Pathogenesis: Understanding How Disorders Develop

            To understand how disorders develop we need a conceptual framework to understand the disorder. The Diathesis-stress model is one of the more recent model that give us a way of understanding disorders, the model is also called the Epigenetic model. The Model proposes that people have a genetic tendency for a behavioral trait inherited from their parents that is activated under certain environmental conditions. In the textbook Abnormal Psychology: An Integrated Approach written by Barlow and Durand an example is provided of a girl who had “blood-injury-injection phobia”. This girl never had any episodes of fainting or becoming nauseated at the sight of blood or of any other injury, until she was unintentionally forced to watch a video of an animal dissection. This environmental trigger activated the gene expression which altered her behavior. Henceforward, at the mere mention of a cut or blood she would faint. The Barlow and Durand go on to say that if this girl had never taken a biology course the gene expression (diathesis) caused by an environmental trigger would have never happened and she would have gone through her life without knowing of her own tendency for swooning at the sight of blood.
            This model allows us to understand how twins possessing identical genetic makeup could in one circumstance develop a disorder and not in the other. Separated at birth, parents divorce, one twin is kidnapped and raised by his captors, there are many possibilities in which twins could be separated and raised in two different environments thus exposing one twin to certain environmental triggers and not to the other. Therefore, one twin experiencing different environment triggers could develop a disorder like clinical depression and the other twin experiencing a different environment could not. According to this model it would all be determined by the environment and the genetic tendencies inherited by that person’s parents.

Reference

 Barlow, David H. & Durand, V. Mark (2008).   Abnormal Psychology: An Integrated Approach, CengageNOW™

SEX, CULTURE AND WORLDVIEWS

            Have you ever wondered how culture affects our conception of sexuality? If there is a consistent standard of sexual practices in every culture? How do different cultures see sexual problems or disorders? It is true that the perception of a sexual disorder can differ from culture to culture and for that matter the definition of sexuality can differ from culture to culture. The textbook "Abnormal Psychology" written by Barlow and Durand provides some examples of differing cultural views of sexuality, such as the sexual practices of Sambian adolescent boys in Papua New Guinea. The people believe that the male body doesn't produce its own semen naturally and that it’s inappropriate to masturbate, so the young boys roughly 7 engage in oral sex with older teenage boys. The boys then become semen providers for others, when the boys become teenagers they enter into a heterosexual marriage. Or take the example of a group in India who encourage the opposite of the Sambian tribe, the natural view of them is to have children to live together and engage in heterosexual intercourse. And one last example, in Swedish culture women are much more promiscuous, which reflects the general acceptance of promiscuity in the public eye. With so many views in mind how can we effectively asses disorder in the realm of sexuality?

          As you can see from the various examples given, there is little consistent cross-cultural standard or norm. We must also take into account that cultural conceptions change, this makes matters worse if we are to make and accurate analysis. Take for example the issue of homosexuality in the United States. Some researchers have tried to make the case that homosexuality, a sexual practice historically considered in our society a paraphilia, is due to biological factors, but the study that proposes this view has yet to be replicated and recognized by the scientific community. In my opinion, I don’t understand why we are associating what is cultural with what is right. 

           This speaks to the issue of worldviews and which worldview truth claims best correspond to reality. Since this is a rather large issue, I will only address a few points briefly here and who knows, maybe write full fledged blog one day on the issue of worldviews. The two main worldview at least in the US are Christian Theism, and Materialism, which usually entails Naturalism, Darwinian Evolution, and Atheism. Christian Theism takes into account what is, but its primary focus is on what ought to be. In other words, Christian Theism provides a philosophical and conceptual ground of what is, why things are, and the way they should be. It provides grounds to be prescriptive and not merely descriptive. So when we take the issue of sexuality, we have the groundwork for establishing norms, and recognizing deviations. In terms of a Materialistic worldview and all its entailment's we only have data on what is, that is to say, we only have descriptive data, and therefore there is no basis for making the assertion of norms, should's and prescriptive statements. 

