Neuroscience for Psychologists and Other Mental Health Professionals

Jill Littrell, PhD, LCSW, is Associate Professor, Georgia State University School of Social Work.

Preface


1. Ways of Thinking About Behavioral Syndromes


The Current Paradigm and How We Got There


History of the Diagnostic and Statistical Manuals of the American Psychiatric Association


Major Depression and Anxiety Used to Be Neurosis


The DSM-IV Continues the Tradition of Medicalizing More of Us


Controversy Over the DSM-5


The Limitations of Current Diagnostic Categories


Abandonment of the DSM-5


Extensive Nature of the Mind–Body Connection


Are Diagnoses Needed?


What Should Be the Criteria for Disorder?


Has Labeling Ordinary Behavior as Mental Illness Resulted in Better Outcomes?


The Approach in This Book


2. Physiology


Section 1: Genes and Epigenetics


The Two-Step Process of Making a Protein


How the Cell Decides Whether to Make a Protein


Epigenetics


Telomeres


Section 2: Neurons and Neurotransmitters


The Life Cycle of a Neurotransmitter


How Are the Functions of Neurotransmitters Investigated?


Specific Neurotransmitters


Section 3: The Immune System


Two Major Divisions: Innate and Adaptive Immunity


The Glial Cells


Section 4: Circuits


Appetitive Signaling


Creating Learned Helplessness


Regulation of Impulses, Motor Activity, and Emotions


Putting It All Together: BAS and BIS


Section 5: Emotions


Emotions in General


Autonomic Nervous System


Hormonal Activity


Specific Emotions


Section 6: The Human Brain Is Social


Exercises to Rehearse the Vocabulary Used in Subsequent Chapters


3. Psychopharmacology


Pharmacokinetics and Pharmacodynamics


Ways to Ingest Drugs


Ways in Which Drugs Are Eliminated From the Body


Drug Dependence


General Concepts


Major Classes of Psychotropic Drugs


Stimulants


Antipsychotics


Antidepressants


Sedative-Hypnotic Agents


Mood Stabilizers


Major Classes of Drugs of Abuse


Marijuana


Opioids


Nicotine


Alcohol


Marketing of Drugs in the United States


Concerns About Threats to Health


Concerns Over Cost


Where Does the Pharmaceutical Industry Spend Its Money?


Mechanisms for Controlling Medical Practice


Psychiatric Medications


The Role of Behavioral Health Clinicians With Regard to Pharmaceuticals


Obligations in Assuming Responsibilities for Monitoring Side Effects


Clinicians Functioning Independently


Informed-Consent Duties of Clinicians in Clear Mental Health Professional Roles


What Can Nonmedical Clinicians Say About Medications?


Websites for Information Regarding Drugs


4. Depression


The Syndrome of Depressive Behaviors


Prevalence Over Time and Cultures


Findings in Those With Major Depression


Brain Imaging and EEG Findings


Hormonal Findings


Thinking Styles


Emotional Control or Regulation


Brain-Derived Neurotrophic Factor


Theories


Learned Helplessness


Inflammation


Heritability


Drug Treatment


Efficacy


Withdrawal


Side Effects


Pregnancy


Changing Recommendations


Ketamine


Novel Drugs


Electrical Stimulation Treatment


Transcranial Magnetic Stimulation


Deep Brain Stimulation


Activities to Increase Regulatory Capacity


Cognitive Behavioral Therapy


Ways to Target Inflammation


Increasing HRV (Vagal Tone)


Direct Anti-Inflammatories


Diet


Obtaining Adequate Sleep


Exercise


Meditation


Social Engagement


Summary


Useful Websites and Information on Food


5. Anxiety


The Physiology of Anxiety


Basic Physiology of Fear


Differentiating Anxiety From Fear


Fear Memories


How Does Extinction Happen?


Possibility of Reconsolidation


Teaching Active Coping


Types of Anxiety Disorders


Generalized Anxiety Disorder


Obsessive-Compulsive Disorder


Posttraumatic Stress Disorder


Treatments


Talk Therapies


Medications for Anxiety


Other Nondrug Treatments


Ways in Which to Talk About and Deal With Past Traumatic Events


Making Decisions About How to Proceed


6. Psychotic Disorders


Physiology of Psychosis


Fast-Spiking, GABA-Producing Interneurons


Problems With the NMDA Receptor


Inflammatory Factors and Free Radicals


Limitations in Current Diagnostic Practices


Current Treatments


Side Effects With Current Treatments


Questions Raised by Long-Term Follow-Up Studies


Better Targets for Treatment


Dilemma for Society and Clinicians


7. Bipolar Disorders


History of the Concept


Why Was Bipolar II Added?


Bipolar I


Does Depression Always Occur in Those With Mania?


Bipolar II


Nonclinical College Student Samples of Bipolar II


Summary


Treatment


Must Pharmacological Treatment Be Initiated to Prevent Kindling?


The Pharmacological Treatments: Lithium, Anticonvulsants, and Atypical Antipsychotics


Efficacy of Pharmacological Treatment


Current Outcomes for Those With Bipolar II


Alternative to Drugs


Regular Routines


Omega-3s


N-Acetylcysteine


Where Have We Been and Where Are We Going?


8. Addictions


Neuroscience of Addiction


The Process of Becoming Addicted: Drug Sensitization


It Is Not About Pleasure


The Brain Is Being Changed


When Are Addicts More Vulnerable to Relapse?


Understanding Addiction


Do Addicts Use Because They Are in Pain?


Substance Abusers Are a Heterogeneous Population


Genetic Predisposition


How to Approach Clients


Is Breaking Down Denial Relevant?


New Approaches: Transtheoretical Models of Change and Motivational Interviewing


What Level of Drug Consumption Should Be Changed?


The Wisdom of Initial Sobriety


Initial Engagement


Assessing Detox Requirements


Assessing Level of Care


Goals of Treatment


Relapse Prevention


Developing Self-Regulation


Dealing With Abstinence Violation Syndrome


Pharmaceutical Treatments


Efficacy of Treatment


Reflections on U.S. Drug Policy


9. Children


Rise in Medicating Children


Pediatric Bipolar Disorder


The Push to Medicate


Side Effects of the Drugs


The Status of the Diagnosis


Major Depression


Efficacy of Antidepressants


Attention Deficit Hyperactivity Disorder


Genetics and Neurobiology


Stimulant Treatment Efficacy


Alternatives


Foster Care


Posttraumatic Stress Disorder


General Alternatives for Children


10. New Opportunities and How to Proceed


Mental Illness in the United States Is an Epidemic


Case Against Diagnoses That Create Harm


Lessons From the Resilience Literature


The Goal of Flourishing


What to Do to Increase Positive Mood


Primacy of Social Support


Humor


Music


Making Blessings Salient


Meditation and Yoga


Envisioning Positive Future Selves


Being Able to Forgive


Increasing the Probability of Taking Action


Integrating Behavioral Health Into Primary Care


Screening


Larger Social Change


Appendix: Screening Instruments


Alcohol Use Disorders Identification Test


CAGE Questionnaire


The Satisfaction With Life Scale


The Center for Epidemiologic Studies Depression Scale


Index