Multidimensional Perspective Of The Etiology Of Psychological Disorders

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Psychological disorder or an abnormal behavior refers to “a psychological dysfunction within an individual that is associated with distress or impairment in functioning and a response that is typical or culturally not expected” (Barlow et al., 2018). The causes of mental disorders are often unclear and an attempt towards etiology results in emergence of new models of abnormality (Hooley et al., 2017). Etiology refers to the study of causes or reasons that lead to the development of psychological disorders. It is important to know the causes not only to prevent conditions that result in mental distress and maladaptive behavior, but also to improve diagnosing and assessing techniques. One-dimensional perspective attempts to show that a psychological disorder is originated from a single cause; ignoring other factors that can have an influence on the disorder (Barlow et al., 2018). To have a good understanding of the causes of psychological disorders, we must adopt a multidimensional perspective which emphasizes on multiple interacting causal factors (Paris, 1999). There can be multiple influences causing an abnormal behavior, and hence, biopsychosocial approach must be adopted to look through biological, psychological and social factors.

Biological Causes of Abnormality

Genetic Abnormalities

Genes are made of DNA (deoxyribonucleic acid). Genes are the carrier of inherited information. It is rare for genes to fully determine the development of a mental disorder, however, it can have considerable influence on most mental disorders (Hooley et al., 2017). Examples of rare disorders strongly determined by our genes are Huntington’s disease and phenylketonuria. Huntington’s disease is an inherited disorder that results in neurodegeneration reliably in basal ganglia. It usually appears between the age of 30 and 50. The symptoms include jerky body movement, personality changes and cognitive inability (Pringsheim, 2012). Phenylketonuria is another example of disorder which is caused by a flaw in a single gene. More precisely, phenylketonuria is caused by the lack of phenylalanine hydroxylase which results in high concentration of blood phenylalanine and serious mental retardation. However, it can be prevented by adopting the dietary treatment in which the amount of phenylalanine can be controlled. Nonetheless, cognitive functioning continues to be abysmal (De, 2010).

Most psychological disorders are caused by an interaction between genes and environment. Genetic factors can contribute to a vulnerability to cause mental disorder which only results with the presence of a stressor in one’s life (as in the diathesis-stress models) (Hooley et al., 2017). For example, people who are genetically at risk for depression, are more likely to react to a stressful event through being depressed than are people unaccompanied by genetic risk who encounter the same stressful event (Moffitt et al., 2005). As environmental experiences of a child are shaped by genes, correlation exists between genes and environment (Hooley et al., 2017). For instance, genetic predisposition to aggressive behavior may result in a child facing rejection by his or her fellow classmates in junior years of school. Such unacceptance may make him or her associate with aggressive classmates in senior years of school which may further lead to complete delinquency in adolescence.

Brain Dysfunction

Abnormal behavior or psychological disorders can be caused by defects of specific structures or functions of the brain. An example of such disorder is obsessive-compulsive disorder (OCD). OCD refers to a condition involving continues and undesired “thoughts, images and urges (obsessions) and repetitive behaviors (compulsions)”(Krebs & Heyman, 2015). Neuroimaging studies have demonstrated that OCD is due to altered processes of frontostriatal circuitry (David et al., 2014). Frontostriatal circuits are neural pathways connecting frontal lobe regions with the basal ganglia (striatum) that mediate motor, cognitive, and behavioural functions within the brain (Alexander et al., 1 March 1986). In a healthy person, inhibitory functions of indirect pathway regulates direct pathway, in other words, excitatory pathway (David et al., 2014). However, in a person with OCD, there is greater activity in direct pathway than in indirect pathway due to low threshold for activation of this system. This leads to hyperactivation of orbitofrontal cortex – subcortical pathway which results in continuous thoughts about threat (obsession), making the person to attempt to neutralize the perceived threat (compulsion).

Biochemical Imbalance-Neurotransmitters

Imbalances in neurotransmitters in the brain can cause psychological disorders. For instance, dopamine and glutamate are the two neurotransmitters involved in schizophrenia. Schizophrenia is characterized by “delusions, hallucinations, disorganized behavior and cognitive difficulties” (Seeman & Kapur, 2002). In patients with schizophrenia, dopamine is released in greater amount, leading to more D2 receptors and greater amount of monomer forms of D2. This dysregulation of dopamine system leads to psychotic episode – causing abnormal thinking and perceptions (Seeman & Kapur, 2002). Glutamate is another neurotransmitter involved in schizophrenia. A meta-analysis of proton magnetic resonance spectroscopy (1H-MRS) studies in schizophrenia found that schizophrenia patients have low level of glutamate and high level of glutamine in frontal region (Marsman et al., 2011). However, the levels of both glutamate and glutamine in frontal region decrease as the disease progresses, leading to lower synaptic activity, and hence, psychosis. As a result, schizophrenia is an example of mental disorders that are caused by imbalances of neurotransmitters.

