Causal Factors

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Causal Factors

• 7.26.2006

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Causes and Risk FactorsDefinitions

• Etiology is the causal pattern of abnormal
  behavior
• Necessary cause - a condition that must exist for
  a disorder to occur is a necessary cause
• Sufficient cause a condition that guarantees
  the occurrence
• Contributory cause A condition that increases
  the probability of the occurrence
• Distal causal factors causal factors that
  operate relatively early in life but do not show
  their effects for years
• Proximal causal factors are causal factors that
  operate shortly before the occurrence of the
  symptoms of a disorder
• Reinforcing contributory cause a condition that
  maintains maladaptive behavior

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Causes and Risk FactorsFeedback and Circularity

• When more than one causal factor is involved, a
  causal pattern is found
• Simple cause and effect sequences are rare in
  abnormal psychology
• Complex systems of feedback produce patterns of
  interaction and circularity

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Causes and Risk FactorsDiathesis-Stress Models

• Diathesis - A predisposition toward a given
  disorder
• Can derive from biological, psychosocial, and
  sociocultural causal factors
• Diathesis may be perceived as the distal
  necessary or contributory cause
• Stress a response to an adjustment demand
• Stress is a more proximal undesirable event or
  situation
• Stress produces the disorder in someone with the
  distal necessary or contributory cause

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Causes and Risk FactorsDiathesis-Stress Models

• Diathesis-Stress Models
• Multicausal development models
• Additive model diathesis and stress together
  must reach a particular level can reach this
  level with only diathesis or stress, but easier
  if both are present
• Interactive model some amount of diathesis and
  stress required if both are not present, the
  disorder will not develop
• These models emphasize that we must know what is
  normal development to understand what constitutes
  abnormal development

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Causes and Risk FactorsProtective Factors

• Protective factors influences that modify a
  persons response to environmental stressors,
  making it less likely that the person will
  experience the adverse consequences of the
  stressors
• Protective factors may lead to resilience (the
  ability to cope successfully with very difficult
  circumstances)
• Examples
• Having at least one parent who is warm and
  supportive
• Exposure to moderately stressful experiences that
  are dealt with successfully
• Easygoing temperament
• High self-esteem
• High intelligence/school achievement

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Viewpoints

• Biological
• Psychosocial
• Sociocultural
• Theoretical Perspectives
• Psychodynamic
• Behavioral
• Cognitive-Behavioral

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Biological Viewpoint

• Mental disorders are inherited or caused by some
  biological process
• Mental disorders are viewed as disorders of the
• Central Nervous System (CNS)
• Autonomic Nervous System
• Endocrine System

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Biological ViewpointNeurotransmitter Hormonal
Influences

• Imbalances of Neurotransmitters
• May be excessive production and release of the
  neurotransmitter substances into the synapses
• Dysfunction may occur in how neurotransmitters
  are deactivated
• Maybe a problem with receptors in the
  postsynaptic neuron
• Imbalances of Hormones

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Biological ViewpointGenetic Vulnerabilities

• Abnormalities in the structure or number of
  chromosomes
• Vulnerabilities to mental disorders are almost
  always caused by multiple genes
• Genes affect behavior indirectly but it is the
  end product of a process that is influences by
  the internal and external environment
• Genotype vs. Phenotype

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Biological ViewpointsGenotype-Environment
Interaction

• Genotype-Environment Interaction
• Occur when a childs genotype shapes the
  environmental experience the child has
• People with different genotypes may be
  differentially sensitive or susceptible to their
  environment
• Types of Genotype-Environment Interactions
• Passive effect
• Evocative effect
• Active effect

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Biological ViewpointsGenetic and Environmental
Influences

• Genetic influences those that are influenced by
  genes
• Shared environmental influences those that
  would affect all children in a family similarly
• Nonshared environmental influences those in
  which children in the same family differ
• Studying genetic and environmental influences
• Pedigree or family history method
• Twin method
• Adoption method
• Linkage and association studies

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Biological ViewpointsBrain Dysfunction and
Neural Plasticity

• There is considerable neural plasticity of the
  brain in making changes in organization and
  function
• Respond to pre- and post-natal experiences,
  stress, diet, drugs, disease, maturation, etc.
• Animal studies clearly show that both positive
  and negative events can lead to changes in the
  structure and functioning of the brain
• Recent evidence suggests that unstimulating,
  deprived environments can cause retarded
  development in humans
• Developmental systems approach
• Genetic activity influences neural activity which
  influences behavior which in turn influences the
  environment
• However, these influences are bidirectional

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Psychosocial ViewpointsEarly Deprivation or
Trauma

