00:00:02
welcome everyone to uh our second
00:00:04
lecture in unit one which focuses on
00:00:06
chapter 2 in the last lecture we talked
00:00:09
about the difficulty determining what is
00:00:12
Normal and abnormal and we were given
00:00:15
the four D's to help us make a
00:00:17
determination distress dysfunction
00:00:20
deviance and
00:00:22
dangerousness I just want to add that
00:00:24
diagnosis is an inexact science
00:00:28
Psychopathology lies on a Continuum with
00:00:31
normality that is the line where
00:00:33
Behavior becomes abnormal is not always
00:00:36
clear psychiatric diagnosis is difficult
00:00:39
because it's based on observations of
00:00:42
signs and symptoms rather than the
00:00:45
underlying pathological processes we
00:00:49
don't have a blood test to tell us if
00:00:52
someone is depressed or has an anxiety
00:00:55
disorder so diagnoses describe symptom
00:00:59
clusters or syndromes and not
00:01:03
diseases now this unit introduces us to
00:01:06
the multipath model because research has
00:01:09
shown that disorders are caused by
00:01:12
numerous factors and here are the four
00:01:15
dimensions of the multipath model and
00:01:18
the possible Pathways of influence or
00:01:21
possible causes of mental disorders
00:01:24
conceptually mental disorders arise from
00:01:27
four possible dimensions and from the
00:01:30
reciprocal interactions between these
00:01:33
factors there can be factors within each
00:01:36
Dimension and dental disorder may be the
00:01:39
result of influences from more than one
00:01:42
of these dimensions and they are
00:01:45
biological
00:01:47
psychological social and
00:01:52
sociocultural psychopathology is complex
00:01:55
and as I mentioned diagnosis is an
00:01:58
inexact science diagnosis describes
00:02:01
syndromes and not underlying pathology
00:02:04
we really don't have enough knowledge
00:02:06
about the causes or ideology of mental
00:02:10
disorders we do need to differentiate
00:02:12
between the ups and downs of life or
00:02:15
between what Freud called normal human
00:02:18
unhappiness and a mental
00:02:20
disorder this lecture will explore the
00:02:23
dimensions of the multi-path model
00:02:25
biological psychological social and
00:02:28
sociocultural
00:02:30
in this chapter there is a lot of
00:02:31
important information on the biological
00:02:34
factors that can be involved in mental
00:02:36
disorders this information is important
00:02:39
to study and thoroughly understand as
00:02:41
the brain is composed of neurons and
00:02:44
their functioning has a lot to do with
00:02:46
mental health or the lack of it it will
00:02:50
also help you to better understand how
00:02:52
certain medications can
00:02:54
help and I hope you'll take some time to
00:02:57
view the talk by Thomas insul under
00:02:59
video videos in this unit Insel talks
00:03:02
about the progress we've made in
00:03:04
treating other disorders and argues that
00:03:07
we need to better understand mental
00:03:09
disorders as brain
00:03:11
diseases Insel points out that
00:03:14
there are 38,000 suicides in the United
00:03:18
States each year and that number has
00:03:21
remained steady over the past couple of
00:03:24
decades suicide is more common than
00:03:27
deaths from traffic accidents and tce
00:03:29
tce as common as deaths from homicide
00:03:33
90% of suicides are related to a mental
00:03:36
illness and suicide is the third leading
00:03:39
cause of death among young people aged
00:03:42
15 to
00:03:44
25 the dsm5 represents a major change in
00:03:49
diagnosis and it's added a little
00:03:52
complexity as clinicians are adjusting
00:03:54
to those
00:03:55
changes it has gotten rid of the
00:03:58
multi-axial system of diagnosis and
00:04:00
simply list diagnoses on a single axis
00:04:04
now uh some diagnoses like Aspergers
00:04:07
have been eliminated autism and
00:04:09
schizophrenia are now considered as
00:04:12
Spectrum disorders and hoarding is now a
00:04:16
diagnosable mental
00:04:21
disorder let's take a peek inside the uh
00:04:24
dsm5 which has a complex definition of a
00:04:27
mental disorder let me point out a
00:04:29
couple of uh aspects of this definition
00:04:32
