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Factors that Influence the Development of Psychopathology
Many elements, including but not limited to biological (for instance, brain trauma), psychological (for instance, a stressful event), environmental (for instance, a twins study), and sociocultural (for instance, poverty) factors, affect the development of psychopathology (Centers for Disease Control and Prevention [CDC], 2011).
According to biology, different parts of the brain are in charge of carrying out neuronal processes such as attention, executive functions, language, motor activities, visuospatial functioning, language, and verbal and nonverbal memories. Psychiatric disorders result from dysfunction in any of the brain regions in charge of the aforementioned processes (Jackson & Milberg, 2018). The central nervous system is where chemical neurotransmission takes place. Psychopathology is linked to an imbalance of chemical neurotransmitters and other forces. For instance, according to the neurotransmitter hypothesis, symptoms of serious depression are caused by a serotonin imbalance, while symptoms of dopamine imbalance are caused by (Liu, 2017). Several parts of the brain are in charge of causing particular psychiatric diseases. For instance, the emotional response to fear is controlled by the cingulate gyrus, while the amygdala controls the emotional response. Both have links to anxiety problems (Jackson & Milberg, 2018). The hippocampus reacts to neurochemical changes and is linked to bipolar disorder, posttraumatic stress disorder, and depression (Jackson & Milberg, 2018). The emotional reaction is influenced by the orbitofrontal cortex. The insular cortex controls a number of bodily processes and is linked to anxiety, depression, and bipolar illness. It is a crucial factor in social anxiety disorder and posttraumatic stress disorder (PTSD) (Jackson & Milberg, 2018).
The thalamus also plays a role in homeostasis and emotional response. It is linked to depression in the same way as the frontal cortex controls conscious behavior and social awareness, which causes depression, bipolar disorder, and anxiety disorders (Jackson & Milberg, 2018). Recent studies have revealed a link between traumatic brain injury and the later emergence of anxiety, sadness, violence, and criminality (Connolly & McCormick, 2019). It is possible to pass down a family history of mental illnesses, yet this is not always the case because environmental circumstances play a significant role in determining whether such gene transmission would result in psychopathology because of how the environment affects gene expression. One study on identical twins offers proof that depression, bipolar disorder, autism, and other psychiatric diseases may all have hereditary roots. Environmental factors, however, can greatly influence whether these illnesses can develop or how severe they are (CDC, 2011). Most psychiatric diseases are caused by genetic variation, and inheritability varies depending on the ailment. Many structural and single nucleotide polymorphisms have been found to have an impact on a variety of psychiatric disorders (Smaller et al., 2019).
While thinking about how mental diseases evolve, psychological aspects are crucial. Children who grow up in institutions are more likely to develop psychiatric disorders, typically as a result of psychosocial events that have a negative impact on their cognitive, behavioral, and social development. These outcomes are symptomatic of how stress impacts a developing brain (TrollerRenfree et al, 2018). Psychotherapy and education are just two examples of the experiences that affect how genes are expressed in people. This changes how certain synaptic connections are distributed, which affects behavior (Stahl 2013). With the understanding that the course of individual development results from various interactions with the changing systems within and outside the organism, which work together to shape the structure and function of the developing individual, developmental psychopathology integrates the ecological system of individual development with general system theory (Master & Kalstabakken, 2018). Because of interactions at multiple levels of functioning, such as the epigenetic, neurological, cultural, and societal levels, human nature is dynamic (Master & Kalstabakken, 2018). The interactions/exchanges may be with relatives, schools, peers, the media, culture, governmental regulations, and healthcare systems, all of which are dynamic throughout time. Those who engage with the system also alter their behavior in response to the system’s evolving modifications (Master & Kalstabakken, 2018). For instance, external influences on a developing fetus are mediated through internal processes in the biological mother. If external influences like trauma, food, or sickness have an impact on the pregnant woman, this will undoubtedly change the biology of the developing fetus before birth (Master & Kalstabakken, 2018). As children grow, they interact directly with the system through play, school, work, and social relationships. As a result, they are shaped by many of these interactions and in many cases can affect the development of psychopathology. In a similar way, early childhood experiences with various systems are mediated by the caring adult (Master & Kalstabakken, 2018). In the same way, young people’s relationships with their parents, instructors, peers, friends, romantic partners, and other social circumstances affect them, and the opposite is also true (Master & Kalstabakken, 2018). As a result, while experiences can have an impact on the emergence of psychopathology, an individual’s conduct can also have an impact on the type of experiences they have and the ecological system’s quality (Master & Kalstabakken, 2018).