• Institutionalization
• Many children institutionalized in infancy or
  early childhood show severe emotional,
  behavioral, and learning problems and are at risk
  for disturbed attachment relationships and
  psychopathology
• Adoption can lead to significant improvement (the
  earlier, the better)
• Neglect and Abuse in the home
• Among infants, gross neglect may be worse than
  abuse
• Abused children may be overly aggressive, have
  communication or language difficulties, and
  significant impairment in behavioral, emotional,
  and social functioning
• May develop conduct disorder, depression,
  anxiety, etc.
• Atypical styles of attachment may develop
• Improvements may be seen when the caregiving
  environment changes, but for some, these early
  experiences may never be overcome

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Psychosocial ViewpointsInadequate Parenting
Styles

• Parent-child relationships are always
  bidirectional
• Parental psychopathology
• Parents suffering from schizophrenia, depression,
  antisocial PD, and alcoholism tend to have
  children at heightened risk for a variety of
  developmental difficulties
• Effects do not seem to be due simply to genetic
  variables
• Protective factors can buffer these effects
  warm/nurturing relationship with an adult, high
  intellect, social/academic competence, etc.
• Parenting Styles Warmth and Control
• Styles of parenting vary in warmth and control
• Authoritative parenting
• Authoritarian parenting
• Permissive-indulgent parenting
• Neglectful-uninvolved parenting
• Restrictiveness can actually protect children
  growing

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Psychosocial ViewpointsMarital Discord/Divorce

• Marital Discord
• When marital discord is longstanding, it may lead
  to frustrating, hurtful, and generally damaging
  effects on both adults and kids
• Effects may be buffered if one parent is warm and
  prone to praise/approval, or if the child has
  supportive peers
• Divorced Families
• Long-lasting modest negative effects documented
• Effects of divorce are often more favorable than
  the effects of remaining in a home with marital
  discord
• Children living with stepparents especially
  very young children are at increased risk for
  physical abuse

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Psychosocial ViewpointsMaladaptive Peer
Relationships

• Despite negative attitudes against bullying
• Most children do nothing to discourage bullying
• 20-30 of children actually encourage the bully
• Popularity vs. Rejection
• Popular children tend to be either prosocial or
  antisocial
• Rejected children tend to be either too
  aggressive or too withdrawn

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Sociocultural ViewpointsSociocultural Environment

• Each sociocultural group fosters its own cultural
  patterns by systematically teaching its offspring
• Subgroups foster beliefs and norms of their own
• When social roles conflict, healthy personality
  development may be impaired

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Sociocultural ViewpointsPathogenic Societal
Influences

• Low SES status and unemployment
• Correlation between psychopathology and low SES
  strength of correlation varies by disorder
• Lower SES families tend to have more
  problems/dysfunction because of the stressors
  associated with low SES
• Relationship between psychopathology and
  unemployment
• Underemployed people show rates of depression
  comparable to those seen in unemployed
  individuals
• Prejudice and discrimination in race, gender, and
  ethnicity
• Stereotypes are demoralizing
• Types of Discrimination
• Access
• Treatment
• In addition to discrimination, women have also
  suffered from sexual harrassment in the workplace

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Sociocultural ViewpointsPathogenic Societal
Influences

• Social change and uncertainty
• Numerous adjustments demanded by change in our
  society
• Helplessness engendered by events such as
  September 11, 2001 Hurricane Katrina, etc.
• Urban stressors Violence and homelessness
• Annually 3.5 million people worldwide die from
  violence
• Domestic violence impacts physical health, lost
  productivity, and increases rates of anxiety,
  PTSD, depression, and suicide
• 1/3 of homeless people suffer from mental illness

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Sociocultural ViewpointImpact of the
Sociocultural Viewpoint

• Broadened view from a focus on the individual to
  include a concern with societal, communal,
  familial, and other group settings
• Led to design of programs
• Led to community facilities
• Changes in the DSM system

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Theoretical ViewpointsThe Psychodynamic
Perspective

• Sigmund Freud founded the psychoanalytic school,
  which emphasizes the role of unconscious motives
  and thoughts
• Structure of personality
• Id
• Ego
• Superego
• Life instincts and libido
• Death instincts

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Theoretical ViewpointsThe Psychodynamic
Perspective

• Anxiety, defense mechanisms, and the unconscious
• Freud believed that anxiety played a key causal
  role in most forms of psychopathology
• Neurotic and moral anxiety, because they are
  unconscious and so distressing, cannot be dealt
  with rationally
• Ego resorts to irrational protective mechanisms
  referred to as ego-defense mechanisms
• Psychosexual stages of development
• Oral
• Anal
• Phallic
• Latency
• Genital

