Lecture 1 Development and Mental Health 2 introduction
The scientist practitioner; consumer of science, evaluator of science, creator of science.
How can we define a psychological disorder? What is normal and abnormal?
Three pitfalls of therapy; wanting to help, power and curiosity.
The study of abnormal thoughts, behavior and feelings.
How many psychopathology arise in early childhood and then intensify over a lifetime?
Stressors over the lifespan; equifinality (the samen outcome can be arrived at from different origins)
versus multifinality (the same origin can end up at different outcomes)
The majority does get a psychological disorder in life.
Anxiety develops very early. Best predicter to getting an disorder, is having an disorder. Woman have
a much higher risk to develop anxiety and depression.
How can we define a psychological disorder?
Categorical; healthy or ill
Typological; healty – ill (twee gebieden die overlappen)
Dimensional; healty -> ill (een spectrum)
If the problem is biological, people think its not your own responsibility. People are ashamed.
Psychotherapy is most of the time a better option, than medication.
Abnormal or normal? -> what is the norm? You have an idea of the norm, is not always what makes
people happy, your own background gets in the way sometimes.
Abnormal behavior often violates the social norms of a given culture.
Subjective; personal distress; Behavior or feelings may be abnormal if it creates great distress. (not
always, mania or ED). not all distressed people have a mental disorder.
Dysfunction; does the behavior impair an individual’s ability to function in life?
Thus;
Several factors need to be taken into account to determine what is abnormal and can accordingly be
considered as psychopathology.
,Psycholgical disorder; DSM
- Psychological dysfunction
- Distress or impairment
- Atypical response (in emotion, cognition and behavior)
Almost every disorders come gradually.
The Rosenhan Study.
- We can not diagnose by just looking at people.
- Context is very important! (Milgrams experiment)
Why do we diagnose or classify?
- Accurate description
- Prediction
- Intervention
- Communication
Hoorcollege 2 Etiology
How do they come into existence?
Kraepelin; mental health is only biological based.
Freud expressed that childhood is a very important phase for mental health (attachment).
Development of mental disorders; timeline; as a process of change and development
- Dispositional factors (in the first few years of childhood, vulnerabilities, does not have to be
biological, trauma, or being poor)
- Provoking factors (triggers, stressors that trigger the disorders, schizophrenia is strongly
relates to triggers, positive and negative) (depression is also most of the time triggered, some
sort of loss) (can also be accumulation of small events)
- Maintaining factors (we usually work on this one to change in treatment) (how do you treat
this now)
In normal cases genes and environmental influences are often together, or the same. Because
children learn from their parents and copy their behavior. Biology and environment are often very
interlinked.
How do genes interact with environment to influence behavior?
We will not look at illnesses, we look at change of behavior. There is not one gene for a illness.
Behavior is influenced by genes and inherited from parents.
- Family studies, twin studies, adoption studies, high risk studies
,For all mental disorders there seems to be some kind of genetic risk involved. Monozygotic twins
have a high risk of both getting the illness if they have a genetic vulnerability.
The environment and your behavior influence which genes are being activated.
- A typical human behavior trait is associated with very many genetic variants, each of which
accounts for a very small percentage of the behavioral variability.
The brain;
Prefrontal cortex (working memory, consciousness), amygdala (emotions, anxiety) and thalamus are
really important. In many disorders there is a dysbalance between the prefrontal cortex and the
amygdala.
Almost all brain research shows only correlations, not cause and effect.
Psychotherapy changes the connections in the brain. That doesn’t mean the brain was the problem
in the first place.
Serotonin; travels through many key areas of the brain, affecting the function of those area.
Implicated in depression, anxiety and aggressive impulses.
Dopamine; found in areas of the brain associates with the experience of reinforcements or rewards.
Affected by substances (alcohol) and behaviors (sex) that are pleasurable. Also motor behavior is
linkes to dopamine. Parkinson and schizophrenia. Substance abuse disorder.
Norepinephrine; produces by neurons in the brainstem.
GABA; inhibits the action of other neurotransmitters. Linked to anxiety.
Hormones;
Cortisol; stress regulation hormone.
Testosterone; reason for aggression or medication for social anxiety?
Oxytocin; social or asocial?
Cultural factors;
The cause of mental disorders can partly be found in the social environment of the person;
- Deprivation in the early development (being poor)
- Trauma (strong predictor) (abuse, sexual abuse, very clearly linked to psychopathology)
- Marital problems/divorce (small risk factors, do not play a big role, depends on friendly or
unfriendly divorces)
- Parenting styles (neglect (linked to eating disorders and substance abuse) and over-
controlling lead to problems, over-protective parents give a message that the world is not
, safe, that nobody can be trusted, their coping skills cannot be trained, they never learn they
can do things by themselves, linked to depression and anxiety)
- Mental disorders of parents (strong predictor, genetic, observational learning, changed
behavior of the parents)
Gender;
Anxiety disorders are partly due to gender roles. Fear showing is for boys not commen.
Girls are more expected to be afraid.
Learning theories;
Classical conditonering, operant and observational learning.
Lecture 3 Anxiety disorders
Fear; is adaptive and has an evolutionary value. People are biologically predisposed. It includes
activation of the sympathetic nerve system. It is hardwired for us to survive. To fight or flight.
If you look across all the disorders, anxiety disorders are the most common ones.
If you don’t experience fear, psychopath, extreme risk taker, no empathy.
3 sides of fear;
- Body; palpitations, rapid breathing, muscle tension
- Thoughts; danger
- Behavior; freeze (normal anxiety reaction, if it takes too long, not good for surviving), fight or
flight.
Typical time course; already started before the information is in the visual cortex, there is a shortcut
that goes to the amygdala. Fast increase, slow decrease of hormones, adrenaline.
Anxiety; a broader concept then fear has. Fear has a clear focus. Anxiety can be much more fuzzy,
worry, apprehension.
Fear is linked to phobia. Anxiety is linked to anxiety disorders.
Disorder;
- Fear is at the core
- If the fear is excessive and/or prolonged
- If there is no reason (or not enough) to be anxious
- If it cannot be controlled or tolerated
- If it causes suffering and impairments (not be able to do part of your daily life)
