How do we define mental health? What causes mental illness? Even though psychopathology has always been around, our understanding of them constantly changes.
A few centuries ago, mental illness was considered a form of demonic possession; Freud saw mental illness as the result of unconscious conflicts, often linked to psychosexual development. Then the medical perspective arose, and we started viewing mental illness as a chemical imbalance. Currently, a lot of discourse around mental health focuses on the cognitive perspective, which proposes that how we think and make meaning of our experiences can affect our mental health.
- We'll begin by defining the psychopathology meaning and introducing how abnormality is understood.
- Next, we'll look at psychopathology case studies illustrating common disorders like phobias, depression and obsessive-compulsive disorder.
- Then, we'll briefly outline what developmental psychopathology is.
- Moving along, we'll discuss the psychopathology causes.
- Finally, we'll explore the diathesis-stress model psychopathology.
Fig. 1 - How we understand psychopathology also relates to how we understand mental health and well-being and how we treat people experiencing mental health difficulties.
The Psychopathology Meaning
Psychopathology is the scientific study of abnormal mental states, behaviours and thinking. The progression of psychopathology research has revolutionised modern psychiatry.
It studies psychological disorders such as depression, anxiety, obsessive-compulsive disorders or phobias. Diagnosis of psychological disorders is based on one's behaviour; each condition is associated with a particular pattern of abnormal behaviour.
Measuring Psychopathology
But how do we establish what behaviour is abnormal?
One way to understand abnormal behaviour is statistical infrequency. If behaviours deviate from the population enough, these behaviours can then be deemed abnormal. Although some may argue that many psychological disorders do not meet this condition, as they can frequently occur in a population.
Only 1% of people can touch their noses with their tongues; this behaviour is statistically infrequent. However, we don't necessarily view it as abnormal. IQ is another example; extremely low or high IQ can be seen as abnormal. However, those with a higher IQ are not seen as abnormal.
The examples show why we can see why statistical infrequency is not a concrete measuring tool for psychopathology.
Abnormal behaviour may also be defined as a deviation from social norms. Social norms are unwritten and differ widely across cultures.
Another way to define abnormal behaviour is as behaviour that prevents proper functioning. Such behaviour may hinder people's ability to function as part of society or cope with daily challenges.
Those with depression may not feel well enough to maintain their relationships, work or academic commitments.
Abnormal behaviour is also identified when it deviates from typical mental health, like becoming anxious whenever you leave the house.
This ideal mental health perspective is based on individualistic values and can differ across cultures.
Psychopathology Case Studies
Let's look at what mental health problems can look like in real life.
Psychopathology: Phobias
Fear becomes a mental disorder when it affects our lives and our ability to function. We can identify when fear has become a phobia by identifying behavioural, emotional and cognitive characteristics.
A behavioural characteristic of a phobia would be avoidance of the object, an emotional characteristic would be high anxiety levels around the object, and a cognitive characteristic would be irrational beliefs about the object.
An example of a phobia includes:
Arachnophobia, the fear of spiders.
Depression
Depression is characterised by a low mood that lasts for an extended period and affects one's everyday life. There are many types of depression and different treatment methods, such as medication and therapy.
Again, identifying depression involves behavioural, emotional and cognitive characteristics.
For instance, changes in sleeping and eating are behaviours that could indicate depression, the low mood could be an emotional characteristic, and poor concentration could be a cognitive characteristic of depression.
An example of depression includes:
Seasonal Affective Disorder is a form of depression that often occurs after daylight savings, the colder weather and less sunlight are associated with depression.
Fig. 2 - Seasonal Affective Disorder is a form of depression associated with changes in weather and light.
Psychopathology: Obsessive-Compulsive Disorder (OCD)
OCD is a mental illness that causes recurrent thoughts and compulsions which interfere with everyday activities. These are beyond the person's control and significantly interfere with their daily lives.
For instance, excessive checking is a behavioural characteristic, anxiety caused by these excessive checking behaviours is an emotional characteristic, and recurring thoughts of worst-case scenarios are cognitive characteristics.
An example of OCD includes:
Thinking that if you don't turn the lights on and off in your house before you go to bed, your family will die is an example of OCD.
Developmental Psychopathology
Developmental psychopathology investigates how psychopathology develops, progresses and changes throughout one's lifespan. It attempts to distinguish between what we see as typical and abnormal development, whether we should see mental health problems as categorical (either someone is depressed or not depressed) or dimensional identities (based on the presence of symptoms).
The critical assumption is that psychopathology results from processes that start early in an individual's life. The discipline suggests that targeting vulnerable individuals at earlier stages can prevent the progress of psychopathology.
