The Physiology of Psychological Disorders: Schizophrenia, Depression, Anxiety, and Substance Abuse

327 Pages·1990·11.02 MB·English

by  James G. Hollandsworth Jr. (auth.)

The Physiology of
Psychological Disorders
Schizophrenia, Depression, Anxiety,
and Substance Abuse
THE PLENUM SERIES IN BEHAVIORAL PSYCHOPHYSIOLOGY
AND MEDICINE
Series Editor:
William J. Ray, Pennsylvania State University, University Park, Pennsylvania
BIOLOGICAL BARRIERS IN BEHAVIORAL MEDICINE
Edited by Wolfgang Linden
HANDBOOK OF RESEARCH METHODS IN CARDIOVASCULAR
BEHAVIORAL MEDICINE
Edited by Neil Schneiderman, Stephen M. Weiss, and Peter G. Kaufmann
PHYSIOLOGY AND BEHAVIOR THERAPY
Conceptual Guidelines for the Clinician
James G. Hollandsworth, Jr.
THE PHYSIOLOGY OF PSYCHOLOGICAL DISORDERS
Schizophrenia, Depression, Anxiety, and Substance Abuse
James G. Hollandsworth, Jr.
The Physiology of
Psychological Disorders
Schizophrenia, Depression, Anxiety,
and Substance Abuse
James G. Hollandsworth, Jr.
Univerty of Southern Mississippi
Hattieshurg, Mississippi
Springer Science+ Business Media, LLC
Library of Congress Cataloglng-ln-Publ1cation Data
Hoilandsworth, James G.
The physiology of psychological disorders : schizophrenia,
depression, anxiety, and substance abuse / James G. Hoilandsworth,
Jr.
p. cm. — (Plenum series 1n behavioral psychophyslology and
medicine)
Includes bibliographical references.
ISBN 978-1-4899-3572-4
1. Schizophrenia—Physiological aspects. 2. Depression, Mental-
-Phys1olog1cal aspects. 3. Anxiety—Physiological aspects.
4. Substance abuse—Physiological aspects. I. Title. II. Series.
[DNLM: 1. Anxiety Disorders—etiology. 2. Depressive Dlsorders-
-etlology. 3. Mental Disorders—etiology. 4. Psychophyslology.
5. Schizophrenia—etiology. 6. Substance Abuse—etiology. WM 100
H7375p1
RC514.H59 1990
616.89'07—dc20
DNLM/DLC
for Library of Congress 89-26559
CIP
© 1990 Springer Science+Business Media New York
Originally published by Plenum Press, New York in 1990
Softcover reprint of the hardcover 1st edition 1990
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means, electronic, mechanical, photocopying, microfilming,
recording, or otherwise, without written permission from the Publisher
ISBN 978-1-4899-3572-4 ISBN 978-1-4899-3570-0 (eBook)
DOI 10.1007/978-1-4899-3570-0
For my wife,
Brenda Dawson
Foreword
Explanations of abnormal behavior that emphasize the importance of
physiological determinants of disorder are relatively unpopular among
psychologists, especially among those who work as clinicians in an ap~
plied setting. The reasons for this are theoretical and historical, as well
as practical. Physiology and its associated biological disciplines of bio~
chemistry, pharmacology, and genetics are traditionally more associated
with medicine; their use to underpin explanations and treatments of
behavioral abnormality has consequently demanded knowledge to
which most psychologists are not exposed and skills that are unavailable
to them. The dichotomy thus created between medical and psychologi~
cal approaches has caused many psychologists to disregard physiologi~
cal factors. Even when the latter are recognized as important, many
psychologists have been unwilling to admit to the fact, in the belief that
by doing so they will commit themselves to an overly medical model of
psychological disorder, undermining what they see as preferred views
of abnormality. As I have become increasingly aware in following the
progress of this book, in the United States the theoretical issues in this
debate have been further sharpened by professional rivalries (present
but less explicit on the European scene from which I write) between
medical and nonmedical health care workers, regarding facilities for and
approaches to the treatment of the mentally disturbed.
Faced with these divisions of interest, psychologists have available
two courses of action. One is to distance themselves even further from a
consideration of physiological factors in disorder, presumably in the
hope that progress in the development of alternative perspectives will
result in fully valid, self~contained models for understanding and treat~
ing psychological deviance. The other choice is to learn something about
vii
viii FOREWORD
such factors and, in the course of doing so, help to strengthen the
position of psychologists as professionals who, perhaps uniquely, have
the opportunity to acquire a fully rounded appreciation of the psycho
biological nature of all behavior, not least abnormal behavior.
The philosophy that lies behind Hollandsworth's book is very much
the latter. He argues cogently-with succinct reviews of the appropriate
evidence-that none of the major forms of psychological disorder· of
