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PSYB32 Abnormal Psychology - Lecture 2.docx

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Konstantine Zakzanis

PSYB32 Abnormal Psychology Lecture 2 - Current Paradigms and the Role of Cultural Factors The Role of Paradigms Paradigm -Conceptual framework or approach within which a scientist works ->Paradigm exists consciously and unconsciously. ->Clinicians are all trained in various disciplines of clinical psychology. >Some are Freudians or psychoanalytic therapists, Behaviorists, cognitive psychologists, clinical neuropsychologists, and etc. ->Ways that clinicians study psychopathology, conduct doctoral researches, training by supervisors defines the way in which we approach the patients (the way we diagnose and treat the patients). >Therefore the paradigm that a clinician adopts would have a profound impact on the patients because there are very different ways we diagnose and treat patients. -For example, a person with depression ->Humanistic paradigm - the clinician may not even diagnose the patient but they will accept the person for who they are instead of labeling the person with major depressive disorder. In terms of treatment, the clinician would spend some time on the patient and bring insight to and counseling with them. ->Psychiatrist paradigm - Clinicians may use a formal term to diagnose the patient as having major depressive disorder as they believe in the DSM. And they will usually treat the clinicians with psychopharmacology and maybe a bit of counseling. -Does these different paradigms have a vastly different course for the patient? ->Counseling may do nothing for the patient while medication may allow the patient to function in the real world again, work and have a family. ->Or the opposite might happen, counseling may teach the patient how to cope and be able to exist with their symptoms yet medication could kill them from side effects. ->Which paradigms prevail? No paradigms prevail over another as it goes back and forth, and shifts over time. >Nowadays as technology come about, biological approaches started to prevail again. New drugs that are more specific in their targeting, different kinds of treatment such as the brain stimulation. >Not only technological but cultural as well can really prevail a paradigm at a given time and place. Biological Paradigm Behaviour genetics -Study of individual differences and behaviour that are attributable to ones genetic makeup ->Genotype versus phenotype >Genotype is our total genetic makeup, this includes all of our genes that are unobservable and have at birth (fixed) -However, even though genotype are genetic makeup that are fixed since birth, it can turn on and off as mediated by the environment or other biological ,psychological, social factors. >Phenotype is the totality of observable behavioural characteristics which changes overtime. -Phenotype is the product between the genotype and the environment. >In terms of genotype presenting itself or phenotype can be mediated by lots of different factors -For example, you are born with white skin (genotype), but overtime you may become interested in sun-tanning; which turns your skin into a brownish color, or maybe you are diagnosed with skin cancer, rash or different kinds of dermatosis problems overtime and etc that can change your phenotype. >When talking about the diagnosis and treatment of psychopathology, we are talking about the diagnosis of a phenotype as clinicians don’t really work with genetics, but one exception would be Huntington’s disease, in which once a person has a genetic predisposition of this gene, it is fixed and will always manifest itself (no turn off, just turn on). ->The methods for behaviour genetics are utilized to understand whether or not the person has a genetic predisposition for psychopathology. >Family method -Search for probands (somebody that is identified with a disorder) ->For example, someone with schizophrenia is the proband in the family. -Then we look for family members of that proband, typically first degree relatives, who shares 50% of genes with the proband. -By looking at the family members that have the gene overlap with the proband, this will help us to understand the incidence or prevalence of the disorder in that relative. -If there is an increase incidence of that relative, it shows that the relative has an increased genetic predisposition. ->In general population, about 1% would have schizophrenia. If you are an offspring of a parent with schizophrenia, you have 10% chance of getting it. -By family method, we can argue that schizophrenia has a genetic predisposition; you are more likely to have