Topic 2: CONTEMPORARY PERSPECTIVES ON ABNORMAL BEHAVIOR AND METHODS OF TREATMENT

Learning Objectives:

▪ At the end of this chapter, you should be able to identify the contemporary perspectives and
distinguish it from forces of psychology.

▪ Be familiarized with different perspectives and utilize them in the analysis of cases.

▪ Understand the methods of treatment.

An Integrative Approach to Psychopathology

No influence operates in isolation. Each dimension—biological or psychological—is strongly influenced by the

others and by development, and they weave together in various complex and intricate ways to create a
psychological disorder.

▪ Huntington’s disease, a degenerative brain disease that appears in early to middle age, usually the early 40s. This
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.

▪ Phenylketonuria (PKU), which can result in intellectual disability (previously called “mental retardation”). This
disorder, present at birth, is caused by the inability of the body to metabolize (break down) phenylalanine, a
chemical compound found in many foods. Like Huntington’s disease, PKU is caused by a defect in a single gene,
with little contribution from other genes or the environmental background.

▪ In linkage studies, scientists study individuals who have the same disorder, such as bipolar disorder, and also share
other features, such as eye color; because the location of the gene for eye color is known, this allows scientists to
attempt to “link” known gene locations (for eye color, in this example) with the possible location of a gene
contributing to the disorder.
▪ The environment may occasionally turn on certain genes. This type of mechanism may lead to changes in the
number of receptors at the end of a neuron, which, in turn, would affect biochemical functioning in the brain.

▪ The brain and its functions are plastic, subject to continual change in response to the environment, even at
the level of genetic structure.

▪ For years, scientists have assumed a specific method of interaction between genes and environment.
According to this diathesis–stress model, individuals inherit tendencies to express certain traits or behaviors,
which may then be activated under conditions of stress.

➢ Each inherited tendency is a diathesis (vulnerability), which means, literally, a condition that makes
someone susceptible to developing a disorder. When the right kind of life event, such as a certain type of
stressor, comes along, the disorder develops.

➢ The smaller the vulnerability, the greater the life stress required to produce the disorder; conversely, with
greater vulnerability, less life stress is required.
▪ There was reason to believe, from prior work with animals, that individuals with at least two copies of the
long allele (LL) were able to cope better with stress than individuals with two copies of the short allele (SS).

▪ Gene–environment correlation model or reciprocal gene–environment model. Some evidence now

indicates that genetic endowment may increase the probability that an individual will experience stressful
life events.

➢ For example, people with a genetic vulnerability to develop a certain disorder, such as blood–injection–
injury phobia, may also have a personality trait—let’s say impulsiveness— that makes them more likely to
be involved in minor accidents that would result in their seeing blood. In other words, they may be accident
prone because they are continually rushing to complete things or to get to places without regard for their
physical safety.

▪ Neither nature (genes) nor nurture (environmental events) alone, but rather a complex interaction of the
two, influences the development of our behavior and personalities.
The Central Nervous System

▪ The human nervous system includes the central nervous system, consisting of the brain and the spinal
cord, and the peripheral nervous system, consisting of the somatic nervous system and the autonomic
nervous system.

▪ Dendrites have numerous receptors that receive messages in the form of chemical impulses from other
nerve cells, which are converted into electrical impulses.

▪ The other kind of branch, called an axon, transmits these impulses to other neurons.

▪ Neurons are not actually connected to each other. There is a small space through which the impulse must
pass to get to the next neuron. The space between the axon of one neuron and the dendrite of another is
called the synaptic cleft.

▪ The biochemicals that are released from the axon of one neuron and transmit the impulse to the dendrite
receptors of another neuron are called neurotransmitters.
▪ The brain stem is the lower and more ancient part of the brain. Found in most animals, this
structure handles most of the essential automatic functions, such as breathing, sleeping, and moving
around in a coordinated way.

▪ The forebrain is more advanced and evolved more recently.

▪ The lowest part of the brain stem, the hindbrain, contains the medulla, the pons, and the
cerebellum. The hindbrain regulates many automatic activities, such as breathing, the pumping
action of the heart (heartbeat), and digestion.

➢ The cerebellum controls motor coordination, and recent research suggests that abnormalities in
the cerebellum may be associated with the psychological disorder autism, although the connection
with motor coordination is not clear.
▪ Also located in the brain stem is the midbrain, which 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.

