Psychopathology is the study of mental illness. It includes the signs and symptoms of all mental disorders. The field includes abnormal cognition, maladaptive behavior, and experiences which differ according to social norms. This discipline is an in-depth look into symptoms, behaviors, causes, course, development, categorization, treatments, strategies, and more.
Biological psychopathology is the study of the biological etiology of abnormal cognitions, behaviour and experiences. Child psychopathology is a specialization applied to children and adolescents.
Early explanations for mental illnesses were influenced by religious belief and superstition. Psychological conditions that are now classified as mental disorders were initially attributed to possessions by evil spirits, demons, and the devil. This idea was widely accepted up until the sixteenth and seventeenth centuries. Individuals who had these so-called "possessions" were tortured as treatment or as Foucault outlines in the History of Madness: viewed as seers (Joan of Arc).[ citation needed ] Religious practitioners used this technique in hoping to bring their patients back to sanity but increasingly there was the shift to the great confinement. [1] [ unreliable source? ]
The Greek physician Hippocrates was one of the first to reject the idea that mental disorders were caused by possession of demons or the devil. He firmly believed the symptoms of mental disorders were due to diseases originating in the brain. Hippocrates suspected that these states of insanity were due to imbalances of fluids in the body. He identified these fluids to be four in particular: blood, black bile, yellow bile, and phlegm. [2] This later became the basis of the chemical imbalance theory used widely within the present.
Furthermore, not far from Hippocrates, the philosopher Plato would come to argue the mind, body, and spirit worked as a unit. Any imbalance brought to these compositions of the individual could bring distress or lack of harmony within the individual. This philosophical idea would remain in perspective[ vague ] until the seventeenth century. [1] It was later challenged by Laing (1960) along with Laing and Esterson (1964) who noted that it was the family environment that led to the formation of adaptive strategies.
In the eighteenth century's Romantic Movement, the idea that healthy parent-child relationships provided sanity became a prominent idea. Philosopher Jean-Jacques Rousseau introduced the notion that trauma in childhood could have negative implications later in adulthood. [1]
The scientific discipline of psychopathology was founded by Karl Jaspers in 1913. It was referred to as "static understanding" and its purpose was to graphically recreate the "mental phenomenon" experienced by the client. [3] A few years earlier, in 1899, the German book Lehrbuch der Psychopathologischen Untersuchungs-Methoden was published by Robert Sommer. [4] [5]
Sigmund Freud proposed a method for treating psychopathology through dialogue between a patient and a psychoanalyst. Talking therapy would originate from his ideas on the individual's experiences and the natural human efforts to make sense of the world and life. [1]
The study of psychopathology is interdisciplinary, with contributions coming from clinical psychology, abnormal psychology, social psychology, and developmental psychology, as well as neuropsychology and other psychology subdisciplines. Other related fields include psychiatry, neuroscience, criminology, social work, sociology, epidemiology, and statistics. [6]
Psychopathology can be broadly separated into descriptive and explanatory. Descriptive psychopathology involves categorising, defining and understanding symptoms as reported by people and observed through their behaviour which are then assessed according to a social norm. Explanatory psychopathology looks to find explanations for certain kinds of symptoms according to theoretical models such as psychodynamics, cognitive behavioural therapy or through understanding how they have been constructed by drawing upon Constructivist Grounded Theory (Charmaz, 2016) or Interpretative Phenomenological Analysis (Smith, Flowers & Larkin, 2013). [7]
There are several ways to characterise the presence of psychopathology in an individual as a whole. One strategy is to assess a person along four dimensions: deviance, distress, dysfunction, and danger, known collectively as the four Ds. Another conceptualisation, the p factor, sees psychopathology as a general, overarching construct that influences psychiatric symptoms.
A description of the four Ds when defining abnormality:
Benjamin Lahey and colleagues first proposed a general "psychopathology factor" in 2012, [9] or simply "p factor". This construct shares its conceptual similarity with the g factor of general intelligence. Instead of conceptualising psychopathology as consisting of several discrete categories of mental disorders, the p factor is dimensional and influences whether psychiatric symptoms in general are present or absent. The symptoms that are present then combine to form several distinct diagnoses. The p factor is modelled in the Hierarchical Taxonomy of Psychopathology. Although researchers initially conceived a three-factor explanation for psychopathology generally, subsequent study provided more evidence for a single factor that is sequentially comorbid, recurrent/chronic, and exists on a continuum of severity and chronicity. [10]
Higher scores on the p factor dimension have been found to be correlated with higher levels of functional impairment, greater incidence of problems in developmental history, and more diminished early-life brain function. In addition, those with higher levels of the p factor are more likely to have inherited a genetic predisposition to mental illness. The existence of the p factor may explain why it has been "... challenging to find causes, consequences, biomarkers, and treatments with specificity to individual mental disorders." [10]
A 2020 review of the p factor found that many studies support its validity and that it is generally stable throughout one's life. A high p factor is associated with many adverse effects, including poor academic performance, impulsivity, criminality, suicidality, reduced foetal growth, lower executive functioning, and a greater number of psychiatric diagnoses. A partial genetic basis for the p factor has also been supported. [11]
Alternatively, the p factor has also been interpreted as an index of general impairment rather than being a specific index that causes psychopathology. [11]
The term psychopathology may also be used to denote behaviours or experiences which are indicative of mental illness, even if they do not constitute a formal diagnosis. For example, the presence of hallucinations may be considered as a psychopathological sign, even if there are not enough symptoms present to fulfil the criteria for one of the disorders listed in the DSM or ICD.