          How does this work itself out in the real world? If you buy into the Materialistic worldview and you read the part mentioned above about the Tribe in Sambian that forces young boys as young as 7 to ingest the semen of older males, and you had a reaction of disgust, moral outrage, and you felt that the practice was wrong, then based on you're worldview, you would have no justification for feeling that way. In fact you should rightly have no feeling about it at all. The most qualitative statement you could make in regards to that issue would be a mere descriptive one, "It is something that occurs." And you would have no conceptual basis for thinking it is wrong. And yet you do, something deep inside you senses that forcing young boys against there will to perform sexual acts with an older male is intrinsically wrong. But how can this be when you're worldview doesn't allow for thinking that way. You cannot derive an "ought" from an "is."
        On the other hand, the Christian Theistic worldview has a conceptual framework that serves as a ground for thinking prescriptively about what is. We know that forcing young boys against there will to perform oral sex and ingest the semen of older males is intrinsically wrong because it violates what is right, and we know what is right because what is right is reflective of the character and nature of God. And so, the Christian Theist is justified in reacting to the sexual practices of the Sambian Tribe with disgust, moral outrage, and thinking that they are wrong for doing that. There is a logical and rational justification for thinking this way, there is no logical and rational justification for thinking this way in the Materialistic worldview, they are being illogical and irrational for thinking that is wrong. The Materialist doesn't realize it, but in order to make that qualitative claim of wrongness, they must borrow from the Christian Theistic worldview. And therefore, their worldview is utter lacking.
          If what I said is true, wouldn't it stand to reason that what I have described plays a major factor in many other debates such as the homosexuality discussion? Abortion? Contraceptives? Cross-Cultural Analysis?

Reference

 Barlow, David H. & Durand, V. Mark (2008).   Abnormal Psychology: An Integrated Approach, CengageNOW™

What are the Different Types of Depression?

            Major Depressive Disorder is separated into two distinctions: major depressive disorder, single episode and major depressive disorder, recurrent. Single episode must last longer than two weeks and subsist up to 4-9 months, the cognitive symptoms are feelings of worthlessness and indecisiveness, and the physical symptoms are altered sleep patterns, loss of energy, changes in weight and appetite. This makes every physical activity very strenuous, pleasurable activities are no longer enjoyable (Anhedonia) and the person’s relationships begin to suffer. Major depressive disorder, recurrent is diagnosed with most of the symptoms that one experiences with the major depressive disorder, single episode, the only main difference is frequency and that recurrent episodes last usually 4-5 months. Major depressive disorder, recurrent is diagnosed when two major depressive episodes happen less than two months apart.
            The unfortunate truth for those who experienced a major depressive episode is that they are 85% likely to have another episode and 20% to experience another one within a year. Dysthymic disorder is related to major depressive disorder in that they share some similar symptoms, but dysthymia displays these symptoms in low levels and they can last up to 20-30 years. Hypomania is related to these major depressive disorders in that it falls under the mood disorder category, but it is somewhat different from a major depressive episode. They are similar because at the tail end of a manic episode one can experience anxiety and depression while still being manic. A hypomanic episode must last at least one week and can extend up to 3-6 months if not treated, symptoms are low levels of hyperactivity, little sleep and ideas of grandiosity, which at this low level usually doesn’t result in function impairment.

Reference

Abnormal Psychology: An Integrated Approach David H. Barlow, V. Mark Durand 

What's the Difference between Anxiety and Panic Disorders?

          For all of you who were wondering what the difference is between Anxiety and Panic Disorders, here’s a brief run down. Generalized Anxiety Disorder (GAD) is characterized by 6 months of ongoing excessive anxiety and worry. The worry involved in GAD is not typical; it is defined as indiscriminant and unproductive. Usually when a person worries about an upcoming event the worry stops at the fruition of the situation, but worry associated with GAD does not discontinue at the completion of a problem. The physical symptoms of GAD are muscle tension, mental agitation, irritability, sleeping difficulties and susceptibility to fatigue. The causes can either be due to generalized biological vulnerability, in which one inherits vulnerability for the GAD or generalized psychological vulnerability, which vulnerability to GAD is due to early life stressors. The epidemiology of GAD is a gradual progression usually having an onset in early adulthood; the population most affected by GAD is the elderly.

          Treatments for this disorder are pharmacological and behavioral; the most effective of the drug therapies is Benzodiazepine, however this drug has been shown to be very habit forming, so other drugs such as antidepressants are a better option. Cognitive Behavioral Treatment (CBT) allows the patient to enter into the worry process during the therapy session; through the guidance of the therapist the patient confronts anxiety provoking images and thoughts. Other behavioral treatments exist and like the CBT have demonstrated some success, like with many disorders there is no cure, but through effective drug and behavioral therapy one suffering from GAD can be equipped to confront their anxious tendencies and work through them.

          A panic attack is “an abrupt experience of intense fear or acute discomfort, accompanied by physical symptoms that usually include heart palpitations, chest pain, shortness of breath, and, possibly, dizziness.” The differences are fairly obvious; a panic attack is confined to a single episode of acute physical symptoms and fear which has a definite ending point, GAD is a psychological disorder that has a gradual onset and does not have a definite ending point and requires long-term pharmacological and behavioral treatment for slight relief.