PARADIGMS AND ETIOLOGY OF ABNORMAL BEHAVIOR The etiology (or the cause) of most abnormal behavior remains a mystery. Various paradigms to explain the etiology of mental disorders. Paradigm: a set of shared assumptions → Theory → Collect data and test hypotheses Biological, psychodynamic, cognitivebehavioral, humanistic paradigms Abnormal behavior is caused by a combination of biological, psychological, and social factors → biopsychosocial model ♦ The Biological Paradigm Looks for biological abnormalities that might cause abnormal behavior General paresis is caused by syphilis ( General paresis is severe neuropsychiatric disorder, type of madness. Symptoms: loss of inhibitions, antisocial behavior − Assumption: biological causes for other mental disorders Only in some cognitive disorders biological causes have been identified. But: most mental disorders appear to be “lifestyle diseases” that are caused by a combination of biological, psychological, and social influences. Focus on symptom alleviation: reducing symptoms, but not eliminating its cause Psychopharmacology - Psychotropic medications are chemical substances that affect psychological states. - Relieve symptoms by improving the functioning of neurotransmitter systems. Antipsychotics (also called major tranquilizers or neuroleptics) • • • Reducing symptoms of psychosis (hallucinations and delusions) schizophrenia First group of antipsychotics - severe side effects Atypical antipsychotics Antidepressants • • SSRIs – selective serotonin reuptake inhibitors SNRIs – selective serotonin-norepinephrine reuptake inhibitors Lithium • • Metallic element present in the sea, in natural springs, in animal and plant tissue Mood stabilizer Anticonvulsants (Nöbete sebep olan nöronların senkronize aktivitesini önleyerek nöbetlerin oluşmasını, tekrarlanmasını engeller.) • Used in treatment of mania Antianxiety drugs (also called minor tranquilizers) • • Barbiturates - highly addictive (Sedative hypnotic- sakinleştirici uyku verici) Benzodiazepines - also used as sleeping pills, also addictive Psychotropic medications do not cure underlying causes, but symptom alleviation still is extremely important. Psychopharmacology → → → → → → Often safe and effective Alleviate symptoms, not cure causes of illness Many must be taken for long periods of time All medications have side effects, some of which very unpleasant Psychotropic medications are prescribed by primary care physicians, not psychiatrists. A quick fix (as a medication) to treat psychological disorders. Electroconvulsive Therapy (ECT) Involves causing seizures by passing electricity through the brain ECT involves 6 to 12 sessions over the course of a few weeks Severe depressions that do not respond to other treatments Electrical current is approximately 100v Bilateral ECT: Electrodes are placed on left and right temples. Current passes through both hemispheres Unilateral ECT: Current passes through one hemisphere, the nondominant hemisphere Side effect: retrograde amnesia (loss of memory, confusion) Unilateral ECT produces less retrograde amnesia Bilateral ECT > Unilateral ECT Today: infrequently use - Side effects can be serious! Do not work for everyone For some disorders psychotherapy works better than drugs Side effects People turn to drugs rather than deal with the issues in their lives Ignoring of environmental and psychological factors Attributing mental health problems to biological causes - more pessimistic about prognosis ♦ The Psychodynamic Paradigm Sigmund Freud (1856–1939) Abnormal behavior is caused by unconscious mental conflicts that have roots in early childhood Conflict between superego and ego - moral anxiety Conflict between id and ego - neurotic anxiety Id, ego, and super ego do not coexist peacefully - Intrapsychic conflict Ego protects itself from neurotic anxiety by using different defense mechanisms. Psychodynamic Psychotherapy • • • • → → → All seek to uncover hidden motivations All emphasize the importance of insight Therapists more actively involved with patients than psychoanalysts Short-term psychodynamic psychotherapy Uses many techniques Is shorter and less expensive More amenable to research ♦ The Cognitive-Behavioral Paradigm Views abnormal behavior—and normal behavior—as a product of learning Learning maladaptive behaviors/ cognitive processes Cognitive-Behavioral Techniques → → → → Exposure Therapies Attribution retraining Social skills training Problem-solving training "Third-Wave" CBT Focuses on broad, abstract principles such as mindfulness, acceptance, values, relationships Poor regulation of emotions as a risk factor Techniques from CBT with mindfulness meditation practices - help to accept, understand, and better regulate emotions Dialectical behavior therapy → → → → Includes mindfulness, increased awareness of feelings, thoughts, and motivations Increasing problem-solving skills, interpersonal skills Focus on difficulties in managing negative emotions, controlling impulsive behavior Borderline Personality Disorder, Suicidal behavior, Eating disorders Acceptance and commitment therapy (Steven Hayes) → Experiential avoidance - avoidance of painful thoughts, memories, and feelings → Accepting oneself, not just making changes → To be present → Living according to own values Metacognitive Therapy (Adrian Wells) → → → → ❖ Not the content of thoughts, the function of thoughts What patients believe about their own thoughts How these beliefs lead to unhelpful responses Proving alternative ways to responding to thoughts Telephone metapher ♦ The Humanistic Paradigm An explicitly positive