The Biological Approach To Psychopathology
The core in your skeleton notes refers to two areas where the biological approach has been influential: autism and depression. The core is all you need to know for the exam but following these links will help you to understand more deeply what has been found and what issues remain. Deeper understanding brings better recall.
Firstly, you need to understand what mirror neurons are. This video explains this: it comes from a PBS documentary from the US. For the connection to autism, watch this extract from the same programme. If you want to know more about autism, use the autism tag on this blog or use the search box at the top. The idea that autism is the result of a problem in the mirror neurone system has been challenged more recently. In this article, Mo Costandi explains what the problem might be.
Firstly, you need to be sure that you understand how neurotransmitters work. This video explains it really clearly. It comes from the University Of Bristol website: please follow this link for further details. The idea that depression is related to problems with the neurotransmitter serotonin is explained in this extract from a documentary made for New Zealand television. You can read about the research into the serotonin transporter gene research here and you can watch some video about it here. This research is now a few years old. Researchers are gradually realising that depression is not simply all about serotonin but is a complex condition which has many different causes. This programme is a good place to start to explore current research. You can also use the depression category at the bottom of this blog to explore more.
How can the nature vs nurture debate be applied to explanations for abnormality? Can we really separate nature and nurture?
In our lesson, we will look at what each of the explanations of abnormality has got to say about nature-nurture. We will then focus on explanations of eating disorders. The best research in this area is being done at the Institute Of Psychiatry. You can visit their Eating Disorders Unit website here. You can click on the information button on the right of the screen to get to the What We Already Know page. Start with the section on Why Do Eating Disorders Develop?. Work out which of the ideas there are about nature and which are about nature. Most researchers now think that it is impossible to separate out nature and nurture. Do you agree with them? If so, why?
For a different take on the nature-nurture debate, you can listen to this podcast here from Naked Neuroscience. It features Professor Mike Owen from Cardiff University and Prof Barbara Sahakian from Cambridge University, two big names in the field.
Biological And Psychological Therapies: Further Questions
Both groups watched and commented on the Rick Stein video. Here is a summary of the questions to be asked.
We noted that back when Rick Stein’s father was being treated, psychoanalysis was not very effective. The only viable treatment for someone with such serious bipolar disorder was ECT. Since then, cognitive behavioural therapy has grown into a major force in therapy. Question: what is the evidence from recent studies about how to combine drug treatment with CBT?
If Rick Stein’s father was alive now, it would be possible to give him drugs to stabilise his mood. It would be possible in theory to personalise the treatment to reflect his needs, adjusting his medication to match his mood. However, some people have suggested that drug treatments for mental disorders are not always appropriate to the needs of patients. Question: what are the problems about personalising treatments for mental disorders?
When Rick Stein’s father was ill, there was little understanding about what caused bipolar disorder. In the fifty years since, much work has been done to understand that it is a disorder with a biological basis. Question: what is the evidence that disorders such as depression, eating disorders and autism have a biological cause?
In the time since Rick Stein’s father died, progress has been made in discovering new therapies and understanding how and why they work. Research has been done to demonstrate the effectiveness of these therapies. Question: how well do we understand how therapies used for conditions such as depression, eating disorders and bipolar disorder work?
The treatment given to Rick Stein’s father was in some ways inhumane. People at that time would be given ECT without anaesthetic, which could be painful and distressing. People then were given treatments without the understanding of how they worked or whether they would be effective. This would have caused anxiety to the patient and to his/her family and friends. We would like to think that therapies today are less stressful for the people who undergo them. Question: what are the risks and costs in terms of time, money and distress for therapies used today? Is the therapy always worth the cost?
The psychiatrist in the video talks about using drugs to prevent a condition like the one suffered by Rick Stein’s father from getting worse. This suggests that prevention is better than cure. Question: what steps have been taken to use therapies to prevent illness rather than just cure it?
You can answer these questions by focusing on biological therapies. The best place to start to understand the controversy about the use of drugs to treat abnormality is this radio documentary. You can listen to the programme by clicking here. After that, use the Prozac tag or use the search box to read about more of the controversies which surround the use of drugs to treat depression and other disorders. ECT is in many ways a less controversial therapy. As a contrast to the video about Rick Stein’s father which we will have watched in class, watch this TED talk by Sherwin Nuland. You can use the ECT tag on this blog to find out a bit more.
For a general overview of CBT and the issues which surround it, this programme is excellent. There are many links on this blog to articles about CBT. Use the tag to access some of them. This story on the BBC website shows how CBT is being used to treat serious mental illness. It’s controversial though. You can find out about how drug treatments and CBT have been combined effectively by reading this article here.
On psychoanalysis, the main controversy concerns repressed memories. You can read about this issue here and here. Psychoanalysis went out of fashion for a while but is still a powerful therapy for many people. Here’s a discussion about psychoanalysis and religion.
To find out more about systematic desensitisation, listen to this programme about the originator of systematic desensitisation, Joseph Wolpe. A couple of clips from this programme focusing on evaluation and limitations of SD can also be accessed.
The final word on both models and treatment of abnormality ought to go to Thomas Insel. He is director of the National Institute of Mental Health in the US. You can read more about him and his ideas by clicking on the Insel tag on this blog. Here he speaks about what the future of prevention and treatment might look like.