Current Paradigms in Psychopathology PDF

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Notes about current paradigms in psychopathology...

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CURRENT PARADIGMS IN PSYCHOPATHOLOGY Paradigm (Thomas Kuhn) ● A conceptual framework or approach within which a scientist works ○ A set of basic assumptions ○ A general perspective ○ An approach to conceptualize the study of a subject and how to interpret data ● No one paradigm offers the best conceptualization of psychopathology GENETIC PARADIGM ● Almost all behavior is heritable to some degree ● Genes do not operate in isolation from the environment ○ The environment shapes how our genes are expressed ○ Our genes also shape our environments ● Relationship between genes and environment is bidirectional ○ Nature via nurture (Ridley, 2003) Important Genetic Terms ● Genes - carriers of genetic information (DNA) ● Gene expression - proteins influence whether the action of a specific gene will occur ● Polygenic - multiple genes expressions interacting with a person’s environment ● Heritability ○ Extend to which variability in behavior is due to genetic factors ■ Heritability estimate ranges from 0.00 to 1.00 ■ Group, rather than individual, indicator Important Environmental Terms ● Shared environment ○ Events and experiences that family members have in common ○ E.g. income level, child-rearing practices, parent’s marital status and quality ● Nonshared environment ○ Events and experiences that are distinct to each family member ○ E.g. relationships with friends, events unique to the person Behavior Genetics ● Study to the degree to which genes and environmental factors influence behavior ○ Not how genes or the environment determine behavior ● Genotype ○ Genetic makeup inherited by an individual ● Phenotype ○ Expressed genetic material ○ Observable behavioral characteristics ○ Depends on interaction of genotype and environment

Molecular genetics ● Identifies genes and their functions ● Identifies differences between peop;le in the sequence of their genes and in the structure of their genes ● Alleles - different forms of the same gene ● Polymorphism - difference in DNA sequence on a gene occurring in a population Current molecular genetics research ● SNPs (Single Nucleotide Polymorphisms) ○ Difference between people in a single nucleotide in the DNA sequence of a particular gene ● CNVs (Copy Number Variations) ○ Abnormal copy of one or more sections of DNA within the gene(s) ○ Differences in structures of the genes ■ Additions or deletions in DNA within genes ● GWAS (Genome-Wide Association Studies) ○ Key method to examine SNPs and CNVs ○ Isolate difference in the sequence of genes between people who have a psychological disorder and people who do not Gene-environment interaction ● A person’s sensitivity to an environmental even is influenced by genes Epigenetics ● Study of how the environment can alter gene expression or function ● Animal studies ○ Epigenetic effects can be passed down across multiple generations Evaluation of the Genetic Paradigm Two challenges ● Understanding how genes and the environment reciprocally influence one another ● Recognizing the complexity of the task ○ Several genes contributing to a specific disorder ○ Each individual gene or genetic mutation may reveal a very small effect ○ Putting all the small genetic pieces together to tell the gene via environment story for psychological disorders remains a very big challenge NEUROSCIENCE PARADIGM ● Psychological disorders are linked to aberrant processes in the brain ● 3 major components ○ Neurons and neurotransmitters ○ Brain structure and function ○ Neuroendocrine system

Neurons and neurotransmitters Neurons ● Cells of the nervous system ● 4 major parts ○ Cell body ○ Dendrites ○ Axons ○ Terminal buttons Synapse ● Gap between neurons ● Nerve impulse travels down axon to synapse Neurotransmitters ● Chemicals that allow neurons to send a signal across the synapse to another neuron ● Can be ○ Excitatory Receptor sites ● Located on postsynaptic neurons which absorb the neurotransmitter Reuptake ● Reabsorption of leftover neurotransmitter by presynaptic neuron Different neurotransmitters ● Serotonin and dopamine ○ Implicated in depression, mania, and schizophrenia ● Norepinephrine ○ Communicates with the sympathetic nervous system ○ Implicated in anxiety and other stress-related conditions ● Gamma-aminobutyric acid (GABA) ○ Inhibits nerve impulses ○ Implicated in anxiety Neurotransmitters & psychopathology ● Ways in which neurotransmitters may contribute to psychopathology ○ Excessive or inadequate levels ○ Errors in the synthesis of neurotransmitters ate the metabolic level ○ Insufficient reuptake ○ Faulty neurotransmitter receptors Brain structure and function ● Surface of cortex (gray matter)

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○ Frontal, parietal, occipital, temporal lobes ○ Prefrontal cortex - regulates the amygdala White matter - consists of fibers that connect cells in cortex with other areas Ventricles - cavities in the brain filled with cerebrospinal fluid

Subcortical structures of the brain ● Subcortical structures implicated in different forms of psychopathology ○ Anterior cingulate ○ Hippocampus ■ Memory ○ Hypothalamus ■ Regulates metabolism, temperature, perspiration, blood pressure, sleeping, and appetite ○ Amygdala ■ Attention emotionally salient stimuli Brain development ● Begins early in the first trimester of pregnancy and continues into early adulthood ● A third of our genes are expressed in the brain ● Pruning ○ Elimination of synaptic connection ○ The connections become fewer, but faster ● Brain networks ○ Clusters of brain regions that are connected to one another in that activation in these regions is reliability correlated The Neuroendocrine system - the HPA Axis ● HPA axis involved in response to stress ○ Hypothalamus releases CRF ○ Pituitary gland releases ACTH ○ Adrenal cortex promotes the release of cortisol ● Takes 20-40 minutes for cortisol to peak ● Takes up to 1 hour for cortisol levels to return to normal The Immune System ● Stress has no effect on the immune system ● The immune system involves a broad array of cells and proteins that are activated when the body is infected ● Cytokines (a protein) ○ Initiate responses to infection such as fatigue, inflammation, and activation of the HPA axis ○ Proinflammatory cytokines produce helpful inflammation ○ Implicated in some psychological disorders

