Abnormal Psychology
Lecture 2
An Integrative Approach to
Psychopathology
Chapter 2
Outline
• One-Dimensional Versus Multidimensional
Models
• Biological Contributions to
Psychopathology
• Psychological Contributions to
Psychopathology
• Cultural, Social and Developmental
Factors
One-Dimensional Versus
Multidimensional Models
• Factors contributing to psychological
disorder
– Biological
• Genetics, brain and neural systems
– Psychological
• Behavioral and cognitive factors, unconscious
processes, learned helplessness
– Social
• Friends and family, social learning
– Developmental
• More or less reactivity, critical period
One-Dimensional Versus
Multidimensional Models
•  Judy – each of the four groups should
pick one of the four factors and develop
arguments about what could have caused
Judy’s illness
• Try to persuade your classmates in the
other group that your factors are the right
explanation of Judy’s disorder
One-Dimensional Versus
Multidimensional Models
Biological Contributions to
Psychopathology
• Genetic contributions to psychopathology
– Genes are very long molecules of DNA at
various locations on chromosomes (23 pairs),
within the cell nucleus
– Most of our behavior and personality is
probably polygenic (influenced by many
genes)
– There are no individual genes for mental
disorders
– In general – our psychological make-up is
heritable up to 50%
Biological Contributions to
Psychopathology
• The Interaction of Genetics and
Environmental Effects
– The Diathesis-Stress Model
• The diathesis (inherited tendency) interacts with
stress we encounter; the more diathesis the less
stress needed to initiate the illness
– The Reciprocal Gene-Environment Model
• Genetic endowment may increase the probability
that an individual will experience stressful life
events
Biological Contributions to
Psychopathology
• Neuroscience and its contributions to
psychopathology
– The Central Nervous System
– Structures contributing to psychopathology
– Neurotransmiters
Biological Contributions to
Psychopathology
Biological Contributions to
Psychopathology
Biological Contributions to
Psychopathology
Biological Contributions to
Psychopathology
Biological Contributions to
Psychopathology
Biological Contributions to
Psychopathology
• Neuron structure
• Cell body, dendrites, axon, synaptic cleft
• Neurotransmitters
• Chemicals released from axon of one nerve cell that
transmit the impulse to the receptors of another nerve
cell
• There are multiple neurotransmitter currents (brain
circuits) in the brain
• Drugs can influence neurotransmitters as agonists
(increase the activity of a neurotrasmitter), antagonists
(decrease or block) or inverse agonists (effects opposite
to effects of a neurotrasmitter)
Biological Contributions to
Psychopathology
• Neurotransmitters
– Serotonin
• regulates moods, thought processes, regulation
of eating, sexual and aggressive behavior
• Redux (antiobezity)and Prozac (antidepressant)
– Gamma Aminobutyric Acid (GABA)
• Reduces anxiety, overall arousal and emotional
responses (aggressive behavior, hostility)
How neurotrasmitters and drugs
influencing them work
Biological Contributions to
Psychopathology
• Neurotransmitters
– Norepinephrine
• Controls heart rate, blood pressure, and
respiration; contributes to panic attacks, anxiety
and mood disorders (beta-blockers)
– Dopamine
• Activates other neurotransmitters and aids in
exploratory and pleasure-seeking behaviors
• Excess is implicated in schizophrenia and deficit in
Parkinson’s disease
Biological Contributions to
Psychopathology
• genetic contributions may lead to patterns of
neurotransmitter activity that influence
personality
• psychological treatment can influence neural
circuits directly (e.g. OCD)
• extreme abuse severely impedes intellectual,
emotional, and social growth
• psychosocial factors changes activity levels of
neurotransmitters (e.g. sense of control and
reaction to GABA antagonist)
Psychological Contributions to
Psychopathology
• Learned helplessness
– Martin Seligman
– if people believe that they have no control
over the stress in their lives, they give up
attempting to cope and develop depression
• Social learning
– people can learn a lot by observing what
happens to someone else in a given situation
(modeling or observational learning)
Psychological Contributions to
Psychopathology
• Prepared learning
– we became highly prepared for learning about
certain types of objects or situations over the
course of evolution
• Cognitive science and the unconscious
– we are not aware of much of what goes on
inside our heads
– dissociation between consciousness and
behavior (blind sight and implicit memory)
Psychological Contributions to
Psychopathology
• emotions
– components of emotions (physiological
reactions, motor expression, action tendency,
appraisal (CBT), subjective feeling)
