Psychopathology

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Psychopathology is the study of mental illness, mental distress, and abnormal/maladaptive behavior. The term is most commonly used within psychiatry where pathology refers to disease processes. Abnormal psychology is a similar term used more frequently in the non-medical field of psychology. Psychopathology should not be confused with psychopathy, a theoretical subtype of antisocial personality disorder.

Psychopathology as the study of mental illness

Many different professions may be involved in studying mental illness or distress. Most notably, psychiatrists and clinical psychologists are particularly interested in this area and may either be involved in clinical treatment of mental illness, or research into the origin, development and manifestations of such states, or often, both. More widely, many different specialties may be involved in the study of psychopathology. For example, a neuroscientist may focus on brain changes related to mental illness. Therefore, someone who is referred to as a psychopathologist, may be one of any number of professions who have specialized in studying this area.

Psychiatrists in particular are interested in descriptive psychopathology, which has the aim of describing the symptoms and syndromes of mental illness. This is both for the diagnosis of individual patients (to see whether the patient's experience fits any pre-existing classification), or for the creation of diagnostic systems (such as the Diagnostic and Statistical Manual of Mental Disorders or International Statistical Classification of Diseases and Related Health Problems) which define exactly which signs and symptoms should make up a diagnosis, and how experiences and behaviours should be grouped in particular diagnoses (e.g. clinical depression, paraphrenia, paranoia, schizophrenia).

Before diagnosing a psychological disorder, Clinicians must study the themes, also known as abnormalities, within psychological disorders. The most prominent themes consist of: deviance, distress, dysfunction and danger. These themes are known as the 4 D's, which define abnormality.

Description of the 4 D's when defining abnormality: Deviance: this term describes the idea that specific thoughts, behaviours and emotions are considered deviate when they are unacceptable or not common in society. Clinicians must, however, remember that minority groups are not always deemed deviate just because they may not have anything in common with other groups. Therefore, we define an individuals actions as deviate or abnormal when his or her behaviour is deemed unacceptable by the culture he or she belongs to. Distress: this term accounts for negative feelings by the individual with the disorder. He or she may feel deeply troubled and affected by their illness. Dysfunction: this term involves maladaptive behaviour that impairs the individuals ability to perform normal daily functions such as getting ready for work in the morning, or driving a car. Such maladaptive behaviours prevent the individual from living a normal, healthy lifestyle. However, we must remember that a person's behaviour, who is acting dysfunctional, is not always caused by a disorder. Dysfunctional behaviour may be voluntary, such as engaging in a hunger strike. Danger: this term involves dangerous or violent behaviour directed at the individual, or others in the environment. An example of dangerous behaviour that may suggest a psychological disorder is engaging in suicidal activity.

Psychopathology as a descriptive term

The term psychopathology may also be used to denote behaviors or experiences which are indicative of mental illness, even if they do not constitute a formal diagnosis. For example, the presence of a hallucination may be considered as a psychopathological sign, even if there are not enough symptoms present to fulfill the criteria for one of the disorders listed in the DSM or ICD.

In a more general sense, any behaviour or experience which causes impairment, distress or disability, particularly if it is thought to arise from a functional breakdown in either the cognitive and neurocognitive systems in the brain, may be classified as psychopathology.

Diagnostic and Statistical Manual

The DSM, or Diagnostic and Statistical Manual of Mental disorders, is an official guideline for the diagnosis of psychological disorders. Clinicians, researchers and psychologists use this manual as a reference guide to diagnose psychological disorders. For a diagnosis to be made, 2 levels of criteria within the DSM must be met.First, the disordered behaviour must originate within the person, and it must not be a reaction due to external factors. Second, the disorder must be involuntary, meaning that the individual cannot physically or mentally control their symptoms.

The DSM uses a Multiaxial system of classification, which requires the individual to be placed on 5 separate axes which describe possible mental health factors. Most disorders are recorded on axis I, which are state dependent. Axis II describes disorders that are trait dependent. Axis III describes current physical conditions, Axis IV describes psychosocial or environmental stressors, and lastly, Axis V is used to discuss the individuals global assessment of functioning.

• Axis I: Most psychological disorders
• Axis II: Personality disorders and mental retardation
• Axis III: General medical condition
• Axis IV: Psychosocial and environmental stressors
• Axis V: Global assessment of functioning

Examples of Disorders classified within the DSM include:

• Major Depressive Disorder is a mood disorder defined by symptoms of loss of motivation, decreased mood, lack of energy and thoughts of suicide.
• Bipolar Disorders are mood disorders characterized by depressive and manic episodes of varying lengths and degrees.
• Dysthymia is a mood disorder similar to depression. Characterized by a persistent low mood, Dysthymia is a less debilitating form of depression with no break in ordinary functioning.

Bibliography

References

• Atkinson, L et al. (2004). Attachment Issues in Psychopathology and Intervention. Lawrence Erlbaum.
• Freud, S (1916) The Psychopathology of Everyday Life. MacMillan.
• Keating, D P et al. (1991). Constructivist Perspectives on Developmental Psychopathology and Atypical Development. Lawrence Erlbaum.
• Maddux, J E et al. (2005). Psychopathology: Foundations for a Contemporary Understanding. Lawrence Erlbaum.
• McMaster University. (2011). Psychological disorders. In Discover psychology (pp. 154-155, 157-158, 162-164) [Introduction]. Toronto, ON: Nelson Education.
• Widiger, T A et al. (2000). Adult Psychopathology: Issues and Controversies. Annual Review of Psychology.

Further reading

• Sims, A. (2002) Symptoms in the Mind: An Introduction to Descriptive Psychopathology (3rd ed). Elsevier. ISBN 0-7020-2627-1
• Berrios, G.E.(1996) The History of Mental Symptoms: Descriptive Psychopathology since the 19th century. Cambridge, Cambridge University Press, ISBN 0-521-43736-9
• Elisabeth Roudinesco, Why Psychoanalysis?, New York, Columbia University Press, 2003
• Elisabeth Roudinesco and Michel Plon, Dictionnaire de la Psychanalyse, Fayard, Paris, 2000