Explaining Mental Disorder

The study of mental disorder involves:

Definition: What do we mean by mental disorder?

Classification: How do we distinguish between different mental disorders?

Explanation: How do we understand mental disorder?

Treatment: How do we treat mental disorder?

Different Approaches to Explaining Mental Disorder

No completely dominant approach.

Different Approaches to Explaining Mental Disorder

All of the approaches we will explore assume that the proximal cause of behaviour and experience is biological.

The approaches emphasize different distal causes.

Different Approaches to Explaining Mental Disorder

Most psychologists today do not propose linear, one dimensional causal explanations

Approaches to Explaining Mental Disorder

Biological / Neuroscience PerspectivePsychodynamic PerspectiveCognitive PerspectiveBehavioural PerspectiveSociocultural PerspectiveHumanistic / Existential PerspectiveInterpersonal Perspective

Biological / Neuroscience Perspective

the functioning of the brain and other biological systems

Behaviour Genetics

Behaviour Genetics studies the extent to which mental disorder is caused by genetics.

The “nature-nurture” debate explores the role of genes vs. the environment.

Behaviour Genetics

Three different methods are used: family studies twin studies adoption studies

Family Studies

Examine family members of an individual with a mental disorder to see what percentage of relatives also have the disorder.

Twin Studies

Monozygotic twins (MZ) share exactly the same genotype.

Dizygotic twins (DZ), have 50% of their genes in common.

Adoption Studies

Attempt to remove environmental influence that DZ and MZ twins share by studying twins that have been separated at birth.

Adoption Studies

Adoptions studies still do not control for all environmental factors because:

People with the same genes seek out and elicit the same kinds of environments. Outgoing vs. Shy Energetic vs. Passive

Genes and BehaviourSummary

It is most helpful to think of how genes and environment interact to produce disorders.

Interactions, or “that depends”

What is the influence of X? that depends on Y.

The Diathesis-Stress Model

Individuals inherit tendencies to express certain traits or behaviours, which are then expressed or activated under conditions of stress.

The reciprocal Gene-Environment Model

Genes may actually increase the probability that an individual will experience a stressful event.

Evaluating the Biological Approach

Effective treatment does not mean we understand causation

Side effects of biological treatments Correlation does not mean

causation the disorder could cause the biological

correlate a third factor might cause both the

disorder and the biological correlate

The Psychodynamic Explanation of mental disorder

Psychodynamic Model mental mechanisms emphasis on childhood experiences emphasis on unconscious motives

Freud and the “Classical” Psychodynamic model

Unconscious: most mental activity takes place

outside of awareness the unconscious contains passively and

actively forgotten information

The Structure of the Mind according to Freud

Id basic primitive biological drives or

instincts Ego

develops to help the Id find adaptive ways to fulfill it’s desires and cope with reality

Superego internalized moral standards of parents does not consider what is realistic only

what is abstractly ideal

Reality

Super Ego

EgoMediator

Id

Conscience

Logical / Rational

Illogical / Emotional

Competing / Conflicting Demands on the Ego

The Ego’s Defense Mechanisms

Ego defense mechanisms involve distorting or denying internal and external reality.

Repression

Repression is the basis of all defense mechanisms.

Impulses that are unacceptable to the ego are pushed into the unconscious

Sublimation

Sublimation is the most adaptive defense mechanism

Sublimation is the transformation of Id impulses into more socially acceptable forms.

Anxiety

Anxiety is a signal that the ego’s controls are at risk of being overcome by the id or the superego.

The Psychodynamic Explanation of mental disorder

Disorder occurs when the ego is not able to adequately balance the Id, Superego and reality.

The Psychodynamic Explanation of mental disorder

Poor ego defense leads to anxiety Rigid ego defense leads to

constricted behaviour and impoverished relationships.

Ego collapse leads to a flooding of id impulses.

Evaluating the Psychodynamic Approach

First well developed approach to mental disorders that did not consider mental disorder as a biological or a moral, religious problem.

Difficult to subject many of the ideas to empirical testing.

Gender and cultural bias in original Freudian ideas

The Cognitive Explanation of mental disorder

“Men are disturbed not by things but by the views they take of them” Epictetus

Cognitive Appraisal

Stimulus--->Appraisal---> Response evaluation of stimulus based on

memories, beliefs, and expectations

Cognitive Appraisal

Appraisals are determined by: Competencies (acquired skills) Perception/Understanding Expectancies Values Plans and Goals

Cognitive Appraisal

Attribution is an example of an appraisal belief about the cause of an event

global/specificstable/unstable internal/external

Information Processing

Selective Attention what information we take in from the

environment (Schizophrenia, depression, anxiety)

Schema how we organize and understand the

information we take in (self schemas)

Evaluating the Cognitive Approach

Does it explain causes or describe symptoms? (Why do people have maladaptive beliefs?)

If an individual could change their thoughts then they would not have a problem.

Changing beliefs or views about the world may not be the best solution in some situations.

Behavioural Approach

mental disorder is the result of “learning” or environmental experience

The Background of Behaviourism

Learning the process whereby behaviour

changes in response to the environment

Pavlov The conditioned Reflex

Watson study only what can be observed “Little Albert”

The Background of Behaviourism

Thorndike The Law of Effect

Skinner Radical Behaviorism predict and influence behaviour by

focusing on environmental contingencies

Respondent (Classical) Conditioning

UCS -----> UCR the unconditioned or unlearned

stimulus causes an unconditioned or unlearned response

UCS -----> UCRCS -----> CR after conditioning the conditioned

stimulus causes a conditioned response

Operant Conditioning

The organism does something or “operates” on the environment.

The likelihood of a response is altered by its consequences.

Punishment and Reinforcement

Reinforcement any consequence of a behaviour that

increases the probability of the behaviour occurring again

Punishment any consequence of a behaviour that

decreases the probability of the behaviour occurring again

Learning Mechanisms

Extinction Generalization Discrimination Shaping

Behavioural Explanation of Mental Disorder

Abnormal behaviour, or mental disorders are the result of various environmental experiences (learning or conditioning) eg Dog Phobia

respondent conditioning negative reinforcement

eg Depression extinction

Behavioural Explanation of Mental Disorder

Less inclined to use Diagnostic Labels symptoms have different functional

roles in different people

Less focused on the past, more focused on present environmental factors

Sociocultural Approach

mental disorder is the result of social and political factors

Sociocultural Approaches

Mental disorder is a social label or a social construction.

Social Construction

Social Concept the boundary between what is and is

not a mental disorder is not “natural” but “cultural” (think back to mental disorder defined as a norm violation)

Social Construction

Social Role the “cause” of a mental disorder is the

fact that an individual is fulfilling or carrying out a social role

this role has a function for the individual, and/or society as a whole

Three umpires are sitting around over a beer, and one says, “There’s balls and there’s strikes, and I call ‘em the way they are.” Another says, “There’s balls and there’s strikes, and I call ‘em the way I see ‘em.” The third says, “There’s balls and there’s strikes, and they ain’t nothin’ until I call ‘em.”

Anderson, 1990 p. 75

Humanistic / Existential Approach

Natural vs. Human Science Importance of ‘Understanding’ and

entering into subjective world of client Emphasis on uniqueness of each person

rather than general patterns Agency

Contrast with determinism Authenticity, Freedom, and Responsibility

Humanistic Approach

‘Acorn’ Theory Potential and Uniqueness Fulfill possibilities Self actualization