Imany 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?” (Boland, Verduin, & Ruiz, 2022).
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? +500 WORDS
Psychopathology is a complex phenomenon that can manifest in myriad ways. It is affected by biological (e.g., genetic and neurological), psychological, social-cultural, and environmental factors. While there may be some overlap between all of these domains when it comes to the expression, classification, diagnosis, and prevalence of psychopathology, each domain plays an important role in understanding the pathophysiology behind mental health disorders. This makes it essential for nurse practitioners to take a multidimensional approach to mental health care that considers the diverse contributing factors at play when making diagnoses or creating treatment plans.
At its core, psychopathology involves dysregulation within multiple systems—neural systems such as those responsible for emotions and cognition; chemical systems such as hormones; cellular systems such as neurotransmitter receptors; immune systems such as inflammatory markers; and metabolic pathways within cells that control energy production. All of these can be influenced by genetics or epigenetics (i.e., changes in gene activation caused by exposure to external substances). For example, genetic variation associated with serotonin transporter activity has been linked to increased risk for depression (Rajkumar et al., 2017). Additionally, certain neural circuits are more likely than others to become dysregulated during times of stress or trauma (Shepherd & Koenen 2019). Thus even if the causes of psychopathology remain largely unknown on an individual level due to the complexity involved in tracing exact pathways from environment exposures through brain networks into behaviors or symptoms along specific phenotypes (Gottesman & Gould 2003), we can still see how genetics alone might create predispositions towards psychiatric disorders across populations.
But despite this evidence linking neurobiology with psychological states like depression and anxiety disorders, this type of research should not be seen as suggesting that biology alone dictates behavior or mental health functioning—in fact it may do just the opposite—as suggested by evolutionary psychologist Steven Pinker: “The irony is that our genes equip us with minds tailored not only for survival but also for joy”(Pinker 1995). In other words, while biology does play a role in influencing behavior which could have implications for mental health outcomes over time—it does not fully determine them either directly nor indirectly through geological forces entirely outside our control either socially constructed environments like poverty levels or cultural norms around gender roles etc.—allowing individuals some degree of personal agency even amidst broader systemic constraints affecting their lived experience .
In addition to considering biological processes when assessing any given individual’s mental health status, nurse practitioners must also take into account psychosocial influences which interact with biology over time often creating bidirectional relationships throughout development: i..e what happens psychologically affects biological processes and vice versa Everyday stressors like interpersonal conflicts can alter hormone balances leading towards anxiety related disorder trajectories while similarly ongoing experiences with financial hardships might lead one toward depression based ones via both biopsychosocial means alike(Gallagher-Thompson et al 2018) It is also worthwhile noting here how sociocultural contexts help shape experiences further too – consider higher rates of PTSD found among African Americans compared whites after experiencing similar traumas indicative of different resiliency adjustment profiles being adopted based upon prevailing stereotypes around race experienced growing up essentially providing additional contextualizing frames against which present experiences are evaluated/processed internally further perpetuating any negative patterns already established . Moreover self-criticism frequently seen amongst certain religious groupings —or alternatively collective identity shared amongst immigrant narratives–are examples illustrating how culture itself could represent another layer worth exploring beyond merely diagnosing physical symptoms at face value.; Ultimately though whatever constellation if sources exist contributing towards someone’s state of mental wellness nurses should strive for comprehensive assessments accounting considering each factor jointly rather than individually so as to provide truly holistic treatments explaining best practices going forward aligned appropriately with patient orientated approaches ideally thereby helping facilitate sustained long term success stories versus merely addressing short-lived symptom reliefs only temporarily relieving issues without really attending underlying root causes needing to be resolved accordingly