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Chapter 2

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University of Toronto St. George
Konstantine Zakzanis

Chapter 2 – current paradigms and the role of cultural factors - Paradigm is a set of basic assumptions, a general perspective, that defines how to conceptualize and study a subject, how to gather and interpret relevant data, even how to think about a particular subject Role of paradigms - Paradigm  conceptual framework/approach within the scientist works o Specify what problems scientists will investigate and how they will go about the investigation o Injects inevitable biases into the definition and collection of data and may also effect the interpretation of facts The biological paradigm - Biological paradigm  continuation of the somatogenic hypothesis o Often referred to as the medical model/disease model - For a time, the germ theory was the paradigm of medicine but it soon became apparent that this theory could not account for all diseases - Biological paradigm was the dominant paradigm in Canada and elsewhere from late 1800s – th middle of 20 century Contemporary approaches to the biological paradigm: - Psychopathy is viewed as caused by the disturbance of some biological process Behaviour genetics: - Genes  carriers of genetic information (DNA) passed from parents to child - Behaviour genetics  study of individual differences in behaviour that are attributable in part to differences in genetic makeup - Phenotype changes over time and is viewed as the product of an interaction between the genotype and the environment - Study relied on 4 basic methods to uncover whether a predisposition for psychopathy is inherited o Comparison of members of a family o Comparison of pairs of twins o Investigation of adoptees o Linkage analysis - Family method  used to study a genetic disposition among members of a family because the average number of genes shared by two blood relatives is known - First-degree relatives = people who share 50% of their genes with a given individual o Ex. sisters and brothers - Second-degree relatives = share 25% of the genetic makeup o Nephews and nieces - Index cases/probands  sample of individuals who bear the diagnosis in question - In twin method o Both monozygotic (MZ) twins and dizygotic twins (DZ) twins are compared - Equal environment assumption = environmental factors that are partial causes of concordance are equally influential for MZ pairs and DZ pairs o ability to offer a genetic interpretation of data from twin studies o would assert that MZ pairs and DZ pairs have equivalent numbers of stressful life experiences - other factors can also complicate the results of twin research - 3 factors as biasing heritability estimates o Violation of equal environments assumptions o Sex of the participant o His/her age when the assessment took place - Analyses of the role of these factors in a person’s exposure to traumatic events revealed that only environmental factors contributed to exposure to events involving non-assaultive traumas (ex. motor vehicle accidents) but both genetic and environmental factors contributed to exposure to events involving non-assaultive trauma (ex. sexual assaults) - Researchers using the adoptee method o Study children with abnormal disorders who were adopted and reared apart from their parents Molecular genetics: - Molecular genetics is a highly advanced approach that goes beyond mere attempts to show whether a disorder has a genetic component o Tries to specify the particular gene/genes involved and the precise function of these genes - Genetic polymorphism = variability among members of the species o Involves differences in the DNA sequence that can manifest in very different forms among members in the same habitat o Entails mutations in a chromosome that can be induced/naturally occurring - Linkage analysis  method in molecular genetics that is used to study people o Used typically to study families in which a disorder is heavily concentrated o Collect diagnostic information and blood samples from affected individuals and their relatives and use the blood samples to study the inheritance pattern of characteristics whose genetics are fully understood (genetic markers)  Ex. eye colour o Researchers in this area often hypothesize gene-environment interactions  Notion that a disorder/related symptoms are the joint product of a genetic vulnerability and specific environmental experiences/conditions - Focus on gene-environment interactions is important in qualifying the perceived influence of genetic factors - One concern is that an exclusive focus on genetic factors promotes the notion that illness and mental illness are predetermined Neuroscience and biochemistry in the nervous system: - Neuroscience can come in numerous forms o Cognitive neuroscience o Molecular neuroscience o Cellular neuroscience - Each neuron has 4 major parts o Cell body o Several dendrites (short and thick extensions) o One or more axons (of varying lengths) o Terminal buttons on the many end branches of the axon - For a nerve impulse to pass from one neuron to another and for communication to occur, impulse must have a way of bridging the synaptic gap - Terminal buttons of each axon contains synaptic vesicles o Small structures filled with neurotransmitters (chemical substances that allow a nerve impulse across a synapse) - Nerve impulses cause the synaptic vesicles to release molecules on their transmitter substances and these molecules flood the synapse and diffuse toward the receiving, or postsynaptic neuron - Cell membrane of the postsynaptic cell contains neurons (receptor sites) that are configured so that specific neurotransmitters can fit into them - When a neurotransmitter fits in a receptor site, message can be sent to the postsynaptic cell - What actually happens to the postsynaptic