first it's characterized by a clinically
00:04:34
significant disturbance which requires
00:04:38
some uh clinical judgment and the mental
00:04:41
health professional will describe this
00:04:43
in the uh assessment or psycho
00:04:46
diagnosis secondly uh there's
00:04:50
dysfunction thirdly there's significant
00:04:52
distress or disability I just want to
00:04:55
point out this sentence as well an
00:04:58
expectable or cultur approved response
00:05:00
to a common stressor or loss is not a
00:05:04
mental disorder and this reflects one of
00:05:07
the Contemporary Trends in abnormal
00:05:09
psychology which we discussed from
00:05:12
chapter one and that is the influence of
00:05:15
Multicultural
00:05:19
psychology the multipath model considers
00:05:21
the multitude of factors researchers
00:05:24
have confirmed are associated with each
00:05:26
disorder it views disorders from a holis
00:05:29
IC framework some assumptions of the
00:05:32
multipath model include multiple
00:05:35
Pathways and influences contribute to
00:05:37
the development of any single disorder
00:05:40
and not all Dimensions contribute
00:05:42
equally there are individual differences
00:05:46
and the model is integrative and
00:05:49
interactive in other words it is dynamic
00:05:52
influences can change over
00:05:56
time there are some other important
00:05:59
aspects of the multi-path model many
00:06:01
disorders tend to be heterogeneous in
00:06:04
nature depression for example can be the
00:06:07
result of genetics stress and traumatic
00:06:10
experiences and substance abuse
00:06:13
different combinations within the four
00:06:15
dimensions May influence the development
00:06:17
of a particular condition within each
00:06:20
Dimension distinct theories exist under
00:06:23
psychological factors psychoanalysts
00:06:26
will have a completely different
00:06:28
explanation for a disorder compared to a
00:06:31
cognitive behaviorist or an
00:06:35
existentialist and we are not all alike
00:06:38
or identical so the same triggers or
00:06:41
vulnerabilities may cause different
00:06:46
disorders let's move on to uh talk about
00:06:49
the dimensions of the multipath model
00:06:51
starting with Dimension One biological
00:06:54
factors in understanding and treating
00:06:57
mental disorders it helps to look at
00:06:59
brain structures and brain function we
00:07:02
know that dysfunction in a particular
00:07:05
region of the brain affects people in
00:07:07
certain ways now there are a lot of
00:07:10
terms in this section to become familiar
00:07:12
with so be sure to understand the
00:07:14
terminology in the margins of the
00:07:16
chapter the text identifies three major
00:07:19
divisions of the brain the forbrain the
00:07:22
midbrain and the hind brain the forbrain
00:07:25
controls all the higher mental functions
00:07:28
and these includ include thoughts
00:07:30
perceptions intelligence decisionmaking
00:07:34
personality and so on the four brain
00:07:36
houses the cerebrum which is the largest
00:07:40
and most advanced part of the brain the
00:07:43
cerebral cortex is also part of the
00:07:46
forbrain and it has layers of neurons or
00:07:49
nerve cells which transmit information
00:07:52
to other parts of the brain and to the
00:07:54
body this is the outermost layer of the
00:07:58
brain the pre prefrontal cortex is a
00:08:00
region of the cerebral cortex which is
00:08:03
involved in executive functioning it
00:08:06
plays a role in emotions decision-making
00:08:09
and
00:08:10
memories this area is the last to
00:08:13
develop and may explain why adolescence
00:08:16
can be impulsive and may not always
00:08:19
exercise good judgment the prefrontal
00:08:22
cortex keeps our feelings and impulses
00:08:24
in
00:08:25
check now the limic system is a group of
00:08:29
deep brain structures which links our uh
00:08:33
emotions to uh memories its uh
00:08:37
structures include the amydala
00:08:38
hippocampus and Thalamus the lyic system
00:08:42
controls our emotional reactions and
00:08:45
motivation as well the brain is composed
00:08:48
of neurons and we'll take a closer look
00:08:51
at these nerve cells in the next
00:08:55
slide nerves or uh neurons send
