A Cybernetic Theory of Psychopathology

Abstract

Cybernetics, the study of principles governing goal-directed, self-regulating systems, offers a useful approach to understanding psychopathology or psychological dysfunction, overcoming limitations of other naturalistic approaches. Whereas influential theories of psychopathology have relied on definitions of dysfunction rooted in evolution and fitness, we define psychopathology in terms of cybernetic dysfunction, failure to make progress toward important goals. Cybernetic function in organisms is not identical to evolutionary function, despite their causal phylogenetic relationship. We define psychopathology as persistent failure to move toward one’s goals, due to failure to generate effective new goals, interpretations, or strategies when existing ones prove unsuccessful. This definition allows a thorough integration of dimensional approaches to psychopathology and personality and provides a new perspective on the nosology of mental disorder. We review evidence that the major dimensions of psychopathology correspond to major trait dimensions of personality, but we assert that extremity on these dimensions is neither necessary nor sufficient for psychopathology, which requires cybernetic dysfunction. Drawing from psychological and neurobiological research on personality and psychopathology, we present a theory of the mechanisms underlying the five major dimensions of psychopathology, some of their subdimensions, and the general risk factor for psychopathology. We conclude by discussing implications of our theory for research, diagnosis, and mental health interventions.     

Recognition of Emotion in Facial Expressions and Vocal Tones in Children With Psychopathic Tendencies

The authors investigated the ability of children with emotional and behavioral difficulties, divided according to their Psychopathy Screening Device scores (P. J. Frick & R. D. Hare, in press), to recognize emotional facial expressions and vocal tones. The Psychopathy Screening Device indexes a behavioral syndrome with two dimensions: affective disturbance and impulsive and conduct problems. Nine children with psychopathic tendencies and 9 comparison children were presented with 2 facial expression and 2 vocal tone subtests from the Diagnostic Analysis of Nonverbal Accuracy (S. Nowicki & M. P. Duke, 1994). These subtests measure the ability to name sad, fearful, happy, and angry facial expressions and vocal affects. The children with psychopathic tendencies showed selective impairments in the recognition of both sad and fearful facial expressions and sad vocal tone. In contrast, the two groups did not differ in their recognition of happy or angry facial expressions or fearful, happy, and angry vocal tones. The results are interpreted with reference to the suggestion that the development of psychopathic tendencies may reflect early amygdala dysfunction (R. J. R. Blair, J. S. Morris, C. D. Frith, D. I. Perrett, & R. Dolan, 1999).     

Project ABLE

This paper describes a proposed model for the management of Army soldiers rendered ineffective due to inadequate skills in coping with life stress. The history of Army mental health programs is reviewed to establish the rationale for program development. The proposed treatment methods and staffing are discussed. The application of this peacetime treaetment model in the management of combat psychiatric casualties is presented. Emphasis is placed on the role of the Army occupational therapist as a professional skilled in the use of task-directed behavior to enhance daily living skills.     

The Relationships Among Sensory Processing Styles,Personality Traits,and Body Mass Index: A Pilot Study

The purpose of the authors in this study is to explore the possible relationships among sensory processing styles, possible sensory processing disorders, personality traits, and body mass index. There is research on the relationship between obesity as defined by body mass index and temperament, and sensory processing and temperament; however, no information could be found on the relationship between body mass index and sensory processing styles, or the role that temperament and personality styles may play in these relationships. The 50 female participants were recruited from the University of New England community. The sample included women between the ages of 19 and 59 years, and of various weights. None of the participants had a history of thyroid problems, diabetes, or any physical disabilities that would limit daily physical activity. None had been diagnosed with sensory processing disorder. All participants filled out two self-reports and a demographic questionnaire. The Adult/Adolescent Sensory Profile (Brown &; Dunn, 2002 Brown , C. E. , &; Dunn , W. ( 2002 ). Adult/Adolescent Sensory Profile . San Antonio , TX : The Psychological Corporation . [Google Scholar]) determines a person's sensory processing style and possible sensory processing disorder, and the Basic Personality Inventory (Jackson, 1996 Jackson , D. N. ( 1996 ). Basic Personality Inventory Manual , (2nd ed.) . Port Huron , MI : Sigma Assessment  [Google Scholar]) focuses on everyday behaviors to describe temperament and “adult behavioral syndromes” (p. 5). Through this study the authors show only tentative relationships between body mass index and sensory processing styles and personality traits. The data could be interpreted to support both discriminant and convergent validity between the Adult/Adolescent Sensory Profile and the Basic Personality Inventory. There were, however, significant correlations between aspects of sensory processing and aspects of personality that appeared to strengthen the idea that differences in sensory processing result in predictable types of behavior, indicating that sensory processing disorders are a separate diagnostic category.     

Daily Occupations and Adaptation to Daily Life Described by Women Suffering from Borderline Personality Disorder

Clients suffering from Borderline Personality Disorder have significant impairments in relation to health. Despite this, their occupational status is rarely described. The aim of this study was to examine how women with Borderline Personality Disorder describe their daily occupations and adaptation to daily life. The study included nine participants. The data were collected using a semi-structured interview and were analyzed using content analysis.

