Overview
This lecture covers the multipath model of mental disorders, emphasizing its four dimensions (biological, psychological, social, and sociocultural) and highlighting the complexity and multidimensionality of psychopathology and diagnosis.
Psychopathology and Diagnosis
- Determining normal vs. abnormal behavior is challenging; the "Four D's" are distress, dysfunction, deviance, and dangerousness.
- Diagnosis is based on observed symptoms and syndromes, not underlying pathology.
- Mental disorders exist on a continuum with normality; no clear-cut line between normal and abnormal.
- The DSM-5 removed the multi-axial system, redefined several diagnoses, and uses a single axis for diagnosis.
- A mental disorder is defined as a clinically significant disturbance, dysfunction, and distress or disability; cultural responses to stressors are not considered disorders.
The Multipath Model
- Disorders arise from four interacting dimensions: biological, psychological, social, and sociocultural.
- Different combinations of factors influence each individual’s risk and manifestation of mental disorders.
- The model is integrative, dynamic, and accommodates individual differences.
Biological Dimension
- The brain's major divisions are forebrain (higher mental functions), midbrain, and hindbrain.
- Key brain structures: cerebral cortex (thinking, decision-making), prefrontal cortex (executive function), and limbic system (emotion, memory).
- Neurons communicate via neurotransmitters across synapses; reuptake inhibitors (like SSRIs) increase neurotransmitter availability.
- Neuroplasticity and neurogenesis show the brain can form new cells and connections.
- Genetics influence risk, but environment and epigenetics (gene expression changes) are also crucial.
- Biological treatments include medications (antidepressants, antipsychotics, mood stabilizers), ECT, and rare neurosurgical interventions.
- Biological models may ignore environmental, psychological, and social factors.
Psychological Dimension
- Psychodynamic theory sees disorders as results of unconscious conflicts and childhood trauma (Freud: id, ego, superego).
- Behavioral models explain abnormal behavior through learning (classical and operant conditioning, observational learning).
- Cognitive-behavioral models link thoughts, emotions, and behaviors (e.g., ABC model, schemas, DBT).
- Humanistic-existential models emphasize personal growth, meaning, and self-actualization.
- Each psychological theory offers different explanations and treatments.
Social and Sociocultural Dimensions
- Healthy relationships and social support are critical for mental health.
- Family systems theory views individual disorders within the context of family dynamics.
- Sociocultural factors include race, ethnicity, gender, sexual orientation, religion, immigration, culture, and socioeconomic status.
- Poverty and low socioeconomic status are linked to increased risk for mental and physical health problems.
- Cultural context must be considered in diagnosis and treatment.
Key Terms & Definitions
- Four D's — Distress, dysfunction, deviance, and dangerousness; criteria for abnormality.
- Multipath Model — Integrative framework considering biological, psychological, social, and sociocultural influences.
- Neurotransmitter — Chemical messenger transmitting signals between neurons.
- Neuroplasticity — Brain's ability to form new connections or neurons.
- DSM-5 — Manual for diagnosing mental disorders using a single-axis system.
- Epigenetics — Study of how environment affects gene expression.
- Schema — Cognitive framework or belief influencing perception and behavior.
Action Items / Next Steps
- Study the biological factors and brain structures discussed in the chapter.
- Review and understand the differences between classical and operant conditioning.
- Watch the Thomas Insel video in this unit.
- Read further on the multipath model and familiarize yourself with key terminology in the margins of the chapter.