▪ At the top of the brain stem are the thalamus and hypothalamus, which are involved broadly with regulating
behavior and emotion. These structures function primarily as a relay between the forebrain and the remaining
lower areas of the brain stem.

▪ At the base of the forebrain, just above the thalamus and hypothalamus, is the limbic system.

➢ Limbic means border, so named because it is located around the edge of the center of the brain.

➢ The limbic system, which figures prominently in much of psychopathology, includes such structures as the
hippocampus (sea horse), cingulate gyrus (girdle), septum (partition), and amygdala (almond), all of which are
named for their approximate shapes.

➢ This 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.
▪ The basal ganglia, also at the base of the forebrain, include the caudate (tailed) nucleus. Because damage to these
structures may make us change our posture or twitch or shake, they are believed to control motor activity.

▪ The largest part of the forebrain is the cerebral cortex, which contains more than 80% of all neurons in the central
nervous system. This part of the brain provides us with our distinctly human qualities, allowing us to look to the
future and plan, to reason, and to create.

➢ The left hemisphere seems to be chiefly responsible for verbal and other cognitive processes.
➢ The right hemisphere seems to be better at perceiving the world around us and creating images.
➢ Each hemisphere consists of four separate areas, or lobes: temporal, parietal, occipital, and frontal.

❖ The temporal lobe is associated with recognizing various sights and sounds and with long-term memory storage.
❖ The parietal lobe is associated with recognizing various sensations of touch and monitoring body positioning.
❖ The occipital lobe is associated with integrating and making sense of various visual inputs.
❖ The frontal lobe is the most interesting from the point of view of psychopathology. The front (or anterior) of the
frontal lobe is called the prefrontal cortex, and this is the area responsible for higher cognitive functions such as
thinking and reasoning, planning for the future, as well as long-term memory. This area of the brain synthesizes
all information received from other parts of the brain and decides how to respond.
The Peripheral Nervous System

▪ The peripheral nervous system coordinates with the brain stem to make sure the body is working properly.

▪ Its two major components are the 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.

➢ The autonomic nervous system includes the sympathetic nervous system and parasympathetic 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.
➢ 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. When the sympathetic division goes on
alert, three things happen. The heart beats faster, thereby increasing the flow of blood to the muscles;
respiration increases, allowing more oxygen to get into the blood and brain; and the adrenal glands are
stimulated.

➢ 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 after the sympathetic nervous system has been active for a
while, normalizing our arousal and facilitating the storage of energy by helping the digestive process.
▪ 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 into the bloodstream.

➢ The adrenal glands produce epinephrine (also called adrenaline) in response to stress, as well as salt-
regulating hormones;
➢ The thyroid gland produces thyroxine, which facilitates energy metabolism and growth;
➢ The pituitary is a master gland that produces a variety of regulatory hormones;
➢ and the gonadal glands produce sex hormones such as estrogen and testosterone.

▪ The hypothalamus connects to the adjacent pituitary gland, which is the master or coordinator of the
endocrine system. The pituitary gland, in turn, may stimulate the cortical part of the adrenal glands on top of
the kidneys. As we noted previously, surges of epinephrine tend to energize us, arouse us, and get our bodies
ready for threat or challenge. When athletes say their adrenaline was really flowing, they mean they were
highly aroused and up for the competition. The cortical part of the adrenal glands also produces the stress
hormone cortisol. This system is called the hypothalamic–pituitary–adrenocortical axis, or HPA axis.
Neurotransmitters

▪ Research on neurotransmitter function focuses primarily on what happens when activity levels change.
We can study this in several ways. We can introduce substances called agonists that effectively increase
the activity of a neurotransmitter by mimicking its effects; substances called antagonists that decrease, or
block, a neurotransmitter; or substances called inverse agonists that produce effects opposite to those
produced by the neurotransmitter.

▪ After a neurotransmitter is released, it is quickly drawn back from the synaptic cleft into the same
neuron. This process is called reuptake. Some drugs work by blocking the reuptake process, thereby
causing continued stimulation along the brain circuit.
Amino-acid neurotransmitters

▪ 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. Thus, the job of
GABA is to inhibit (or regulate) the transmission of information and action potentials.

▪ Because these two neurotransmitters work in concert to balance functioning in the brain, they have been
referred to as the “chemical brothers”.

▪ GABA was discovered before glutamate and has been studied for a longer period; its best-known effect is to
reduce anxiety.

