NRNP 6635 Factors That Influence Development of Psychopathology

NRNP 6635 Factors That Influence Development of Psychopathology

The development of psychopathology stands on the course of observing many factors that may contribute to the diagnosis of many psychiatric disorders.

Biological

Biological influences of psychopathology development involve studying the brain over time to evaluate anatomies present in normal conditions and structural deviations present in occurrences of mental disorders. This foundation allows science to link brain and behavior. This relationship provides the framework for the diagnosis and treatment of many. Jackson and Milberg (2018) present neuropsychology assessments are particular for diagnosing and providing treatment for psychiatric conditions; exemplify the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as standard.  These assessments can detect cognitive disorders and promote a pathway for initiation of treatment measures.

Psychological

Emotions and behaviors are sometimes isolated to certain events or situations.  It’s imperative to differentiate if these occurrences are situation based or if an ongoing condition is present.  An assessment measuring overtime can separate isolated events from behavioral conditions.  Sheppes, Suri, and Gross (2015) expresses that failure to obtain emotion-regulation can lead to psychopathologies. Identifying the type of emotional dysregulation can provide a framework measuring the time, environment, and responses specific to situations.  This knowledge can break negative patterns and work to provide treatment for pathologies.

 

Social/Cultural

Social guidelines generally determine the norms on which to base many behaviors. Social-economic status, race, gender, and sexual orientation can all attribute to an array of plights that may directly impact mental health generally and especially in the presence of disorders. Cheung and Mak (2018) explain how those who are unemployed, limited with education, and constrained economically are linked to many mental disorders in both female and male genders. Sexual orientation presented as well with increased prevalence of depression, suicidal ideations, self-harm among those who identify as gay or bisexual. Social inequalities were also linked to occurrences of mental disorders within that particular group.  Racial discrimination along with economic constraints posed on many minority groups resulted later in presentations of mental disorders. Cheung and Mak (2018) maintain that observation, interviewing and testing are standard for conducting assessments and should be done so free of biases.

Interpersonal

            Interpersonal defines how we interact with other people.  Communication for some individuals may be a challenge and an overall impact on one’s mental wellbeing.  Psychiatric conditions experienced by some may correlate with their interpersonal skills with others.  Arcelus, Haslam, Farrow, and Meyer (2013) exemplify how interpersonal barriers can result in behaviors.  For example, a person who has a pattern to avoid or has difficulties sharing their feelings.  May have behaviors aligned with eating disorder anorexia. During interviewing, interpersonal relationships can be assessed and alert for the possible patterns that may exhibit for psychiatric conditions.

 

 

References

Arcelus, J., Haslam, M., Farrow, C., & Meyer, C. (2013). The role of interpersonal functioning in the maintenance of eating psychopathology: a systematic review and testable model. Clinical psychology review, 33(1), 156–167. https://doi.org/10.1016/j.cpr.2012.10.009

 

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. 

 

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. 

 

Sheppes, G., Suri, G., & Gross, J. J. (2015). Emotion regulation and psychopathology. Annual review of clinical psychology, 11, 379–405. https://doi.org/10.1146/annurev-clinpsy-032814-112739

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In many 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?” (Sadock et al., 2015).

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?

To Prepare:

• Review this week’s Learning Resources, considering the many interacting factors that contribute to the development of psychopathology.
• Consider how theoretical perspective on psychopathology impacts the work of the PMHNP.

By Day 3 of Week 1

Explain the biological (genetic and neuroscientific); psychological (behavioral and cognitive processes, emotional, developmental); and social, cultural, and interpersonal factors that influence the development of psychopathology.

Read a selection of your colleagues’ responses

By Day 6 of Week 1

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.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

 

Post by Day 3 of Week 1 and Respond by Day 6 of Week 1

To Participate in this Discussion:

Week 1 Discussion

What’s Coming Up in Week 2?

In Week 2, you will be introduced to assessment and diagnosis of the psychiatric patient. You will explore elements of the psychiatric interview, history, and examination as well as psychiatric rating scales. You also will review the classification system of psychiatric disorders in the DSM-5 and the role the DSM-5 plays in diagnosis.

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

Practicum – Upcoming Deadline

In the Nurse Practitioner programs of study (FNP, AGACNP, AGPCNP, and PMHNP) you are required to take several practicum courses. If you plan on taking a practicum course within the next two terms, you will need to submit your application via  .

For information on the practicum application process and deadlines, please visit the  web page.

Please take the time to review the  for your courses.

Please take the time to review the practicum manuals, FAQs, Webinars and any required forms on the  web page.

Next Week

 

 

 

Week 2: Assessment and Diagnosis of the Psychiatric Patient

A sensitively crafted intake assessment can be a powerful therapeutic tool. It can establish rapport between patient and therapist, further the therapeutic alliance, alleviate anxiety, provide reassurance, and facilitate the flow of information necessary for an accurate diagnosis and appropriate treatment plan.

—Pamela Bjorklund, clinical psychologist

Whether you are treating patients for physical ailments or clients for mental health issues, the assessment process is an inextricable part of health care. To properly diagnose clients and develop treatment plans, you must have a strong foundation in assessment. This includes a working knowledge of assessments that are available to aid in diagnosis, how to use these assessments, and how to select the most appropriate assessment based on a client’s presentation.

This week, as you explore assessment and diagnosis of patients in mental health settings, you examine assessment tools, including their psychometric properties and appropriate uses. You also familiarize yourself with the DSM-5 classification system.

_{Reference: Bjorklund, P. (2013). Assessment and diagnosis. In K. Wheeler (Ed.), Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.) (pp. 95–168). Springer Publishing Company.}

Learning Objectives

Students will:

•  Evaluate elements of the psychiatric interview, history, and examination
•  Analyze psychometric properties of psychiatric rating scales
• Justify appropriate use of psychiatric rating scales in advanced practice nursing

Learning Resources

 

 

Carlat, D. J. (2017). The psychiatric interview (4th ed.). Wolters Kluwer.

• Chapter 34, Writing Up the Results of the Interview

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

• Chapter 5, Examination and Diagnosis of the Psychiatric Patient
• Chapter 6, Classification in Psychiatry
• Chapter 31, Child Psychiatry (Sections 31.1 and 31.2 only)

 

 

 

 

 

 

 

 

Getting Started With the DSM-5

If you were to give a box of 100 different photographs to 10 people and ask them to sort them into groups, it is very unlikely that all 10 people would sort them into the exact same groups. However, if you were to give them a series of questions or a classification system to use, the chances that all 10 people sort them exactly the same increases depending on the specificity of the system and the knowledge of those sorting the photographs.

Photo Credit: [Peter Polak]/[iStock / Getty Images Plus]/Getty Images

This is not unlike what has occurred in the process of classifying mental disorders. A system that provides enough specificity to appropriately classify a large variety of mental disorders while also attempting to include all of the possible symptoms, many of which can change over time, is a daunting task when used by a variety of specialists, doctors, and other professionals with varied experience, cultures, expertise, and beliefs. The DSM has undergone many transformations since it was first published in 1952. Many of these changes occurred because the uses for the DSM changed. However, the greatest changes began with the use of extensive empirical research to guide the creation of the classification system and its continued revisions.

In order to assess and diagnose patients, you must learn to use the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, usually abbreviated as the DSM-5, to render a diagnosis. In this second week of the course, you will examine how DSM-5 is organized and how clinicians use it to render diagnoses.

Review the Learning Resources this week, with special emphasis on viewing the Diagnostic Criteria video. This video explains the purpose and organization of the DSM-5 classification system, the purpose of the ICD-10 coding system, their relationship to one another, and the importance to the PMHNP role.