An Integrative Approach to

Psychopathology
Presented by: Rachel Anne A. Gime, RPm
 Topics to be discussed:
✓ One-Dimensional versus ✓ Neuroscience
and its Contributions to
Multidimensional Models Psychopathology
✓ Behavioral Influences
✓ The Central Nervous System
✓ Biological Influences
✓ Emotional Influences ✓ The Structure of the Brain
✓ Social Influences ✓ The Peripheral Nervous System
✓ Developmental Influences ✓ Neurotransmitters
✓ Implication of Psychopathology

✓ Genetic
Contributions to
Psychopathology
✓ The Nature of Genes
✓ New Developments in the Study of Genes and
Behavior
✓ The Interaction of Genes and the Environment
✓ Epigenetics and the Nongenomic “Inheritance” of
Behavior
✓ Implication of Psychopathology
 1.One-Dimensional versus Multidimensional Models

PSYCHOPATHOLOGY
Cognitive

Biological MULTIDIMENSIONAL Social and Cognitive

MODEL
Behavioral Emotional
1.One-Dimensional versus Multidimensional Models
1.One-Dimensional versus Multidimensional Models

Behavioral Influences

The cause of Judy’s phobia might at first

seem obvious. She saw a movie with graphic
scenes of blood and injury and had a bad
reaction to it. Her reaction, an unconditioned
response, became associated with situations
similar to the scenes in the movie, depending
on how similar they were.
1.One-Dimensional versus Multidimensional Models

Behavioral Influences
1.One-Dimensional versus Multidimensional Models

Biological Influences
• Judy experienced a vasovagal syncope, which is a common cause of fainting. Syncope
means “sinking feeling” or “swoon” caused by low blood pressure in the head.
• Amount of blood reaching her brain diminished until she lost consciousness.
• In one study, 61% of the family members of individuals with this phobia had a similar
condition.
• Interestingly, the tendency to overcompensate seems to be inherited, a trait that may
account for the high rate of blood–injection–injury phobia in families.
• The cause of blood–injection–injury phobia is more complicated than it seems.
1.One-Dimensional versus Multidimensional Models

Behavioral Influences
1.One-Dimensional versus Multidimensional Models

Emotional Influences
• Emotions can react physiological responses such as blood
pressure, heart rate, and respiration, particularly if we know
rationally there is nothing to fear, as Judy did.

• Emotions also changed the way she thought about situations

involving blood and injury and motivated her to behave in ways
she didn’t want to, avoiding all situations connected with blood
and injury, even if it was important not to avoid them.
1.One-Dimensional versus Multidimensional Models

Behavioral Influences
1.One-Dimensional versus Multidimensional Models

Social Influences
• Judy’s friends and family rushed to her aid when she fainted. Did their support help or
hurt? Her principal rejected her and dismissed her problem.

• Rejection, particularly by authority gestures, can make psychological disorders worse

than they otherwise would be. Then again, being supportive only when somebody is
experiencing symptoms is not always helpful because the strong ffects of social
attention may actually increase the frequency and intensity of the reaction.
1.One-Dimensional versus Multidimensional Models
Case: Judy required close therapeutic supervision during this program. At one point, while
driving home with her parents from an evening session, she had the bad luck to pass a car crash,
and she saw a bleeding accident victim.
At night, she dreamed about bloody accident victims coming through the walls of her bedroom.

A discussion in more depth follows, examining the research

underlying the many biological, psychological, and social influences
that must be considered as causes of any psychological disorder.
. Genetic Contributions to Psychopathology
2

• Genes are long molecules of deoxyribonucleic

acid (DNA) at various locations on chromosomes,
within the cell nucleus.

• Gregor Mendel’s pioneering work in the 19th

century, - we have known that physical
characteristics such as hair color and eye color
and, to a certain extent, height and weight are
determined—or at least strongly influenced—by
our genetic endowment. To some extent, our
weight and even our height are affected by
nutritional, social, and cultural factors.
 2 . Genetic Contributions to Psychopathology

Huntington’s disease
• a degenerative brain disease that appears in early to middle age,
usually the early 40s.
• is disease has been traced to a genetic defect that causes
deterioration in a specific area of the brain, the basal ganglia.

