Purpose of Theories (4)
- Explain etiology
- Identify maintaining factors
- Predict course
- Design effective treatments
Impact of Theories (4)
- Directs research
- Guides diagnostic decisions
- Defines treatment responses
- Shapes interpretation of clinical presentation
=> Nature vs Nurture Debate => not either/or (reductionistic)
=> Case example: Depression
- Biological: mother’s depression history (does it run in the family)
- Psychodynamic: childhood relationship with parents
- Behavioral: withdrawal from others
- Cognitive: negative beliefs about self and others
- Humanistic/existential: actions and choices
- Sociocultural: level of social support
Levels of Theories
Single-factor explanation:
- Attempts to trace the origins of a particular dx to one factor => but, human beh is unlikely to be product of a single factor
Interactionist explanations:
- View beh as the product of interaction between a variety of factors
Biopsychosocial - Biological
- View mental disorders as diseases => Co-opt language of medicine (ex: “patients”, “symptoms”, “disorder”, “treatment”)
Focuses on dysfunction in: CNS, ANS, Endocrine System
- NT Imbalances => Major neurotransmitters: Norepinephrine, Dopamine (too much = schizo, too little = depression), Serotonin (depression), Glutamate, GABA
=> Too much or too little of the NT produced and released in the synapse, Too few or too many receptors on dendrites, Excess or deficit in the amount of transmitter-deactivating substance in the synapse, Reuptake process too rapid or slow
=> Medications used to treat disorders have synapse as site of action
=> Causal role of NT on psychopathology?
- Assume that since medications work to relieve sx, NT must cause the disorder
- Might not be true – environment and beh also influences neurotransmitters (bidirectional relationship)
Biopsychosocial - Bio 2
- Neural Plasticity => Capacity of the brain to reorganize its circuitry as a function of experience: pre and post natal experiences, Psychoactive drugs (e.g., nicotine, cocaine), Hormones, Diet, exercise
=> Bidirectional relationship between environment and biology
- Hormones => Chemical messengers secreted by endocrine glands
=> Hypothalamic-pituitary adrenal (HPA) axis: Activated in response to stressor, Release of stress hormone cortisol, Altered functioning implicated in depression and anxiety
- Genetics => Notion that human beh is inherited, Evidence that mental dx run in
families *Although no disorder is perfectly heritable
=> Most genes are probabilistic, make small contributions (with other genes) => polygenic: sx of psychopathology influenced by many genes in certain combination
*“Genes confer a liability not a certainty”
Diathesis-Stress Models (2)
- Interactive Diathesis-Stress Models => not having a diathesis = protective factor
- Additive Diathesis-Stress Models => still have potential to get the dx even if no diathesis
(see graph in ppx)
- Etiological heterogeneity (equifinality) => Assumes diathesis and stressor are independent (Gene-environment correlations)
=> Diathesis is not only about genetic factors ex: early childhood experiences, cognitive factors
=> Important Terms in Etiology:
- Equifinality
- Final common pathway (final step in the process)
- Multifinality
Biopsychosocial - Psychodynamic Theories
- Psychodynamic Theories (Sigmund Freud): Unconscious forces within individual control beh
=> Three levels of awareness: Conscious, Preconscious, Unconscious
Id - instincts (fully unconscious, desires), Ego - reality (conscious and preconscious; max pleasure & minimize conseq), Superego - inhibition (cons/precon/uncon, morality)
=> Talks about psychosexual stages, defense mechanisms (to soothe anxiety)
=> Incredibly influential theory on the field, Role of the unconscious
=> Early childhood experiences: “Schizophrenogenic mother” (very protective and then reject), “Refrigerator mother” (very cold/uncaring), later attachment theories
=> Criticized for not being a scientific theory: Reliance on case studies, Lack of empirical evidence for claims,Infallible theory
(SEE GRAPHS IN PPX)
Biopsychosocial - Behavioral Theories (3)
Introduced by John B. Watson => More experimental, scientific approach (Human beh both normal and
abnormal = learned) *Classical conditioning
- Classical conditioning: Stimulus-stimulus expectancy (Transfer response from one stimulus
(UCS - food) to another (CS - bell)
=> Watson applied to the acquisition of phobias => But, doesn’t explain persistence of phobias (Extinction when CS is presented without UCS repeatedly)
- Operant Conditioning (B.F. Skinner): Focus on consequences of beh => Reinforcement: + beh vs Punishment: - beh (Response-outcome expectancy )