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Depression: Interleukin-1 (IL-1)and tumor necrosis factor alpha (TNF-alpha) Schizophrenia: IL-6 and IL-8

Neurosciences approaches to treatment ● The use of psychiatric drugs continues to increase ● Antidepressants were the third most commonly prescribed medication for any type of health issue in 2013 ● A person could hold a neuroscience view about the nature of a disorder and yet recommend psychological intervention ● Non Biological interventions can influence brain functioning Evaluating the neuroscience paradigm Challenge of Reductionism ● View that whatever is being studied can and should be reduced to its most basic elements or constituents ● Trying to reduce mental and emotional responses to biology ● Ignores more complex view of behavior COGNITIVE BEHAVIORAL PARADIGM ● Rooted in learning principles and cognitive science ● Problem behavior continues if it is reinforced ○ Escape or avoidance ○ Access to desirable objects or events ● To alter behavior, modify the consequences ○ Time out - period of time without reinforcer ○ Behavioral activation - engage in tasks that are positively reinforcing ○ Exposure - anxiety will extinguish if the person can face the situation long enough with no actual harm occurring Cognitive science ● Behaviorism criticized for ignoring thoughts and emotions ● Cognition ○ Mental process of perceiving, recognizing, conceiving, judging, and reasoning ● Schema ○ Organized network of previously accumulated knowledge ○ If new information doesn’t fit a scheme ■ Reorganize the schema ■ Construe information to fit schema ● Role of attention in psychopathology ○ Individuals with anxiety are more likely to attend to threat or danger Role of the unconscious

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Cognitive neuroscientists have explored how the brain supports behavior outside conscious awareness

Implicit memory ● A memory formed without conscious awareness ● A person can, without being aware of it, be influenced by prior learning ● People with social anxiety and depression have trouble with implicit memory tasks Cognitive Behavior Therapy (CBT) ● Attends to thoughts, perceptions, judgements, self-statements, and unconscious assumptions Cognitive restructuring ● Changing a pattern of thought ● Changes in thinking can change feelings, behaviors, and symptoms Beck’s Cognitive Therapy ● Initially developed for depression ● Depression caused by distorted perceptions ○ “Nothing ever goes right for me” ● “Third wave” treatments focus on spirituality, values, emotion, and acceptance ○ Dialectical behavioral therapy ○ Mindfulness-based cognitive therapy ○ Acceptance and commitment therapy Evaluating the Cognitive Paradigm ● Some cognitive explanations do not appear to explain much ● Thoughts are regarded as causing the other features of the disorder, such as sadness ● Where do negative schemas come from? ○ Focus on understanding mechanisms that sustain negative schemas in different psychopathologies EMOTIONS AND PSYCHOPATHOLOGY ● Emotions ○ Influence how we respond ○ Help us organize our thoughts and actions ○ Guide our behavior ● 85% of psychological disorders include disturbances in emotional processing of some kind (Thoits, 1985) ● Emotions (affect) are fairly short lived states ○ Lasting a few seconds, minutes, or at most hours ● Moods are emotional experiences that endure for a longer period of time Components of Emotion Response

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Expressive - behavioral and facial expressions Experiential - subjective feeling; how someone reports he or she feels at any given moment Physiological - changes in the body that accompanies emotion Most psychopathology includes disturbances of one or more component of emotion

Ideal affect ● Kinds of emotional states that a person ideally wants to feel ● Vary depending on cultural factors ○ Western cultures value happiness as their ideal state ○ East asian cultures value less arousing positive emotions, such as calmness, more than happiness ● Shown to be linked to drug use ○ More people in the US seek treatment for cocaine and amphetamines stimulants associate with excitement ○ More people in china seek treatment for heroin, a drug that has calming effects SOCIOCULTURAL FACTORS AND PSYCHOPATHOLOGY ● Gender, race, culture, ethnicity, and socioeconomic status ○ Some disorders affect men and women differently ○ No country or culture is without psychopathology of some sort, but the conceptualization and meaning of the symptoms may vary ○ Drug and their effects vary by ethnicity ○ Poverty is related to antisocial personality disorder, anxiety disorders, and depression ● Environmental factors can trigger, exacerbate, or maintain the symptoms that make up the different disorders INTERPERSONAL FACTORS AND PSYCHOPATHOLOGY How the quality of relationships influences different disorders ● Relative closeness, support offered, degree of hostility ● The role of trauma, serious life events, and stress in psychopathology Object relations theory ● Importance of longstanding patterns of relating to others ● The way a person comes to understand how the self is situated in relation to other people Attachment theory ● Type and style of infant’s attachment to caregivers can influence later psychological functioning Relational self

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The self in relation to others Individuals will describe themselves differently depending upon which close relationships they are told to think about

Interpersonal therapy (IPT) ● Impact of current relationships on psychopathology ● Focus on four interpersonal issues ○ Unresolved grief ○ Role transitions ○ Role disputes ○ Social deficits DIATHESIS-STRESS ● Integrative paradigm ○ Genetic, neurobiological, psychological, and environmental ● Diathesis ○ Underlying predisposition ■ Can be biological or psychological ○ Increase risk of developing disorder ■ Does not guarantee a disorder will develop ● Stress ○ Environmental or life disturbances ■ May occur at any point after conception ■ Triggering event ○ How a diathesis may be translated into an actual disorder ● Psychopathology unlikely to result from one single factor...