Theme: Having few organized daily activities and poor personal causation prevent changes in adaptation to daily life. Two categories: performance and self-image, and four subcategories: competent or incompetent to perform, positive self-image, and lack of self-image were identified.     

Recollections of parent–child relationships,attachment insecurity,and obsessive–compulsive beliefs

To adequately understand Obsessive Compulsive Disorder (OCD), it is important to understand the developmental origins of obsessive beliefs and corresponding compulsive acts. Prior work has shown that having cold, neglectful parents in childhood and/or insecure attachment styles are both linked to emotional disturbances. In this study, we explored the potential contributions of early parent–child relationships to attachment styles and the severity of obsessive–compulsive beliefs in adulthood. A sample of 397 college students completed online, self-report measures of retrospective parent–child relationships, adult attachment styles, and ongoing obsessive–compulsive symptoms. Analyses revealed that attachment anxiety partially mediated the association between parent–child relationships and obsessive beliefs; attachment avoidance failed to operate as a mediating mechanism. Our findings provide support for interpersonal approaches to obsessive–compulsive symptoms and disorder, with implications for the continuity of relationship dysfunction from childhood into adulthood.     

Cases to cases: A study of psychotherapy

The background to the study was a research project on psychotherapy (279 subjects) in the context of the Finnish Student Health Service. Patients were divided into three groups by duration of treatment. For each group, a hypothetical case was constructed. The hypothetical case in relation to short-term treatment (less than six months) is someone whose temporarily disturbed mental balance is supported by the therapist. The hypothetical case in relation to medium-term treatment (one to two years) exhibits recovery through release from self-objects. The hypothetical case in relation to long-term treatment (two to five years) was marked by the partial working through of object relationships.     

Understanding,respecting and integrating difference in therapeutic practice

The purpose of this paper is to promote thought and discussion around how and why we treat patients in chosen ways. In the present climate practitioners are required to treat patients following NICE guidelines in which cognitive behavioural therapy (CBT) is the treatment of choice in the majority of diagnoses. This paper raises concerns that this may lead to an homogenization of treatment, loss of invaluable skills and understanding from other treatment approaches, and loss to the patient who may be best cared for by a combination of treatments and approaches, most notably patients presenting with complex pathology. This paper aims to present this as a general principle, and by way of example, will focus on coupling two specific treatment orientations, cognitive behavioural therapy with psychodynamic psychotherapy, with the specific diagnosis of obsessive compulsive disorder (OCD).

Methods: Clinical material is drawn from case studies from practice in secondary adult mental health care services within the NHS. All patients were referred to the psychological services for treatment for OCD and provided with 1:1 therapy with UKCP‐registered therapists. Details have been anonymized by describing fictitious cases re‐constructed from clinical material. A theoretical understanding is included which provides both an overview for integrating treatment for the specific example of OCD and is intended by extension to other diagnoses.

Results: Working with the commonalities of therapeutic approaches, and integrating specific skills of CBT and psychodynamic psychotherapy, appears to offer a viable mode of treatment for cases resistant to single‐orientation therapies.

Conclusions: Coupling the skills of different therapies can be effective in treating complex patients that are referred to the secondary mental health services. Conversely, restricting practice to single orientation therapies can lead to an impoverished care for patients and diminution of invaluable therapeutic skills which may become underused, undervalued and lost in the practice of mental health care within the NHS. Acknowledgement of the skills of others, valuing these and learning from each other can help to avoid the defensive reactions of practitioners, where each may defensively retreat to their corners of specialism. Respecting and sharing skills from different orientations, and acknowledging this in the NICE guidelines, is good for both mental health services and patient care and addresses the concerns raised by practitioners exemplified by Bateman (2000 Bateman, A. 2000. Integration in psychotherapy: An evolving reality in personality disorder.. British Journal of Psychotherapy, 17(2): 147–156.  [Google Scholar], p. 147) that ‘psychotherapy continues to be bedeviled by ideological schisms with practitioners apparently ignoring alternative conceptualizations and potentially superior interventions’.     

Happy,sad, scary and peaceful musical excerpts for research on emotions

Three experiments were conducted in order to validate 56 musical excerpts that conveyed four intended emotions (happiness, sadness, threat and peacefulness). In Experiment 1, the musical clips were rated in terms of how clearly the intended emotion was portrayed, and for valence and arousal. In Experiment 2, a gating paradigm was used to evaluate the course for emotion recognition. In Experiment 3, a dissimilarity judgement task and multidimensional scaling analysis were used to probe emotional content with no emotional labels. The results showed that emotions are easily recognised and discriminated on the basis of valence and arousal and with relative immediacy. Happy and sad excerpts were identified after the presentation of fewer than three musical events. With no labelling, emotion discrimination remained highly accurate and could be mapped on energetic and tense dimensions. The present study provides suitable musical material for research on emotions.Keywords.