– emotions (last from several minutes to several
hours), mood (more persistent affect), affect
(momentary emotional tone)
– influence of anger and hostility on heart is
much stronger than stress alone
– suppressing emotional reactions has
significant physiological consequences
Cultural, social and developmental
factors
• voodoo and other disorders
– voodoo death -intolerable autonomic arousal
combined with lack of social support
• gender differences
– women – an insect or small animal phobia
– men – alcoholism
• social effects
– social relationships seem to protect individuals
against many physical and psychological disorders
• the principle of equifinality
– developmental psychopathology says that a behavior
or disorder may have several different causes
Integrative approach
• applying contributions from all the factors
to explain causes of a mental disorder in a
specific individual
• integrative approach
Clinical Assessment and
Diagnosis
Chapter 3
Outline
• Assessing Psychological Disorder
(systematic evaluation and measurement
of psychological, biological, and social
factors)
• Diagnosing Psychological Disorders
(the process of determining whether the
particular problem afflicting the individual
meets all the criteria for a psychological
disorder according to the DSM-IV-TR)
Assessing Psychological Disorder
• Key Concepts in Assessment
– Reliability
• The degree to which a measurement is consistent
across people (inter-rater reliability) or across time
(test-retest reliability)
– Validity
• Whether something measures what it is designed
to measure (e.g. concurrent validity of IQ tests)
– Standardization
• Process of establishing specific norms and
requirements for a measurement technique
Assessing Psychological Disorder
• The Clinical Interview
– Unstructured interviews
– Semistructured interviews
– The Mental Status Exam
(careful observation of behavior)  Y-Steve
• Appearance and behavior (overt behavior, posture,
expressions)
• Thought processes (rate, continuity and content of speech)
• Mood and affect (current and predominant feeling of the
individual)
• Intellectual functioning (type of vocabulary, use of metaphors
and abstractions)
• Sensorium (orientation in time, place and person)
Assessing Psychological Disorder
• Physical examination
– Psychological disorders associated with
medical conditions (e.g. thyroid gland –
overactive results in anxiety, underactive
results in depression)
• Behavioral assessment
– To assess formally an individual’s thoughts,
feelings, and behavior in specific situations or
contexts
Assessing Psychological Disorder
• Psychological testing
– Projective testing
• Ambiguous stimuli are presented to a person who is
asked to describe what he/she sees
• Rorschach inkblot test
• Thematic Apperception Test (TAT)
– Personality inventories
• Minnesota Multiphasic Personality Inventory (MMPI)
(scales like anxiety, depression etc.)
– Intelligence testing
• Stanford-Binet test
• Wechsler test (verbal scales, performance scales)
Rorschach inkblot test
Assessing Psychological Disorder
• Neuropsychological testing
– Measuring language abilities, attention, memory,
perception, motor skills, learning and abstraction to
detect possible brain dysfunction
– Luria-Nebraska Neuropsychological Battery
– Halstead-Reitan Neuropsychological Battery
• Neuroimaging
– Structural (computerized axial tomography (CAT),
magnetic resonance imaging (MRI))
– Functional (measuring metabolic changes (PET,
fMRI))
Assessing Psychological Disorder
• Psychophysiological assessment
– Electroencephalogram (EEG)
– ERP (event-related potentials)
– Skin conductance response
– Heart rate
– Respiration
– Electromygraphy (EMG)
Diagnosing Psychological
Disorders
• Some concepts
– classification (assignment into categories)
– taxonomy (system fo classification in science)
– nosology (naming system for medical and
psychological phenomena)
• Approaches to classification
– classical categorical approach (clear-cut
differences, different cause)
– dimensional approach (continuum)
– prototypical approach (defining, essential
characteristics)
Diagnosing Psychological
Disorders
• Prototypical approach (used in DSM-IV)
– System for categorizing disorders using both essential,
defining characteristics and a range of variation on other
characteristics  B-Diagnosis
– Criteria for Panic Disorder with Agoraphobia
• recurring unexpected panic attacks
• one or more of the following during the month after a panic
attack: (1) persistent worry about having an additional attack; (2)
worry about the implications of an attack; (3) a significant change
in behavior related to the attack
• anxiety about being in places or social situations from which
escape might be difficult or embarrassing, such as being in a
crowd, travelling on a bus, or waiting in line