PSYC3102 Lecture 2 : Models of Psychopathology with correct answers

The Scientist-Practitioner Approach Models used to explain: - origins of abnormal behaviour - how to treat it - how to prevent it Models are representations of the real world. Research test hypotheses derived from models Models of Psychopathology 1) Biological (physiological, neurochemical factors) 2) Psychodynamic (internal unconscious factors) 3) Humanistic/Existential (internal conscious factors) 4) Behavioural (interaction of social and psychological factors) 5) Cognitive (cognitions) Note: There is no single explanation for why behaviour occurs - Biopsychosocial model The Biomedical Model (Genetics as etiology) Studies of gene-environment interactions. 1) The Pedigree Method (where a parent has it and then you see if the child has it, or compare this family to another family without it) 2) The classical twin design (Compares concordance rates for MZ and DZ twins) 3) Adoption studies (Compares the concordance of adopted children to their biological versus their adoptive relatives) 4) Molecular genetics (Candidate gene studies - seeing if one allele is more common in people with it. Or Genome wide association studies: common variation across the entire genome) limited: families share genetics and environment. cant differentiate between what is causing it. The Biomedical Model (Biochemistry as etiology) Most drug therapies increase or decrease the activity of specific neurotransmitters. Drugs assume there is an imbalance of specific transmitters and try to correct it (over simplistic). BUT: effects of neurotransmitter activity are very broad. Four neurotransmitter systems: 1) Serotonin (regulates behaviour, mood & thought processes: Low = aggression, suicide, bad. Drugs prevent reuptake, allowing it to stay in synapse longer) 2) Gamma Aminobutyric Acid (GABA) - Inhibits a variety of behaviours & emotions: reduces arousal and anxiety. 3) Noradrenalin - secreted by adrenal glands. 4) Dopamine - Relays messages to control movements, mood and thought processes. Parkinson's disease: dopamine-producing cells damaged - symptoms show when 60% of cells damaged. The Biomedical Model (Neuroanatomy as etiology) 3 Major structures in brain and all can be implicated by mental health disorders. Hindbrain : Bodily functions involved in sustaining life, regulation of stages of sleep. Midbrain : Involved in regulation of some motor activities (fighting & sex), and sleep. Forebrain : Site of most sensory, emotional and cognitive functioning. Limbic system. Specific disturbances may result from damage to specific areas of the brain - damage to reticular activating system in mid-brain disturbs sleep, aggression and sexual behaviour - orbitofrontal damage causes disinhibited behaviour The Biomedical Model (Endocrine system as etiology) The endocrine organs produce hormones - message transmitted through bloodstream Functions of hormones: - Help regulate the body's physiological processes - Co-ordinate internal bodily processes with external events Prolonged stress can cause dysfunction. *HYPAC - Hypothalamic-pituitary-adrenal-cortical axis HYPAC axis is where the hypothalamus and endocrine system interact and controls reactions to stress Hypothalamus connects to pituitary gland - which co-ordinates endocrine system The pituitary gland, in turn, may stimulate the cortical (outer part) of the adrenal glands to produce: Surges of adrenalin and/or Cortisol. Biological Treatment 1) Electro-convulsive shock treatment 2) Pharmacotherapy - Drugs discovered to treat mental disorder by chance. - Side effects: tiredness, anti-depressant induced suicide (6-13%) - cause issues with adherence - overreliance on drugs? - drug with highest sale is antipsychotic. Peter Gøtzsche claims few people benefit from medications & big pharma has corrupted health care. - 15% of people in 3rd world, vs 60% of people in 1st world countries who are psychotic are on antipsychotics. - when coming off psychotropic drugs, there is a chemical inbalance also: people get Cymbalta: many neuropathic pain sensations, i.e. feel like people cutting them with a knife. Psychodynamic Model (Stages of psychosexual development) 5 overlapping stages in psycho-sexual development: 0-1 ½ 1-3 2-6 5-12 11-20 Psychodynamic Model (Fixation + Adult Personality) Psychodynamic Model (3 parts of personality) 3 parts of personality, in addition to the stages: The Id : Motivated by BASIC biologically driven instincts (sex, aggression) Operates at the unconscious level according to the pleasure