neuron depends on its integrating thousands of similar messages o Sometimes are excitatory = leading to creation of a nerve impulse in the postsynaptic cell o Messages can be inhibited = postsynaptic cell less likely to fire - Once a presynaptic neuron (sending neuron) has released its neurotransmitter, last step is for the synapse to be returned to its normal state o Not all of the released neurotransmitter has found its way to postsynaptic receptors o Some of what remains in the synapse is broken down = enzymes o Reuptake  some of neurotransmitter is pumped back into the presynaptic cell - Several key neurotransmitters have been implicated in psychopathology - Norepinephrine (neurotransmitter of the peripheral sympathetic nervous system) = involved in producing states of high arousal and thus may be involved in anxiety disorders - Serotonin and dopamine are neurotransmitters in the brain o Serotonin may be involved in depression o Dopamine may be involved in schizophrenia - Another important brain transmitter is GABA = inhibits some nerve impulses and may be involved in anxiety disorders - Maturational changes influence neurotransmitter levels o Ex. onset of puberty - Neurotransmitters are synthesized in the neuron through a series of metabolic steps o Beginning with an amino acid - Too much or too little of a particular transmitter could result from an error in these metabolic pathways - Similar disturbances in the amounts of specific transmitters are deactivated after being released into the synapse - If the receptors on the postsynaptic neuron were too numerous/too easily excited = result would be akin to having too much transmitter released S TRUCTURE AND FUNCTION OF THE HUMAN BRAIN - Brain is enveloped within 3 layers of non-neural tissues o Meninges - Brain is divided by a midline fissure into two mirror-image cerebral hemispheres o Together constituting most of the cerebrum - Cerebrum = thinking centre of the brain o Includes cortex and subcortical structures (ie/ basal ganglia and limbic system) - Major connection between 2 hemispheres = corpus callosum - Upper, side and some of the lower surfaces of the hemisphere = cerebral cortex - Cortex consists of 6 layers of tightly packaged neuron cell bodies with many short, unsheathed interconnecting processes - These neurons (10-15 billion) make up a thin outer covering = grey matter of the brain - Gyri  ridges of the cortex o Depression between them = sulci/fissures  Deep fissures divide the cerebral hemispheres into several distinct areas = lobes - Frontal lobe  lies in front of the central sulcus o Reasoning and other highly mental processes, regulation of fine voluntary movement - Parietal lobe  behind the frontal lobe and about the lateral sulcus - Temporal lobe  located below the lateral sulcus o Discrimination of the sounds - Occipital lobe  lies behind the parietal and temporal lobes o Vision - Initiation of movements of the skeletal musculature in a band in front of central sulcus - Receipt of sensations of touch, pressure, pain, temperature and body position from skin, muscles, tendons and joints in a band behind the central sulcus - Two hemispheres of the brain have different functions o Left = responsible for speech and analytic thinking in right handed people (according to some neuropsychologists)  generally controls the right half of the body = crossing over of motor and sensory fibres o right = discerns spatial relations and patterns, involved iin emotion and intuition  controls the left side of the body - two hemispheres communicate with each other constantly = corpus callosum - much of the interior of the brain is white matter o large tracts/bundles of myelinated (sheathed) fibres that connect cell bodies in the cortex with those in the spinal cord and other centres lower in the brain - 4 masses are deep within each hemisphere = basal ganglia (called collectively) - Ventricles  cavities within the brain o Continuous with the central canal of the spinal cord and are filled with cerebrospinal fluid - Diencephalon  connected in the front with the hemispheres and behind with the midbrain o Contains the thalamus and the hypothalamus  Thalamus = rely station for all sensory pathways (except the olfactory)  Hypothalamus = highest centre of integration for many visceral processes  Regulating metabolism, temperature, perspiration, blood pressure, sleeping, appetite o Both consisting groups of nuclei - Midbrain  mass of nerve-fibre tracts connecting the cerebral cortex with the pons, the medulla oblongata, the cerebellum, and the spinal cord - Brain stem  compromises the pons and the medulla oblongata and functions primarily as a neural relay station o Pons  contains tracts that connect the cerebellum with the spinal cord and with motor areas of the cerebrum o Medulla oblongata  main line of traffic for tracts ascending from the spinal cord and descending from the higher centres of the brain - Reticular formation (reticular activating system)  important role it plays in arousal and alertness o In the core of the brain stem - Cerebellum  receives sensory information from the inner ear and from muscles, tendons, and joints o Consists primarily of two deeply convoluted hemispheres with an exterior cortex of grey matters and an interior of white tracts o Information is received and integrated relates to balance, posture, equilibrium and to smooth coordination of the body when in motion - Limbic system  controls the visceral and physical expressions of emotions (ie/ quickened heartbeat, trembling, sweating, alterations in facial expressions, etc.), appetite, and other primary drives (hunger, thirst, mating, defense, attack, etc.) o structures that are continuous with one another in the lower cerebrum and that developed earlier than the mammalian cerebral cortex N EUROSCIENCE OF ATTENTION DEFICIT HYPERACTIVITY DISORDER - One