In a more general sense, any behaviour or experience which causes impairment, distress or disability, particularly if it is thought to arise from a functional breakdown in either the cognitive or neurocognitive systems in the brain, may be classified as psychopathology. It remains unclear how strong the distinction between maladaptive traits and mental disorders actually is, [12] [13] e.g. neuroticism is often described as the personal level of minor psychiatric symptoms. [14]
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a guideline for the diagnosis and understanding of mental disorders. It serves as reference for a range of professionals in medicine and mental health in the United States particularly. These professionals include psychologists, counsellors, physicians, social workers, psychiatric nurses and nurse practitioners, marriage and family therapists, and more. [15] [ better source needed ]
A mental disorder, also referred to as a mental illness, a mental health condition, or a psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. A mental disorder is also characterized by a clinically significant disturbance in an individual's cognition, emotional regulation, or behavior, often in a social context. Such disturbances may occur as single episodes, may be persistent, or may be relapsing–remitting. There are many different types of mental disorders, with signs and symptoms that vary widely between specific disorders. A mental disorder is one aspect of mental health.
A mental disorder is an impairment of the mind disrupting normal thinking, feeling, mood, behavior, or social interactions, and accompanied by significant distress or dysfunction. The causes of mental disorders are very complex and vary depending on the particular disorder and the individual. Although the causes of most mental disorders are not fully understood, researchers have identified a variety of biological, psychological, and environmental factors that can contribute to the development or progression of mental disorders. Most mental disorders result in a combination of several different factors rather than just a single factor.
A delusion is a false fixed belief that is not amenable to change in light of conflicting evidence. As a pathology, it is distinct from a belief based on false or incomplete information, confabulation, dogma, illusion, hallucination, or some other misleading effects of perception, as individuals with those beliefs are able to change or readjust their beliefs upon reviewing the evidence. However:
Abnormal psychology is the branch of psychology that studies unusual patterns of behavior, emotion, and thought, which could possibly be understood as a mental disorder. Although many behaviors could be considered as abnormal, this branch of psychology typically deals with behavior in a clinical context. There is a long history of attempts to understand and control behavior deemed to be aberrant or deviant, and there is often cultural variation in the approach taken. The field of abnormal psychology identifies multiple causes for different conditions, employing diverse theories from the general field of psychology and elsewhere, and much still hinges on what exactly is meant by "abnormal". There has traditionally been a divide between psychological and biological explanations, reflecting a philosophical dualism in regard to the mind–body problem. There have also been different approaches in trying to classify mental disorders. Abnormal includes three different categories; they are subnormal, supernormal and paranormal.
In psychology, an idée fixe is a preoccupation of mind believed to be firmly resistant to any attempt to modify it, a fixation. The name originates from the French idée, "idea" and fixe, "fixed."
In psychoanalytic theory, a defence mechanism is an unconscious psychological operation that functions to protect a person from anxiety-producing thoughts and feelings related to internal conflicts and outer stressors.
Abnormality is a behavioral characteristic assigned to those with conditions that are regarded as rare or dysfunctional. Behavior is considered to be abnormal when it is atypical or out of the ordinary, consists of undesirable behavior, and results in impairment in the individual's functioning. Abnormality in behavior, is that in which is considered deviant from specific societal, cultural and ethical expectations. These expectations are broadly dependent on age, gender, traditional and societal categorizations. The definition of abnormal behavior is an often debated issue in abnormal psychology, because of these subjective variables.
The diathesis-stress model, also known as the vulnerability–stress model, is a psychological theory that attempts to explain a disorder, or its trajectory, as the result of an interaction between a predispositional vulnerability, the diathesis, and stress caused by life experiences. The term diathesis derives from the Greek term (διάθεσις) for a predisposition or sensibility. A diathesis can take the form of genetic, psychological, biological, or situational factors. A large range of differences exists among individuals' vulnerabilities to the development of a disorder.