00:08:58
information through electrical impulses
00:09:01
now here's a diagram of a sending neuron
00:09:04
and a receiving neuron at one end of a
00:09:06
neuron you see the dendrite which comes
00:09:09
from the Greek word meaning Branch or
00:09:11
root dendrites are on the cell body and
00:09:15
receive information from other
00:09:17
neurons this chemical and electrical
00:09:20
information is sent along the axon to
00:09:23
the axon terminal information is sent
00:09:26
from there to the next neuron and its
00:09:28
dendrit across a gap called the
00:09:34
synapse now here's where it gets
00:09:37
interesting information is traveling
00:09:39
from top to bottom in this diagram the
00:09:42
pre synaptic neuron is at the top
00:09:45
synaptic transmission involves the
00:09:46
release of a neurotransmitter at the
00:09:49
axon terminal this neurotransmitter
00:09:52
molecule travels across the synapse
00:09:54
where it eventually May bind with a
00:09:57
receptor site eventually it is released
00:10:00
where it can be taken back in by the
00:10:03
sending neuron this is called
00:10:06
reuptake now some medications called
00:10:09
reuptake Inhibitors block the reuptake
00:10:12
leaving more of the neurotransmitter
00:10:14
available in the
00:10:16
synapse medications called ssris
00:10:20
selective serotonin reuptake Inhibitors
00:10:23
are used to treat depression and are
00:10:25
thought to work by blocking the
00:10:27
re-uptake of Serotonin leaving leaving
00:10:29
more available for synaptic
00:10:34
transmission neuroplasticity is another
00:10:37
biological process we used to think that
00:10:40
we had a limited number of neurons and
00:10:43
when they died or were damaged we had
00:10:46
less to work with research has shown us
00:10:49
that neurogenesis occurs there can be
00:10:51
the birth of new neurons at any point in
00:10:54
life neural stem cells have the capacity
00:10:57
to generate new neural needed for new
00:11:00
skills or
00:11:01
experiences here's a photo of human
00:11:04
neural stem cells in red neural stem
00:11:08
cells are immature neurons researchers
00:11:11
are hoping to be able to use stem cells
00:11:13
to study and treat mental disorders such
00:11:16
as Alzheimer's depression and
00:11:19
schizophrenia we know that chronic
00:11:21
stress results in negative changes in
00:11:24
brain activity and exercise can produce
00:11:27
positive changes through altering levels
00:11:30
of
00:11:31
neurotransmitters and through
00:11:36
neurogenesis the biological dimension of
00:11:38
the multi-path model also explains
00:11:41
mental disorders as being passed on
00:11:43
through heredity which is the genetic
00:11:46
transmission of
00:11:47
traits just because we've inherited a
00:11:50
gene for a certain trait doesn't mean it
00:11:52
will show up in us there are chemical
00:11:55
compounds outside of the genome which
00:11:58
control Gene expr expression these
00:12:00
compounds determine whether or not genes
00:12:02
are turned on or turned off our genetic
00:12:06
makeup is called the genotype our
00:12:09
genotype interacts with the environment
00:12:12
and produces our phenotype which refers
00:12:15
to what we observe our physical and
00:12:17
behavioral
00:12:19
characteristics our genetic
00:12:21
characteristics also result from genetic
00:12:24
mutations when errors occur in cell
00:12:27
reproduction epigenetic is the study of
00:12:30
the biochemical activities that occur
00:12:32
outside our genes and we are learning
00:12:35
how environment can affect gene
00:12:37
expression exposure to toxins
00:12:40
malnutrition and stress can have an
00:12:45
effect another biological factor
00:12:47
involves sex differences in brain
00:12:50
development differences in size of some
00:12:53
brain structures between men and women
00:12:56
provide possible explanations the corpor
00:12:59
kosum for example which connects uh the
00:13:02
two hemispheres of the brain is larger
00:13:05
in women compared to men which may
00:13:08
explain why men and women use different
00:13:10
regions for certain activities males and
00:13:13
females are wired differently and
00:13:16
different areas of the brain are
00:13:17
