6635.Res JtT

JtT

Jane,

Iwill post two separate posts. Reply to both. Same as usual 2-3 paragraphs and 2-3 sources. Thanks!

Assignment

Respond to at least two of your colleagues on 2 different days by explaining the implications of why, as an advanced practice nurse, it is important to adopt a multidimensional, integrative model of psychopathology.

Post 1 (DG)

Psychopathology refers to the study of mental illnesses and how it manifests in behaviors that impair an individual’s daily functioning. The DSM-5 is a manual used for assessment and diagnosis of mental health disorders with clinically significant cognition, emotional, or behavioral dysfunction in the individual associated with distress or disability. There are several factors that have been found to play a role in developing mental illnesses, which are genetics and social, cultural, and interpersonal factors. The better we are able to understand the reasons for mental health issues, the easier it will be for clinicians to provide an effective treatment plan.

Genetics

Heredity is a biological process where the parents pass on to their children physical and social characteristics. These shared characteristics influence how the child will grow and develop. There is increasing evidence that adult health and wellbeing begins with childhood experiences. Adverse early experiences include both the absence of stimulation needed for typical development and the presence of harmful or threatening stimulation (Koss & Gunnar, 2018). The severity of these early experiences will determine one’s mental health, especially in adolescence and adulthood. Specific genes and gene variations are associated with mental disorders, so having a close family member with a mental illness can increase the chances that the disorder can be hereditary. According to Sadock, Sadock, and Ruiz (2015), 40 to 70 percent of aspects of cognition, temperament, and personality are attributed to genetic factors. Most psychiatric disorders are highly heritable, with high rates of heritability found in bipolar disorder, schizophrenia, and autism (Burmeister, McInnis, & Zollner, 2008). According to Sanchez-Roige et al. (2018), studies have found that neuropsychiatric disorders are highly polygenic. These characteristics go back to Freud’s theory that relationships depend primarily on the quality of children’s relationships during the early stages of life.

Psychological

Many patients with mental illnesses experience cognitive impairment. To help understand how cognition impacts mental illnesses, neuropsychological assessments are used to inform diagnostic and treatment outcomes in neurological, psychiatric, and mixed populations (Jackson & Milberg, 2018). Neuropsychological assessments can help the clinician determine whether the patient is experiencing cognitive impairments due to a mental illness or for other reasons such as a brain injury or from natural changes due to aging. According to Jackson and Milberg (2018), cognitive dysfunction may contribute to the high rates of functional impairment found within psychiatric groups. The part of the brain that is cognitively impaired may determine what type of mental health conditions the patient may experience. For example, if a patient’s thalamus is impaired, they are more likely to exhibit signs of depression and bipolar disorder compared to a person that has normal functioning in the same area (Jackson and Milberg, 2018). Neuropsychological evaluations may offer significant insight into an individual’s cognitive strengths and weaknesses and may be used to inform treatment recommendations. There has also been literature that implies that DNA methylation induced by stress might increase the risk for psychopathology (Booij, Tremblay, Szyf, & Benkelfat, 2015).

Social, Cultural, and Interpersonal Factors

Environment plays an essential role in human life. Psychologically, a person’s environment consists of stimulations such as physical and psychological, which one receives from at the time of birth. There are different types of environments, such as physical, social, and psychological. The way a person is exposed to these different types of environments can affect how a person behaves, thinks, feels, and relates to their social interactions. A person’s exposure to activity, stress, drugs, and their environment can regulate the way genes are expressed, leading to mental health illnesses (Sadock, Sadock, & Ruiz, 2015). Certain conditions surrounding stress, such as gender and a person’s sexual orientation, may increase vulnerability, which may cause a group of people to be exposed to a higher number of risk factors for developing psychological distress. According to Cheung and Mak (2018), people in a lower socioeconomic status are associated with an increased chance of developing mental disorders.

Due to culture playing such a significant role in mental health, culture-specific disorders have been found in certain cultures. So, it’s very important to grasp the different types of cultures our patients may have that can potentially have an impact on psychopathology. Some clinicians may feel that a person is exhibiting a mental health disorder and want to prescribe medications, when they are just exhibiting normal behaviors for their culture.

Conclusion

An individual’s genome can be altered by many factors, leading to increased chances of mental illnesses. While genetic factors are important in the etiology of most mental disorders,environmental, social, interpersonal, and stress are also known to play a role in the onset of these illnesses and must be factored in as well. Due to these factors playing an essential role in the development of mental illnesses, it is vital for the clinician to perform a thorough history and physical when interviewing a client so that an accurate diagnosis and treatment plan can be developed.

References

Booij, L., Tremblay, R. E., Szyf, M., & Benkelfat, C. (2015). Genetic and early environmental influences on the serotonin system: consequences for brain development and risk for psychopathology. Journal of Psychiatry & Neuroscience, 40(1), 5–18. doi:10.1503/jpn.140099

Burmeister, M., McInnis, M. G., & Zollner, S. (2008). Psychiatric genetics: Progress amid controversy. Nature Reviews Genetics, 9(7), 527-540. doi:10.1038/NRG2381

Cheung, F. M., & Mak, W. W. S. (2018). Sociocultural factors in psychopathology. In J. N. Butcher, J. M. Hooley, J. N. Butcher (Ed), & J. M. Hooley (Ed) (Eds.), APA handbook of psychopathology: Psychopathology: Understanding, assessing, and treating adult mental disorders., Vol. 1. (pp. 127–147). American Psychological Association. doi:10.1037/0000064-006