• It causes broad changes in personality, cognitive functioning, and,

particularly, motor behavior, including involuntary shaking or
jerkiness throughout the body
 2 . Genetic Contributions to Psychopathology
Nature of Genes
• Normal human cell has 46 chromosomes arranged in
23 pairs. One chromosome in each pair comes from
the father and one from the mother.
• The 22 pairs provided directions for the development
of the body and brain.
• The last pair called sex chromosomes.
• XX = Female
• XY = Male
• Dominant gene - strongly influences a particular trait,
and we need only one of them to determine, for
example, our eye color or hair color.
• Recessive gene - by contrast, must be paired with
another (recessive) gene to determine a trait.
 . Genetic Contributions to Psychopathology
2

New Developments in the Study of genes and Behavior

• The best estimates attribute about half of our enduring personality traits and cognitive
abilities to genetic influence (Rutter, 2006).
• It has also become clear that adverse life events such as a “chaotic” childhood
can overwhelm the influence of genes (Turkheimer, Haley, Waldron, D’Onofrio, &
Gottesman, 2003).
• This means that if one of a pair of identical twins has schizophrenia, there is a less-than-
50% likelihood that the other twin will also have schizophrenia (Gottesman, 1991).
• Second, as noted earlier, it has become increasingly clear that genetic contributions
cannot be studied in the absence of interactions with events in the
environment that trigger genetic vulnerability or “turn on” specific genes.
 2. Genetic Contributions to Psychopathology
The interaction of genes and the environment

PSYCHOPATHOLOGY
 2. Genetic Contributions to Psychopathology
Interaction of genes and
environment
A. The Diathesis–Stress Model
• Stress model, individuals inherit tendencies to express certain traits
or behaviors, which may then be activated under conditions of
stress.
 2. Genetic Contributions to Psychopathology
Interaction of genes and environment
B. The Gene–Environment Correlation Model
• With additional study, psychologists have found the web of interrelationships between
genes and environment to be even more complex.
• Genetic endowment may increase the probability that an individual will experience
stressful life events
• Some evidence indicates that it applies to the development of depression, because some
people may tend to seek out difficult relationships or other circumstances that lead to
depression.
 2 . Genetic Contributions to Psychopathology
Interaction of genes and environment
C. Epigenetics and the Nongenomic “inheritance” of Behavior
• A number of reports suggest that studies to date have overemphasized the extent of
genetic influence on our personalities, our temperaments, and their contribution to the
development of psychological disorders.

Genes are
Not the whole
Story
3. Neuroscience and its Contributions to Psychopathology
 3. Neuroscience and its Contributions to Psychopathology

Central Nervous System

• Processes all information received from our sense organs and reacts, as necessary.
3. Neuroscience and its Contributions to Psychopathology

Central Nervous System

The Brain
• Uses an average of 140 billion nerve cells, called neurons, to control our
thoughts and action.
• Dendrites have numerous receptors that receive messages in the form of
chemical impulses from other nerve cells, which are converted into electrical
impulses.
• Axon, transmits these impulses to other neurons.
Any one nerve cell may have multiple connections
to other neurons. ese connections are called synapses
3. Neuroscience and its Contributions to Psychopathology

Central Nervous System

The Structure of the Brain
• Two parts
• Brainstem
• Forebrain
3. Neuroscience and its Contributions to Psychopathology

