Discussion: Factors That Influence the Development of Psychopathology

This week’s discussion aims to analyze historically and currently recognized biological, psychological, and sociocultural factors that inform the expression, course, and prevalence of psychopathology.  Historically, psychopathology’s perception is that of behaving outside the norm of what the present culture and society perceive as “normal.” Exactly who is responsible for deeming what is normal or not has perplexed this writer. Just as Marturano, A., (2020) wrote in his article “Italy and leadership: psychopathology or culture of a nation,” The history of an area, culture, war, persecution influences the prevalence of psychopathology.  The cultural beliefs of ancient times are still found in the leadership of the leaders in Italy.  Aristotle was responsible for categorizing concepts and objects etc. It has always needed to have things organized into ideas with descriptions and lists of the intrinsic aspect of what is being classified.   The identification of psychopathology can be found during Biblical times when what would be called today psychopathology was considered being “possessed” by evil spirits.

Experiences and education, research, studies have brought different theoretical constructs. As more information is gathered, more theories are discovered.  In the late 1970s, this writer can remember discussing the Nature vs. Nurture construct.  Today we would have to say both are responsible for the development or the expression of psychopathology as the interactions and experiences stimulate the individual’s biological and genetic expressions, which result in behaviors manifested.  However, it wasn’t until the Era of Enlightenment when the study and focus on psychiatric care came to be.  Until the 19th century, Schizophrenia, the worse of mental illness, was considered “another form of lunacy: (Kaplan,2008).  During the era of Enlightenment, the attitude towards mental health began to change. Phillipe Pines, a psychiatrist during this era, believed in an illness model of symptoms and treatment. Thus, the mentally ill’s moral treatment was brought to light because it was the belief the cause of the mental illness was to be found in the patient’s environment Kaplan,2008). Pines believed in studying the brains of psychiatric patients hoping to find the root cause of mental illness. The rationalization of doing this resulted in the destruction of the once scientific German psychiatrist under the Nazi influence. They would gas their patients under a cloud of eugenics.

Masten and Kalstabakken (2018) Discuss the implications for developmental psychopathology (DP) as a multidisciplinary approach for research and therapy.  The idea is that one needs to understand the psychopathology in a developing person and know what the “normal” behaviors and expectations exist for a specific developing person at a given point in time. This developmental theory appears to have built upon Erickson’s theory of developmental psychology.  Individuals grow and learn from the interactions they have in society. “Individuals grow and change due to their interaction between natural ecosystem factors (e.g., air and water quality, and exposure to macrobiotic organisms) also play a critical role to development” (Masten, and Kulstabakken,2018).

Those who live in extreme poverty areas, lead-based tenements, gangs at each corner, and now the stress of virtual schooling and not being with their peers are greater at risk of having some form of mental health problem. Continuous pressure from the unknown increase an individual’s risk of psychopathology as well.  Those living in poverty with a lack of health care coverage, housing, and food security are at higher risk for mental health issues.

The root cause of psychopathology is related to social, cultural, genetic, and biological factors.  Not one element can be identified.

Reference

Kaplan, R. M. (2008). Being Bleuler:  the second century of Schizophrenia, The Royal Australian and New Zealand College of Psychiatrists. Doi:  10.1080/10398650802302176

Marturano, A., (2020), Italy and leadership: psychopathology or culture of a nation?, International Journal of Psychoanalysis and Education, 12(1)

Masten, A.S., & Kalsstabakken, A. W., (2018), Developmental Perspectives on Psychopathology in Children and Adolescents, APA Handbook of Psychopathology:  Child and Adolescent Psychopathology, edited by Butcher, J. Nl, & Kendall, P. C.

 

response
There are so many great points in this post. I am worried about the mental health as well of the students having to be isolated and do virtual learning. “Social isolation leads to chronic loneliness and boredom, which if long enough can have detrimental effects on physical and mental well-being. The timelines of the growing pandemic being uncertain, the isolation is compounded by mass panic and anxiety (Duan, 2020).”  Not only has the pandemic caused illness and death across the country, it has wreaked havoc on the mental health of those who are isolated. The upcoming holidays are even more worrisome. With the social isolation that is now in place, our future as mental health providers is even more important that before. :Last year, about 374,000 people ended up in the nation’s emergency rooms with self-inflicted injuries, and 48,000 people died by suicide.”

Carley S, Hamilton M. Suicide at Christmas. Emergency Medicine Journal 2004;21:716-717

Duan, L., Zhu, G. (2020). Psychological interventions for people affected by the COVID-19 epidemic. The Lancet Psychiatry, 7(4), 300302.

