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Chapter 3

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McMaster University
Richard B Day

Psych 2AP3: Abnormal Psychology – Major Disorders Chapter 3: Casual Factors and Viewpoints Causes and Risk Factors for Abnormal Behaviour - Necessary, Sufficient, and Contributory Causes:  Necessary cause: condition that must exist for a disorder to occur  Sufficient cause: is a condition that guarantees the occurrence of a disorder  Contributory cause: increases the probability of the development of a disorder but is neither necessary nor sufficient for the disorder to occur  Distal causal factors: causal factors occurring early in life but may not show their effects for many years contributing to predisposition to develop a disorder  Proximal causal factors: causal factors operating shortly before the occurrence of the symptoms of a disorder  Reinforcing contributory cause: condition that tends to maintain maladaptive behaviour that is already occurring - Feedback and Circularity in Abnormal Behaviour:  Determining cause-and-effect relationships focuses on isolating the cause that can be demonstrated to lead to effect  Causal pattern: more than one causal factor is involved - Diathesis-Stress Models:  Diathesis: predisposition or vulnerability toward developing a disorder  Diathesis stress models: disorders believed to develop as the result of some kind of stressor operating on a person who has a diathesis  Stress: response of an individual to demands that he or she perceives as taking or exceeding his or her personal resources  Additive model: individuals who have a high level of diathesis may need only a small amount of stress before a disorder develops and vice versa  Interactive model: some amount of diathesis must be present before stress will have any effect  Protective factors: influences that modify a person’s response to environmental stressor, making it less likely that person will experience the adverse consequences of the stressors  Resilience: ability to adapt successfully to even very difficult circumstances  Good outcome despite high-risk status  Sustained competence under threat  Recovery from trauma  Multicausal developmental models: cumulative risk factors that may interact in determining the risk for psychopathology  Developmental psychopathology: focuses on determining what is abnormal at any point in the development by comparing with normal and expected changes that occur in the course of development 3.1 Canadian Focus: Studying Resilience in Children, Youth, and Families - The international resilience project: understand how children and youth in different cultures cope with the adversities they face - Negotiation resilience: study the ways in which children cope with being out of place in important ways - Pathways to resilience: examining service use patterns among Atlantic Canadian at-risk youth and understanding how taking advantage of community services can lead to healthier outcomes - Stories of transition: developing and understanding of the supports, roadblocks, and detours that affect the educational and occupational paths that high school students take after graduating Viewpoints for Understanding the Causes of Abnormal Behaviour - Help professionals organize observations they have made, provides a system of thought to place the observed data, and suggests areas of focus for research and treatment - Help determine the kids of potential causes - Biological, behavioural and cognitive-behavioural, sociocultural, biopsychosocial The Biological Viewpoint and Biological Causal Factors - Neurotransmitter and Hormonal Imbalances:  Synapse: fluid filled space, site of communication between the axon of one neuron and the dendrites or cell body of another neuron  Neurotransmitters: chemical substances that are released into the synapse by the presynaptic neuron when a nerve impulse occurs  Imbalances of neurotransmitters:  Excessive production and release of the neurotransmitter substance into the synapses, causing a functional excess in levels of that neurotransmitter  Dysfunctions in the normal processes by which neurotransmitters, one released into the synapse, are deactivated o Reuptake o Degradation by enzymes  Problems with the receptors in postsynaptic neuron  Chemical circuit: neurons that are sensitive to a particular neurotransmitter tend to cluster together, forming neural paths between different parts of the brain  Monoamines: noradrenaline, dopamine, serotonin synthesized from single amino acid  Hormonal imbalances:  Hormones: chemical messengers secreted by a set of endocrine glands in our body  Central nervous system is linked to the endocrine system by the effects of the hypothalamus on the pituitary gland which is the master gland of the body, producing hormones that regulate or control the other endocrine glands  Hypothalamic-pituitary-adrenal-cortical axis: o Messages in the form of CRH travel from the hypothalamus to the pituitary o In response to CRH, pituitary releases ACTH which stimulates the cortical part of the adrenal gland to produce adrenaline and the stress hormone cortisol o Cortisol provides negative feedback to the hypothalamus and pituitary to decrease the release of CRH and ACTH, which reduces the