Affective Science and Psychopathology (SOWPSB3DH45E)
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Uitgebreiede uitwerking van de colleges van Affective Science & Psychopathology
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Affective Science and Psychopathology (SOWPSB3DH45E)
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Radboud Universiteit Nijmegen (RU)
Uitgebreide aantekening van de colleges van affective science. In combinatie met de verplichte literatuur (artikelen) heb ik hier een hoog cijfer voor kunnen halen :)
Affective Science and Psychopathology (SOWPSB3DH45E)
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LECTURES AFFECTIVE SCIENCE AND PSYCHOPATHOLOGY
LECTURE 1
INTRODUCTION
Learning objectives week 1: (1) summarize in what form affect and its regulation might be disrupted
in psychopathological processes, (2) reflect on the recent state of affairs and possible improvements in
psychological clinical practice by use of affective science, and (3) argue how transdiagnostic models
can contribute to understanding origin and maintenance of psychopathology, yet also come with
potential challenges.
Affective processes involve an evaluation of a situation as salient and thereby triggering an
evolutionary adaptive response. Affective processes consist of: (1) subjective components (negative or
positive feeling), (2) behavioral components (motor expression or inclination), and (3) physiological
components (brain and body).
James Gross modal model: you encounter a situation, then you have to pay attention to this situation
because it is somehow relevant to you, then you appraise it, which means that you evaluate it (do you
feel negative or positive about the situation), and then there is the adaptive response.
There are different ways you can regulate your affective processes. You can select the situation,
modify the situation, you can deploy your attention in different ways, you can use cognitive change, or
at the final stage you can modulate your responses.
Emotions are part of affective processes.
Event-focus relates to what extent an affective
process is trigger or coupled directly to an
event. Embodiment is the bodily response to an
affective process.
A scheme for some of the most prominent
affective processes
, LECTURES AFFECTIVE SCIENCE AND PSYCHOPATHOLOGY
The relation between affective process and psychopathology is the clearest in affective disorders (e.g.,
depression, bipolar disorder, anxiety).
Affective disturbance is present in almost every other psychological disorder: (1) emotional flattering
(schizophrenia, psychopathy), (2) high sensitivity to reward (addiction), (3) being hyposensitive to
social emotional cues (autism), and (4) explosive emotional responding (conduct disorder, borderline).
There are 2 categories of affective disturbance: (1) emotional reactivity problems, and (2) emotion
regulation problems. Emotional reactivity problems are characterized by emotional intensity (over-
and underreactions), emotional duration (too short or long), emotional frequency (too little or
frequent), and emotion type (inappropriate). Emotion regulation problems are characterized by
awareness (over or under), goals (excessive dampening or searching for the peak), and strategies
(overuse or wrong implementations).
Efficacy of psychological and pharmacological treatment for mental disorder is around 50%. Likely
reasons for the lack of higher efficacy despite all the research is (1) the clinical heterogeneity,
psychiatric syndromes are hugely divers, and (2) the lack of mechanistic understanding, lack of
mechanistic specificity understanding precludes tailored treatment.
For comorbidity there is a need for a transdiagnostic perspective because of (1) the poor discriminant
validity, (2) one disorder may act as a risk factor for another, and (3) the common risk (shared risk
factors that can occur at different stages of the disease. Pre-disposing; they are already there before the
disorder is there, precipitating; factors that are there in an acute state, perpetuating; transdiagnostic risk
factor).
The grouping of disorders by the DSM does not reflect a mechanistic level. The goal of the DSM is to
develop a system to provide specific, reliable diagnosis based on clinical experience. The problem of
this goal is that this doesn’t necessarily reflect the mechanism that we try to find with research.
Scientific mechanistic research needs to focus on symptoms rather than syndromes. Because of this
there is a gap between the goals of current clinical diagnosis and scientific studies and there is only
research on one disorder, isolated form parallel research to other disorders.
Advantage of a disorder focus (like in the DSM) is the common language for communication between
clinicians, scientists, etc. Disadvantages of this disorder focus is (1) that a specific diagnosis can be at
the cost of a complex clinical reality at the level of the patient, (2) implicitly, the DSM treats each
disorder as an independent, separated entity, (3) implicitly, it assumes that the disorders are abruptly
, LECTURES AFFECTIVE SCIENCE AND PSYCHOPATHOLOGY
distinct from ‘normal behavior’, and (4) arbitrary cut-offs not so extremely evidence based as one
would hope.
A transdiagnostic focus, focusses on processes that contribute to the aetiology and maintenance of
symptoms across diagnostic borders/disorders.
A functional approach dissect the syndrome in component parts, focus lies on individual patient and
central problematic behavior, specific tailored therapy, and focus on common processes of etiology or
maintenance.
Advantages of a transdiagnostic perspective: (1) could deal better with comorbidity, (2) the
heterogeneous disorders in the current diagnostic system are each made up of dysfunctional versions
of processes that vary along continua in the general population, and (3) treatment development – there
is a greater transfer of theoretical and treatment advances across disorders and specific treatment
components that are effective across disorders.
Disadvantages of transdiagnostic perspective: (1) why do people with different psychological
disorders sometimes present so differently – why does one individual with a particular transdiagnostic
risk factor develop one set of symptoms while another with the same transdiagnostic risk factor
develops another set of symptoms, and (2) how can one transdiagnostic risk factor lead to multiple
disorders.
LECTURE 2
EMOTIONAL CONTROL
Affective cues automatically activate (approach-avoidance) action tendencies (e.g., asking for a raise
at work, walking in the office of your boss, seeing an angry face on your boss, and walk out). Control
over emotional action tendencies is essential for everyday interaction.
Emotions guide many of our actions and decisions (Damasio, 1996). This is relevant when reliance on
rationality is too costly. Sometimes we need to control our emotions to achieve long term goal
(Damasio, 1997).
There are 3 types of emotion regulation: (1) attention distraction, (2) extinction learning, and (3)
reappraisal. Many forms of psychopathology are associated with failure in controlling feelings or
emotional actions (Damasio, 2013).
Understanding emotion as an action tendency is relevant because within this framework we could
better understand psychopathology. You can think of psychopathology as a disbalance in approach-
avoidance tendencies: (1) in anxiety, social avoidance may increase, (2) in aggression avoidance will
, LECTURES AFFECTIVE SCIENCE AND PSYCHOPATHOLOGY
decrease, people look for a fight for example, (3) in depression, people may less approach situation,
and (3) in addiction approach to substances increases.
RDoC is a research framework for investigating mental disorders. Its goals it to foster new research
approaches that will lead to better diagnosis, prevention, intervention, and cures. RDoC is not meant to
serve as a diagnostic guide, nor is it intended to replace current diagnositc systems. The aim is to
understand the nature of mental health and illness in terms of varying degrees of dysfunction in
fundamental psychological/biological symptoms.
Transdiagnostic mechanisms of psychopathology: how do we explain psychopathological phenotypes?
We search for endophenotypes or underlying mechanisms. Endophenotypes are biological or
psychological phenomena of a disorder believed to be in the causal chain between genetic
contributions to symptoms of psychopathology. Do not look at disorders, only at symptoms.
Controlling emotional actions:
The automatic defensive action contains fight, flight, or freeze (immediate responses). The model
below explains how different people response to a stressful situation and which brain regions are
involved. After deliberation we can make an approach or avoidance response, and this is balanced by
hormones.
Red side:
In response to stress cortisol levels rise. Leading to
submissiveness fear/avoidance.
Green side:
Testosterone leads to dominance, anger/approach
behavior.
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