principle and wish fulfillment The Ego : Motivated by the reality principles (operates on conscious and unconscious level) Uses a range of defence mechanisms to ward off unpleasant feelings (and mental health problems) The Super Ego : Conscience and ego ideal *Often in conflict - the degree they work in harmony is the degree that we have good mental health. Psychodynamic Model (The neo Freudians) Jung: - De-empahsis of biological drives - Collective unconscious and archetypes Erikson: - Formation of ego identity and psysocial development - Lifespan approach: Eight psychosocial (instead of psychosexual) stages of development Psychodynamic Model (Symptom Formation) Psychodynamic Model (Symptom Removal) Free association: minimal prompts to get person to speak from subconscious. Contributions of Psychodynamic Theory 1) Impact of childhood experiences on later development 2) The impact of the unconscious on behaviour 3) The continuity of the normality and abnormality (contiuum of mental illness) 4) Demystified mental illness 5) Defence mechanisms (still mentioned today) Limitations of Psychodynamic Theory 1) Resistance to empirical investigation (hard to test) 2) Emphasises abnormality rather than psychological health (i.e. what leads to illness, rather than wellness) 3) Hasn't contributed to prevention or early intervention methods Humanistic Model Explicitly positive view of human nature - Humans born with natural inclination to be friendly, cooperative and constructive and are driven to self-actualise Argues we have free will: we control, choose and are responsible for our actions - Origins: 1940s, Carl Rogers - client centred therapy Humanistic Model (Explanation of abnormal behaviour) Basic need to receive positive regard from significant others to accept our authentic selves unconditionally unconditional +ve regard leads to unconditional +ve SELF regard *if not received: distress Focus on: acceptance, congruence, understanding. Behavioural Model (First Wave of Behaviour Therapy) 1940s 1950s In response to humanistic? - John B. Watson : founder of behavioural movement - rejection of introspection - focus on behaviour which could be observed and measured - learning has the key role in the development of behaviour Behavioural Model (Principal Modes of Learning) 1) Classical Conditioning : Pavlov (gave example slide of what classical conditioning is) 2) Operant Conditioning : Skinner 3) Observational Learning/Modelling: Bandura - Can be construed in conditioning terms but requires some extra assumptions - Observer must attend to the model and understand the connection between the model's behaviour and the contingent reinforcement - Observer must store what has been learned in memory and recall the information - The observer must be capable of performing the required behaviour - Thus, non-observable processes are necessary to explain modelling Behavioural Treatments Are not sufficient in themselves. 1) Classical conditioning techniques: is about conditioning a stimulus - i.e. pavlovs dog. - Systematic desensitisation - Aversion therapy - Exposure therapy: relearning connections when exposed to stimulus increasing amounts (fear of public speaking). 2) Operant conditioning techniques - is about creating/changing behaviour. - Positive/negative reinforcement(increases behaviour)/punishment(decreases behaviour) - Extinction: suppressing behaviour by removing reinforcers Discriminitive stimulus: external events that cause certain behaviours to ellicit certain responses at certain times (i.e. mum is tired, more likely to get icecream if nag). - Token economies - Behavioural activation: reengagement with rewards 3) Modelling techniques (based on observational Learning/Modelling) - Social skills training (role plays) - emerged from behavioural paradigms Benefits of Behavioural Model - Behavioural theory and treatments can be tested in the laboratory - Laboratory research supports the behavioural model - Many of the techniques remain useful - i.e. exposure Weakness of Behavioural Model - No indisputable evidence that abnormal behaviour is due to improper conditioning - Too simplistic - Over-emphasis on learning and environmental determinants of behaviour - Human cognition could not be accounted for (attention processing, etc) Cognitive Theory (Second wave of behavioural therapy) 1960s 1970s: Cognitive revolution 1980s: CBT with cognitive model at its core A (Event) --- B (Belief) --- C (Consequences) Cognitive Theory (Ellis' 10 irrational beliefs) - I must be loved, or at least liked, and