view of human nature Behavior is the product of free will • We control, choose, and are responsible for our actions. Humanistic paradigm is against Determinism (The scientific assumption that human behavior is caused by potentially knowable factors) Humanistic Therapies Emotional awareness Involves “uncovering” hidden emotions, but concerned with how people feel rather than why! Views the therapist–client relationship as the method of change → Relationship is the treatment The Problem with Paradigms Paradigms can both direct and misdirect scientists. • Biological paradigm Can overemphasize the medical model • Psychodynamic paradigm Can be inflexible in focusing on childhood and the unconscious conflicts • Cognitive behavioral paradigm Can overlook social and biological context of human behavior • Humanistic paradigm Can be antiscientific Systems Theory Integrative approach to science Offers important perspective on causes of abnormal behavior Includes biopsychosocial model Includes elements of each of the four paradigms Highlights the need to understand the ecology of human behavior Holism • Views mental illness in the context of the individual’s personality, including their strengths in the interpersonal and societal contexts. • Levels of analysis ❖ Each paradigm use a different “lens” ❖ No lens is right, they are just different Causality (we want to know the cause of cancer or the cause of mental disorders) • ❖ • ❖ • Equifinality The view that there are many routes to the same destination (multiple pathways) Multifinality The view that the same event can lead to different outcomes (e.g. abused children) Diathesis-Stress Model: common way to of summarizing multiple influences on abnormal behavior ❖ Diathesis: A predisposition toward developing a disorder ❖ Stress: A difficult experience; risk factors may contribute to mental disorders • Reciprocal causality ❖ Causality operates in both directions Biological Factors The Neuron and Neurotransmitters Neurons are the basic building blocks of the brain. Basic anatomic components Soma (cell body), Dendrites (receive the message from other cells), Axon(trunk of the neuron that transmits the messages), Axon terminal (end of the axon, where messages are sent out to other neurons) Synapse is a small gap filled with fluid. Information is transmitted chemically across a synapse to other neurons. Axon terminal contains vesicles containing chemical substances. → Neurotransmitter Neurotransmitters are chemical substances released into the synapse (e.g. serotonin, dopamine) Receptors receive the neurotransmitters once they are released. Not all neurotransmitters cross the synapse and reach the other neuron – Reuptake Synaptic Transmission Communication within a neuron is electrical. Communication between neurons is chemical. Neurotransmitters and Psychopathology Neurotransmitter disruptions were found in some people with mental disorders. Schizophrenia—dopamine Depression—serotonin But: mental health problems are not necessarily caused by "a chemical imbalance in the brain.” Major Brain Structures Hindbrain Regulation of basic bodily functions Midbrain Involved in the control of some motor activities (fighting and sex), regulation of sleep Specific brain traumas or tumors: extreme disturbances in sexual behavior, aggressiveness, and sleep Forebrain Site of most sensory, emotional, and cognitive processes Forebrain is linked with the midbrain and hindbrain by the Limbic system, which regulates regulate emotion and learning → Thalamus → Hypothalamus Forebrain composed of two cerebral hemispheres Cerebral functions are lateralized. → Left cerebral hemisphere is involved in language and related functions. → Right cerebral hemisphere is involved in spatial organization and analysis. Hemispheres are connected by corpus callosum (coordinator between left and right hemispheres) Chambers, or ventricles, are connected in the forebrain. • Filled with cerebrospinal fluid Cerebral Cortex: surface area of the forebrain, underneath the skull • • • • Frontal lobe Parietal lobe Temporal lobe Occipital lobe Only the most severe mental disorders have clearly been linked to abnormalities in the neuroanatomy. → Stroke → Alzheimer's Disease (tangles of neurons) → Schizophrenia (enlarged ventricles , asymmetries are also found in other brain structures) Psychophysiology The study of changes in the functioning of the body that result from psychological experiences Psychophysiological responses → Heart rate → Electro dermal activity → Flushed face → Tears → Sexual excitement Psychophysiological arousal results from the activity of 2 different communication systems: → Endocrine System → Nervous System Endocrine System Produces psychophysiological arousal by releasing hormones Certain abnormalities cause psychological symptoms - hyperthyroidism (restlessness, anxiety) Psychophysiology and Psychopathology • • • • Overarousal and underarousal can both contribute to abnormal behavior. Overactivity of the autonomic nervous system has been linked to anxiety. Chronic autonomic nervous system underarousal found in antisocial personality disorder. Psychophysiological assessment useful in objective measurements. Behavior Genetics Genes are ultramicroscopic units of DNA that carry information about heredity. Located on Chromosomes Behavior genetics studies genetic influences on normal and abnormal behavior. Genotype is an individual's actual genetic structure. Phenotype is an expression of the given genotype. → environment can affect a phenotype, but experience does not change genotype!! Most disorders are not caused