Understanding and Treating Mental Disorders

Understanding and Treating Mental Disorders

2 Understanding and Treating Mental Disorders Cengage Learning 2016 Cengage Learning 2016 One-Dimensional Models of Mental Disorders Model Attempts to describe a phenomenon that

cannot be directly observed Models are intrinsically limited and cannot explain every aspect of a disorder Human behaviors are complex Models of psychopathology Biological, psychological, social, and sociocultural Cengage Learning 2016 Biopsychosocial Model Highlights the fact that interactions between biological, psychological, and

social factors cause mental disorders Limitations Does not focus on how these factors interact to produce illness Provides little guidance on treatment Neglects the influence of culture Cengage Learning 2016 Multipath Model Considers the multitude of factors researchers have confirmed are

associated with each disorder Views disorders from a holistic framework Some assumptions of the multipath model Multiple pathways and influences contribute to the development of any single disorder Not all dimensions contribute equally Cengage Learning 2016 The Multipath Model

Cengage Learning 2016 The Four Dimensions and Possible Pathways of Influence Cengage Learning 2016 Aspects of the Multipath Model Many disorders tend to be heterogeneous in nature Different combinations within the four dimensions may influence development of

a particular condition Within each dimension, distinct theories exist Same triggers or vulnerabilities may cause different disorders Cengage Learning 2016 Dimension One: Biological Factors The human brain Forebrain controls all higher mental functions Cerebrum Cerebral cortex

Prefrontal cortex helps manage attention, behavior, and emotions Limbic system Role in emotions, decision-making, and memories Cengage Learning 2016 Structures in the Limbic System Cengage Learning 2016

Multipath Implications Biological explanations alone are onedimensional and linear Science increasingly rejects idea of one gene for one disease Diathesis-stress theory: holds that people do not inherit a particular abnormality but rather a predisposition to develop illness Environmental forces (stressors) may activate the predisposition, resulting in a disorder Cengage Learning 2016

Biochemical Processes within the Brain and Body The brain is composed of: Neurons (nerve cells) Dendrites Axon Glia cells act in supporting roles Cengage Learning 2016 Synaptic Transmission

Cengage Learning 2016 Major Neurotransmitters and Their Functions Cengage Learning 2016 Major Neurotransmitters and Their Functions (contd.) Cengage Learning 2016

Neuroplasticity Ability of the brain to evolve and adapt Neurogenesis Birth of new neurons Neural stem cells have capability to generate new neurons needed for new skills or experiences Chronic stress results in negative changes in brain activity Exercise can produce positive changes

Cengage Learning 2016 Genetics and Heredity Heredity: genetic transmission of traits Chemical compounds outside the genome control gene expression Whether or not genes are turned on or turned off Genotype and phenotype Genetic mutations Epigenetics

Biochemical activities occurring outside genes Cengage Learning 2016 Sex Differences in Brain Development Differences in size of some brain structures between men and women Men and women use different brain regions for certain activities Frequency and progression of mental disorders differs Disorders involving reactivity to stress higher among women

Disorders involving risk-taking higher among men Cengage Learning 2016 Biology-Based Treatment Techniques Psychopharmacology Study of effects of psychotropic medications Medication categories Anti-anxiety drugs Anti-psychotics Antidepressants

Mood stabilizers Cengage Learning 2016 Types of Medications Antidepressant categories Selective serotonin reuptake inhibitors (SSRIs) Tricyclic antidepressants Monoamine oxidase inhibitors (MAOIs) Others (buproprion)

Medications do not cure mental disorders Help alleviate symptoms Cengage Learning 2016 Other Biological Approaches Electroconvulsive therapy Induce small seizures with electricity or magnetism Reserved for those not responding to other treatments

Neurosurgical and brain stimulation treatments Psychosurgery (removing parts of brain) Very uncommon today Deep brain stimulation Cengage Learning 2016 Criticisms of Biological Models and Therapies Model fails to consider individuals unique circumstances

Rapid growth in sale and marketing of psychotropic medications Drug-drug interactions possible Cengage Learning 2016 Dimension Two: Psychological Factors Four major perspectives Psychodynamic Behavioral Cognitive Humanistic-existential

Cengage Learning 2016 Psychodynamic Models The components of personality Id: pleasure principle Ego: realistic and rational Superego: moral considerations (conscience) Psychosexual stages Freud proposed that human personality largely developed during first five years of life

Defense mechanisms Protect us from anxiety Cengage Learning 2016 Contemporary Psychodynamic Theories Adler and Erickson Suggested that the ego has adaptive abilities With the ability to function separately from the id Bowlby and Mahler Proposed that the need to be loved, accepted,

and emotionally supported is of primary importance in childhood Cengage Learning 2016 Therapies Based on the Psychodynamic Model Psychoanalysis Objective: uncover material blocked from consciousness Free association Dream analysis

Effect of experiences with early attachment figures Interpersonal psychotherapy Links childhood experiences with current relational patterns Cengage Learning 2016 Criticism of Psychodynamic Models and Therapies Fails to address cultural and social influence

Freud relied on case studies and self-analysis His parents represented a narrow spectrum of society Far fewer outcome studies exist compared to other models May not be useful with certain people (less talkative, etc.) Cengage Learning 2016 Behavioral Models Concerned with the role of learning in

development of mental disorders Based on experimental research Three paradigms Classical conditioning (Ivan Pavlov) Operant conditioning (B. F. Skinner) Observational learning (Albert Bandura) Cengage Learning 2016 Behavioral Therapies Exposure therapy Graduated exposure

