Psychopathology 751

Ψ diathesis stress models

Ψ uses/problems with diagnostic enterprise

Ψ evolutionary thoughts

theory in psychopathology Diathesis Complexities— Include perhaps include cognitive deficits/styles

but harder to differentiate from symptoms of disorders.

“I favor focusing attention on those at a somewhat lower level of functioning (soft neurology and psychophysiology) rather than social behavior, or even psychometrics, on the ground that the former kinds of behavior are closer to the DNA and so have, by and large, been subject to less influence from complex social learnings contributing to individual differences variation and, hence, to increased statistical overlap.” (Meehl, 1990, p. 3).

theory in psychopathology Stress— “an interference or change in conditions

affecting the individual which has an adverse effect, such as worry or hostility, especially when prolonged; also external conditions producing anxiety” Walton, 1985, p.157.

state like (versus trait of diathesis) desire to create objective, temporally

proximal stress definition.

theory in psychopathology Difficulties defining Stress— Difficult but worthy goal to reduce the

reliance on individual differences in stress definitions (“what makes me stressed out is…” because these differing stressor may reflect various diatheses.

e.g., shy people stress in social situations whereas extroverts enjoy such contact.

theory in psychopathology Diathesis—Stress Model put forth by

Paul Meehl (1962) Argued that vulnerability interacts with

stress (i.e., schizogenic mother) to cause schizophrenia.

Posited that without right kind/amount of stress, an individual will have a residual, genetically coded, condition he labeled schizotaxia which he saw as akin to a necessary but not sufficient condition for schizophrenia.

theory in psychopathology Diathesis—Stress Model elegant:

– fits data that humans are genetically coded to be the least biologically determined animals. We are the animal most open to good and environmental influence (culture, language)

limitations:– In the simplified model we are seduced into a

limited view of both vulnerability and stress as unidimensional but they are not.

– e.g., time of stressor may be very important, most disorders are polygenic

theory in psychopathology Diathesis—Stress modified models additive model

– stress causes x disorder but those with a low level of diathesis require much more stress…implies that disorder x will occur with sufficient stress

threshold model– sufficient diathetic risk required to develop x disorder– at some threshold of diatheses, the individual will

develop disorder x (without stressors).

theory in psychopathology Diathesis—Stress complications diathesis—stress interactions:

– complicate the picture by questioning the independence of diatheses and stressors.

– diathesis may cause stressors (e.g., traits of anxiousness and introversion may lead to greater strain in social support

timing of stressors may be critically linked – x stressor my be crucial a y developmental window

but not important before/after multiple genetic pathways may independently

contribute to clinical condition (hard to measure) genetics probably code for both vulnerability

and protection (stress may work similarly)

Why diagnose? Many clinical reasons… treatment planning predict outcomes/responses protection of consumers (informs client what to

expect) can be used to communicate empathy reduce risk of flight from treatment nomenclature for communication organize, retrieve info describe patterns facilitate theory/research socio-political functions (who are patients, who

gets to treat whom?)

psychodiagnosis

What’s wrong with the DSM-III (III-R, and IV)? Valliant: it is parochial reductionistic muddles state and trait no theory (ignores conflict, adaptation,

development, time course of symptoms) validity sacrificed for reliability

psychodiagnosis

More problems with the DSM-IV Co-morbidity threatens specificity of

treatment goal. not very good reliability under the best of

circumstances – those kappa estimates are under structured

diagnostic interview conditions but you won’t be applying the DSM under such circumstances

there is no gold standard (it’s a consensus/compromise document).

psychodiagnosis

ALTERNATIVE MODELS— Use taxometrics to help identify discrete disorders

– schizophrenia, schizotypy, unipolar and bipolar disorders, anti-social PD

– from those probably not; dysthymia, impulse regulation problems

Dimensional models such as – Watson and Clark’s– Eysenck’s Model– Widiger et al.’s (1987) model with superordinate traits of

social involvement, assertiveness, anxious

psychodiagnosis

A few evolutionary thoughts (de Waal)a point or two to ponder

the presence of observable behaviors/traits do not imply adaptive success/fitness.

the position that aberrant behaviors are adaptive has to account for majority of folks w/out beh.

rape, murder, etc.

ideas more consistent with the datawe have a wide range of possible behaviors that can

be learned. we are coded to be possible murderers, rapists, etc.

conservation of form—nature can only use what is available

if specific traits are not sufficiently maladaptive they will not be removed from our genotype.

A few more evolutionary thoughts evolution requires

small isolated gene pool of organisms mating so that a particular trait can become dominant

think of the Galapagos islands of Darwin’s finchesFINCHES!

Check em out (with pictures!):http://www.rit.edu/~rhrsbi/GalapagosPages/DarwinFinch.html

A few more evolutionary thoughts "Seeing this gradation and diversity of structure in one small, intimately

related group of birds, one might really fancy that from an original paucity of birds in this archipelago, one species had been taken and modified for different ends.”

Darwin The Voyage of the Beagle, 1909

evolution requirespressures towards fitness (organisms w/out x trait need

to fail to reproduce or be outstripped in future procreation)

we are not evolving. we do not effectively practice eugenics (Hitler’s efforts

notwithstanding) the handicapped/disabled folks procreate

The Concept of a Mental Disorder (Wakefield)there are no mental illness

labels are used for pathologizing the difficult, undesirable, etc.: social control.

refutation: yes, there are no ‘diseases’ only what we decide are natural circumstances that precipitate death, but there is harmful mental dysfunction.

disorders as whatever professionals treat:personal attributes that are of therapeutic concern refutation: not specific enough. what about marital

distress, occupational concerns, etc.

disorder as statistical deviance:objective/scientific, deviation from the mean. refutation/problems: what about the other end of

scale?extreme conscientiousness, intelligence, what qualifies as a dimension? clumsy, short, …

disorder as biological disadvantage

1. harmful dysfunction (science) + values (real harm)

‘dysfunction’ as unfulfilled function-emotions as information.

(problem here with assumed functions that we don’t really understand and mental functions may not be as functionally hardwired but flexible by design.

‘harm’ requires values such as freedom, distress, symptoms.

fits with Freud (repression) and Behaviorism (distressing maladaptive behaviors).