intriguing study received widespread interest found that ADHD clients experienced delays in cortical maturation o reflected by attaining peak levels of cortical thickness at an older age - Seq. of the development was the same for those with/without ADHD but it was delayed by up to 5 years in ADHD clients - Delay in cortical maturation was most evident in the lateral prefrontal cortex which is the region responsible for working memory and attention - Dopaminergic hypothesis is that ADHD is due to a dopamine deficit believed to be genetic in origin - In one of the most widely cited papers, Castellanos and Tannock (2002) suggested that 3 particular features of ADHD are particularly amenable to collaborative neuroscientific investigation o A specific abnormality in reward-related circuitry that leads to shortened delay gradients o Deficits in temporal processing that result in high intrasubject intertribal variability o Deficits in working memory - Tannock is in the process of creating a network of Canadian researchers focusing on the neuroscientific aspects of inattention Biological approaches to treatment: - Important implication of biological paradigm is that prevention/treatment of mental disorders should be possible by altering bodily functioning - Most biological interventions in common use, have not been derived from knowledge of what causes a given disorder - Use of psychoactive drugs have been increasing - Drugs are an important component of any interventions for mental disorders - General public in Canada has become more aware of the potential usefulness of neuroimaging (as a result of Daniel Levitin’s book = This is Your Brain on Music) - Clinical scientist can believe in a biological basis for a mental problem yet recommend psychological interventions - Contemporary workers realize that non-biological interventions can have beneficial effects Evaluating the biological paradigm: - Reductionism  view that whatever is being studied can and should be reduced to its most basic elements/constituents o Asserts that psychology, psychiatry, and psychopathology will ultimately be nothing more than biology - Cognitive-behavioural paradigm is highly influential today and is regarded as a generally effective, evidence-based approach Cognitive – behavioural paradigm Rise of behaviourism: - John B. Watson (1878 – 1958) is a key figure in the rise of behaviourism o As a response to the focus on introspection favoured by many others in the field of human psychology in 1913, Watson promoted a focus on behaviourism  By extrapolating from the work of psychologists who were investigating learning in animals - Behaviourism  an approach that focuses on observable behaviour rather than on consciousness - Three types of learning have attracted the research efforts of psychologists o Classical conditioning  Discovered by the Russian physiologist and Nobel laureate Ivan Pavlov (1849 – 1936)  The bell ringing and dog salivating experiment  Dog was conditioned to salivate when hearing the bell ring  Unconditioned stimulus (UCS) = meat powder/food  Unconditioned response (UCR) = salivation  Conditioned stimulus (CS) = bell ringing  Conditioned response (CR) = elicit salivary response  Extinction  what happens to the CR when the repeated soundings of the bell are later not followed by meat powder, fewer and fewer salivations are elicited and the CR gradually disappears  Famous experiment (conducted by John Watson and Rosalie Rayner (1920)) discovered that classical conditioning could instill pathological fear  Introduced a white rat to an 11 month old boy (Little Albert) who indicated no fear of the animal  Whenever the boy reached for the rat, the experimenter made a loud noise by striking a steel bar behind Albert’s head (UCS)  Caused him to become frightened (UCR)  After 5 such experiences, albert became frightened (CR) by the sight of the white rat (CR)  Study suggest the possible association between classical conditioning and the development of certain emotional disorders (including phobias)  Role of classical conditioning may be more pervasive than realized o Operant conditioning  B. F Skinner (1904 – 1990) introduced operant conditioning  Reformulated law of effect by shifting the focus from the linking of stimuli and responses (S-R connections) to the relationships between responses and their consequences/contingencies  Subtle distinction reflects Skinner’s contention that stimuli don’t so much get connected to responses as they become the occasions for responses to occur  If in the past they have been reinforced  Discriminative stimulus  external events that in effect tell an organism that if it performs a certain behaviour, a certain consequence will follow  Distinguished two types of reinforcement that influence behaviour  Positive reinforcement  strengthening of a tendency to respond by virtue of the presentation of a pleasant event (positive reinforcer) o Ex. complimenting/praising someone positively  Negative reinforcement  strengthens a response, but it does so via the removal of an aversive event (negative reinforce)  Ex. Scratching an insect bite  Can produce abnormal behaviour o Modelling  learn by watching and imitating others  Experimental work by Albert Bandura and others has demonstrated that witnessing someone perform certain activities can increase/decrease diverse kinds of behaviour  Albert bandura and Menlove (1968) used a modelling treatment to reduce fear of dogs in children  May explain the acquisition of abnormal behaviour  Ex. children of parents with phobias/substance-abuse problems may acquire similar behaviour patterns (in part through modelling) A LBERT B ANDURA : THE WORLD ’S GREATEST LIVING PSYCHOLOGIST ? - Received his BA degree in 1949 from the university of British Columbia and his Ph.D from the University of Iowa in 1952 where he remains to this day - Jointed the faculty