release of adrenaline and cortisol - Genetic Vulnerabilities:  Genes: very long molecules of DNA and are present at various locations on chromosomes  Chromosomes: chain-like structures within a cell nucleus that contains the genes  Genes can be turned on and turned off in response to environmental influences such as stress  Relationship of genotypes to phenotypes:  Genotype: person’s total genetic endowment  Phenotype: observed structural and functional characteristics that result from interaction of genotype and environment  Genotype-environment correlation: when the genotype shapes the genotype shapes the environmental experiences a child has - Genotype-Environment Correlations:  Passive effect: environment resulting from the genetic similarity of parents and children  Evocative effect: genotype may evoke particular kinds of reactions from the social and physical environment  Active effect: child seeks out or builds environment that is congenial  Genotype-environment interactions: people with different genotypes may be differentially sensitive or susceptible to their environment  Methods for studying genetic influences: behaviour genetics  Family history method: observe samples of relative of each proband or index case to see whether the incidence increases in proportion to the degree of hereditary relationship compared with the incidence in a normal population  Twin method: study of both identical and fraternal twins o Concordance rate: percentage of twins sharing the trait  Adoption method: o Biological parents of individuals who have a given disorder are compared with the biological parents of individuals without the disorder to determine their rates of disorder o Compare rates of disorder in the adopted-away offspring of biological parents who have a disorder with those seen in the adopted-away offspring of normal biological parents  Separating genetic and environmental influences: testing influence of environmental factors and differentiating shared from nonshared environmental influences  Linkage analysis and association studies:  Linkage analysis: studies of psychological disorders capitalize on several currently known locations on chromosomes of genes for other inherited physical characteristics or biological processes  Association studies: researchers compare the frequencies between groups of individuals with or without the disorder of a certain genetic marker that are known to be located on particular chromosomes - Temperament:  Refers to a child’s reactivity and characteristic ways of self-regulation  Our early temperament is thought to be the basis from which our personality develops  Fearfulness, irritability and frustration, positive affect, activity level, and attentional persistence  Neuroticism or negative emotionality, extroversion or positive emotionality and constraint  Temperament of an infant has profound effects on a variety of important developmental processes  Temperament may also set the stage for the development of various forms of psychopathology later in life - Brain dysfunction and neural plasticity  Neural plasticity: flexibility of the brain in making changes in organization and/or function in response to pre and postnatal experiences, stress, diet, disease, drugs, maturation and continues to some extend through the life span  Developmental systems approach: acknowledges not only that genetic activity influences neural activity, which influences behaviour, which influences environment, but also these influences are bidirectional - The impact of the biological viewpoint:  Decision about what constitutes a mental illness still rests on clinical judgment regarding the functional effects of the disordered behaviour  Given that all our behaviour and cognitions are reducible to a set of biological events occurring in the brain, it is a mistake to distinguish between biological and psychological causes in this way 3.1. Developments in Research: Neurotransmission and Abnormal Behaviour - Neurotransmitters can either stimulate the postsynaptic neuron to initiate an impulse, or to inhibit impulse transmission - Neurotransmitters destroyed by enzymes or returned to storage vesicles in the axonal button by a reuptake mechanism - Many of the medications used to treat various disorders have the synapse as their site of action 3.2 Developments in Thinking: “Nature, Nurture, and Psychopathology: A New Look at an Old Topic” - Even if we are discussing a trait or disorder that has a strong genetic influence, environmental factors can have a major impact on the level of that trait - One’s potential can change if one’s environment changes - Genetic research strategies provide critical test of environmental influences on personality and psychopathology - Genetic effects operate mainly through their effect on susceptibility to environmental influences - Although many people assume that genetic effects should be maximal at birth, with environmental influences getting stronger with increasing age, it is now evident that this is not always true. - Disorder can run in families and not be genetic, or not run in families yet be genetic. The Psychosocial Viewpoints - The psychodynamic perspective:  The conscious part of the mind represents a relatively small area, whereas the unconscious part, is the