 

Thank you for your post. I agree with your points in your post. Mental health has evolved over time and different ways of analyzing social and cultural views. Mental disorders impose a significant economic burden, not just on the individuals with the disorders but also on households, communities, employers, healthcare systems and government budgets (Jenkins, Baingana, Ahmad, McDaid & Atun, 2011). As you mentioned poverty can have an increased impact on mental health for those who are already at risk, although the effects of poor health on poverty are by no means unique to mental illness, their negative impacts are greater than for most acute and chronic illnesses (Jenkins et al., 2011).

Jenkins, R., Baingana, F., Ahmad, R., McDaid, D., & Atun, R. (2011). Social, economic, human rights and political challenges to global mental health. Mental health in family medicine8(2), 87–96.

Discussion: Factors That Influence the Development of Psychopathology

 

In many realms of medicine, objective diagnoses can be made: A clavicula is broken.  An infection is present. TSH levels meet the diagnostic criteria for hypothyroidism. Psychiatry, on the other hand, deals with psychological phenomena and behaviors. Can these, too, be “defined objectively and by scientific criteria (Gergen, 1985), or are they social constructions?” (Sadock et al., 2015).

Thanks to myriad advances during recent decades, we know that psychopathology is caused by many interacting factors. Theoretical and clinical contributions to the field have come from the neural sciences, genetics, psychology, and social-cultural sciences. How do these factors impact the expression, classification, diagnosis, and prevalence of psychopathology, and why might it be important for a nurse practitioner to take a multidimensional, integrative approach?

To Prepare:

  • Review this week’s Learning Resources, considering the many interacting factors that contribute to the development of psychopathology.
  • Consider how theoretical perspective on psychopathology impacts the work of the PMHNP.
By Day 3 of Week 1

Explain the biological (genetic and neuroscientific); psychological (behavioral and cognitive processes, emotional, developmental); and social, cultural, and interpersonal factors that influence the development of psychopathology.

Read
 a selection of your colleagues’ responses

By Day 6 of Week 1

Respond to at least two of your colleagues on 2 different days by explaining the implications of why, as an advanced practice nurse, it is important to adopt a multidimensional, integrative model of psychopathology.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

 

post

Mental, emotional, and behavioral (MEB) development is a product of complex neurobiological processes that interact with characteristics of the physical and social environment, beginning before conception and continuing beyond adolescence. Healthy development is shaped by experiences and circumstances that cross generations within families and affect entire neighborhoods and communities. Therefore, understanding of MEB development must be based on an integrated appreciation of connections that have been identified among.

Biological processes, including brain development and the expression of genes as individual characteristics; physical, social, behavioral, and intergenerational experiences that affect conception, gestation, and childbirth;  Although neurobiological mechanisms are a central focus of research on MEB outcomes, it is important to note that these mechanisms are the downstream consequence of complex cellular and molecular variation that emerges in response to the interplay between genes and environments. Genes and environments both operate to create variation, and the interplay between these variables is the foundation for the emergence of individual variation

Development accelerates in response to environmental threat. For example, girls who encounter several types of challenges experience the onset of puberty earlier than girls who do not. The challenges for which these connections have been established include an absent father, maternal depression, family conflict, and low ratio of income to needs, but these effects can be buffered by secure childhood attachment (Deardorff et al., 2011; Ellis and Garber, 2000; Sung et al., 2016).

Neuroimaging studies suggest that the acceleration of development is also evident in brain systems, such as those that regulate fear and learning (Gee et al., 2013), and in the connectivity between cortical and subcortical brain structures that have implications for emotional regulation (Callaghan and Tottenham, 2016).

Genetic, environmental, neurobiological, and behavioral characteristics account for differences in the way’s individuals respond to influences such as stress or adversity. This phenomenon, known as differential susceptibility, provides a framework for thinking about ways to account for both healthy MEB development and the development of MEB disorders, a framework that focuses not on the relative vulnerability or resilience in distinct subtypes of individuals but on the degree of plasticity an individual exhibits. Cortical sensory processing capacity and the ability of the prefrontal cortex to filter emotional stimuli have been suggested as potential neural mechanisms accounting for differential susceptibility (Boyce, 2018).

A growing body of evidence is revealing the ways in which characteristics of the more distal social environment affect development. These factors include poverty and inequality, discrimination and racism, marketing of unhealthy products, and effects of involvement with the criminal justice system. These more distal influences on MEB development place distinct limits on society’s ability to foster healthy MEB development and prevent MEB health disorders at a population level.

Healthy early development (physical, social, emotional, and cognitive) strongly influences a wide range of later outcomes, including mental health, heart disease, literacy and numeracy, criminality, and economic participation across the life span. Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic status; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion (Healthy People, 2015).

