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Chapter 3

Ch. 3 - Perspectives and Traumas.pdf

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Richard B Day

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 Causesand RiskFactorsfor AbnormalBehaviour  Understanding causes is the ultimate goal, but it is difficult. So, speaking of risk factors is most preferred  NecessaryCauses o If disorder Y occurs, then cause X must have been present o Exp. PTSD  Need traumatic event to develop anxiety PTSD response  Sufficient Cause o If cause X occurs, then disorder Y will also occur o A cause that guarantees the occurrence of a disorder o Exp. If you are hopeless enough about the future, you will become depressed  ContributoryCause o If X occurs, then the probability of getting disorder Y increases o Not necessary or sufficient, just increases the probability o Exp. Parental rejection increases probability of a child's difficulty with adult relationships o Reinforcing Contributory Cause  Condition that helps to maintain maladaptive behaviour that is already occurring  Exp. The sympathy and attention youget while sick, may unintentionally discourage recovery  Exp. The way you alienate friends while depressed, reinforces the rejection and reinforces your depression  TimeFrameMatters o Distal Causal Factors  Causal factor occurring early in life, doesn't show its effects for many years  Sets up a predisposition for another disorder later in life  Exp. Abusive parents is a distal cause, predisposing someone to depression o Proximal cause  Causal factor occurs shortly before the occurrence of the disorder's symptoms  Can also serve as a distal cause later in life  Exp. Brain damageto get Wernicke's Aphasia  Have a good understanding of contributory causes, not necessary or sufficient causes  CausalPattern o When more than 1 causal factoris involved o Conditions A, B & C leads to condition Y  Diathesis-StressModel o Disorders that develop as a result of some kind of stressor operating on a person who has a diathesis for that disorder o Neither diathesis or stress is by itself sufficient to cause the disorder, but in combination they can lead to abnormality o Diathesis  Predisposition/vulnerability towards developing a disorder  Bio, psych & social factors  Relatively distal necessary or contributory cause  May even act as a highly potent stressor o Additive Model  Diathesis and stress sum together  If one is high, the other can be low (v/v)  Therefore, a person with no or very low diathesis can still develop a disorder, but you'd need a tragic stressor o Interactive Model  Some amount of diathesis must be present before stress will have any effect  If you do not have any diathesis, you cannot develop the disorder regardless the strength of the stressor o Protective Factors  Influences that modify someone's response to an environmental stressor  Promote resilience in the face of vulnerability and stress  Makes it less likely to experience adverse consequences of the stressor  If a child's systems of adaptation are weak, damaged or are exceeded by a stressor, problems will arise  Systems of adaptation = Intelligence, cognition, self-regulation, motivation, parenting etc. Can be positive or negative   Positive  Having a warm & protective adult figure or positive sibling relationship throughout development  Negative  Steeling / Inoculation effect Some stressors promote coping   Successfully dealing with a stressful experience can improve self-esteem and protect you  Most often lead to resilience  Ability to successfully adapt to even very difficult circumstances (overcoming the odds)  Not set in stone; isn't a cure to being affected by stress  Used to describe… o Good outcomes despite high risk o Sustained competence despite threat o Recovery from trauma o Need to be considered under a broad multicausal developmental model  Multicausaldevelopmentalmodel o A child may acquire a variety of cumulative risk factors that may interact in determining their risk for psychopathology o But, protective factors also interact to determine if they will express psychopathology  Developmentalpsychopathology o Understanding what is normal human development allows you to investigate what is abnormal  Biopsychosocialviewpoint  Recent viewpoint for understanding abnormal behaviour  Biological, psychosocial and sociocultural factorsall interact and play a role in psychopathology and treatment  BiologicalViewpointand Causal Factors  NeurotransmitterImbalances o Neurotransmitter imbalances can be created in a variety of ways:  Excess production and release of NT  After NT is released into synapse, it is deactivated  Reuptake or enzyme degradation (monoamine oxidase)  Receptor problems on post synaptic membrane o Most medications act to increase or decrease the concentrations of certain NT at the synaptic gap Block the reuptake process or affectthe enzymes degradation qualities  o Neurotransmitters Monoamines   Synthesized from a single amino acid  Norepinephrine  Emergency reactions to stressful or dangerous situations  Dopamine  Schizophrenia and addictive disorders  Serotonin  How we think and process info  Behaviours and mood  Anxiety and depression  GABA  Reducing anxiety and other emotional states characterized by high arousal levels o Chemical circuits  Neurons sensitive to a certain NT, cluster together forming neural pathways  Different disorders are thought to stem from different patterns of NT imbalances in various brain areas  HormonalImbalances o Hormones  Chemical messengers secreted by a set of endocrine glands in our bodies  Each gland has its own set of hormones o Neuroendocrine system  Central nervous system is linked to the endocrine system  Hypothalamus' effects on the pituitary gland  Master gland of the body, produces many hormones that regulate and control other glands o Hypothalamic-pituitary-adrenal-cortical