by a single gene – Polygenic Polygenic: influence of multiple genes and environment • Appear to be multiple genes involved in the risk for mental disorders Family Incidence Studies Investigation about whether diseases “run in families” → Normal and ill probands → Which other members of their families suffer from the same disorder? → Higher prevalence in a family - genetic causation? - do not lead to final conclusions! Twin Studies Can provide strong evidence about genetic and environmental contributions to a disorder Monozygotic (MZ), twins are identical, share 100% of their genes Dizygotic (DZ), twins are fraternal, share 50% of their genes. → Most of them share the same environment Provide a concordance rate for two sets of twins Concordance: both twins have the same disorder or are free from disorder But: abnormal behavior is not explained purely by genes, shared/nonshared environment! Adoption Studies • • If concordance is higher for biological relatives, genetic factors are involved If children are more similar to their adoptive relatives, environment is involved Genetic and Psychopathology • • Genes are important, but many genes appear to affect abnormal behavior “a gene for depression” is wrong! Psychological Factors Psychological factors affecting mental health are divided into 6 categories: 1. Human nature 2. Temperament 3. Emotion 4. Learning and cognition 5. Sense of self 6. Human development Human Nature Evolutionary Psychology The application of principles of evolution to our understanding of the animal and human mind. Species-typical characteristics Genetically influenced motivations that people share in common Individual differences What makes people different from one another Assumption that human psychology (also animal) evolved trough natural and sexual selection. Freud supposed that we have basic drives, Watson suggested that we come into the world as blank state. Attachment Theory (John Bowlby) Human need to form close relationships Infants form attachments early in life—special and selective bonds with caregivers. Theory based on ethology, the study of animal behavior. Bonds, coupled with distress when separated, keep the parent and infant in proximity. Proximity has survival value. Attachment behavior is inborn. Insecure or anxious attachments • Uncertain or ambivalent parent–child relationships • Inconsistent or unresponsive parenting during the first 5 years of life → Can make children mistrustful or dependent Psychological Factors Dominance The hierarchical ordering of a social group into more- and less-privileged members Dominance observed in human as well as other animal social groups. Recent research suggests, that dominance motivation play a role in antisocial behavior , narcissism, and mania. Temperament Characteristic styles of relating to the world Consists of five dimensions: The "Big Five" 1. Openness to experience 2. Conscientiousness 3. Extraversion 4. Agreeableness 5. Neuroticism Emotions Internal feeling states Essential to understanding of mental disorders 6 Basic emotions Love, Anger, Joy, Sadness, Surprise, Fear Negative emotions are most relevant to abnormal psychology Emotions come without intension, effort, or desire Feelings are more basic or primitive than thoughts Cognition and emotion?? Learning and Cognition Modeling: Albert Bandura Learning through imitation Other learning mechanisms: attention, information processing, memory (e.g human computer) Cognitive errors because of heuristics (shorthand calculations) Attributions Perceived causes or people's beliefs about cause-effect relations. ➢ The Sense of Self Erik Erikson (1968) - Identity is an integrated sense of self. Other theorists - We do not have one identity, but many “selves” Self-control Learned through the process of socialization (parents, teachers, peers) Externalized rules become internalized Self-esteem Valuing one's abilities Low self-esteem can result from psychological problems as wells as cause them • The Sense of Self Represented in the brain May reside in frontal lobe → Degeneration of the frontal lobe has caused patients to lose self-reflection and self-control. Stages of Development Developmental stages Periods of time marked by age and/or social tasks during which children or adults face common social and emotional challenges. Freud - Psychosexual (focus of libido) Erikson - Psychosocial (focus of social tasks and the conflicts involved in meeting the demands of the external world) Development continues throughout lifespan. Developmental transitions mark end of one and beginning of another stage (e.g. end of childhood and beginning of adolescence) Social Factors Close Relationships → Are associated with various emotional disorders Marital Status and Psychopathology → Image of marriage changed over years → Factors are clearly correlated. → Does marital status cause the problems? Social Relationships is associated with better mental health Social support → The emotional and practical assistance received from others → No social support - high risk → Example: mobbing Gender and Gender Roles Gender roles may influence the development, expression, or consequences of psychopathology. → Women’s traditional roles foster dependency and helplessness - accounts for the higher rates of depressions among women → Influence how psychopathology is expressed Prejudice, Poverty, and Society → Prejudice and poverty increase the risk for psychological disorders → Poverty increases exposure to stressors and chemical toxins. → Societal practices, beliefs, and values help shape the definition of abnormal behavior.
