CURRENT PARADIGMS IN PSYCHOPATHOLOGY Psikologi AbnormalGanjil 2009 Kuliah
CURRENT PARADIGMS IN PSYCHOPATHOLOGY Psikologi Abnormal-Ganjil 2009 -Kuliah 2
Current Paradigms: Genetic 2 Heredity plays a role in most behavior Genes Carriers of genetic information (DNA) Impacted by environmental influences e. g. , stress, relationships, culture Relationship between genes and environment is bidirectional Nature via nurture (Ridley, 2003)
Important Genetic Terms 3 Gene expression Polygenic transmission Proteins influence whether the action of a specific gene will occur Multiple gene pairs vs. single gene Heritability Extent to which variability in behavior is due to genetic factors Heritability estimate ranges from 0. 00 to 1. 00 Group, rather than, individual indicator
Environmental Effects 4 Shared environment Events and experiences that family members have in common Nonshared environment Events and experiences that are unique to each family member
Behavior Genetics 5 Study of the degree to which genes and environmental factors influence behavior Genotype Genetic material inherited by an individual Unobservable Phenotype Expressed genetic material Observable behavior and characteristics Depends on interaction of genotype and environment
Current Paradigms: Neuroscience Examines the contribution of brain structure and function to psychopathology Mental disorders are linked to aberrant processes in the brain. Four mechanisms: Neurons and neurotransmitters Brain structure and function Autonomic system Neuroendocrine system
Figure 2. 3 The Neuron Basic Unit of the Nervous System 7
Neurons and Neurotransmitters 8 Neurotransmitter Receptor sites on postsynaptic neuron absorb neurotransmitter Chemicals that allow neurons to send a signal across the synapse (gap) to another neuron. Excitatory Inhibitory Reuptake Reabsorption of leftover neurotransmitter by presynaptic neuron
Neurotransmitters and Psychopathology 9 Serotonin and dopamine Norepinephrine Anxiety and other stress related disorders Gamma-Aminobutyric Acid (GABA) Depression, mania, and schizophrenia Anxiety Possible mechanisms Excessive or inadequate levels Insufficient reuptake Excessive number or sensitivity of postsynaptic receptors
Figure 2. 5 The Process by which a Second Messenger is Released 10
Figure 2. 6 Brain Structure and Function 11 Sulci define regions or lobes: Frontal Parietal Temporal Occipital
Autonomic Nervous System (ANS) 12 Sympathetic Nervous System Excitatory Heartbeat acceleration, pupil dilation, gastrointestinal inhibition, electrodermal activity increases Parasympathetic Nervous System Quiescent Heartbeat deceleration, pupil constriction, gastrointestinal activation Involved in anxiety disorders, especially Panic and PTSD Copyright 2009 John Wiley & Sons, NY
Neuroscience and Treatment 13 Psychoactive drugs alter neurotransmitter activity Antidepressants Antipsychotics Benzodiazepenes A neuroscience view does not preclude psychological interventions Copyright 2009 John Wiley & Sons, NY
14 Evaluating the Neuroscience Paradigm Reductionism View that behavior can best be understand by reducing it to its basic biological components Ignores more complex views of behavior Copyright 2009 John Wiley & Sons, NY
Current Paradigms: Psychodynamic 15 Fails to contribute to our empirical understanding of the causes of psychopathology Greatest contribution are in treatment Copyright 2009 John Wiley & Sons, NY
Role of the Unconscious 16 Contemporary theorists have attempted to study the unconscious scientifically Pathogenic beliefs Beliefs that occur outside of conscious awareness Trigger maladaptive thoughts and emotions Implicit memory Cognitive neuroscience paradigm The unconscious may reflect efficient information processing rather than a repository for troubling material Copyright 2009 John Wiley & Sons, NY
17 Importance of Interpersonal Relationships Object relations theory Longstanding patterns of relating to others Attachment theory Type and style of infant’s attachment to caregivers can influence later psychological functioning. Relational self Individuals will describe themselves differently depending upon which close relationships are told to think about (Chen et al. , 2006) Copyright 2009 John Wiley & Sons, NY
Neuroscience and Treatment 18 Psychoactive drugs alter neurotransmitter activity Antidepressants Antipsychotics Benzodiazepenes A neuroscience view does not preclude psychological interventions Copyright 2009 John Wiley & Sons, NY
19 Evaluating the Neuroscience Paradigm Reductionism View that behavior can best be understand by reducing it to its basic biological components Ignores more complex views of behavior Copyright 2009 John Wiley & Sons, NY
Current Paradigms: Psychodynamic 20 Fails to contribute to our empirical understanding of the causes of psychopathology Greatest contribution are in treatment Copyright 2009 John Wiley & Sons, NY