Jackson, C. E., & Milberg, W. P. (2018). Examination of neurological and neuropsychological features in psychopathology. In J. N. Butcher, J. M. Hooley, J. N. Butcher (Ed), & J. M. Hooley (Ed) (Eds.), APA handbook of psychopathology: Psychopathology: Understanding, assessing, and treating adult mental disorders., Vol. 1. (pp. 65–90). American Psychological Association. doi:10.1037/0000064-004

Koss, K. J., & Gunnar, M. R. (2018). Annual Research Review: Early adversity, the hypothalamic–pituitary–adrenocortical axis, and child psychopathology. Journal of Child Psychology & Psychiatry, 59(4), 327–346. doi:10.1111/jcpp.12784

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.

Sanchez-Roige, S., Gray, J. C., MacKillop, J., Chen, C. H., & Palmer, A. A. (2018). The genetics of human personality. Genes, Brain, and Behavior, 17(3), e12439. doi:10.1111/gbb.12439

Post 2 (BS)

Dynamic and ever-changing, individuals grow and change because of many interactions across levels of functioning, from the epigenetic and neurobiological levels to cultural and societal levels. Natural ecosystem factors (e.g., air and water quality, exposure to macrobiotic organisms) also, play a critical role in development (Masten & Kalstabakken, 2018).

The psychopathology in children and adolescents can be more complicated and potentially more changeable than adult problems (Butcher & Kendall, 2018). An example is that a slight change in children can severely impact a child’s daily conduct. Developmentally, children and some adolescents have limited capability in communicating their issues than adults. Consequently, some symptoms may go unrecognized or ignored by children.

Cognitive development during the adolescent age suggests years when reasoning first appears and therefore is very important. Children may psychologically behave differently from adults. An example is the lack of self-control for children may manifest when they take a doll forcefully from another child, while an adult may manifest a lack of self-control by indulging in substance abuse(Butcher & Kendall, 2018). Cognitive impairments may relate to mental health conditions. Damage to the prefrontal lobes, for example, particularly the orbital and medial regions, have consistently been associated with behavioral and personality changes (Jackson & Milberg, 2018)

The PMHNP, to provide appropriate care, must remember that multiple regions of the brain may affect memory and attention. the temporal lobes, medial temporal structures (i.e., hippocampus, entorhinal and perirhinal cortices, amygdala), diencephalon (i.e., thalamus, hypothalamus), and basal forebrain might imply the memory that affects the attention(Jackson & Milberg, 2018)

Genetics and physiological factors may influence the development of psychopathology. Some child and adolescent disorders associated with genetics and youth in some families are susceptible to mental illnesses through gene transmission. Study shows that polygene is related to the externalizing problems in children (Butcher & Kendall, 2018)

The socioeconomic factor can negatively affect the development of a young person and have a negative impact on behavior as well. Growing up in a complex society lacking or with limited family support and economic resources can seriously and negatively impact how a young person develops. Not surprisingly, there is evidence to indicate that psychological adjustment is negatively influenced by low socioeconomic status (Jackson & Milberg,2018). Less privileged, less social position was associated with a higher prevalence of common mental disorders among women and men, with unemployment, less education, and lower-income having stronger association than occupational status with common mental disorders. Similarly, gay and bisexual men have a higher prevalence of depression, panic attacks, and overall psychological distress than heterosexual men; lesbian and bisexual women have a higher prevalence of generalized anxiety disorder than heterosexual women (Cheung & Mak, 2018).

Conclusion

Adequate knowledge of factors that influence psychopathological development, such as the genetic and neuroscientific; psychological (behavioral and cognitive processes, emotional, developmental); and social, cultural, and interpersonal factors, will enable the PMHNP to be more prepared for more effective treatment of patients.

References

Butcher, J. N., & Kendall, P. C. (2018). Introduction to childhood and adolescent psychopathology. In J. N. Butcher & P. C. Kendall (Eds.), APA handbook of psychopathology: Child and adolescent psychopathology., Vol. 2. (pp. 3–14). American Psychological Association. https://doi-org.ezp.waldenulibrary.org/10.1037/0000065-001

Cheung, F. M., & Mak, W. W. S. (2018). Sociocultural factors in psychopathology. In J. N. Butcher & J. M. Hooley (Eds.), APA handbook of psychopathology: Psychopathology: Understanding, assessing, and treating adult mental disorders., Vol. 1. (pp. 127–147). American Psychological Association. https://doi- org.ezp.waldenulibrary.org/10.1037/0000064-006

Jackson, C. E., & Milberg, W. P. (2018). Examination of neurological and neuropsychological features in psychopathology. In J. N. Butcher & J. M. Hooley (Eds.), APA handbook of psychopathology: Psychopathology: Understanding, assessing, and treating adult mental disorders., Vol. 1. (pp. 65–90). American Psychological Association. https://doi- org.ezp.waldenulibrary.org/10.1037/0000064-004

Masten, A. S., & Kalstabakken, A. W. (2018). Developmental perspectives on psychopathology in children and adolescents. In J. N. Butcher & P. C. Kendall (Eds.), APA handbook of psychopathology: Child and adolescent psychopathology., Vol. 2. (pp. 15–36). American Psychological Association. https://doi-org.ezp.waldenulibrary.org/10.1037/0000065-002