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Theoretical ViewpointsThe Psychodynamic
Perspective

• Psychodynamic Psychopathology
• Oedipus Complex/Electra Complex
• Castration anxiety/Penis envy
• Newer psychodynamic perspectives
• Object relations theory focuses on individuals
  interactions with real and imagined other people
  and on the relationships that people experience
  between their internal and external objects
• Interpersonal perspective views psychopathology
  as rooted in unfortunate tendencies we have
  developed while dealing with our interpersonal
  environments
• Attachment theory - emphasizes the importance of
  early experiences, specifically the quality of
  parental care to the development of secure
  attachments

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Theoretical ViewpointsThe Psychodynamic
Perspective

• Impact of the Psychodynamic Perspective
• Development of therapeutic techniques (free
  association, dream analysis, etc.)
• Recognition of the influence of the unconscious,
  early childhood experiences, and sexual factors
• Theory that problems develop as failed coping
  strategies
• Two important criticisms
• Failure to recognize scientific limits of
  personal reports of information
• Lack of scientific evidence to support many of
  its assumptions and the effectiveness of
  traditional psychoanalysis
• Impact of the Newer Psychodynamic Perspective
• Increased scientific rigor
• More focus on documenting effectiveness of
  treatment
• Enormous amount of research generated by
  attachment theory

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Theoretical ViewpointsThe Behavioral Perspective

• Classical Conditioning
• Unconditioned stimulus (food)
• Unconditioned response (salivation)
• Conditioned stimulus (bell)
• Conditioned response (salivation)
• Extinction
• Spontaneous recovery
• Generalization and Discrimination
• Observational Learning

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Classical Conditioning
Unconditioned Stimulus (FOOD)
Unconditioned Response (SALIVATION)
Conditioned Response (SALIVATION)
Conditioned Stimulus (BELL)
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Theoretical ViewpointsThe Behavioral Perspective

• Operant conditioning
• Reinforcement (positive and negative)
• Punishment (positive and negative)
• Response-outcome expectancy
• Conditioned avoidance response
• Generalization and Discrimination
• Observational Learning (Bobo doll)

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Operant Conditioning
Add Something to Environment
Take Something out of Environment
Increase Occurrence of Behavior
POSITIVE REINFORCEMENT
NEGATIVE REINFORCEMENT
Decrease Occurrence of Behavior
POSITIVE PUNISHMENT
NEGATIVE PUNISHMENT
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Theoretical ViewpointsThe Behavioral Perspective

• Impact of the Behavioral Perspective
• Maladaptive behavior is viewed essentially as the
  result of
• Failure to learn necessary adaptive behaviors or
  competencies
• Learning of ineffective or maladaptive responses
• Focus of therapy is to change specific behaviors
  and emotional responses
• Hailed for precision and objectivity, wealth of
  research, and for its demonstrated effectiveness
  in changing specific behaviors
• Criticized for being unemotional or lacking
  empathy, focusing on specific behaviors, and for
  the misconception that it simplifies behavior

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Theoretical ViewpointsThe Cognitive-Behavioral
Perspective

• Bandura stressed that human beings regulate their
  behavior by internal symbolic processes or
  thoughts (internal reinforcement)
• Believed that treatment works by improving
  self-efficacy (the belief that one can achieve
  ones desired goal)

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Theoretical ViewpointsThe Cognitive-Behavioral
Perspective

• Schemas and Cognitive Distortions
• Today, the cognitive or cognitive-behavioral
  perspective focuses on how thoughts and
  information processing can become distorted and
  lead to maladaptive emotions and behavior
• Beck developed the concept of a schema or
  underlying representative of knowledge that
  guides the current processing of information and
  often leads to distortions in attention, memory,
  and comprehension
• Self-schemas include our views about who we are,
  what we might become, and what is important to us
• Assimilation and accomodation
• Different forms of psychopathology are
  characterized by different maladaptive schemas
  that have developed as a function of adverse
  early learning experiences

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In sum

• Advantages of having a theoretical viewpoint
• Consistent approach
• Disadvantages of having a theoretical viewpoint
• No one viewpoint accounts for the complex variety
  of maladaptive behaviors
• Ascribing to one approach may blind researchers
  to other factors
• Eclectic Approach
• Accepting working ideas from several viewpoints
  and incorporating whatever is found to be useful
• Works best in clinical practice rather than at a
  theoretical/abstract level
• Biopsychosocial Viewpoint
• Attempt at a unified perspective
• Most likely a particular combination of factors
  that is unique for each individual