Abnormal Psychology

28 CHAPTER 1

caregiver and infant. Consider that if the infant frequently fusses, this will elicit a

different pattern of responses from the caregiver than if the infant frequently smiles;

if the infant is fussy and “diffi cult,” the caregiver might handle him or her with less

patience and warmth than if the infant seems happy and easy-going. And the way the

caregiver handles the infant in turn affects how the infant responds to the caregiver.

In turn, these early interactions between child and caregiver (a social factor) contrib-

ute to a particular attachment style, which is associated with particular biases in pay-

ing attention to and perceiving emotional expressions in faces (psychological factors;

Fraley & Shaver, 1997; Maier et al., 2005).

In fact, some researchers who championed the biopsychosocial approach ac-

knowledged that explanations of psychological disorders depend on the interactions

of biological, psychological, and social factors (Engel, 1977, 1980). But these re-

searchers did not have the benefi t of the recent advances in understanding the brain,

and hence were not able to specify the nature of such interactions in much detail.

These two problems led to a revision of the traditional biopsychosocial approach,

to align it better with recent discoveries about the brain and how psychological and

social factors affect brain function. We call this updated version of the classic ap-

proach the neuropsychosocial approach, which is explained in the following section.

The Neuropsychosocial Approach: Refi ning the

Biopsychosocial Approach

The neuropsychosocial approach has two defi ning features: the way it character-

izes the factors and the way it characterizes their interactions. As we discuss below,

this approach emphasizes the brain rather than the body (hence the

neuro- in its name) and maintains that no factor can be considered in

isolation.

Emphasis on the Brain. As psychologists and other scientists have learned

more about the biological factors that contribute to psychological dis-

orders, the primacy of the role of the brain—and even particular brain

structures and functions—in contributing to psychological disorders has

become evident. Ultimately, even such disparate biological factors as genes

and bodily responses (e.g., the increased heart rate associated with anxi-

ety) are best understood in terms of their relationship with the brain.

Because of the importance of the brain’s infl uence on all biologi-

cal functioning involved in psychological disorders, this book generally

uses the term neurological rather than biological and the term neuro-

psychosocial rather than biopsychosocial to refer to the three types of

factors that contribute to psychological disorders.

Emphasis on Feedback Loops. In addition, neurological, psychological,

and social factors are usually involved simultaneously and are constantly

interacting (see Figure 1.4). These interactions occur through feedback

loops: Each factor is affected by the others, and also feeds back to affect the

other factors. Hence, no one factor can be understood in isolation, without con-

sidering the other factors. For example, problems in relationships (social factor)

can lead people to experience stress (psychological factor); in turn, when people

feel stressed, their brains cause their bodies to respond with a cascade of events.

As you will see throughout this book, interactions among neurological, psycho-

logical, and social factors are common. Icons that look like this will highlight parts

of the text that illustrate specifi c ways that these factors interact with one another:

• indicates feedback between neurological and psychological factors: P S

N

• indicates feedback between neurological and social factors: P S

N

• indicates feedback between psychological and social factors: P S

N

and

• indicates feedback among all three pairs of factors: P S

N

1.4 • The Neuropsychosocial Approach

According to the neuropsychosocial approach,

neurological, psychological, and social factors

interact with one another via feedback loops to

contribute to the development of psychopathology.

Figure 1.4g

Social

factors

Neurological

factors

Psychological

factors