➢ Scientists have discovered that a particular class of drugs, the benzodiazepines, or minor tranquilizers,
makes it easier for GABA molecules to attach themselves to the receptors of specialized neurons. Thus, the
higher the level of benzodiazepine, the more GABA becomes attached to neuron receptors and the calmer
we become (to a point).
▪ The GABA system rides on many circuits distributed widely throughout the brain. GABA seems to
reduce overall arousal somewhat and to temper our emotional responses.

▪ In addition to reducing anxiety, minor tranquilizers have an anticonvulsant effect, relaxing muscle
groups that may be subject to spasms.
➢ Furthermore, the GABA system seems to reduce levels of anger, hostility, aggression, and perhaps
even positive emotional states such as eager anticipation and pleasure, making GABA a generalized
inhibiting neurotransmitter, much as glutamate has a generalized excitatory function.
Monoamine Neurotransmitters Serotonin

• The technical name for serotonin is 5-hydroxytryptamine (5HT).

• Serotonin is believed to influence a great deal of our behavior, particularly the way we process information.

• The serotonin system regulates our behavior, moods, and thought processes. Extremely low activity levels of
serotonin are associated with less inhibition and with instability, impulsivity, and the tendency to overreact to
situations.

• Low serotonin activity has been associated with aggression, suicide, impulsive overeating, and excessive sexual
behavior.

• Several classes of drugs primarily affect the serotonin system, including the tricyclic antidepressants such as
imipramine (known by its brand name, Tofranil).

• However, the class of drugs called selective-serotonin reuptake inhibitors (SSRIs), including fluoxetine (Prozac),
affects serotonin more directly than other drugs, including the tricyclic antidepressants.
• SSRIs are used to treat a number of psychological disorders, particularly anxiety, mood, and eating disorders.
Norepinephrine

• A third neurotransmitter system in the monoamine class important to psychopathology is norepinephrine

(also known as noradrenaline).

• We have already seen that norepinephrine, like epinephrine (referred to as a catecholamine), is part of the
endocrine system.

• Norepinephrine seems to stimulate at least two groups (and probably several more) of receptors called
alpha-adrenergic and beta-adrenergic receptors.

• In the central nervous system, a number of norepinephrine circuits have been identified. One major circuit
begins in the hindbrain, an area that controls basic bodily functions such as respiration.

• Another circuit appears to influence the emergency reactions or alarm responses that occur when we
suddenly find ourselves in a dangerous situation, suggesting that norepinephrine may bear some relationship
to states of panic.

• More likely, however, is that this system, with all its varying circuits coursing through the brain, acts in a
more general way to regulate or modulate certain behavioral tendencies and is not directly involved in
specific patterns of behavior or in psychological disorders.
Dopamine

• 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.

• Dopamine has been implicated in the pathophysiology of schizophrenia and disorders of addiction.

• Some research also indicates it may play a significant role in depression and attention deficit
hyperactivity disorder.

• Remember the wonder drug reserpine that reduced psychotic behaviors associated with schizophrenia?
This drug and more modern antipsychotic treatments affect a number of neurotransmitter systems, but
their greatest impact may be that they block specific dopamine receptors, thus lowering dopamine activity.

• Dopamine circuits merge and cross with serotonin circuits at many points and therefore influence many
of the same behaviors. For example, dopamine activity is associated with exploratory, outgoing, pleasure-
seeking behaviors, and serotonin is associated with inhibition and constraint; thus, in a sense they balance
each other.
• One of a class of drugs that affects the dopamine circuits specifically is L-dopa, which is a dopamine
agonist (increases levels of dopamine). One of the systems that dopamine switches on is the locomotor
system, which regulates ability to move in a coordinated way and, once turned on, is influenced by
serotonin activity. 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.

• Cognitive science, which is concerned with how we acquire and process information and how we store
and ultimately retrieve it (one of the processes involved in memory).

• Along similar lines, Martin Seligman, and his colleague Steven Maier, also working with animals,
described the phenomenon of learned helplessness, which occurs when rats or other animals encounter
conditions over which they have no control.
• Another influential psychologist, Albert Bandura, observed that organisms do not have to experience
certain events in their environment to learn effectively. Rather, they can learn just as much by observing
what happens to someone else in a given situation. This fairly obvious discovery came to be known as
modeling or observational learning.

• According to the concept of prepared learning, we have become highly prepared for learning about
certain types of objects or situations over the course of evolution because this knowledge contributes
to the survival of the species.