activated or lit up in research exposing
00:13:21
participants to
00:13:23
stress the frequency and progression of
00:13:25
mental disorders differs disorders
00:13:28
involving reactivity to stress are
00:13:31
higher among women disorders involving
00:13:34
risk-taking are higher among
00:13:39
men biology based treatments for mental
00:13:42
disorders include
00:13:44
psychopharmacology which is the study of
00:13:46
effects of psychotropic medications
00:13:49
psychotropic medications are prescribed
00:13:51
after careful
00:13:52
diagnosis there are several medication
00:13:55
categories anti-anxiety medications
00:13:58
include the benzo dipin such as Xanax
00:14:01
and Valium which can be addictive so
00:14:04
they have to be prescribed with caution
00:14:07
antis psychotics are prescribed to treat
00:14:09
symptoms that indicate a break from
00:14:11
reality like Visual and auditory
00:14:14
hallucinations and paranoid delusions
00:14:17
anti-depressants treat symptoms of
00:14:19
depression and many increase the
00:14:21
availability of neurotransmitters in the
00:14:24
synapse many treat both symptoms of
00:14:27
depression and anxiety
00:14:29
mood stabilizers treat manic episodes
00:14:32
and smooth out mood
00:14:34
swings under anti-depressants there are
00:14:37
several categories there are the
00:14:39
selective serotonin reuptake Inhibitors
00:14:41
which I previously
00:14:43
mentioned there are some older
00:14:45
anti-depressant categories uh tricyclic
00:14:49
anti-depressants uh aren't used quite as
00:14:51
much anymore because of uh the uh side
00:14:55
effects associated with these uh
00:14:56
medications and MAOI Inhibitors are also
00:15:00
available they're an older type of
00:15:03
anti-depressant uh they also have some
00:15:05
serious side effects sometimes and also
00:15:08
individuals on
00:15:09
maois uh need to follow a special diet
00:15:13
buproprion uh is marketed as Wellbutrin
00:15:16
or zyban and it's used to help people
00:15:19
quit smoking and it's also used for
00:15:22
depression it's uh effective on its own
00:15:25
and it's sometimes added though to
00:15:27
ssris in cases where the ssris aren't
00:15:31
completely effective uh it's believed to
00:15:34
work as a norepinephrine and dopamine
00:15:37
reuptake
00:15:39
inhibitor the important point I want to
00:15:41
make here is that medications do not
00:15:44
cure mental disorders they do help
00:15:47
alleviate symptoms the most effective
00:15:50
treatments combine medication with
00:15:52
psycho theapy because ideological
00:15:55
factors are unclear sometimes people try
00:15:58
numerous medications before they find
00:16:01
one that
00:16:04
works there are some other biological
00:16:06
approaches ECT electroconvulsive therapy
00:16:10
which involves inducing small seizures
00:16:13
with electricity or magnetism may be
00:16:16
used but it is reserved for those not
00:16:19
responding to other treatments and it's
00:16:21
not like it's been protrayed in the
00:16:23
movies it uses very low levels of uh
00:16:27
electricity which are ad ministered
00:16:29
unilaterally only on one side of the
00:16:31
brain and not bilaterally also it can be
00:16:35
performed on an outpatient basis there
00:16:38
are Neurosurgical and brain stimulation
00:16:41
treatments psychosurgery which involves
00:16:44
removing parts of the brain is very
00:16:47
uncommon today and vegus nerve
00:16:49
stimulation is very interesting it's a
00:16:52
surgical procedure that can be used to
00:16:55
treat those with treatment resistant
00:16:57
depression it uses a uh pacemaker if you
00:17:01
will that's implanted in the body the
00:17:04
device is attached to a uh stimulating
00:17:07
wire that is threaded along a nerve a
00:17:09
cranial nerve called the vagus nerve the
00:17:12
vagus nerve travels up the neck to the
00:17:15
brain where it connects to areas
00:17:17
believed to be involved in regulating
00:17:19
mood and once it's implanted the device
00:17:22
delivers regular electrical impulses to
00:17:26
the Vegas nerve
00:17:29
the biological Dimension provides some
00:17:32
rather compelling explanations for
00:17:34
mental disorders however these
00:17:36
explanations alone are one-dimensional
