Assignment task:
Respond by explaining the implications of why, as an advanced practice nurse, it is important to adopt a multidimensional, integrative model of psychopathology. (at least 2 references for each response)
Discussion 1:
1. Biological Factors (Genetic and Neuroscientific)
Genetic Factors: Genetic predisposition plays a crucial role in the development of many mental disorders. "Roughly 40-70 percent of aspects of cognition, temperament, and personality are attributable to genetic factors" (Boland et al., 2022). Certain genes can increase vulnerability to disorders such as schizophrenia, bipolar disorder, and depression (Andreassen et al., 2023). Family and twin studies have shown that the heritability of these disorders is significant, although no single gene has been identified as solely responsible (Andreassen et al., 2023).
Neuroscientific Factors: Brain structure and function also contribute to psychopathology. Neurotransmitter imbalances (serotonin, dopamine, glutamate) are often implicated in mood disorders, schizophrenia, and anxiety disorders (Teleanu et al., 2022). Additionally, abnormalities in brain regions such as the prefrontal cortex, amygdala, and hippocampus can affect emotional regulation, impulse control, and cognitive processing; potentially leading to psychopathological conditions (Teleanu et al., 2022).
2. Psychological Factors (Behavioral, Cognitive, Emotional, Developmental)
Behavioral and Cognitive Processes: Learned behaviors and cognitive distortions can influence the development of mental health disorders (Admon &Klavir, 2021). For example, maladaptive coping strategies, negative thought patterns, and rumination can contribute to depression and anxiety. Cognitive-behavioral theories suggest that how individuals perceive and interpret their experiences can either increase vulnerability or act as a protective factor against psychopathology (Admon &Klavir, 2021).
Emotional Factors: Emotional dysregulation is a key feature in many mental health disorders, including borderline personality disorder, depression, and anxiety (Menefee et al., 2022). Poor emotional awareness and regulation can lead to chronic stress, affecting both psychological and physical health (Menefee et al., 2022).
Developmental Factors: Adverse childhood experiences (trauma, neglect, abuse) and disrupted attachment can have long-term effects on mental health (National Academies of Sciences, 2019). Early developmental stages are critical for emotional and psychological growth, and any disruption can predispose an individual to various forms of psychopathology later in life (National Academies of Sciences, 2019).
3. Social, Cultural, and Interpersonal Factors
Social Factors: Socioeconomic status, education, and access to resources are crucial determinants of mental health (National Academies of Sciences, 2019). Poverty, unemployment, and lack of social support can exacerbate stress and contribute to the development of mental disorders. Additionally, societal stigma associated with mental illness can discourage individuals from seeking help, thereby worsening their condition (National Academies of Sciences, 2019).
Cultural Factors: Cultural beliefs and norms significantly influence the perception, expression, and management of mental health issues. Cultural stigma, discrimination, and the cultural context of symptoms can affect both the presentation and treatment of psychopathology. Furthermore, cultural background can impact the types of stressors individuals experience and their coping mechanisms (Fogel et al., 2024).
Interpersonal Factors: Relationships with family, peers, and significant others play a vital role in mental health. Dysfunctional family dynamics, peer pressure, and toxic relationships can contribute to the onset or exacerbation of mental health conditions. On the other hand, positive social interactions and strong support networks can provide resilience against the development of psychopathology (Alegría et al., 2018).
Discussion 2:
The development of psychopathology is multifactorial and complex. As Boldan et al. (2022) outlined, biological, psychological, and social influences determine a person's development from infancy to adolescence. Biological factors can result from genetic disorders but may also develop from maternal influence. Prenatal genetic tests, such as amniocentesis, ultrasounds, x-ray studies, fetoscopy, and blood work, are highly recommended to evaluate for abnormalities and congenital disabilities (Boldan et al., 2022). Other external factors that may impede healthy fetal development may include maternal drug/alcohol use, stress, medication-related, and maternal age.
As studied by Jean Piaget, psychological growth results from emotional and social development. Their reactions are primarily in response to the mother's reactions, and are able to imitate responses such as facial movements as early as three months old. As the primary stimulus for a newborn, caregivers significantly influence the infant's cognitive and emotional development (Braams &Krabbendam, 2022). Simply put, "Infants' behavior controls mother's behavior, just as mothers' behavior modulates infants' behavior" Boldan &et al. (2022). Although babies smile spontaneously during the first two months of life, they later learn to smile in response to their mother smiling at them. The maternal response directly impacts the infant's emotional development. Although perfect parenting does not exist, a sense of good-enough parenting must exist to prevent detrimental outcomes for the child later in life. For example, a mother who holds and feeds her baby when crying provides a sense of safety and security. In contrast, an absent mother may lead to a distorted sense of self and emotional disturbances later in life (Boldan et al., 2022).
Social influences play a significant role in a child's development. At the start of preschool, children may express several emotions related to internal needs and anxiety from being in a 'strange situation' while away from their parent(s). Typically, children outgrowth this phase after preschool and become more interested in developing relationships outside their family. Although family relationships modulate social development, peers have an even greater influence on one's social skills and behavior (Braams &Krabbendam, 2022). According to a study by Harry Sullivan, children develop close, unique relationships with a same-sex person. This 'best friend' milestone is usually seen around ten years old and is essential for the continuation of healthy psychological growth. Furthermore, his research found that children who lacked a close friend within the same age group had a higher incidence of developing schizophrenia in later years (Boldan et al., 2022). Aside from friends and school, social influences in the household also play a significant role in a child's temperament based on the family dynamics. Children from households of absentee fathers, divorced parents, and disruptive households are more likely to have difficulties in school, experience health issues, and become anxious and depressed (Boldan et al., 2022). Socioeconomic status is also plays a part in child development. Aside from lower academic achievements, higher stress levels in the home have been associated in families of poverty. Stressors in the home, especially financially, may have a snowball effect and predispose a child to see their parents angry or upset, which may lead to childhood trauma (Butcher & Kendall, 2018).