axis (HPACA)  Negative feedback system  It's malfunctioning is implicated in psychopathologies such as, depression and PTSD  Activation involves:  Messages via CRH travel from hypothalamus to the pituitary  Pituitary releases ACTH which stimulates adrenal gland to produce epinephrine (adrenaline) and the stress hormone cortisol  Cortisol provides negative feedback to the hypothalamus to decrease their release of CRH & ACTH o Imbalance in sex hormones (produced by gonadal glands) can also contribute to maladaptive behaviour  GeneticVulnerabilities o Most psych disorders show at least some genetic influence  Indirect influence, interacts with the environment o Abnormalities in the structure or # of chromosomes = major defects or disorders  More commonly, abnormalities of the genes ON the chromosomes affect disorders  Disorders are polygenic = influenced by multiple genes o Heredity determines the range within which behaviour can be modified by the environment or experiences o Genotype-environmentCorrelations  Genotype shapes the environmental experiences a child has  Exp. Predisposed to aggression, kid is aggressive and thus gets rejected by peers and goes on to associate with similarly aggressive kids who increase the likelihood of him developing adolescent delinquency  3 ways genotypes shape environment  Passive effect  Parents provide an environment that will interact with their child's genetic disposition for a trait  EXP. Smart parents have a stimulating environment to promote smart kids  Active effect  Child seeks out an environment that is inline with there genetic disposition for a trait  Aka niche building  Exp. Extroverts seek out lots of friends, enhancing sociable tendencies  Evocative effect  Child's genotype evokes particular kinds of reactions from social & physical environment Exp. Happy babies evoke a positive response from others   Genotype-environment interaction  People with different genotypes are differentially sensitive or susceptible to their environment  Exp. PKU-Induced mental retardation  Different response to phenylalanine in foods can cause retardation in the susceptible population  Studying genetic influences  Family history / pedigree method  Observe samples of relatives of each disorder to see if incidence increases in proportion to the degree of heredity relationship  Proband or index case = subject, carrier of the trait or disorder in question  Compare to the incidence rate of the disorder in the normal populations = control  Con = Those who are more related, also tend to share more similar environments  Twin method  Identical Twins  If a disorder is 100% heritable, the concordancerate should be 100% in identical twins  Percentage of twins sharing the disorder or trait Dizygotic Twins   Concordance rates should be lower than foridentical twins  CON  Assimilation and contrast effect  Using identical twins reared apart is best  Adoption method Rates of disorder in biological parents were compared for:   Child with and without a disorder who was adopted away at a very young age  If high genetic; higher rates in biological relatives of those with disorder  Rates of disorder in adopted-away offspring of:  Biological parents with the disorder and without  If high genetic; higher rates in offspring who's parents have disorder  Environmental influences  Shared  Affect all children within a family similarly  Exp. Poverty and nutrition  Non-shared  Affect each child differently within one family  Exp. Unique school experiences and friends o Methodstodetermineactuallocationof genesresponsiblefordisorders  Linkage Analysis  Look forlinks between a disorder throughout a family and inherited physical or biological traits  We know the location of X trait on a chromosome, so if Y disorder is associated with X trait… we know that the Y disorder's gene may be near the gene forthe X trait.  Current studies are inconclusive, most disorders are influenced by many different genes  Exp. Autism on chrom. 11, anxiety on chrom. 14… but isn't well replicated Most successful for single-gene brain disorders, exp. Huntington's   Association Studies  Have a large group of people with and without a disorder  Compare frequency of known genetic markers that are present in people with and without the disorder If one genetic marker is more common in people with a disorder, we  can infer that 1+ genes associated with a gene are located on that same chromosome for the trait  Better for polygenic disorders  Temperament o Child's reactivity and characteristic ways of self-regulation o Differences in emotional and arousal responses to stimuli and tendency to approach, withdraw or attend to situations o Early temperament (2 - 3 months +) is thought to be the basis from which our personality develops  Moderate degree of stability throughout life  5 dimensions of Adult personality Potential for psychopathology temperament relation fearfulness Neuroticism Very fearful = Behavioural inhibited = anxiety Not fearful = uninhibited = aggressive/delinquent  Add hostility = conduct & antisocial disorder Irritability & " frustration Positive affect Extroversion Activity level " Attentional Constraint persistence (conscientiousness)  DevelopmentalSystemsTheory o Genetic effectson environment are bidirectional o Everything interacts with each other: genetic, neural, behaviour, environment o Neural Plasticity  Brain development is not rigid and determined, the brain can make changes in organization and function in response to pre and post natal experiences  Less extensive as we get older, but still possible throughout the lifespan  These changes can be beneficial or detrimental  Exp. Normal rearing conditions with caring parents is great, BUT, un- stimulating, deprived environments can really retard development in children  Gorenstein's2commonerrors  Believe establishing a biological difference