Psychopathology Causes
There are three main approaches to understanding and treating psychopathology; each focuses on a specific domain associated with the disorder (behaviour, cognition or biology).
Psychopathology Phobias: Behavioural Approach
The behavioural approach to explaining phobias sees phobias as a result of classical and operant conditioning (two-process model). Classical conditioning occurs when we learn to associate a physiological response with a certain environmental stimulus.
For example, if you got stuck in an elevator, which caused you a lot of fear and stress, you learned to associate fear with enclosed spaces. This fear can arise again when you want to use the elevator in the future.
The fear response causes people to avoid the stimulus in the future - avoidance results in temporary relief from anxiety, reinforcing the phobia through operant conditioning.
Every time you avoid the elevator and choose the stairs instead, your fear decreases, rewarding you for avoidance.
Behavioural treatments like systematic desensitisation have been developed based on the assumption that phobias are learned. Systematic desensitisation gradually exposes people to the stimulus while teaching them to relax, substituting the body's fear response with a relaxation response.
Systematic desensitisation starts with learning relaxation techniques and follows with gradual exposure to stimuli from the one that causes the least to the most anxiety. It might involve exposing a person to a photo of an elevator first and practising relaxation. Once the person doesn't feel anxiety in response to the photo, another stimulus is introduced, e.g. the sound of an elevator.
Other behavioural approaches to phobia treatment include flooding.
Psychopathology Depression: The cognitive Approach
The cognitive approach to understanding depression assumes that unhelpful behaviours and thoughts maintain depressive symptoms. There are two cognitive theories of depression:
- Beck's negative triad – Beck proposed that depression is associated with a cognitive bias, a distorted way of perceiving and thinking about situations. This cognitive bias affects how individuals feel about themselves, the world and the future; the three components mutually reinforce themselves, increasing depressive symptoms.
- Ellis's ABC model – According to this model, depression develops due to irrational thinking, which causes emotional distress.
Based on the assumption that depressive symptoms are maintained through distorted cognition, depression can be treated with cognitive behaviour therapy (CBT). CBT aims to challenge people's irrational thoughts, so they can develop a more realistic view of their reality, which aims to change their unhelpful patterns of thinking and behaviour and improve their functioning.
Psychopathology OCD: The Biological Approach
Genetic and neural explanations of the disorder explain the biological approach to understanding OCD. Several genes have been associated with vulnerability towards developing OCD, indicating that it's a polygenic condition.
COMT and SERT genes, implicated in neurotransmitter production and transmission, have been linked to increased vulnerability to developing OCD.
Neural explanations of OCD highlight potential differences in brain circuits, specifically the orbitofrontal cortex in people with OCD or the transmission of dopamine and serotonin.
Drug therapy treatments support the understanding of OCD as a biological problem. One type of medication prescribed for OCD is Selective Serotonin Reuptake Inhibitors (SSRIs), which increase the serotonin level available for transmission between neurons.
Fig. 3 - OCD treatments, based on the biological approach to understanding behaviour, include drug therapy.
Diathesis Stress Model Psychopathology
The diathesis-stress model of psychopathology attempts to provide a more holistic view of disorders by accounting for the influence of nature (genetic factors) and nurture (behaviour, past experiences and learning).
The diathesis-stress model argues that psychopathology develops due to vulnerability combined with stressors.
Each person has a different vulnerability level towards disorders; this vulnerability can either be biological (genes) or environmental (adverse experiences early in life).
We all also engage in activities that can act as stressors and trigger mental health problems. However, the number of stressors resulting in psychopathology varies depending on one's vulnerability.
Philip and Jess both smoke cannabis. Smoking cannabis is considered a stressor that can trigger an episode of psychosis in vulnerable individuals. Jess has a high genetic vulnerability to developing schizophrenia, which puts her at a much higher risk of psychosis. While Philip, who has low underlying vulnerabilities, is at much lower risk.
Based on this example, you can see how environmental and biological actors can interact in the development of psychopathology.
Psychopathology - Key takeaways
- Psychopathology meaning is the scientific study of abnormal mental states, behaviours and thinking. The progression of psychopathology research has revolutionised modern psychiatry.
- Abnormality can be defined in terms of statistical infrequency, deviation from social norms, interference with proper functioning or deviation from ideal mental health.
- Examples of psychopathology include phobias, depression and obsessive-compulsive disorder.
- The psychopathology cause has been linked to the behavioural, cognitive and biological approaches.
- The diathesis-stress model psychopathology highlights how biological and environmental factors contribute to mental illnesses.
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