Role of the Unconscious 21 Contemporary theorists have attempted to study the unconscious scientifically Pathogenic beliefs Beliefs that occur outside of conscious awareness Trigger maladaptive thoughts and emotions Implicit memory Cognitive neuroscience paradigm The unconscious may reflect efficient information processing rather than a repository for troubling material Copyright 2009 John Wiley & Sons, NY
22 Importance of Interpersonal Relationships Object relations theory Longstanding patterns of relating to others Attachment theory Type and style of infant’s attachment to caregivers can influence later psychological functioning. Relational self Individuals will describe themselves differently depending upon which close relationships are told to think about (Chen et al. , 2006) Copyright 2009 John Wiley & Sons, NY
Factors Common to Paradigms 23 Emotion Components Expressive Experiential Physiological Most psychopathology includes disturbances of one or more component e. g. , flat affect in schizophrenia Cultural factors influence ideal affect (Tsai, 2007) Copyright 2009 John Wiley & Sons, NY
Factors Common to Paradigms 24 Sociocultural Factors Culture, ethnicity, gender, & social relationships May increase vulnerability to psychopathology e. g. , women more likely to experience depression than men May also serve as a buffer e. g. , social support Some disorders specific to certain cultures Hikikomori in Japanese culture Copyright 2009 John Wiley & Sons, NY
Table 2. 2 Lifetime Prevalence Rates of DSM-IV-TR Disorders among Different Ethnic Groups 25 Copyright 2009 John Wiley & Sons, NY
Diathesis-Stress 26 Integrative model that incorporates multiple causal factors (Zubin & Spring, 1977) Diathesis Underlying predisposition Increases one’s risk of developing disorder Stress Environmental events May be biological or psychological May occur at any point after conception Triggering event Psychopathology unlikely to result from one single factor Copyright 2009 John Wiley & Sons, NY
Diagnosis Multiaksial DSM (Diagnostic and Statistical Manual of Mental Disorder) published by American Psychiatric Association (APA) In Indonesia, mental disorder diagnosis classify in PPDGJ (Pedoman Penggolongan dan Diagnostik Gangguan Jiwa) based on DSM and ICD (International Classification of Diseases) published by WHO
Diagnosis Multiaxial Classification in DSM (1994) are description, atheoretical, and multiaxial more comprehensif (Millon & Davis, 2000) DSM-IV-TR includes five axes = multiaxial classification system, by requiring judgements on each of the five axes, forces the diagnostician to consider a broad range of information
5 Axes in DSM-IV-TR Axes I: Clinical Disorder Other conditions that may be a focus of clinical attention Axes II: Personality Disorder Mental Retardation Axes III: General Medical Condition Axes IV: Psychosocial and environmental problems Axes V: Global Assesment of Functioning (GAF) Scale
GAF Scale Consider psychological, social, and occupational functioning on a hypothetical continuum of mental heal/illness. Do not include impairment in functioning due to physical (or environment) limitations. 0 : Inadequate information 1 -10 : Persistent danger of severely hurting self or others/ persistent inability to maintain minimal personal hygiene 51 -60 : moderate symptoms/moderate difficulty in social, occupational, or school functioning 91 -100: No symptoms, superior functioning in a wide range of activities
Diagnosis Multiaxial Axes III Axess IV Axes V : (296. 23) Severe major depression, without psychotic feature : (301. 6) Personality disorder, defence mechanism denial : none : Occupational Problem : GAF=35 (current)
Current issues related to DSM-V Disorder that might include in DSM-V Behavioral Addiction Definition: excessive use sex, shopping, or computers may signal addiction. These behavior can be taken to such extremes that they easily mimic the behaviors of drug addicts. Binge Eating Disorder Definition: individuals who binge are unable to control periods of overeating and feel guilty or disgusted with themselves. They often become obese. Some eat alone to avoid feelings of shame.
Current issues related to DSM-V Complicated Grief Definition: after the death of someone close, grief and sadness normally begin to dissipate within six months. But some people continue to mourn for much longer.
Current issues related to DSM-V Disorder that might exclude in DSM-V The Paraphilia: Intense sexual urges involving animals, children, nonconsensual sex, suffering, or humiliation are classified as paraphilias – a term that was thought to be relatively non judgmental when it replaced “perversions” in 1980. Gender Identity Disorder: Since the DSM-III appeared in 1980, individual who wish to be of the opposite sex-and who are uncomfortable with their own-have been diagnosed with Gender Identity Disorder.
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