Central Nervous System

The Structure of the Brain
• Brainstem - handles most of the essential automatic functions, such as breathing, sleeping, and
moving around in a coordinated way.
• Hindbrain, contains the medulla, the pons responsible for breathing, the pumping action of the heart
(heartbeat), and digestion and cerebellum - controls motor coordination, and recent research suggests
that abnormalities in the cerebellum may be associated with autism, although the connection with
motor coordination is not clear.
• Midbrain – located also in brainstem , coordinates movement with sensory input and contains parts of
the reticular activating system, which contributes to processes of arousal and tension, such as whether
we are awake or asleep.
• Thalamus and hypothalamus – Located at the top of brainstem which are involved broadly with
regulating behavior and emotion.
3. Neuroscience and its Contributions to Psychopathology

Central Nervous System

The Structure of the Brain
• Limbic System - system helps regulate our emotional
experiences and expressions and, to some extent, our ability to
learn and to control our impulses. It is also involved with the
basic drives of sex, aggression, hunger, and thirst
 3. Neuroscience and its Contributions to Psychopathology

Central Nervous System

The Structure of the Brain
• Forebrain is more advanced and evolved more recently
• Basal ganglia - also at the base of the forebrain, include
the caudate (tailed) nucleus. Because damage to these
structures is involved in changing our posture or twitching
or shaking, they are believed to control motor activity.
• Cerebral cortex - largest part of the forebrain which
contains more than 80% of all neurons in the central
nervous system. Responsible for human qualities, allowing
us to look to the future and plan, to reason, and to create.
 3. Neuroscience and its Contributions to Psychopathology

Central Nervous System

The Structure of the Brain
• Cerebral Cortex – 2 hemispheres
3. Neuroscience and its Contributions to Psychopathology
Peripheral Nervous System
 3. Neuroscience and its Contributions to Psychopathology

Peripheral Nervous
System
• Somatic nervous system and the
autonomic nervous system.
• The somatic nervous system controls
the muscles, so damage in this area
might make it difficult for us to
engage in any voluntary movement,
including talking. e autonomic
nervous system includes the
sympathetic nervous system and
parasympathetic nervous system
 3. Neuroscience and its Contributions to Psychopathology

Peripheral Nervous
System
• The primary duties of the autonomic
nervous system are to regulate the
cardiovascular system (for example, the
heart and blood vessels) and the
endocrine system (for example, the
pituitary, adrenal, thyroid, and gonadal
glands) and to perform various other
functions, including aiding digestion and
regulating body temperature.
releases it directly into the
bloodstream.

3. Neuroscience and its Contributions to Psychopathology

The endocrine system

• Works a bit differently from other
systems in the body. Each endocrine
gland produces its own chemical
messenger, called a hormone, and
releases it directly in the bloodstream.
releases it directly into the
bloodstream.

3. Neuroscience and its Contributions to Psychopathology

The endocrine system

• Adrenal glands produce epinephrine
(also called adrenaline) in response to
stress.
• Thyroid gland produces thyroxine,
which facilitates energy metabolism
and growth.
• Pituitary gland is a master gland that
produces a variety of regulatory
hormones.
releases it directly into the
bloodstream.

3. Neuroscience and its Contributions to Psychopathology

The endocrine system

• Gonadal glands produce sex hormones
such as estrogen and testosterone.

❑The endocrine system is

closely related to the immune
system; it is also implicated in
a variety of disorders.
releases it directly into the
bloodstream.

3. Neuroscience and its Contributions to Psychopathology

Autonomic nervous system

The sympathetic nervous system is
primarily responsible for mobilizing
the body during times of stress or
danger by rapidly activating the
organs and glands under its control.
releases it directly into the
bloodstream.

3. Neuroscience and its Contributions to Psychopathology

Autonomic nervous system

When the sympathetic division goes on
alert, three things happen. The heart beats
faster, thereby increasing the ow of blood
to the muscles; respiration. increases,
allowing more oxygen to get into the
blood and brain; and the adrenal glands
are stimulated.
releases it directly into the
bloodstream.

3. Neuroscience and its Contributions to Psychopathology

Autonomic nervous system

One of the functions of the parasympathetic
system is to balance the sympathetic system. In
other words, because we could not operate in a
state of hyperarousal and preparedness forever,
the parasympathetic nervous system takes over
the sympathetic nervous system has been active
for a while.
releases it directly into the
bloodstream.

