Freud

• Freud’s theories were unpopular among many scientific communities because they were Victorian and largely untestable.
• 20th centuries saw an explosion in knowledge from animal learning studies, which gave rise to behaviorism and eventually the CB perspective.
• The cornerstone of CB rests in the two waves of behaviorism
  • Classical Conditioning – 1st wave
  • Operant Condition – 2nd wave
• And the rise of Cognitive psychology

Cognitive-Behavioral Perspective - Tenets

• Your mind starts as a blank slate.
• Personality is molded by learning experiences (you are what you learn).
• Mental illness is caused by maladaptive learning.

Rise of Behaviorism

• Emphasis on learning rather than innate tendencies.
• Focus on observable behavior: If we can’t see it, did it really happen?

Classical Conditioning

• Involves linking learned behaviors (conditioned) to unlearned ones (unconditioned).
• Unconditioned Stimulus e.g., Pork Chop. Unconditioned Response Salivate
• Conditioned Stimulus e.g., Bell. Conditioned Response Salivate

Clinical Example of Classical Conditioning

• Unconditioned Stimulus e.g., loud noise. Unconditioned Response Anxiety (Heart racing!)
• Conditioned Stimulus e.g., Dog (Woof!). Conditioned Response Dog Phobia

Operant Conditioning

• Law of effect – a rewarded behavior increases, a punished behavior decreases.

Operant Conditioning Principles

Cognitive Science

• Behaviorism criticized for ignoring thoughts and emotions.
• Sometimes we act because of a thought or emotion, not the situation.
• This led several theorists to begin to focus on the key role of thinking or cognition in controlling our behavior and feelings.

Cognitive Science - Key terms:

• Cognition: refers to mental processes and includes perceiving, recognizing, conceiving, judging, and reasoning.
• Schema: organized network of previously accumulated knowledge through which we actively interpret new information.
• Role of attention in psychopathology
  • Anxious individuals are more likely to attend to threat or danger.
  • A person with hypochondriasis is more likely to attend to health symptoms.

Humanistic Perspective

• Humans are born with a drive for altruism and goodness.
• Personality is molded by free will. You have the power to change.
• Abnormal behavior is caused by frustrations with society.

Factors Common to Paradigms

• Sociocultural Factors
  • Cut across disorders and perspectives
  • Culture, ethnicity, gender, & social relationships
  • These may increase vulnerability to psychopathology
  • May also serve as a buffer
  • Some disorders specific to certain cultures
    • Hikikomori (total isolation) in Japanese culture

Diathesis-Stress

• Integrative model that incorporates multiple causal factors
• Diathesis
  • Underlying predisposition
  • Increases one’s risk of developing a disorder
• Stress
  • Environmental events
  • May occur at any point after conception
  • Triggering event
• Psychopathology is unlikely to result from one single factor

Example of Diathesis-stress Model

• MAOA gene: the ‘warrior’ gene
• Low levels + childhood stress = higher risk of antisocial bx
• But remember: Genes are NOT destiny!
• MAOA gene regulates MAO-A enzyme which breaks down important neurotransmitters

Summary

• Mental health: It's complicated (but fascinating!)
• No single factor explains it all
• The biopsychosocial approach: Because your mind deserves a multi-angle view
• Understanding multiple perspectives = Better treatment for all