00:17:39
and linear they follow the medical model
00:17:43
which tells us that once we can identify
00:17:45
and eliminate the underlying cause the
00:17:48
symptoms will
00:17:49
disappear and this overlooks factors
00:17:52
outside of the
00:17:53
individual science increasingly rejects
00:17:56
the idea of one gene for one disease
00:18:00
research is indicating that multiple
00:18:02
genes are involved in the development of
00:18:05
depression for example the dith thesis
00:18:08
stress Theory holds that people do not
00:18:10
inherit a particular abnormality but
00:18:13
rather a predisposition to develop
00:18:16
illness we have to consider
00:18:18
environmental forces or stressors that
00:18:21
may activate the predisposition
00:18:23
resulting in a disorder some criticisms
00:18:26
of biological models and Therapies
00:18:28
include failing to consider an
00:18:31
individual's unique
00:18:33
circumstances the rapid growth in sale
00:18:36
and marketing of psychotropic
00:18:38
medications leads us to depend on
00:18:41
medications to uh manage
00:18:44
symptoms it's also a reflection of our
00:18:47
society's Quick Fix
00:18:49
attitude sometimes getting better
00:18:51
requires hard work and and some time and
00:18:55
anytime medications are used we need to
00:18:58
be alert to the possibility of drug drug
00:19:04
interactions Dimension two of the
00:19:06
multipath model looks at psychological
00:19:08
explanations for the ideology of mental
00:19:11
disorders these explanations vary
00:19:14
depending on the theoretical
00:19:16
perspective psychodynamic models see
00:19:20
abnormal behavior as the result of
00:19:22
childhood trauma and unconscious
00:19:24
conflicts Sigman Freud developed a model
00:19:27
saying that personality was the result
00:19:29
of interactions between the id ego and
00:19:32
super ego conflicts between these three
00:19:35
are largely unconscious and therapy
00:19:38
tries to bring these internal conflicts
00:19:40
to the surface making them conscious so
00:19:43
they can be dealt
00:19:45
with the three components of personality
00:19:48
the id ego and super ego follow
00:19:51
different principles the ID follows the
00:19:54
Pleasure Principle the ego is realistic
00:19:57
and rational and the super ego is
00:20:00
concerned with moral considerations this
00:20:03
is where the conscience is personality
00:20:07
develops through psychosexual stages
00:20:10
Freud proposed that human personality
00:20:12
largely developed during the first five
00:20:14
years of life if someone is stuck in one
00:20:18
of these stages this is called a
00:20:20
fixation and this can result in
00:20:22
emotional disturbance due to unresolved
00:20:25
conflicts related to that stage of
00:20:27
development
00:20:28
defense mechanisms protect us from
00:20:31
anxiety and they operate unconsciously
00:20:34
and distort
00:20:36
reality traditional psychoanalytic
00:20:38
therapy takes a long time and it's not
00:20:41
favored by Managed
00:20:42
Care some techniques that are used are
00:20:45
free association where someone says the
00:20:47
first thing that comes to mind this is
00:20:50
thought to reveal unconscious conflicts
00:20:53
another technique is dream analysis
00:20:55
where the therapist interprets the
00:20:57
meanings that are HID hidden in
00:20:59
dreams the therapist also explores forms
00:21:02
of resistance in a client to reveal
00:21:05
unconscious conflicts they also look for
00:21:08
transference where the client reacts
00:21:10
emotionally to the therapist in ways
00:21:13
that show unresolved emotions toward
00:21:15
significant others a criticism of
00:21:18
psychodynamic models is the expert role
00:21:21
of the therapist in providing
00:21:24
interpretations other criticisms include
00:21:26
the need for outcome studies and its
00:21:29
failure to address cultural and societal
00:21:32
influences on mental
00:21:36
health behavioral models are concerned
00:21:39
with how we learned certain behaviors
00:21:42
classical conditioning explains learning
00:21:44
is occurring due to conditioned
00:21:47
responses that were paired with
00:21:49
unconditioned
00:21:50
stimuli this is uh more passive uh
00:21:54