much larger portion  Unconscious: memories, forbidden desires and other experiences that have been repressed emerging in fantasies, dreams, slips of the tongue, and hypnosis  Until unconscious material is brought to awareness and integrated into the conscious part of the mind it may lead to irrational and maladaptive behaviour - Fundamentals of Freud’s Psychoanalytic Theory:  The structure of personality: id, ego and superego:  Id: source of instinctual drives and is the first structure to appear in infancy o Life instincts: constructive drives of primarilly sexual nature, which constitute the libido, the basic emotional and psychic energy of life o Death instincts: destructive drives tending towards aggression o Operates on pleasure principle: engaging in selfish and pleasure-oriented behaviour, concerned only with immediate gratification of needs o No reference to reality or moral consideration o Primary process thinking: generate mental images and fantasies but cannot undertake the actions needed to meet demands  Ego: mediates between demands of id and the realities of the external world o Secondary process thinking: requires use of reason and other intellectual resources in dealing with the external o Operates on the reality principle  Superego: outgrowth of internalizing the taboos an moral values of society concerning what is right and wrong o Conscience o Executive branch of personality  Intrapsychic conflict: inner mental conflicts arising from the three sub-systems striving for a different goal. If left unresolved, leads to mental disorder  Anxiety, defence mechanisms, and the unconscious:  Anxiety: almost a universal symptom of neurotic disorders  Ego-defence mechanisms: resulting from the ego resorting to irrational protective measures o Displacement, fixation, projection, rationalization, reaction formation, regression, repression, sublimation  Psychosexual stages of development:  Oral stage: mouth is principle erogenous zone, sucking is necessary for feeding  Anal stage: anus provides major source of pleasurable stimulation, urges both for retention and elimination  Phallic stage: self-manipulation of the genitals provides major source of pleasurable sensation  Latency period: sexual motivations recede in importance as child becomes preoccupied with developing skills  Genital stage: after puberty, the deepest feelings of pleasure come from sexual relations  The Oedipus complex and the electra complex:  Phallic stage  Boy longs for his mother sexually and views his father as a hated rival  Castration anxiety: boy fears that his father will punish his son’s lust by cutting off his penis causing the boy to repress his sexual desire for his mother and his hostility toward his father  Girl desires to possess her father and to replace her mother  Penis envy  Identifies with mother  Resolution of this conflict is considered essential if a young adult is to develop satisfactory heterosexual relationships  Newer psychodynamic perspectives:  Psychopathology develops when the ego does not function adequately to control or delay impulse gratification or does not make adequate use of defense mechanisms when faced with internal conflicts  Role of infants early relationship on the development of his or her personality and self-concept  Social determinants of behaviour and on the importance of people’s interpersonal relationships  Object relations theory:  Focus on individual’s interactions with real and imagined other people and on the relationships that people experiences between their external and internal objects  Introjection: child symbolically incorporates into his or her personality through images and memories important people in his or her life  The interpersonal perspective:  Psychopathology is rooted in the unfortunate tendencies we have developed while dealing with our interpersonal environments  Emphasized social and cultural forces, rather than inner instincts as determinants of behaviour  People adapt in their interactions with others  Attachment theory:  Emphasizes the importance of early experience, especially early experience with attachment relationships as laying the foundation for later functioning throughout childhood, adolescence, and adulthood  Importance of parental care  Infant plays more active role in their own development  Impact of the psychodynamic perspectives:  Developed therapeutic techniques for becoming acquainted with the conscious and unconscious aspects of mental life o Extent to which unconscious motives and defence mechanisms affect behaviour, meaning that the causes of human behaviour are generally not obvious or available to conscious awareness o The importance of early childhood experiences in the development of normal and abnormal personality o Importance of sexual factors in human behaviour and psychological disorders  Certain abnormal mental phenomena occur in the attempt to cope with difficult problems and are simply exaggerations of normal ego-defence mechanisms  Fails to recognize sufficiently the scientific limits of personal reports of experience as the primary mode of obtaining information  Lack of scientific evidence to support many of its explanatory assumptions or the effectiveness of traditional psyc
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