Interpersonal and sociocultural factors
Disparities in mental health across class, race/ethnicity, gender, and sexual orientation have been connected to social gradient (Cheung & Mark, 2018). According to literary works, people in lower socioeconomic classes have greater rates of common mental health disorders, with unemployment, a lack of education, and low money having the most effects and leading to poor mental health (Cheung & Mark, 2018). Several mental diseases can be linked to generally bad social status/conditions. For instance, Alegria et al. (2018) discovered that the risk of mental diseases is higher among migrant workers in Singapore who work for abusive employers despite the threat of deportation. As a result of administrative dominance and emotional stress, nursing assistants employed by for-profit firms experience depressive illnesses (Alegria et al., 2018). The social context has an impact on culture’s influence on the prevalence of psychopathological illnesses. A group of people’s cultural practices define how they act, see the world, and interact with others (Muleiro, 2018). All forms of discrimination, including those based on race/ethnicity, immigration status, sexual orientation, or occupation/financial status, have been associated to poor mental health, including low mood, anxiety, self-harm, and suicide attempts (Alegria et al., 2018). A group of persons who are stigmatized run the risk of acquiring psychopathological problems. LGBT people are more likely to experience mental health issues, suicidal thoughts, substance misuse, and self-harming behaviors, for instance. Similar to heterosexuals, lesbians of Latino and Asian descent experience depression at higher rates than heterosexuals; the nature of the interpersonal interaction varies depending on the individual. It is also reliant on scales of factors like inferiority versus self-acceptance that come from social influences that contribute to the growth of psychopathology (Cheung & Mark, 2018). As a result, it has a big impact on how psychiatric disorders start, continue, and go into remission (King-Casas & Chiu, 2012). For instance, Chinese sociocultural harmony forces them to report stigmatized psychopathological conditions as somatic ailments as a means of avoiding shame (Cheung & Mark, 2018).
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Centers for Disease Control and Prevention. Mental health awareness. (2011). https://www.cdc.gov/genomics/resources/diseases/mental.htm
Cheung, F. M., & Mak, W. W. S. (2018). Sociocultural factors in psychopathology. In J. N. Butcher & J. M. Hooley (Eds.), APA handbook of psychopathology: Psychopathology: Understanding, assessing, and treating adult mental disorders., Vol. 1. (p. 127–147). American Psychological Association. https://doi.org/10.1037/0000064-006
Connolly EJ, McCormick BF. Mild Traumatic Brain Injury and Psychopathology in Adolescence: Evidence from the project on human development in Chicago neighborhoods. Journal of Adolescent Health, 65(1),79-85. https://doi.org/10.1016/j.jadohealth.2018.12.023
Jackson, C. E., & Milberg, W. P. (2018). Examination of neurological and neuropsychological features in psychopathology. In J. N. Butcher & J. M. Hooley (Eds.), APA handbook of psychopathology: Psychopathology: Understanding, assessing, and treating adult mental disorders, Vol. 1. (p. 65– 90). American Psychological Association. https://doi.org/10.1037/0000064-004
King-Casas, B., & Chiu, P. H. (2012). Understanding interpersonal function in psychiatric illness through multiplayer economic games. Biological psychiatry, 72(2), 119–125. https://doi.org/10.1016/j.biopsych.2012.03.033
Liu, B., Liu, J., Wang, M., Zhang, Y., & Li, L. (2017). From Serotonin to Neuroplasticity: Evolvement of Theories for Major Depressive Disorder. Frontiers in cellular neuroscience, 11, 305. https://doi.org/10.3389/fncel.2017.00305
Masten, A. S., & Kalstabakken, A. W. (2018). Developmental perspectives on psychopathology in children and adolescents. In J. N. Butcher & P. C. Kendall (Eds.), APA handbooks in psychology. APA handbook of psychopathology: Child and adolescent psychopathology, Vol. 2 (p. 15–36). American Psychological Association. https://doi.org/10.1037/0000065-002
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Troller-Renfree, S., Zeanah, C. H., Nelson, C. A., & Fox, N. A. (2018). Neural and cognitive factors influencing the emergence of psychopathology: Insights from the bucharest early intervention project. Child Development Perspectives, 12(1), 28–33. https://doi.org/10.1111/cdep.12251
Psychopathology is an in-depth study of mental health with a long list of inclusive elements such as symptoms, behaviors, causes, course, treatments, development, and more. This study is ever-changing and developing as professionals continue recognizing contributing factors to mental disorders’ expression, classification, diagnosis, and prevalence. This discipline is so important because the more we understand mental disorders, the easier it will be to treat them effectively. Professionals have established and continuously revised guidelines to assist in defining psychiatric conditions by scientific criteria. The purpose of this discussion is to explore how theoretical and clinical contributions have impacted the expression, classification, diagnosis, and prevalence of psychopathology and why nurse practitioners should take a multidimensional, integrative approach to treatment.