=> Phobias are maintained thru negative reinforcement and reinforces the idea that avoidance and escape beh are good since they reduce distress
- Social Learning Theory (Bandura): Learning occurs within social context
=> Acquired vicariously (modeling) => Children can learn to be fearful from phobic parents, Children can learn to be aggressive after observing others being rewarded for aggression
=> Cognitive mediating processes ex: expectations, abilities, appraisals, feelings, self-efficacy
*Views abnormal beh as a failure to learn adaptive responses/ learning of maladaptive responses => Therapy = changing specific beh ex: exposure therapies
(Lots of empirical support, Criticized for being overly symptom focused)
Biopsychosocial - Cognitive Theories 1
Assumptions:
- Thinking affects emotion and beh
- Thoughts can be monitored and changed
- By altering one’s thoughts, a person will experience desired beh and emotional change
- Rational-Emotive Beh Therapy (Albert Ellis): Adaptive feelings/ stem from rational thoughts vs Irrational beliefs lead to unhealthy, disturbed emotions (Rigid demands vs. flexible preferences)
Activating Event - Beliefs about event (irrational and maladaptive) - Consequences (mediated thru beliefs about the event)
Biopsychosocial - Cognitive Theories 2
Beck’s Cognitive Theory (Aaron Beck): 3 main levels of cognition => schemas, info processing biases, automatic thoughts
- Schemas: Internal representations of stored info about self, others, and exp => can be distorted and inaccurate (Maladaptive ones develop during early childhood exp) => Becomes activated by negative life experiences
=> Content-specificity: Different types of core beliefs can give rise to different kinds of psychopathology (SEE PPX FOR EXAMPLES)
- Info Processing Biases: Info processing biases for schema-congruent info (Memory, Attention, Interpretation) &. Biases reinforce and maintain negative emotional schemas
- Automatic Thoughts: Info processes outside of conscious awareness, Cognitive by-products that stem from core beliefs and schemas, and interact with env => These negative automatic thoughts influence emotions and beh
*Cog Beh Conceptualization (SEE PPX!)
Biopsychosocial - Sociocultural Theories 1
- Family Env => Childhood maltreatment, Separation from parents (ex: orphaned, hospitalized), Parenting styles (ex: warmth, control), Marital conflict, Parental psychopatho, Parental invalidation of emotions
=> Parental invalidation of emotions: “Neglecting or ignoring the expression of emotion, dismissing or minimizing emotional experiences, and/or punishing the emotional expression”
- Parent communicates that emotions are intolerable and unacceptable => Leads to emotional, beh, and interpersonal dysregulation (Linked to various forms of psychopatho)
*Intergenerational Transmission of Emotion Dysregulation (Parent Emotion Dysreg –> Parental Invalidation of Emotions (mediator) –> Ado Emotion Dysreg –> Either internalizing or externalizing sx)
- Low socioeconomic status => Children and families from low SES backgrounds have 2-3x more risk to develop mental health problems (cause of higher rates of psychopatho)
- Interpersonal Relationships => Human beings have a fundamental need for social belonging & Social support associated with physical and mental health outcomes (present = protective factor), Social isolation increase risk of mortality
=> Stress-buffering? => high stress = + social support but no stress = doesn’t need social support
=> Relational regulation theory* => Emphasis on ordinary social interaction
Biopsychosocial - Sociocultural Theories 2
- Prejudice Toward Social Groups => Members of ethnic minorities often have higher rates of mental dx *stress (often conflated with poverty)
=> Gender differences in rates of mental dx: Socialization processes? ex: thin ideal for women = disproportionate ED prevalence rates) & Biases in DSM diagnostic criteria? ex: Dependent PD vs. Antisocial PD
- Mental Health Stigma: Plays a role in maintenance of mental dx, Represents barrier to seeking treatment, Internalization of public stigma can lead to self-stigma (Predicts + negative attitudes toward treatment seeking)
- Broader Socialcultural context: Twenge => Age of anxiety with birth cohort (Each generation grows up in a different society => Proxy for socialcultural env)
=> Meta-analyses showing substantially higher levels of anxiety and neuroticism in recent decades (ex: average child in 80s reported + anxiety than psychiatric child in 50s)
=> Why has anxiety increased?
- Low social connectedness (ex: more ppl living alone)
- Increases in overall threat (ex: higher crime rates)
- Appears unrelated to economic factors (ex: unemployment)