that disorder if you already have shared that genetic predisposition with someone >Twin method -Monozygotic (MZ) twins [Identical twins that shares 100% genes] ->If one has disorder, the other may or may not have the same disorder since genes can switch on and off. ->If someone has schizophrenia, the other identical twin has 50% of getting that disorder. ->As a result, a lot of disorders have genetic predisposition but it’s not a complete explanation. -Dizygotic (DZ) twins >Adoptees method -Studying twins that are being raised in different environments that would be different from what their parents who likely have the disorder would be. ->This allows us to say things even more specific about the genetic predisposition of a disorder. Biological Paradigm – Biochemistry Two Important Key Terms -Neurotransmission -Reuptake Biological Paradigm – Structure and Function of the Human Brain Cortical structures VS subcortical structures -Cortical structure ->Higher-order cognition >E.g., learning ->Ability to concentrate, learn, consolidate, retrieve, planning, problem solving and etc -Subcortical structures (Areas that are within the brain, below the surface of the cortical structure) ->Basic behavioral features >Sleep & wakefulness, movement -E.g., movement disorder can arise from damages to subcortical structures such as Parkinson’s disease. >Subcortical structures can also be implicated with other types of disorder such as depression. -E.g., people with severe depression can move and talk quite slowly Structure and Function of the Human Brain -Frontal lobes ->Responsible for executive functions, such as memory, planning, motor movement, problem solving, making decisions, understand humour, speech (Broca’s area) >Right side -Responsible for retrieval ->Right frontal lobe also has been implicated for different types of psychotic like symptoms such as mania, patients appearing incredibly apathetic or depress >Left side -Responsible for encoding, learning, taking information in ->Using different neuropsychological tests, you can isolate where the damage is in brain injured patients. Whether they can’t get it in, can’t learn, or they can’t retrieve. -Temporal lobes ->Responsible for language (Wernicke’s area), consolidation [forming and storing memory] (hippocampus) >Right side >Left side -Parietal Lobes ->Responsible for sensation, calculation, visual-spatial abilities, coordination, visual construction >Right side >Left side -Occipital Lobes ->Responsible vision Biological Paradigm Approaches to Treatment: Psychoactive Drugs Anxiolytics (Drug that is responsible for anxiety, stress, sleep disorder, OCD, sometimes may use for depression) ->Benzodiazepines >Alprazolam (Xanax); Clonazepam (Klonopin); Diazepam (Valium); Lorazepam (Ativan) Antidepressants (Drugs that is responsible for depression, anxiety disorder, OCD, eating disorder, personality disorder, pain/somatic form disorder) ->Selective Serotonin Reuptake Inhibitors (SSRIs) >Celexa; Prozac; Zoloft ->Tricyclic Antidepressants >Elavil; Amitryptine ->Monoamine Oxidase Inhibitor (MAOIs) >Nardil; Parnate Antipsychotics (Drugs that is responsible for psychosis such as schizophrenia, severe traumatic brain injury, dementia such as Alzheimer’s disease) ->Phenothiazines >Thorazine ->Thioxanthenes >Cloxan ->Second generation antipsychotics >Clozapine >Olanzapine >Risperidone Psycho-Stimulants (Drugs that is responsible attention deficit disorder, narcolepsy, Alzheimer’s disease or different dementia syndromes, sometimes with depression, often with traumatic brain injury and even with healthy people for recreational use[abuse of drug]) ->Amphetamines >Ritalin; Aricept Psychoanalytic Paradigm Sigmund Freud (1856-1939) -Argues that psychopathology results from unconscious conflict. ->In order to cure this unconscious conflict, is to bring this conflict into consciousness. -Structure of the mind ->Id >Pleasure principle (seeks immediate gratification at all cost) -When not satisfied, it produces anxiety. To deal with that anxiety, it would either engages in the behaviour that would get the person in trouble or cause psychopathology to manifest itself in terms of disorder. Or it causes the person to engage in primary process thinking. >Primary process thinking -To have fantasy or illusions for what id wants so to at least temporarily gratify itself in terms of what it’s looking for. ->Ego >Reality principle (primarily conscious) >Secondary thinking -Ego realizes that you can’t act in terms of pleasure at all time or it’s going to get you into trouble and in fact it limits your ability to survive in this world. ->Superego >Conscience
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