3. Neuroscience and its Contributions to Psychopathology

Neurotransmitters
1. Glutamate and GABA
• Glutamate, is an excitatory transmitter that
“turns on” many different neurons, leading
to action.
• Gamma-aminobutyric acid, or GABA for
short, which is an inhibitory
neurotransmitter. The job of GABA is to
inhibit (or regulate) the transmission of
information and action potentials.
releases it directly into the
bloodstream.

3. Neuroscience and its Contributions to Psychopathology

Neurotransmitters
1. Glutamate and GABA
• High Glutamate (major excitatory) – Psychosis and
neuron death
• Low Glutamate – Huntington's disease
2. GABA
• High Gaba – Relaxation
• Low Gaba - Anxiety
releases it directly into the
bloodstream.

3. Neuroscience and its Contributions to Psychopathology

Neurotransmitters
3. Serotonin
• is 5-hydroxytryptamine (5HT)
• It is in the monoamine category of neurotransmitters.
Approximately six major circuits of serotonin spread from
the midbrain, looping around its various part.
• Because of the widespread nature of these circuits, many of
them ending up in the cortex, serotonin is believed to in-
fluence a great deal of our behavior, particularly the way we
process information
releases it directly into the
bloodstream.

3. Neuroscience and its Contributions to Psychopathology

Neurotransmitters
3. Serotonin
• It was genetically influenced dysregulation in this
system that contributed to depression in the New
Zealand study described earlier are serotonin
system regulates our behavior, moods, and
thought processes
• Low Serotonin – Depression, anxiety and Eating
disorders
• Associated with less inhibition and with
instability, impulsivity, and the tendency to
overreact to situations.
High Serotonin – Mania
releases it directly into the
bloodstream.

Norepinephrine seems to stimulate at least two groups (and probably several more) of receptors called alpha-adrenergic and beta-adrenergic receptors. Someone in your family may be taking a widely u

3. Neuroscience and its Contributions to Psychopathology

Neurotransmitters
4. Norepinephrine -
• A third neurotransmitter system in the monoamine
class important to psychopathology is
norepinephrine (also known as noradrenaline)
• One major circuit begins in the hindbrain, an area
that controls basic bodily
• Norepinephrine seems to stimulate at least two
groups (and probably several more) of receptors
called alpha-adrenergic and beta-adrenergic
receptors. Someone in your family may be taking a
widely used class of drugs called beta-blockers,
particularly if that person has hypertension or
difficulties with regulating heart rate.
releases it directly into the
bloodstream.

Norepinephrine seems to stimulate at least two groups (and probably several more) of receptors called alpha-adrenergic and beta-adrenergic receptors. Someone in your family may be taking a widely u

3. Neuroscience and its Contributions to Psychopathology

Neurotransmitters
4. Norepinephrine -
• High Norepinephrine – Acute and Sleep
disorders
• Low Norepinephrine – Fatigue
releases it directly into the
bloodstream.

Norepinephrine seems to stimulate at least two groups (and probably several more) of receptors called alpha-adrenergic and beta-adrenergic receptors. Someone in your family may be taking a widely u

3. Neuroscience and its Contributions to Psychopathology

Neurotransmitters
5. Dopamine
• Is a major neurotransmitter that is in the
monoamine class and that is also termed a
catecholamine because of the similarity of its
chemical structure to epinephrine and
norepinephrine.
• Responsible for allowing you to feel
pleasure, satisfaction and motivation.
• High dopamine - Schizophrenia
• Low dopamine – Parkinson’s disease
releases it directly into the
bloodstream.