• The alarm reaction that activates during potentially life-threatening emergencies is called the flight or
fight response.

• Emotion scientists now agree that emotion is composed of three related components—behavior,
physiology, and cognition.

• The principle of equifinality is used in developmental psychopathology to indicate that we must

consider a number of paths to a given outcome.
Clinical Assessment and Diagnosis

▪ Clinical assessment is the systematic evaluation and measurement of psychological, biological, and
social factors in an individual presenting with a possible psychological disorder.

▪ Diagnosis is the process of determining whether the particular problem afflicting the individual meets
all criteria for a psychological disorder, as set forth in the fifth edition of the Diagnostic and Statistical
Manual of Mental Disorders, or DSM-5.

▪ Affect refers to the feeling state that accompanies what we say at a given point. Usually our affect is
“appropriate”; that is, we laugh when we say something funny or look sad when we talk about
something sad.

▪ The first neuroimaging technique, developed in the early 1970s, uses multiple X-ray exposures of the
brain from different angles; that is, X-rays are passed directly through the head. As with any X-ray, these
are partially blocked or attenuated more by bone and less by brain tissue. Detectors in the opposite side
of the head pick up the degree of blockage. A computer then reconstructs pictures of various slices of
the brain. This procedure, which takes about 15 minutes, is called a computerized axial tomography
(CAT) scan or CT scan. This gives an image of the brain structure.
▪ Several more recently developed procedures give greater resolution (specificity and accuracy) than a
CT scan without the inherent risks of X-ray tests. A now commonly used scanning technique is called
nuclear magnetic resonance imaging (MRI). The patient’s head is placed in a high-strength magnetic
field through which radio frequency signals are transmitted. These signals “excite” the brain tissue,
altering the protons in the hydrogen atoms. This gives an image of the brain structure.

▪ Subjects undergoing a positron emission tomography (PET) scan are injected with a tracer substance
attached to radioactive isotopes, or groups of atoms that react distinctively. This substance interacts
with blood, oxygen, or glucose. When parts of the brain become active, blood, oxygen, or glucose
rushes to these areas of the brain, creating “hot spots” picked up by detectors that identify the
location of the isotopes. Thus, we can learn what parts of the brain are working and what parts are
not. This gives an image of the brain functioning.
▪ A second procedure used to assess brain functioning is called single photon emission computed
tomography (SPECT). It works much like PET, although a different tracer substance is used, and this
procedure is somewhat less accurate. It is also less expensive, however, and requires far less
sophisticated equipment to pick up the signals. Therefore, SPECT is used more often than PET scans.
This gives an image of the brain functioning.

▪ Functional Magnetic Resonance Imaging (fMRI) procedures have largely replaced PET scans in the
leading brain-imaging centers because they allow researchers to see the immediate response of the
brain to a brief event, such as seeing a new face.

▪ In an electroencephalogram (EEG), electrodes are placed directly on various places on the scalp to
record the different low-voltage currents.

▪ When brief periods of EEG patterns are recorded in response to specific events, such as hearing a
psychologically meaningful stimulus, the response is called an event-related potential (ERP) or evoked
potential.
▪ If we want to determine what is unique about an individual’s personality, cultural background, or
circumstances, we use what is known as an idiographic strategy.

▪ But to take advantage of the information already accumulated on a particular problem or

disorder, we must be able to determine a general class of problems to which the presenting
problem belongs. This is known as a nomothetic strategy.

▪ The term classification itself is broad, referring simply to any effort to construct groups or
categories and to assign objects or people to these categories on the basis of their shared
attributes or relations—a nomothetic strategy.

▪ If the classification is in a scientific context, it is most often called taxonomy, which is the
classification of entities for scientific purposes, such as insects, rocks, or—if the subject is
psychology—behaviors.
▪ If you apply a taxonomic system to psychological or medical phenomena or other clinical areas, you
use the word nosology. All diagnostic systems used in healthcare settings, such as those for infectious
diseases, are nosological systems.

▪ The term nomenclature describes the names or labels of the disorders that make up the nosology (for
example, anxiety or mood disorders).

▪ The classical (or pure) categorical approach to classification originates in the work of Emil Kraepelin
and the biological tradition in the study of psychopathology.

➢ Emil Kraepelin was one of the first psychiatrists to classify psychological disorders from a biological
point of view.