approved by every significant person I meet. - I must be completely competent, make no mistakes, and achieve in every possible way, if I am to be worthwhile. The more you believe these, the more problems you will have. Cognitive Theory (Beck's Automatic Negative Thoughts) - Arbitrary Inference (someone you like didn't look at you, therefore they hate you) - Overgeneralizing - Dichotomous Thinking - Magnification (pf bad things) and Minimisation (of good things) The more often you do these, the more unhappy you are. Benefits of Cognitive Model Not sufficient to explain abnormal behaviour. - Amenable to empirical enquiry - Complements behavioural strategies Weakness of Cognitive Model - Precise role of cognitions in psychopathology unspecified - Narrowness of scope - No link between cognitive therapy and cognitive science - Lack of evidence that cognitive therapy added to behaviour therapy - Lack of evidence supporting hypothesised mediators of change in CBT Third wave of behavioural therapy 1990s: - Dialectical Behaviour Therapy (DBT; Linehan). Good for depression and borderline personality disorder - focus on the here and now. - Mindfulness Based Stress Reduction (Kabat-Zinn) 2000s: - Adaptation of MBSR eg., Mindfulness-Based Cognitive Therapy (MBCT) 1999: - Acceptance and Commitment Therapy (ACT) - still widely used today. Acceptance and Commitment Therapy (ACT) "ACT is a therapy approach that uses acceptance and mindfulness processes to produce greater psychological flexibility." (Hayes & Stroshal, 2004) ACT based on: - Functional contextualism - Relational Frame Theory - Post-Skinnerian contextual theoy of language and cognition Goal: psychological flexibility and avid rigidity ACT Theory of Change Our psychological problems originate from thought (i.e. the thought of it made me sick) and language - Language and cognition can trigger intense emotional pain and psychological discomfort, and associated behaviours - 'The goal is psychological flexibility which involves contact with the present moment and changing or persisting in behaviour in the service of chosen values - Verbal regulation, rigid rules, prevent us from moving in valued directions ACT Hexaflex - Need to live in present or will have rigidity - If we don't have clear life direction = rigidity - Behaviour needs to have meaning and direction, or rigidity - Attachment to descriptions of self cause rigidity (i.e. I need to be X or Y). - Fusion: Extreme version of attachment; FUSING with conceptualised self. - Not being accepting or avoiding future opportunities = rigidity Six core therapeutic processes of ACT Psychological flexibility is established via six core ACT processes (mentioned in the hexaflex) Each of these areas is conceptualised as a positive psychological skill, not merely as a method of avoiding psychopathology Diathesis-Stress perspective on mental disorders Diathesis means predisposition. Diathesis and Stress interact to make up vulnerability to mental disorder. Conclusion Biomedical: heart of biomedical model Psychodynamic: then leads to mental health issues Humanist: if we don't have positive regard from others, we will not have positive self regard, which leads to inauthentic self. ACT: Main model at the moment. Overview Pt 2: Overview of models of Psychopathology: Biomedical - Genetics as aetiology - Biochemistry as aetiology - Neuroanatomy as aetiology - Endocrine System as aetiology Biological Treatments: 1) Electro-convulsive shock treatment 2) Pharmacotherapy Psychodynamic Model: - Freud (ego, id, super ego) - Jung (built on Freud with de-emphasis of biological drives) - Erickson (built on Freud and moved from psychosexual to psychosocial). Humanistic Model: - Carl Rogers (positive/negative regard causes positive/negative self regard). Behavioural Model (1st wave): - Classical Conditioning - Operant Conditioning - Observational learning/modelling Behavioural Treatments: - Classical conditioning techniques - Operant conditioning techniques - Modelling techniques Cognitive Therapy (second wave of behaviour therapy): Mental illness is caused by different ways of thinking about things. - Ellis 10 irrational beliefs - Becks automatic negative thoughts 3rd wave of behaviour therapy: - Dialectical Behaviour Therapy (DBT) - Mindfulness based stress reduction - Adaption of mindfulness-based cognitive therapy - Acceptance and commitment Therapy (ACT) - need to know in detail, compared to others above. Diathesis stress model Add or remove terms You can also click the terms or definitions to blur or reveal them