Normality is a behavior that can be normal for an individual when it is consistent with the most common behavior for that person. Normal is also used to describe individual behavior that conforms to the most common behavior in society. However, normal behavior is often only recognized in contrast to abnormality. In many cases normality is used to make moral judgements, such that normality is seen as good while abnormality is seen as bad, or conversely normality can be seen as boring and uninteresting. Someone being seen as normal or not normal can have social ramifications, such as being included, excluded or stigmatized by wider society.
The trauma model of mental disorders, or trauma model of psychopathology, emphasises the effects of physical, sexual and psychological trauma as key causal factors in the development of psychiatric disorders, including depression and anxiety as well as psychosis, whether the trauma is experienced in childhood or adulthood. It conceptualises people as having understandable reactions to traumatic events rather than suffering from mental illness.
Models of abnormality are general hypotheses as to the nature of psychological abnormalities. The four main models to explain psychological abnormality are the biological, behavioural, cognitive, and psychodynamic models. They all attempt to explain the causes and treatments for all psychological illnesses, and all from a different approach.
The classification of mental disorders, also known as psychiatric nosology or psychiatric taxonomy, is central to the practice of psychiatry and other mental health professions.
Evolutionary approaches to depression are attempts by evolutionary psychologists to use the theory of evolution to shed light on the problem of mood disorders within the perspective of evolutionary psychiatry. Depression is generally thought of as dysfunction or a mental disorder, but its prevalence does not increase with age the way dementia and other organic dysfunction commonly does. Some researchers have surmised that the disorder may have evolutionary roots, in the same way that others suggest evolutionary contributions to schizophrenia, sickle cell anemia, psychopathy and other disorders. Psychology and psychiatry have not generally embraced evolutionary explanations for behaviors, and the proposed explanations for the evolution of depression remain controversial.
The following outline is provided as an overview of and topical guide to abnormal psychology:
Personality disorders (PD) are a class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating from those accepted by the individual's culture. These patterns develop early, are inflexible, and are associated with significant distress or disability. The definitions vary by source and remain a matter of controversy. Official criteria for diagnosing personality disorders are listed in the sixth chapter of the International Classification of Diseases (ICD) and in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM).
Psychology encompasses a vast domain, and includes many different approaches to the study of mental processes and behavior. Below are the major areas of inquiry that taken together constitute psychology. A comprehensive list of the sub-fields and areas within psychology can be found at the list of psychology topics and list of psychology disciplines.
Somatic symptom disorder, also known as somatoform disorder, is defined by one or more chronic physical symptoms that coincide with excessive and maladaptive thoughts, emotions, and behaviors connected to those symptoms. The symptoms are not deliberately produced or feigned, and they may or may not coexist with a known medical ailment.
In personality pathology, dimensional models of personality disorders conceptualize personality disorders as qualitatively rather than quantitatively different from normal personality. They consist of extreme, maladaptive levels of certain personality characteristics. Within the context of personality psychology, a "dimension" refers to a continuum on which an individual can have various levels of a characteristic, in contrast to the dichotomous categorical approach in which an individual does or does not possess a characteristic. According to dimensional models personality disorders are classified according to which characteristics are expressed at which levels. This stands in contrast to the traditional categorical models of classification, which are based on the boolean presence or absence of symptoms and do not take into account levels of expression of a characteristic or the presence of any underlying dimension.
A cognitive vulnerability in cognitive psychology is an erroneous belief, cognitive bias, or pattern of thought that predisposes an individual to psychological problems. The vulnerability exists before the symptoms of a psychological disorder appear. After the individual encounters a stressful experience, the cognitive vulnerability shapes a maladaptive response that increases the likelihood of a psychological disorder.
The Hierarchical Taxonomy Of Psychopathology (HiTOP) consortium was formed in 2015 as a grassroots effort to articulate a classification of mental health problems based on recent scientific findings on how the components of mental disorders fit together. The consortium is developing the HiTOP model, a classification system, or taxonomy, of mental disorders, or psychopathology, aiming to prioritize scientific results over convention and clinical opinion. The motives for proposing this classification were to aid clinical practice and mental health research. The consortium was organized by Drs. Roman Kotov, Robert Krueger, and David Watson. At inception it included 40 psychologists and psychiatrists, who had a record of scientific contributions to classification of psychopathology The HiTOP model aims to address limitations of traditional classification systems for mental illness, such as the DSM-5 and ICD-10, by organizing psychopathology according to evidence from research on observable patterns of mental health problems.