of Stanford University in 1953 where he remains to this day - Albert Bandura has received many awards for his scientific contributions - Served as president of the American Psychological Association and honorary president of the Canadian Psychological Association - Work based on premise that it is important to be able to study clinical phenomena in experimental situations - Initial work focused on social learning theory and on idea that much of what we learn is through process of imitation - Bandura and associates conducted several other classical studies designed to test how situational factors contributed to observational learning (ex. witnessing a model who is rewarded for aggression) - These variations led Bandura to conclude that there are 4 key processes in observational learning o Attention (noticing the model’s behaviour) o Retention (remembering the model’s behaviour) o Reproduction (personally exhibiting the behaviour) o Motivation (repeating imitated behaviours if they receive positive consequences - Self-efficacy  individual’s perceived sense of being capable - Bandura’s more recent work is a cognitive self-regulation theory known as social cognitive theory that focuses on the concept of human agency and self-efficacy - Self-regulation is a multi-stage process that involves self-observation, self-judgement by comparing personal achievements and behaviours with standards and goal, and self-response in the form of self-reinforcement and praise or self-punishment and criticism - Bandura’s recent work (2006) examines human agency from an expanded perspective that incorporates various forms of efficacy which supplement individual difference - Bandura’s focus on both social learning and self-regulation underscores the close interplay between external forces (models in our environment to be imitated) and internal forces (personal beliefs about the self) in adaptive and maladaptive behaviours Behavioural therapy: - Emerged in the 1950s - Therapy applied procedures based on classical and operant conditioning to alter clinical problems - Behavioural modification used particularly by therapists who employ operant conditioning as a means of treatment - Behavioural therapy is an attempt to change abnormal behaviour, thoughts and feelings by applying in a clinical context the methods used and the discoveries made by experimental psychologists in their study of both normal and abnormal behaviour - Important to distinguish 3 theoretical approaches o Modelling o Counterconditioning  relearning achieved by eliciting a new response in the presence of a particular stimulus  Response (R1) to a given stimulus (S) can be eliminated by eliciting a new response (R2) in the presence of the stimulus  Principle is behind an important behaviour technique = system desensitization  developed by Joseph Wolpe (1958)  hypothesized that overconditioning underlies the efficacy of desensitization (state/response antagonistic to anxiety is substituted for anxiety)  some experiments suggest that his hypothesis are possible but most contemporary theorists believe that exposure per se to what the person fears is important  aversive conditioning  stimulus attractive to the client is paired with an unpleasant event (ie/ drug that produces nausea) in hope of endowing it with negative properties  have been employed to reduce smoking, drug use, and socially inappropriate desires (ie/ pedophiles) o Exposure o Application of operant conditioning th - Cognitive behaviour therapy is often considered a 4 aspect of behaviour therapy Operant conditioning as an intervention: - Several behaviours derive from operant conditioning - Problems treated with this method o Autism, learning disabilities, mental retardation, bedwetting, aggression, hyperactivity, tantrums, and social withdrawal The cognitive perspective: - Cognitive  groups together the mental processes of perceiving, recognizing, conceiving, judging, and reasoning - Cognitive paradigm  how people and animals structure their experiences, how they make sense of them and how they relate their current experiences to past ones that have been stored in memory - Cognitive psychologists consider the learning process much more complex than the passive formation of new stimulus-response associations - Learner fits new information into an organized network of already accumulated knowledge (schema/cognitive set) o New information may fit the schema but if it doesn’t, the learner reorganizes the schema to fit the information/construes the information in such a way to fit the schema - Aaron Beck (psychiatrist) developed a cognitive therapy (CT) for depression based on the idea that a depressed mood is caused by distortions in the way people perceive life experiences o Therapy tries to pressure clients to change their opinions of themselves and the way in which they interpret life events o General goal of therapy = provide clients with experiences (both inside and outside the consulting room) that will alter their negative schemas and dysfunctional beliefs and attitudes o Steps in cognitive therapy  Education about social anxiety, depression and the cognitive model  Diary keeping of thoughts, feelings and behaviour across a range of upsetting situations  Reducing avoidance of feared situations  Testing and challenging hypothesized conditional and core beliefs o Dismissed the old psychoanalytic theory that depression is self-directed hostility o Replaced it with a model of negative cognitive bias – automatic misprocessing of information Rational – emotive behaviour therapy: - Albert Ellis was another leading cognitive therapist - Principle thesis = sustained emotional reactions are caused by internal sentences that people repeat to themselves o Sometimes reflect unspoken assumptions (irrational beliefs) about what is necessary t
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