Posted by alexandra_k on September 20, 2006, at 21:06:30
In reply to Re: the brain » alexandra_k, posted by Tomatheus on September 20, 2006, at 12:33:05
> > With mental illnesses what is problematic are behaviours (including verbal behaviours).
> I would contend that dysfunctional feelings and emotions associated with mental illnesses are also problematic, especially from the perspective of those suffering from mental illnesses.What I mean by 'behaviour' is very liberal. How do we know that feelings are problematic? By observing emotional behaviours (including flushing, heat rate, jittering, flattened affect, rate and tone of speech, yelling, etc) and verbal behaviour (what the client / patient reports).
> > We then infer that there is a malfunction within the individual that is causing the problematic behaviours.
> Not necessarily. It is not uncommon for people to infer that the origins of problematic behaviors are 100 percent environmental and 0 percent genetic.Not in psychiatry. Psychiatry is dominated by the medical model which has been criticised for being a biobiobio approach instead of being a biopsychosocial approach. A pure social approach is more common amongst sociologists and anthropologists who focus on cross cultural variations.
> > Usually it is assumed that there is a malfunction on the level of hardware (neuro-physiology).
> I agree that this assumption is sometimes made, but I'm not so sure that it's made in a majority of cases.That is the medical / biological model of mental illness. Psychiatry is moving towards a biopsychosocial approach but it is unclear how the different elements can be integrated into a coherent theory that isn't just a muddle of factors...
> in cases where genetically mediated biochemical abnormalities do contribute to the underlying pathology of a mental illness (which have been confirmed in some individuals), I don't think that a psychopharmacological approach is a "cover up strategy."
It doesn't fix the gene... Does it?
What is the contribution of the gene at any rate?
There is a project... Dammit I can't remember what it is called... It is based on health statistics from Iceland. The most recent research shows that (I might get this a little wrong...) As far as a single gene being implicated in schizophrenia... Something like 15% of people with schizophrenia have it... And something like 7% of people without schizophrenia have it. With respect to structural alterations (enlarged ventricles and smaller structures in other areas) I think the stats come out the same. So things aren't looking so good with respect to the schizophrenia gene. Or with respect to finding neurophysiological changes that are predictive of schizophrenia (especially when a number of people with bi-polar may have similar structural abnormality). Maybe other genes moderate the expression of the schizophrenia gene... or maybe... Certain things like a virus in the third trimester, or certain kinds of environmental or psychological conditions are what differentiates between those who have schizophrenia and those who don't.Surely neuro-chemistry is really nothing over and above chemistry. And surely chemistry is nothing over and above physics. Maybe we just need to wait for microphysics to invent an electron gun that is safe to be used on brains...
Or maybe... A strictly biological approach is inappropriate as it seems that what is crucial is the interaction of biological psychological and social forces...
> However, I don't think that it should be assumed that therapy will lead to clinically relevant neuro-physiological changes in all individuals
Absolutely. I also don't think that it should be assumed that psychpharmacology will lead to clinically relevant neuro-physiological changes in all individuals, however.
That is my point.
Instead of limiting our interventions to one it is more likely intervention will succeed when it is targeted at multiple levels.
poster:alexandra_k
thread:686603
URL: http://www.dr-bob.org/babble/20060919/msgs/687756.html