Furthermore, individual influences including sleep, nutrition, and physical activity; characteristics of the family and surrounding community, including safety, nurturing interactions, peer behavior, and social-emotional support in school; and characteristics of the broader society in which the individual, family, and community are situated, such as poverty and economic inequality, systemic racism and discrimination, law- and policy-driven factors, and the marketing of unhealthful products can also be a factors influencing the development of psychopathology.

References

Boyce WT. The orchid and the dandelion: Why some children struggle and how all can thrive. New York: Alfred A. Knopf; 2018

Callaghan BL, Tottenham N. The stress acceleration hypothesis: Effects of early-life adversity on emotion circuits and behavior. Current Opinion in Behavioral Sciences. 2016; 7:76–81. 10.1016/j.cobeha.201511.018

Deardorff J, Ekwaru JP, Kushi LH, Ellis BJ, Greenspan LC, Mirabedi A, Landaverde EG, Hiatt RA. Father absence, body mass index, and pubertal timing in girls: Differential effects by family income and ethnicity. Journal of Adolescent Health. 2011;48(5):441–447.

Healthy People 2020. Disparities. 2015. https://www.healthypeople.gov/2020/about/foundation-health-measures/Disparities

 

responses

I enjoyed this post! Thank you for pointing out that mental health is not a choice! It a combination of so many things, and making the public aware of this is so important and vital to the future of mental health. “Depression is a disease, where neurotransmitters in the brain, such as norepinephrine, dopamine, and serotonin, are reduced, and there is something wrong in the mood control circuit of the brain (Yim, 2016).”

Your points if healthy early development is poignant in this post. In my initial post, I stated how the rural area that I live in has finally started mental health services in schools and I am hoping that this is the push needed to help my community has a brighter future in mental health as well as erasing the stigma associated with mental health. “The paradox is that young people aged between 12 and 25 years have had by far the worst levels of access to mental health care across the whole lifespan. Health services are poorly designed, grossly under-resourced and typically unfriendly to, and untrusted by, young people (McGorry, 2018).”

 

Yim J. Therapeutic Benefits of Laughter in Mental Health: A Theoretical Review. Tohoku J Exp Med. 2016 Jul;239(3):243-9. doi: 10.1620/tjem.239.243. PMID: 27439375.

 

McGorry PD, Mei C. Early intervention in youth mental health: progress and future directions

Evidence-Based Mental Health 2018;21:182-184

 

 

   Thank you for your very informative post!  Brain development and the expression of genes begin from the time of gestation and continue to adulthood.  Many factors influence the biological processes that determine the growth of these structures.  These changes can result in psychiatric disorders such as depression disorders, anxiety disorders, and more severe disorders such as schizophrenia.  One such variable is stress. The stress response involves the release of the stress hormones epinephrine, norepinephrine, and adrenocorticotropic. These stress hormones are directly released into the maternal bloodstream and the fetal bloodstream.  The fetus will have an increased heart rate and blood pressure. (Sadock, Sadock, and Ruiz,2015, p 1083).  The developing brain circuits and medial prefrontal cortex (mPFC) have significant roles in the top-down regulation of the HPA (stress axis). The stress axis is particularly susceptible to environmental influences. Moreover, there does not need to be a direct experience with stress for the developing brain and genes to be affected. Being near someone who is stress can result in bystander stress (Lehmann, Weigel, Elkahloun, and Herkenham, 2017; Nelson, 2017).

     In today’s world, all are bombarded with stress. All of us are dealing with Covid-19. Many people have lost their dreams, having to close their business, lay off, or have their business burned to the ground.  Many have lost their jobs.  Even though people go through the everyday routine and are not guaranteed or who are “essential workers” and are employed, they put themselves in harm’s way; and stress is felt.  Our gene expressions are being changed.  Worry about finances, our future, or our loved ones’ future are all forms of stress. Stress has been associated with depression, anxiety, and psychosis (Holttum, 2014).    Today, children feel the stress of being confined and not being able to socialize with their friends. Those who are pregnant and undergoing the stress of this world are producing more children with depression, anxiety, ADHD, personality disorders, or psychotic disorders.  Psychotherapy has been found to change the structure of the gene expression and other brain structures.  Psychotherapy may be our saving grace in today’s world.  This writer believes that stress management skills and exercises should be taught in school, and perhaps telehealth sessions for children and adults.  How do you see this society being impacted by the stressors of today’s world?

References

Holttum, S.,(2014), when bad things happen our brains change, but psychotherapy and support can help the recovery of our brains and our lives, Mental Health and Social Inclusion, 18(2), PP 52-58

Nelson, E. E., (2017), Learning through the ages:  How the brain adapts to the social world across development, Cognitive Development, 42(2017), 84-94

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015), Sadock’s & Sadock’s synopsis of psychiatry,  (11th ed.), Wolters Kluwer

 

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