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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?
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.
The history of the diagnosis of mental disorders is fraught with examples of how cultural norms and prejudices interfere with and warp a diagnosis. The result is that normal behavior and orientations have been pathologized as an illness or disease. An example of this would be the story of Alan Turing, the famous British computer scientist of the 20th century, who was instrumental in inventing modern computers and deciphering German code in World War II. He was convicted in 1952 in England of gross indecency for being gay. Turing was forced by the courts to undergo 12 months of hormone therapy and could no longer work for the British government. At the time, homosexuality was pathologized as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders and was criminalized in most Western countries. It was not until 1973 that the American Psychiatric Association (APA) finally removed homosexuality from the DSM.
Historically, the process of rendering a diagnosis has been used to pathologize those who fell outside what was considered the cultural norm of human behavior. This process often marginalized diagnosed populations and prevented individuals from receiving appropriate care. It is of utmost importance to consider cultural issues that influence how you as a clinician interpret a client’s behavior and how cultural issues influence how a client may express behavior. This week, you explore the history of psychopathology and the evolution of theoretical perspectives in the field.
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.
Chapter 1, Neural Sciences
Chapter 2, Contributions of the Psychosocial Sciences
Chapter 3, Contributions of the Sociocultural Sciences
Chapter 4, Theories of Personality and Psychopathology
Chapter 31.17c, Child Psychiatry: Other Conditions: Identity Problem
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., Vol. 2. (pp. 3–14). American Psychological Association. https://doi-org.ezp.waldenulibrary.org/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., Vol. 1. (pp. 127–147). American Psychological Association. https://doi-org.ezp.waldenulibrary.org/10.1037/0000064-006
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. (pp. 65–90). American Psychological Association. https://doi-org.ezp.waldenulibrary.org/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., Vol. 2. (pp. 15–36). American Psychological Association. https://doi-org.ezp.waldenulibrary.org/10.1037/0000065-002
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