▪ Kraepelin first identified what we now know as the disorder of schizophrenia. His term for the
disorder at the time was dementia praecox. Dementia praecox refers to deterioration of the brain that
sometimes occurs with advancing age (dementia) and develops earlier than it is supposed to, or
“prematurely” (praecox).
The Diagnostic and Statistical Manual of Mental Disorders (DSM)

▪ The first Diagnostic and Statistical Manual (DSM-I), published in 1952 by the American Psychiatric Association.
Only in the late 1960s did systems of nosology begin to have some real influence on mental health
professionals.

▪ In 1968, the American Psychiatric Association published a second edition of its Diagnostic and Statistical
Manual (DSM-II).

▪ The year 1980 brought a landmark in the history of nosology: the third edition of the Diagnostic and Statistical
Manual (DSM-III). Under the leadership of Robert Spitzer, DSM-III departed radically from its predecessors.

➢ Three changes stood out.

1. First, DSM-III attempted to take an a theoretical approach to diagnosis, relying on precise descriptions of the
disorders as they presented to clinicians rather than on psychoanalytic or biological theories of etiology.
2. The second major change in DSM-III was that the specificity and detail with which the criteria for identifying a
disorder were listed made it possible to study their reliability and validity.
3. Third, DSM-III (and DSM-III-R) allowed individuals with possible psychological disorders to be rated on five
dimensions, or axes. This framework, called the multiaxial system, allowed the clinician to gather information
about the individual’s functioning in a number of areas rather than limiting information to the disorder itself.

❖ Axis I. The disorder itself, such as schizophrenia or mood disorder, was represented only on the first axis.

❖ Axis II. What were thought to be more enduring (chronic) disorders of personality were listed on Axis II.

❖ Axis III consisted of any physical disorders and conditions that might be present.

❖ Axis IV the clinician rated, in a dimensional fashion, the amount of psychosocial stress the person reported.

❖ Axis V. And the current level of adaptive functioning was indicated on Axis V.
➢ The fourth edition of the DSM (DSM-IV) was published in 1994.

➢ Perhaps the most substantial change in DSM-IV was that the distinction between organically based
disorders and psychologically based disorders that was present in previous editions was eliminated.

➢ The multiaxial system remained in DSM-IV, with some changes in the five axes. Specifically, only
personality disorders and intellectual disability were now coded on Axis II.
DSM IV Axes

✓ Axis I. Pervasive developmental disorders, learning disorders, motor skills disorders, and communication
disorders, previously coded on Axis II, were now all coded-on Axis I.

✓ Axis II. Only personality disorders and intellectual disability were now coded on Axis II.

✓ Axis III. Consisted of any physical disorders and conditions that might be present.

✓ Axis IV. The new Axis IV is used for reporting psychosocial and environmental problems that might
have an impact on the disorder.

✓ Axis V. Axis V was essentially unchanged. It indicates the current level of adaptive functioning.

▪ In 2000, a committee updated the text that describes the research literature accompanying the DSM-IV
diagnostic category and made minor changes to some of the criteria themselves to improve consistency.
This text revision (DSM-IV-TR) helped clarify many issues related to the diagnosis of psychological disorders.
▪ In the almost 20 years since the publication of DSM-IV our knowledge has advanced considerably and, after
over 10 years of concerted effort, DSM-5 was published in the spring of 2013.

➢ The manual is divided into three main sections. The first section introduces the manual and describes how
best to use it. The second section presents the disorders themselves, and section 3 includes descriptions of
disorders or conditions that need further research before they can qualify as official diagnoses.

➢ Perhaps the most notable change is the removal of the multiaxial system since the former axes I, II, and III
have been combined into the descriptions of the disorders themselves, and clinicians can make a separate
notation for relevant psychosocial or contextual factors (formerly axis IV) or extent of disability (formerly axis V)
associated with the diagnosis.

➢ The use of dimensional axes for rating severity, intensity frequency, or duration of specific disorders in a
relatively uniform manner across all disorders has also been substantially expanded in DSM-5, as previously
proposed.

➢ In DSM-5 the term “mental retardation” has been dropped in favor of the more accurate term “intellectual
disability”, which is consistent with recent changes by other organizations.
▪ Individuals are often diagnosed with more than one psychological disorder at the same time, which is called
comorbidity.
 RESEARCH METHODS IN PSYCHOPATHOLOGY

▪ Kiesler labeled the tendency to see all participants as one homogeneous group the patient
uniformity myth. Comparing groups according to their mean scores (“Group A improved by 50% over
Group B”) hides important differences in individual reactions to our interventions.