concern in contemporary society can be fully understood without taking
into account the contribution of physiological mechanisms. Importantly,
however, he does so without falling into the trap which, ironically, has
eo.snared much organic psychiatry: that because psychological disorders
are associated with aberrant physiology, this necessarily validates a nar
row etiological model of such disorders as discrete disease entities, en
shrined at a descriptive level in such classificatory schemes as DSM-III-R.
While using current psychiatric nosology as a framework for organizing
his material, and as a vehicle for communication, Hollandsworth does
not merely attempt to seek a compromise with the medical position over
disorder. Instead he interprets the physiological evidence in a different
way, drawing for part of his theoretical analysis on constructions of the
physiology of abnormality which, as it happens, have actually been
rather critical of conventional disease notions of psychological disorder.
I am referring here to contemporary biological theories of personality
and temperament. These theories, developed by psychologists them
selves, argue for the existence of intrinsic nervous system differences
between individuals, differences that act as predispositions to various
forms of disorder and which, when pushed into dysfunctional states,
represent the physiological component in psychological abnormality.
According to such theories, the understanding of the contribution of
biology to the etiology of disorder then becomes, not the search for
discrete cause, but an appreciation of how and why normal physiology
takes an abnormal functioning. Looked at in this way, the physiological
analysis of disorder is not an alternative to the psychological or the
social. Instead it supplements these approaches, providing a bridge be
tween brain and behavior that many clinicians have been unwilling to
cross-currently fruitless discussions about the relative importance of
psychological (i.e.,cognitive) versus physiological"causes" of panic dis
order are a good example.
The discoveries that are now being made in the neurosciences and
related disciplines already attest to the importance of psychologists ac
quiring a knowledge of the physiology of the disorders they study and
treat. Equally important is the opportunity such knowledge imparts to
them in being able to shape future interpretations-and hence
FOREWORD ix
applications-of it. Hollandsworth's book enables the practicing clini
cian to do both of these things and, although the message it conveys is
one which I suspect may require of some readers that they set aside their
preconceptions, I urge them to try.
GORDON CLARIDGE
Department of Experimental Psychology
Magdalen College
University of Oxford
Oxford, England
Preface
This book is written for students and practitioners of professional psy
chology who would like to know more about the physiological aspects of
the major disorders they encounter with their clients. It is written in the
opinion that most courses in physiological psychology taught in gradu
ate training programs generally fail to make that discipline relevant to
the clinical interests of students. Part of this failure appears to be the
reliance on literature that is based primarily on data drawn from infrahu
man subjects. In addition, there is a tendency in these courses to empha
size physiological rather than psychological dysfunction. The present
work attempts to remedy this shortcoming by approaching the subject
from a clinical perspective and relating information on physiological
function to each of four problem areas. As such, this book can be used as
a supplemental text in courses in either physiological psychology or
advanced psychopathology. Practitioners who have completed their for
mal training may also find the work useful when consulting with their
medical colleagues. With that in mind, special attention has been paid to
issues involving an interdisciplinary approach to the treatment of these
disorders.
The book is divided into three parts. Part I, Chapters 1-3, focuses
on the interrelationship of biological and psychological functions, intro
ducing basic principles and concepts to provide a framework around
which the subsequent chapters are developed. Part II, Chapters 4-7,
looks at specific disorders in terms of how certain physiological factors
affect their development and expression. The diagnostic areas covered
include schizophrenia, depression, anxiety, and substance use disor
ders. Part III consists of a single chapter that discusses some of the
implications of what has been developed in the previous chapters.
Doubtless, some readers will be disappointed to find that I have
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