Flooding Systematic desensitization Social skills training Criticisms of behavioral models and therapies Often neglect inner determinants of behavior Cengage Learning 2016 Cognitive-Behavioral Models Focus on observable behaviors Also on how thoughts influence emotions and

behaviors Beck and Ellis A-B-C theory of emotional disturbance A is an event C is a persons reaction B are the persons beliefs about A, which causes reaction C Cengage Learning 2016 Elliss A-B-C Theory of Personality

Cengage Learning 2016 Third-Wave Cognitive-Behavioral Therapies Nonreactive attention to emotions can reduce their power to create distress Mindfulness Conscious attention to the present Dialectical behavior therapy (DBT) Supportive and collaborative therapy Therapists reinforce positive actions and avoid reinforcing maladaptive behaviors

Acceptance and commitment therapy (ACT) Cengage Learning 2016 Criticisms of the Cognitive-Behavioral Models and Therapies Behaviorists Psychology is about observable behaviors (Watson) Cognitions are not observable phenomena (Skinner)

The authority role of therapist The power to identify irrational beliefs may intimidate clients Cengage Learning 2016 Humanistic Models Emphasize the whole person Acknowledge the role of free will Humanistic perspective (Carl Rogers) Humans are basically good, forward-moving, and trustworthy

Maslows concept of self-actualization The inherent tendency to strive for full potential Cengage Learning 2016 The Existential Perspective A set of attitudes in the context of the human condition Focuses on challenges encountered by all humans

Responsibility to ourselves and others Cengage Learning 2016 Humanistic and Existential Therapies Person-centered therapy Human need for unconditional positive regard Provides an accepting therapeutic environment Existential therapy Rooted in philosophy and universal

challenges of humanity Clients become aware of choices they have made More able to choose a new direction Cengage Learning 2016 Criticisms of Humanistic-Existential Therapies Fuzzy, ambiguous nature Lack of scientific grounding Not suited to scientific investigation

Rely on peoples unique, subjective experiences Do not explain many mental disorders Do not address cultural or social factors Cengage Learning 2016 Dimension Three: Social Factors Social-relational models Healthy relationships are important for human development and functioning Provide many intangible benefits

When relationships are dysfunctional or absent, individuals are more vulnerable to mental distress Cengage Learning 2016 Family, Couples, and Group Perspectives Family systems model Behavior of one family member affects entire family system Characteristics

Personality development strongly influenced by family characteristics Mental illness reflects unhealthy family dynamics and poor communication Therapist must focus on family system, not just an individual Cengage Learning 2016 Social-Relational Treatment Approaches Conjoint family therapeutic approach Stresses importance of teaching messagesending and message-receiving skills to family members

Strategic family approaches Consider family power struggles and move towards more healthy distribution Structural family approaches Reorganizes family in relation to level of involvement with each other Cengage Learning 2016 Couples and Group Therapy Couples therapy

Aimed at helping couples understand and clarify their communication, needs, roles, and expectations Group therapy Initially strangers Share certain life stressors Provides supportive environment Allows therapist to observe patients actual social interactions Cengage Learning 2016

Criticisms of Social-Relational Models Studies have generally not been rigorous in design Cultural diversity is not adequately addressed Family systems models may have negative consequences Parental influence may not be a factor in an individuals disorder but are burdened with guilt Cengage Learning 2016

Dimension Four: Sociocultural Factors Emphasizes importance of several factors in explaining mental disorders Race Ethnicity Gender Sexual orientation Religious preference Socioeconomic status Other factors Cengage Learning 2016

Gender Factors Higher prevalence of depression and eating disorders among women Women are subjected to more stress than men Largely due to societal roles Exposure to sexual harassment Begins during middle school Affects well-being and learning

Cengage Learning 2016 Socioeconomic Class Lower socioeconomic class associated with: Limited sense of personal control Poorer physical health Higher incidence of depression Life in poverty subjects people to multiple stressors Fulfilling lifes basic needs

Cengage Learning 2016 Immigration and Acculturative Stress Acculturative stress Associated with challenges of moving to a new country Loss of social support Hostile reception Educational and employment challenges Most common among first generation immigrants and their children

Cengage Learning 2016 Race and Ethnicity Two early models Inferiority model Deficit model Multicultural model Emerged in the 1980s and 1990s Sociocultural conditions in treatment

Therapists need to be careful not to assume that the patient shares traits common to the group Cengage Learning 2016 Criticisms of the Multicultural Model and Related Therapeutic Techniques Critics see a disorder as a disorder Regardless of culture Example: some believe hallucination is always undesirable Can be considered desirable by some American

Indian or Hispanic/Latino groups Relies heavily on case studies Questions are asked based on a Western worldview Cengage Learning 2016 Contemporary Trends and Future Directions All perspectives have strengths and weaknesses Evidence-based understanding of mental disorders has evolved

Diathesis-stress theory Predisposition to develop illness is inherited Cultural neuroscience Study of how culture shapes biology and how biology shapes culture Cengage Learning 2016 Review What models of psychopathology have been used to explain abnormal behavior? What is the multipath model of mental

disorders? How is biology involved in mental disorders? How do psychological models explain mental disorders? Cengage Learning 2016 Review (contd.) What role do social factors play in psychopathology? What sociocultural factors influence mental health?

Why is it important to consider mental disorders from a multipath perspective? Cengage Learning 2016

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