The brain is the operational hub of the human body. Each portion of the brain and the communication network within the brain (i.e., neurons and neurotransmitters) are responsible for specific functions such as attention, executive function, language, motor activities, visuospatial functioning, and memory (Jackson & Milberg, 2018). Damage or abnormalities to certain areas can result in dysfunction, leading to psychiatric disorders. For example, the prefrontal lobes (orbital and medial regions) have been associated with behavioral and personality changes, and a decrease in volume in this area (among others) has been noted in patients with major depressive disorder (Jackson & Milberg, 2018). Studies have also indicated an increase in ventricular volume and a decrease in both whole brain and hippocampal volume in schizophrenic patients (Jackson & Milberg, 2018). Furthermore, imbalances of neurotransmitters within the brain also cause psychiatric disorders, and treatments often target these neurotransmitters affecting how neurons send, receive, and process signals to decrease or change symptomology. For example, if a neurotransmitter is elevated, it may be linked to one disorder, such as anxiety, but if it is too low, it may be linked to a different disorder, such as depression. A nurse practitioner must consider a patient’s symptomology in relation to how the brain works and how medications will alter the brain’s functions. This knowledge will help a provider know what treatments to consider, how to titrate medication appropriately, and when a medication is not serving a patient well.
Genetics play a large part in a person’s susceptibility to developing many mental disorders and how they will respond to treatment. We have read many studies about twins and their similarities and differences concerning their symptomology, genetics, and experiences. Some mental disorders have a strong genetic predisposition, such as schizophrenia, and some seem less influenced by these biological components. Interestingly, experts have more recently determined that an individual does not likely directly inherit a disorder, but the environment influences what genes are expressed (Butcher & Kendall, 2018).
One of the intentions of psychiatric research is to improve practice by developing interventions or improving existing ones. Past research has successfully refined theoretical models and increased knowledge linked to psychopathology resulting in new evidence-based interventions or further development of existing treatment approaches (Ehring et al., 2022). The DSM-5 was created to aid providers in diagnosing psychiatric disorders based on symptoms that deviate from what is considered the norm (i.e., auditory hallucinations are not common among other people). More recently, this manual has been revised to include other aspects of psychopathology to reflect cultural competence (Cheung & Mak, 2018).
“Emotional and behavioral disorders are closely tied to the social world” (Cheung & Mak, 2018, p. 127). Studies indicate a strong relationship between mental illness and individuals of less privileged social positions or varying cultural conditions. These socio-cultural conditions that alter the development of an individual include poverty, discrimination, war, education, and various positive opportunities (Cheung & Mak, 2018). Furthermore, sexual orientation also seems to have a link to a higher prevalence of mental disorders. A Survey in the United States found that gay and bisexual men have a higher prevalence of depression, panic attacks, and psychological distress than heterosexual men (Cheung & Mak, 2018). Additionally, the survey indicated that non-heterosexual women have a higher prevalence of generalized anxiety (Cheung & Mak, 2018). As a result of the complexity of the impact of society on one’s mental health, it is essential for nurse practitioners not to consider disparities based on just one status (i.e., income level) but on multiple aspects of one’s identity simultaneously because the impact of all of these links impacts an individual immensely (Masten & Kalstabakken, 2018). These statuses and identities affect how a patient identifies and communicates symptoms, perceives symptoms and diagnoses, accesses care, complies with treatment, and more.
Collectively, these elements of psychopathology are essential to nurse practitioners to help them arrive at conclusions regarding the best course of treatment for patients. While there is overlap between people diagnosed with different disorders and dissimilarities between people diagnosed with the same disorder, the various components of psychopathology collectively help providers take a multidimensional approach to treatment to provide the best care possible to patients.
Butcher, J. N., & Kendall, P. C. (2018). Introduction to childhood and adolescent
psychopathology. In J. N. Butcher & P. C. Kendall (Eds.), APA handbook of
psychopathology: Child and adolescent psychopathology. 2. American
Psychological Association. DOI 10.1037/0000065-001
Cheung, F. M., & Mak, W. W. S. (2018). Sociocultural factors in psychopathology.
In J. N. Butcher & J. M. Hooley (Eds.), APA handbook of psychopathology:
Psychopathology: Understanding, assessing, and treating adult mental
disorders. 1. American Psychological Association. DOI: 10.1037/0000064-
Ehring, T., Limburg, K., Kunze, A. E., Wittekind, C. E., Wemer, G. G., Wolkenstein,
L., Guzey, M., & Cludius, B. (2022). When and how does basic research in
clinical psychology lead to more effective psychological treatment for
mental disorders? Clinical Psychology Review, 95. DOI:
Jackson, C. E., & Milberg, W. P. (2018). Examination of neurological and
neuropsychological features in psychopathology. In J. N. Butcher & J. M.
Hooley (Eds.), APA handbook of psychopathology: Psychopathology:
Understanding, assessing, and treating adult mental disorders. 1. American
Psychological Association. DOI: 10.1037/0000064-004
Masten, A. S., & Kalstabakken, A. W. (2018). Developmental perspectives on
psychopathology in children and adolescents. In J. N. Butcher & P. C.
Kendall (Eds.), APA handbook of psychopathology: Child and adolescent
psychopathology. 2. American Psychological Association. DOI:
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