Psychological factors

Learning through Conditioning

Learning is another psychological factor which can contribute to abnormal behaviors. Learning is a process allowing one to acquire or modify existing knowledge, behaviors, skills, values, or preferences (Richard, 2010). Classical conditioning is learning through association in which the conditioned stimulus (environmental stimulus) is paired with the unconditioned stimulus (naturally occuring stimulus) to elicit a conditioned response (Clark, 2004). The Little Albert Experiment (ethically unaccepted) demonstrated classical conditioning by repeatedly pairing the presence of white rat with a loud noise to elicit fear in an infant (Watson & Rayner, 1920). In this case, presence of white rat is an unconditioned stimulus, loud noise is a conditioned stimulus, and fear is a conditioned response. The infant showed no fear until white rat was paired with loud noise; the response to the presence of the rat before conditioning was described as “on the whole stolid and unemotional” known as unconditioned response. Other examples include learning a fear of darkness if fear-inducing stimuli (such as nightmare) takes place in the dark or acquiring fear of snakes if bitten by a snake (Mineka & Zinbarg, 2006). This shows how people may develop phobias.

Learned Helplessness

Learned helplessness occurs when a person is continuously unable to control or handle an unpleasant situation that is stressful or demanding. It affects motivation, cognition, and emotions of the individual. An individual becomes demotivated to voluntarily response to the situation when his or her actions do not lead to the expected outcomes. Upon continues unsuccessful efforts to manipulate the situation, the individual learns that the situation is uncontrollable (Smallheer et al., 2018). This results in the development of cognitive deficit which may make the individual to accept and remain passive in negative situations. This can lead to depressive symptoms. One of the studies showed that there is an association between learned helplessness and depressive symptoms in individuals with Acute myocardial infarction (AMI) (Smallheer et al., 2018). AMI is linked with physical and psychological stressors that can potentially have an impact on health. Depressive symptoms are experienced by 30% to 60% of AMI survivors, 15% of them dealing with major depression (Smallheer et al., 2018). As a result, mental disorders such as depression can be associated with learned helplessness.

Emotions

Basic emotions such as anger, sadness, fear or distress, and excitement can contribute to psychological disorders or may even define them. An example of such disorder is mania. Mania refers to abnormality of mood elevation which is usually associated with depression and can result in bipolar disorder or manic depressive illness. Patients with mania experience “fluctuations of mood between mild elation and depression” (Daly, 1997 & Barlow et al., 2018). During mild elation, patients become highly altered or excited, making them to do anything they want and spend as much money as they can without thinking of the consequences. Instability is also common in these patients; they can easily be evoked to mood states such as sadness or distress when they think all is lost or become hopeless. During excessive sadness, they find it difficult to experience delighted moments in life or even perform simple daily tasks. This state is known as depression.

Cultural, Social and Interpersonal Factors

Culture-Specific Disorders

Culture may determine patterns of certain mental disorders. Examples of culture-specific disorders include “witiko” among the Ojibwa Indians of the Northeast Woodlands (Landes, 1938), “piblokto” in the eastern Arctic (Ackerknecht, 1948). An individual with “writiko” experiences delusional excitement and considers himself to be possessed by a spirit. The individual may even kill or eat his own family members (Leighton & Hughes, 2005). “Piblokto” refers to short-term disarrangement in which an individual is engaged in strange acts such as going out without clothes in cold weather or imitating birds or animal sounds (Leighton & Hughes, 2005). The symptoms of such disorders are found in specific cultural areas. Moreover, there is often interrelation between cultural beliefs or practices and symptoms.

Gender

Gender roles have strong influence on psychopathology. The chances of having a specific phobia is strongly affected by a person’s gender (Barlow et al., 2018). For example, society is more accepting of female to develop small-animal phobia, when, in fact, both male and females may have an equal chance to have experiences that can lead them to develop the phobia. It is unacceptable for a man to show or admit fear, making him to hide it until he overcomes it (Barlow et al., 2018). An example of female to be affected by gender roles is a severe eating disorder known as “bulimia nervosa”. Bulimia mainly occurs in young women. The cause can be linked to culture highlighting female slimness. Males are less likely to be pressurized to be slim. A considerable percentage of males developing bulimia are gay (Rothblum, 2002). Psychopathology is not caused by our gender but rather is influenced by our gender roles.

Social Effects on Health and Behavior

Social isolation is another factor contributing to psychological disorders. Studies have shown that people with sufficient social relationships and contacts are likely to live longer. Contrarily, people with lower number of social relationships are likely to have shorter life expectancy . Many studies have also demonstrated that social relationships can prevent people from having physical and psychological disorders, such as high blood pressure, depression, alcoholism, arthritis, progression of of AIDS and having babies with low birth weight (Barlow et al., 2018). Social isolation and loneliness are moderately correlated, and both of them are associated with depression (Matthews et al., 2016). It is not necessary for people with social isolation to experience loneliness. However, those who are lonely are likely to be depressed.

Conclusion

In conclusion, contributions from genetics, neuroscience, conditioning, emotions, cultural, social and interpersonal factors all must be considered when we look through causes of psychological disorders. From the above discussion, we have observed multiple factors that contribute to psychopathology. We have come to know that psychological disorders are not resulted from a single causal factor, but rather there can be many causes of a disorder and all of them interact with one another. We must adopt the multidimensional approach to understand the interaction between multiple causes to fully know the origin of psychological disorders.

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