automatic learning operant conditioning
00:21:56
involves voluntary Behavior and requires
00:21:59
an action whether a behavior continues
00:22:02
depends on the type of reinforcement
00:22:05
that occurred after the behavior be sure
00:22:07
that you understand the difference
00:22:09
between classical and operant
00:22:11
conditioning and study this section of
00:22:13
the chapter
00:22:14
carefully another type of learning is
00:22:17
observational learning which is based on
00:22:20
social learning theory this suggests
00:22:23
that we can learn Behavior by simply
00:22:25
watching others we may then model the
00:22:29
behavior of others for example social
00:22:31
learning theory says when children are
00:22:34
raised by aggressive parents they learn
00:22:37
through observation to behave
00:22:39
aggressively behavioral therapies
00:22:41
include exposure therapy where people
00:22:44
are gradually exposed to stimuli that
00:22:47
produce anxiety in order to learn new
00:22:50
emotional
00:22:51
responses systematic desensitization
00:22:54
involves having people enter a calm
00:22:56
relaxed state and then exposing them to
00:23:00
the feared objects or
00:23:02
situations a criticism is behaviorist
00:23:05
focus on outward behaviors and Overlook
00:23:09
internal mental
00:23:12
processes cognitive behavioral models
00:23:15
focus on both behaviors and cognitions
00:23:19
especially how thoughts affect our
00:23:21
emotions and behaviors Albert Ellis
00:23:24
developed the ABC Theory of Personality
00:23:27
where emotions and behavior are seen as
00:23:29
the result of irrational thoughts and
00:23:31
beliefs rather than being a direct
00:23:34
response to the activating event or what
00:23:37
happened schemas are identified and pre
00:23:41
they're actually preconceived views
00:23:43
based on underlying assumptions in
00:23:45
therapy these underlying assumptions are
00:23:48
disputed and replaced with more rational
00:23:51
ones and this is called
00:23:53
reframing DBT dialectical behavior
00:23:57
therapy is another form of treatment and
00:23:59
it's sometimes used to treat borderline
00:24:01
personality disorder where therapists
00:24:04
reinforce positive behaviors and avoid
00:24:06
reinforcement of negative behaviors it
00:24:09
is a very structured approach and it
00:24:12
includes mindfulness where clients learn
00:24:15
to tolerate and accept their negative
00:24:17
emotions one criticism of cognitive
00:24:20
behavioral models is the therapist's
00:24:22
role as the expert and authority figure
00:24:26
therapists need to directly point out
00:24:28
and attack a client's irrational
00:24:30
thoughts and this can intimidate
00:24:35
clients humanistic existential models
00:24:39
include a set of philosophical attitudes
00:24:41
that focus on freedom and a search for
00:24:44
meaning in life there's also a focus on
00:24:47
personal responsibility for choices and
00:24:50
the
00:24:50
consequences now there are no specific
00:24:53
techniques used but therapy is person
00:24:55
centered toward helping individuals uh
00:24:59
find and reach their full potential the
00:25:02
humanistic perspective has the
00:25:03
philosophy that humans are basically
00:25:06
good and
00:25:08
problems um that occur block an inborn
00:25:11
tendency for growth therapists provide
00:25:15
environmental conditions such as
00:25:17
unconditional positive regard and
00:25:19
empathy to Foster personality growth
00:25:23
criticisms of this approach include the
00:25:25
Reliance on people's individual subject
00:25:28
Ive
00:25:29
experiences and the model's lack of
00:25:31
scientific grounding these models do not
00:25:34
explain many mental
00:25:39
disorders Dimension three looks at
00:25:41
social factors the first two dimensions
00:25:44
of the multipath model that I talked
00:25:46
about focused on the individual the next
00:25:49
two address the social environment and
00:25:51
how it can influence the development of
00:25:53
mental
00:25:54
disorders there are social relational
00:25:56
models which have these important
00:25:59
assumptions healthy relationships are
00:26:01
crucial for human development and
00:26:03
functioning because these relationships