Norepinephrine seems to stimulate at least two groups (and probably several more) of receptors called alpha-adrenergic and beta-adrenergic receptors. Someone in your family may be taking a widely u

3. Neuroscience and its Contributions to Psychopathology

Neurotransmitters
5. Dopamine
Low Dopamine
• Because of these connections, deficiencies in
dopamine have been associated with disorders such
as Parkinson’s disease, in which a marked
deterioration in motor behavior includes tremors,
rigidity of muscles, and difficulty with judgment. L-
dopa has been successful in reducing some of these
motor disabilities.
 3. Neuroscience and its Contributions to Psychopathology

Implications for Psychopathology

• Psychological disorders typically mix emotional, behavioral, and cognitive symptoms, so
identifiable lesions (or damage) localized in specific structures of the brain do not, for the
most part that cause the disorders
• Neurologists open work with neuropsychologists to identify specific lesions. But
psychopathologists have been focusing lately on the more general role of brain function in
the development of personality, with the goal of considering how different types of
biologically driven personalities might be more vulnerable to developing certain types of
psychological disorders.
Thank you
 An Integrative Approach
to Psychopathology
01
Neuroscience and Its Contributions to
Psychopathology

02 Behavioral and Cognitive Science

03 Emotions

04 Cultural, Social, and interpersonal Factors

05 Life-Span Development
 An Integrative Approach
to Psychopathology
01
Neuroscience and Its Contributions to
Psychopathology

✓ Psychosocial influences on Brain Structure and Function

✓ Interactions of Psychosocial Factors and Neurotransmitter Systems

✓ Psychosocial effects on the Development of Brain Structure and Function

✓ Psychosocial effects on the Development of Brain Structure and Function

 Neuroscience and Its Contributions to Psychopathology

Neuroscience and Its Contributions to

Psychopathology

● Psycho (Mental and Cognition) + Social (Environment,

Interaction )
 Neuroscience and Its Contributions to Psychopathology

Psychosocial influences on Brain

Structure and Function
✓ Stress and Cortisol Regulation: Chronic stress can lead to
dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and
elevated levels of cortisol, which may impact brain structures like the
hippocampus (learning, memory encoding, memory consolidation, and
spatial navigation e.g., Dissociative amnesia ) and prefrontal cortex
(planning complex cognitive behavior, personality expression, decision
making e.g, Personality Disorders)
✓ Early Life Adversity- Neglect or abuse, can alter brain development
and affect emotional regulation, leading to long-term changes in brain
structure and function.
 Neuroscience and Its Contributions to Psychopathology

Interactions of Psychosocial Factors

and Neurotransmitter Systems

Psychosocial factors directly affect levels of neurotransmitters

● Stress and Neurotransmitters- chronic stress can elevate cortisol

levels, impacting serotonin regulation in the brain
● Social Support and Neurotransmitter- Oxytocin, often called the
"bonding hormone," is associated with social bonding, trust, and
overall social behavior.

.
 Neuroscience and Its Contributions to Psychopathology

Psychosocial effects on the Development of

Brain Structure and Function

● Early Life and Critical Periods- Early life experiences, especially

during critical periods of brain development (e.g., early childhood), have
a profound impact on brain structure and function. Adequate nutrition,
sensory stimulation, and emotional nurturing during these critical
periods are crucial for healthy brain development.
● Environmental Enrichment- exposure to a variety of stimulating
experiences, can lead to increased synaptic connections and complexity
in the brain. This enrichment can positively influence brain plasticity
and cognitive function throughout life.
02 Behavioral and Cognitive Science

✓ Conditioning and Cognitive Processes

✓ Learned Helplessness

✓ The Physiology and Purpose of Fear

✓ Emotional Phenomena

✓ Cognitive Science and the Unconscious

 Behavioral and Cognitive Science

Conditioning and Cognitive Processes

● Classical Conditioning-
Behaviors are learned
by connecting a neutral
stimulus with a positive
one.
 Behavioral and Cognitive Science

Conditioning and Cognitive Processes

● Phobias

Acrophobia

Height (Neutral Stimulus) + Negative Experience (unconditioned stimulus) +

Association = Extreme fear of height (Conditioned response)