between a normal and abnormal person = they have an illness  But what is an illness, is upto a clinical judgment since all behaviours have a differential biological bases  Saying that psychological disorders are biological causes with biological conditions  Biological andpsychological factors are in constant interplay, shouldn't distinguish the 2 as separate  PsychosocialPerspectives  Understand humans as more than just biological but as people with motives, desires and perceptions  3 major psychosocial perspectives  All share the importance of early experience, socialinfluence, and psychological processes o Psychodynamic  Freud - psychoanalytic  Deterministic view of human behaviour that minimizes rationality and freedom of self-determination  Intrapsychic conflicts lead to mental disorder  Ego mediates the desires of the id, demands of reality and morality of the superego = executive branch  Inner conflicts arise because the 3 systems are striving for different goals  Anxiety as a key causal role in most forms of psychopathology  Resolution of oedipus/electra complex is essential for healthy heterosexual adult relationships  Freud's contributions  Therapeutic techniques: free association & dream analysis  Realize how unconscious motives & defense mechanisms affect behaviour  Importance of early experience and sexual factors  Abnormal mental things can be exaggerations of normal ego-defense mechanisms  Newer perspectives  Don't emphasize libidinal energy, intrapsychic conflict, importance of the ID  Ego psychology  Psychopathology = ego doesn't function adequately  Infant's very early relationships  Interpersonal relationships  Object-Relations Theory  Emphasizes the importance of the quality of very early mother-infant relationships for normal development  Focus on individual's interactions with real or imagined people &…  On relationships you experience with their external and internal objects  Object = symbolic representation of another person in your environment  Incorporating this person into their personality = introjection  Internalized objects can have conflicting properties --> gives rise to inner conflicts  EXP. Borderline personality disorder , also Narcisstic can be explained  Can achieve a stable personal identity  Can't structure their internal world to believe people can have good and bad traits  The external world has abrupt extremes; all good vs. all bad  Interpersonal Perspective  Psychopathology = unfortunate tendencies we have developed while dealing with our interpersonal environ  Social and cultural forces rather than inner instincts as determinants of behaviour  Adler  People are motivated by the desire to belong to and participate in a group  Fromm & Horney  Psychopathology  Maladaptive dispositions/orientations you adopt when interacting with others  Horney added, Freud had the wrong view of women  Erikson  Broadened Freud's stages into more socially oriented concepts  The oral stage is actually a stage focused on learning trust  Attachment Theory  Bowlby focused on the importance of early experience with attachment relationships, especially parents  Secure attachments are the best but anxious attachment style is hint at future psychopathology o Behavioural Arose out of reaction to the unscientific and non-testable methods of  psychoanalysis  Learning, behaviour, stimuli and reinforcement etc.  Classical, instrumental conditioning & generalization and discrimination & observational learning  Attempts to explain the acquisition, modification and extinction of all behaviours  Psychopathology  Learning that has gone awry and ineffective maladaptive responses  Cons  Oversimplifies human behaviour and can't explain all of its complexities o Cognitive-Behavioural  Bandura  Developed a cognitive-behavioural perspective, learning theorist  Humans can regulate behaviour via thoughts  We learn by internal reinforcement  Theory of self-efficacy  Belief that one can achieve desired goals  CBT works by improving self-efficacy  Cognitive-behavioural perspective  How thoughts & information processing can become distorted and lead to maladaptive emotions & behaviour  Beck's schemas  Underlying knowledge that guides the current processing of information  People have different ones depending on their personality, abilities and experiences  About other people, social roles, events, who you are, should be etc.  Source of vulnerability, if about yourself (self-schemas) can become distorted and inaccurate  Usually unaware of these schemas  A lot of nonconscious processing  Implicit memory and processing without someone's awareness  Accommodation is a basic goal of therapy  Change our existing schemas to incorporate new information that doesn't fit  Psychopathology  Different maladaptive schemas that developed from bad early learning experiences  Attributional theory  Process of assigning causes to things that happen (external or internal cause)  Psychopathology  Distinctive and dysfunctional attribution styles  Characteristic way someone tends to assign causes to good or bad events  Cognitive Therapy  Beck = founder of cognitive therapy  The way we interpret events and experiences determine our emotional reactions to them  Therapy focuses on how to alter distorted and maladaptive cognitions  Change client's self-statements; negative cognitive biases about their experiences  2 other perspectives o Humanistic  Human nature is basically "good" and we should focus on values and personal growth  Values and process of choice is key to guiding our behaviour  Focuses on our conscious present and that we are responsible for our self- direction  Psychopathology = blocking or distorting our personal growth (ideal self) o Existential  Same emphasis on uniqueness, quest for values and meaning and our freedom for self-direction & fulfillment  Exi
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