00:26:06
provide many intangible benefits such as
00:26:09
social support love and
00:26:12
compassion when relationships are
00:26:14
dysfunctional or absent individuals are
00:26:17
more vulnerable to mental
00:26:20
distress there is the family systems
00:26:23
model where the behavior of one family
00:26:26
member affects the entire family system
00:26:28
system the characteristics of this model
00:26:31
is personality development is strongly
00:26:33
influenced by Family
00:26:35
characteristics mental illness reflects
00:26:38
unhealthy family Dynamics and poor
00:26:41
communication so therapists must focus
00:26:43
on the family system and not just an
00:26:47
individual consequently the whole family
00:26:50
must be involved in
00:26:51
treatment one criticism of family
00:26:54
systems models is that uh they can have
00:26:58
negative consequences because parental
00:27:00
influence may not be a factor in an
00:27:02
individual's disorder but the family is
00:27:05
burdened with
00:27:09
guilt Dimension four looks at
00:27:12
sociocultural factors and emphasizes the
00:27:15
importance of the following in
00:27:16
explaining mental disorders race
00:27:19
ethnicity gender sexual orientation
00:27:23
religious preference immigration and a
00:27:26
Cultura of status and socioeconomic
00:27:29
status in an assessment the mental
00:27:32
health professional needs to describe
00:27:34
these factors as they can affect the
00:27:36
expression of mental disorders cultural
00:27:40
experiences need to be understood to
00:27:42
properly diagnose and treat mental
00:27:45
distress we live in an increasingly
00:27:47
diverse Society so these factors
00:27:50
shouldn't be ignored in society there
00:27:53
can be real barriers to healthy growth
00:27:56
and development I'll leave it to you to
00:27:59
study this section but I'll point out
00:28:00
the influence of one of these factors
00:28:03
socioeconomic
00:28:07
status the influence of socioeconomic
00:28:10
class on mental health is often
00:28:12
overlooked lower socioeconomic class is
00:28:15
often associated with a limited sense of
00:28:18
personal control or lower self-efficacy
00:28:22
it's also associated with poorer
00:28:24
physical health and a higher incidence
00:28:26
of depression and hopelessness
00:28:29
poverty exposes people to multiple
00:28:31
stressors life in poverty includes
00:28:34
dealing with low wages unsafe living
00:28:37
conditions and a lack of food
00:28:39
photojournalist Brenda Anne connley took
00:28:42
this picture of Donnie in Troy New York
00:28:45
he was suspended four times when he was
00:28:48
in kindergarten and for more than 20
00:28:50
days in second grade a number of studies
00:28:53
show that children from poor and single
00:28:56
parent households are more likely to be
00:28:58
suspended and expelled than their middle
00:29:01
class
00:29:04
peers in conclusion the multi-path model
00:29:07
shows us the value of analyzing mental
00:29:10
disorders from a variety of perspectives
00:29:14
all perspectives have strengths and
00:29:16
weaknesses so an integrative or
00:29:19
multi-path approach will give us the
00:29:21
best picture of what's
00:29:23
happening if you'll recall the story of
00:29:26
the Seven Blind Men Who were describing
00:29:28
an elephant each had a different idea of
00:29:31
what an elephant was because each was
00:29:35
holding in touching a different part of
00:29:37
the
00:29:38
elephant it's from a broader perspective
00:29:41
that we can truly understand mental
00:29:44
disorders evidence-based understanding
00:29:47
of mental disorders has evolved and will
00:29:49
continue to do so giving us more
00:29:51
knowledge about brain activity the
00:29:55
diathesis stress theory is still helping
00:29:57
us to understand the predisposition to
00:30:00
develop illness uh that is inherited and
00:30:04
epigenetic research is helping us to
00:30:07
understand gene
00:30:08
expression cultural Neuroscience is a
00:30:11
promising field which is the study of
00:30:13
how culture shapes biology and how
00:30:16
biology shapes culture this will help
00:30:19
clinicians to develop and use treatments
00:30:22
that address cultural differences