● Substance Abuse-The cues associated with drug use (e.g., paraphernalia,

environments) can become conditioned stimuli that trigger cravings and
physiological responses (conditioned responses) in individuals addicted to
substances
 Behavioral and Cognitive Science

● Learned Helplessness
 Behavioral and Cognitive Science

Learned Helplessness

● It suggests that when individuals perceive that they have no control over
negative events, they learn to become helpless and may generalize this
belief to other aspects of their lives.
● Depression- Learned helplessness is often associated with depressive
disorders. People who experience chronic stress or adversity and perceive it
as uncontrollable may develop a sense of helplessness, leading to symptoms
of depression.
 Behavioral and Cognitive Science

Social Learning (Albert Bandura )

✓ Modeling or observational learning

 Behavioral and Cognitive Science

Cognitive Science and the Unconscious

✓ Unconscious Processes in Psychopathology- unconscious biases,

memories, and defense mechanisms can impact how individuals
perceive and interact with the world, potentially leading to
maladaptive patterns of behavior.
03 Emotions

✓ The Physiology and Purpose of Fear

✓ The Components of emotion

✓ Anger and Your Heart

✓ Emotions and Psychopathology

03 Emotions

✓ The Physiology and Purpose of Fear

✓ The Components of emotion

✓ Anger and Your Heart

✓ Emotions and Psychopathology

 Emotions

Are negative EMOTIONS such as Fear bad?

 Emotions

Fight or flight response- Alarm reaction that activates during

potentially life-threatening emergencies
 Emotions

The Physiology and Purpose of Fear

✓ Increased heart rate

✓ Heavy Breathing

✓ To Act and prompt you to do something

 Emotions

Action tendency- to behave in a certain way

(for example, escape), elicited by an external event (a
threat) and a feeling state (terror) and accompanied by a
(possibly) characteristic physiological response
 Emotions

The Components of emotion

 Emotions

Emotions and Psychopathology

● Dysregulation of emotions, including intense or

inappropriate emotional responses, is a hallmark of
many psychopathological conditions
04 Cultural, Social, and interpersonal Factors

✓ Voodoo, the evil eye, and Other Fears

✓ Gender

✓ Social effects on Health and Behavior

✓ Social and Interpersonal Infuences on the Elderly

✓ Social Stigma

✓ Global incidence of Psychological Disorders

 Cultural, Social, and interpersonal Factors

Susto- describes various

anxiety-based symptoms, including insomnia, irritability,
phobbias, and the marked somatic symptoms of sweating
and increased heart rate (tachycardia).

But susto has only one cause: The individual believes that
he or she has become the object of black magic, or
witchcraft, and is suddenly badly frightened.
 Cultural, Social, and interpersonal Factors

Gender

● Prevalence
● Sociocultural Factors: Gender roles and expectations
● Risk Factors and Vulnerabilities
● Biology and Neurobiology
-Women: PPD
 Cultural, Social, and interpersonal Factors

● Social effects on Health and Behavior

● Social and Interpersonal Influences on the Elderly
● Global incidence of Psychological Disorders
05 Life-Span Development

✓ we must appreciate how experiences during different periods of

development may influence our vulnerability to other types of stress or to
dieting psychological disorder
✓ Important developmental changes occur at all points in life.
References

• McEwen, B. S. (2004). Protection and damage from acute and chronic

stress: allostasis and allostatic overload and relevance to the
pathophysiology of psychiatric disorders. Annals of the New York
Academy of Sciences, 1032(1), 1-7.
• Carter, C. S., & Porges, S. W. (2013). The biochemistry of love: an oxytocin
hypothesis. EMBO Reports, 14(1), 12-16.
• McEwen, B. S. (2017). Neurobiological and systemic effects of chronic
stress. Chronic Stress, 1, 2470547017692328.
• Reference: Teicher, M. H., & Samson, J. A. (2016). Childhood
maltreatment and psychopathology: A case for ecophenotypic variants as
clinically and neurobiologically distinct subtypes. The American Journal of
Psychiatry, 173(10), 932-944.