▪ One type of correlational research that is much like the efforts of detectives is called epidemiology,
the study of the incidence, distribution, and consequences of a particular problem or set of problems
in one or more populations.

▪ Epidemiologists study the incidence and prevalence of disorders among different groups of people.

▪ Like other types of correlational research, epidemiological research can’t tell us conclusively what
causes a particular phenomenon. Knowledge about the prevalence and course of psychological
disorders is extremely valuable to our understanding, however, because it points researchers in the
right direction.
▪ When behavior changes as a result of a person’s expectation of change rather than as a result of any
manipulation by an experimenter, the phenomenon is known as a placebo effect (from the Latin word
placebo, which means “I shall please”).

▪ As an alternative to using no-treatment control groups to help evaluate results, some researchers
compare different treatments. In this design, the researcher gives different treatments to two or more
comparable groups of people with a particular disorder and can then assess how or whether each
treatment helped the people who received it. This is called comparative treatment research.

▪ One of the more important strategies used in single-case experimental design is repeated
measurement, in which a behavior is measured several times instead of only once before you change
the independent variable and once afterward.
▪ Endophenotypes are the genetic mechanisms that ultimately contribute to the underlying problems
causing the symptoms and difficulties experienced by people with psychological disorders. In the case
of schizophrenia, for example, researchers are not looking for a “schizophrenia gene” (genotype);
instead, they are searching for the gene or genes responsible for the working memory problems
characteristic of people with this disorder (endophenotype), as well as the genes responsible for other
problems experienced by people with this disorder.

The basic principle of genetic linkage analysis is simple. When a family disorder is studied, other
inherited characteristics are assessed at the same time. These other characteristics—called genetic
markers—are selected because we know their exact location. If a match or link is discovered between
the inheritance of the disorder and the inheritance of a genetic marker, the genes for the disorder and
the genetic marker are probably close together on the same chromosome.

▪ The second strategy for locating specific genes, association studies, also uses genetic markers.
Whereas linkage studies compare markers in a large group of people with a particular disorder,
association studies compare such people to people without the disorder.
Prevention Intervention Strategies

▪ Health promotion or positive development strategies involve efforts to blanket entire populations of
people—even those who may not be at risk—to prevent later problems and promote protective
behaviors. The intervention is not designed to fix existing problems but, instead, focuses on skill building,
for example, to keep problems from developing.

▪ Universal prevention strategies focus on entire populations and target certain specific risk factors (for
example, behavior problems in inner-city classrooms) without focusing on specific individuals.

▪ The third approach to prevention intervention—selective prevention—specifically targets whole groups

at risk (for example, children who have parents who have died) and designs specific interventions aimed
at helping them avoid future problems.

▪ Finally, indicated prevention is a strategy for those individuals who are beginning to show signs of
problems (for example, depressive symptoms) but do not yet have a psychological disorder.
▪ A variation of correlation research is to compare different people at different ages. For a cross-
sectional design, researchers take a cross section of a population across the different age groups and
compare them on some characteristic.

➢ In cross-sectional designs, the participants in each age group are called cohorts; Brown and Finn
studied three cohorts: 12-year-olds, 15-year-olds, and 17-year-olds. The members of each cohort are
the same age at the same time and thus have all been exposed to similar experiences.

➢ Differences among cohorts in their opinions about alcohol use may be related to their respective
cognitive and emotional development at these different ages and to their dissimilar experiences. This
cohort effect, the confounding of age and experience, is a limitation of the cross-sectional design.
▪ Rather than looking at different groups of people of differing ages, researchers may follow one group
over time and assess change in its members directly. The advantages of longitudinal designs are that
they do not suffer from cohort effect problems and they allow the researchers to assess individual
change.

▪ Longitudinal designs can suffer from a phenomenon similar to the cohort effect on cross-sectional
designs. The cross-generational effect involves trying to generalize the findings to groups whose
experiences are different from those of the study participants.
Chapter Summary

▪ 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.

▪ Clinical assessment is the systematic evaluation and measurement of psychological, biological, and
social factors in an individual presenting with a possible psychological disorder.

▪ The first Diagnostic and Statistical Manual (DSM-I), published in 1952 by the American Psychiatric
Association.

▪ Endophenotypes are the genetic mechanisms that ultimately contribute to the underlying problems
causing the symptoms and difficulties experienced by people with psychological disorders.