THEORIES OF PSYCHOPATHOLOGY: BIOLOGICAL MODELS

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THEORIES OF PSYCHOPATHOLOGY BIOLOGICAL MODELS
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Overview

• DSM From 1 diagnosis to 354 diagnoses in 154
  years
• Theoretical Models Why do we care?
• Biological Models

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From 1 (1840) to 357 (1994) THE EXPLOSION OF
DIAGNOSTIC CATEGORIES IN PUBLIC HEALTH

• In 1840, the U.S. Census collected data about the
  frequency of idiocy/insanity.
• In 1880, the Census distinguished 7 categories
  mania, melancholia, monomania (partial
  insanity), paresis (impaired mental functioning
  due to syphilis), dipsomania (uncontrollable
  craving for alcohol), and epilepsy.

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From 1 to 357

• 1917 The Statistical Manual for the Use of
  hospitals for Mental Diseases (SMUHMD) lists 59
  disorders.
• 1952 The Diagnostic and Statistical Manual of
  Mental Disorders (DSM) lists 128 diagnoses
• 1968 DSM II introduces personality disorders
  and lists 159 disorders.

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From 1 to 357

• 1980 DSM III lists 227 disorders and introduces
  the multiaxial scheme and polythetic rules
• 1987 DSM III - Revised includes 253 disorders
• 1994 DSM IV lists 357 disorders and includes
  culture-bound syndromes in the appendix

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MAJOR CLASSES OF DISORDERS IN THE DSM-IV
DISTURBANCE OF...

• Emotion (Anxiety Disorders)
• Mood (Mood Disorders)
• Perception and thought (Psychosis)
• Cognition (Delirium, Dementia)
• Substance consumption (Alcohol, Drugs)
• Development (Disorders of infancy, childhood, or
  adolescence)
• Personality (Personality Disorders)

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KEVIN SHEAS SYMPTOMS
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DSM-IV THE FIVE AXES

• I Clinical Disorders
• II Personality Disorders and Mental Retardation
• III General Medical Conditions potentially
  relevant for understanding the individuals
  mental disorder
• IV Psychosocial and environmental problems
• V Global Assessment of Functioning

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MAJOR CLASSES OF DISORDERS IN THE DSM-IV
DISTURBANCE OF...

• Emotion (Anxiety Disorders)
• Mood (Mood Disorders)
• Perception and thought (Psychosis)
• Cognition (Delirium, Dementia)
• Substance consumption (Alcohol, Drugs)
• Development (Disorders of infancy, childhood, or
  adolescence)
• Personality (Personality Disorders)

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THEORETICAL MODELS WHY BOTHER?
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Biological vs. Social
vs. Psychological
Emphasis on psychological factors, such as early
childhood experience and self-concept
Emphasis on biological processes, genetic factors
Emphasis on interpersonal relationships and
social environment
Feedback Loops
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Biological Theories of Mental Disorders
Structural Theories
Biochemical Theories
Genetic Theories
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Example of a genetic disorder with psychiatric
features
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ALCMAEON

• Greek physician
• ( 450 B.C.), first to use anatomic dissection of
  animals as a basis for his theories. Concluded
  that the brain, not the heart, is the seat of
  intelligence.

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HIPPOCRATES (460-377 B.C.)

• Men ought to know that from the brain only arise
  our pleasures, joys, laughter and sorrows.

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HEROPHILUS ERASISTRATUS (300 B.C.)

• Dissect the human body and compare it to the
  animal body.
• Conclude that the seat of intelligence lies in
  the brain ventricles.
• Discover the nervous system

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THE DEVINE GALEN ( 170 B.C.)

• Describes the brain as a glandular organ that
  contains four vital fluids blood, phlegm,
  choler, and bile.
• Temperament and functioning of the body are
  influenced directly by these humors

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ANDREAS VESALIUS

• Renaissance anatomist. De Humani Corporis
  Fabrica (On the Working of the Human Body),
  1543.
• Disputes the prevailing view that the higher
  functions of the brain are situated in the
  ventricles

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DESCARTES (1596-1650)

• Proposed that the brain functions like a machine.
• Argued for a dualistic system in which the organ
  of the brain is distinguished from the immaterial
  mind
• The mind, not the brain, contains thoughts and
  desires.

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DEBATES IN NEUROSCIENCE

• Monism - versus - Dualism
• Are mind (cognition/behavior) and brain separate
  (dualism) or unified (monism) entities?
• Localism - versus - Holism
• Do neurons and brain areas have specific
  functions (localism) or do they work as an
  aggregate entity (holism)?

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GALL (1758-1828) Phrenology

• Brain is the organ of the mind.
• Mind is composed of multiple, distinct faculties.
• Because they are distinct, each faculty must have
  a separate organ in the brain.

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PHRENOLOGY

• The size of the organ is a measure of its power.
• The shape of the brain is determined by the
  development of the various organs.
• The surface of the skull can be read as an
  accurate index of psychological characteristics.

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CAMILLO GOLGI (1844-1926)

• With Cajal, studied neural anatomy.
• Developed several stains that permitted the
  visualization of single neurons.
• Shared Nobel Prize in Medicine 1906

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SANTIAGO RAMON Y CAJAL (1856-1926)

• Discovered that neurons were discrete unitary
  entities.
• Described structural and functional properties of
  neurons.
• Shared Nobel Prize in Medicine with Golgi (1906).