Monitor on Psychology - June 2012 - (Page 32)

would benefit from more intensive therapy, and which aren’t EKG, and take detailed CT images of blood vessels and arteries likely to improve without medication. That would be a welcome to deliver a precise diagnosis. As a result, Insel says, mortality improvement, she says. “Syndromes are so nonspecific by our from heart attacks has dropped dramatically in recent decades. current criteria that the best we can do now is flip a coin. We “In most areas of medicine, we now have a whole toolkit to don’t do that for any other branch of medicine,” she says. help us know what’s going on, from the behavioral level to the Yet despite the progress and promise of her research, molecular level. That has really led to enormous changes in Mayberg isn’t ready to concede that all mental illnesses will one most areas of medicine,” he says. day be described in purely biological terms. “I used to think you Insel believes the diagnosis and treatment of mental illness is could localize everything, that you could explain all the variants today where cardiology was 100 years ago. And like cardiology by the biology,” she says. “I think in a perfect world you could, of yesteryear, the field is poised for dramatic transformation, but we don’t have the tools to explain all those things because he says. “We are really at the cusp of a revolution in the way we can’t control for all of we think about the brain the variables.” and behavior, partly One of the biggest because of technological problems, she says, breakthroughs. We’re is that mental illness finally able to answer diagnoses are often some of the fundamental catchall categories that questions.” include many different Indeed, in recent years underlying malfunctions. scientists have made Mental illnesses have many exciting discoveries always been described by about the function — their outward symptoms, and dysfunction — of both out of necessity and the human brain. They’ve convenience. But just as identified genes linked cancer patients are a wildly to schizophrenia and diverse group marked by discovered that certain many different disease brain abnormalities pathways, a depression increase a person’s risk diagnosis is likely to of developing postERIC KANDEL encompass people with traumatic stress disorder Columbia University many unique underlying after a distressing event. problems. That presents Others have zeroed in challenges for defining the on anomalies associated disease in biological terms. with autism, including “Depression does have patterns,” Mayberg says. “The caveat is abnormal brain growth and underconnectivity among brain different cohorts of patients clearly have different patterns — regions. and likely the need for different specific interventions.” Researchers have also begun to flesh out a physiological explanation for depression. Helen Mayberg, MD, a professor Software malfunction of psychiatry and neurology at Emory University, has been When it comes to mental illness, a one-size-fits-all approach actively involved in research that singled out a region of the does not apply. Some diseases may be more purely physiological brain — Brodmann area 25 — that is overactive in people in nature. “Certain disorders such as schizophrenia, bipolar with depression. Mayberg describes area 25 as a “junction box” disorder and autism fit the biological model in a very clearthat interacts with other areas of the brain involved in mood, cut sense,” says Richard McNally, PhD, a clinical psychologist emotion and thinking. She has demonstrated that deep-brain at Harvard University and author of the 2011 book “What stimulation of the area can alleviate symptoms in people with is Mental Illness?” In these diseases, he says, structural and treatment-resistant depression (Neuron, 2005). functional abnormalities are evident in imaging scans or during Maps of depression’s neural circuits, Mayberg says, may postmortem dissection. eventually serve as a tool both for diagnosis and treatment. Yet for other conditions, such as depression or anxiety, the Understanding the underlying biology, she adds, could help biological foundation is more nebulous. Often, McNally notes, therapists and psychopharmacologists decide which patients “We have a good beginning of understanding of the brain, but boy, have we got a long way to go.” 32 MONITOR ON PSYCHOLOGY • JUNE 2012

Table of Contents for the Digital Edition of Monitor on Psychology - June 2012

Monitor on Psychology - June 2012
Letters
President’s column
Contents
From the CEO
Give an Hour founder is one of Time magazine’s ‘most influential’
APA treatment guidelines panels are being formed
APA supports ‘Speak Up For Kids’
In Brief
Time Capsule
Random Sample
Judicial Notebook
Questionaire
APA honors Howell
Science Watch
Science Directions
What you should know about online education
Speaking of Education
Psychologist Profile
Redefining masculinity
Miscarriage and loss
Something for everyone
Candidates weigh in
Division Spotlight
American Psychological Foundation
Personalities

Monitor on Psychology - June 2012