Psychopathology Theories Of

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The general term psychopathology refers to the scientific study of mental disorders that includes findings from the fields of psychology, psychiatry, pharmacology, neurology, and endocrinology, among others, and is distinguished from the actual practice of clinical psychologists and psychiatrists in the treatment of individuals with mental disorders (cf., functional analytic causal model, or FACM, which is a vector diagram/functional analysis of a patient to clarify, organize, and symbolize various types and factors concerning the individual's behavioral problems; the model constitutes an alternative mode of conceptualizing a clinical case study, its history, and prescriptive actions). The specific terms psychopathy, sociopathy, sociopathic personality, and psychopathic personality refer to a personality disorder characterized by amorality, a lack of affect, and a diminished sense of anxiety/guilt associated with antisocial behaviors. These terms, once popular, are now little used, and the term antisocial personality disorder is more preferred in mainstream psychology today but with the absence of the clinical features of anxiety/guilt under the newer term. The process of diagnosis of psychopathology refers to classifying information relevant to an individual's behavioral and emotional state and the subsequent assignment of a name or label to that state taken from a commonly accepted classification system (cf., anchoring effect - a tendency for clinicians, after they have made a diagnostic decision, usually early in the therapeutic process, to adhere to that diagnosis as time passes, and resisting revisions, even though later evidence argues that the original diagnosis was incorrect). The psychodiagnostic process has been criticized, often, because of the labeling practice where, once identified as a patient, the individual may then feel the "victim" of an illness and, as a consequence, may fail to take responsibility for resolution of problems (cf., the question method/phenomenon - refers to a "strategic question" that a therapist might pose to a client to determine whether the person's problem is medical/physiological or psychological/ functional; for instance, if the therapist asks the client, "If you did not have this symptom/condition, what would you do?" A client's reply such as "I would go back to work to provide for my family" may reveal that the symptom/condition is psychological, but a reply such as "I would feel comfortable and not be in so much pain" may indicate that the problem is medical). Different historical perspectives and theories of psychopathology have been proposed, ranging from beliefs in demons, witches, and supernatural powers inhabiting the afflicted person, to use of mental status examinations by judges to distinguish mental retardation from mental illness [cf., malevolent personality theory - holds that "evil personalities" are not explained by reference to the devil or to mental illness, but rather by choices the person makes between good and bad behaviors, beginning early in life; "malevolent personalities" are said to possess traits such as contempt for others, magical thinking, justification, rationalization, shame, and unwillingness to examine one's own "dark side;" McNaughten rules/principles (altenative spellings are: McNaughton, andM'Naughten) - refers to a set of four rules established in English law in the case Regina v. McNaughten (1843), according to which legal proof of "insanity" and, thus, lack of criminal responsibility, requires evidence that the accused either did not know what he/she was doing or was incapable of knowing "right" from "wrong;" the case involved the defendant Daniel McNaughten who shot and killed the secretary of the British prime minister Sir Robert Peel, but was found to have been of "unsound mind" at the time; and uterine theory - a discredited theory first proposed by the Greek physician Hippocrates (c. 460377 B.C.), stating that hysteria is exclusively a fe-male disorder caused by a displaced or "wandering" womb/uterus]. The comprehensive di-agnostic system of psychopathology used today began with the German-born psychiatrist Emil Kraepelin (1856-1926), the "father of modern psychiatry," who made careful observations of patients and statistical tabulations of symptoms. In his approach, Kraepelin's theory/classification concludes that there are two major mental disorders largely caused by physiological or biological factors: dementia praecox [a term in Latin meaning "early madness," and coined by the English physician and anatomist Thomas Willis (1621-1673)] - was subdivided into the categories of simple, hebephrenia, catatonia, and paranoia types; and manic-depressive psychosis that had many subdivisions depending on the regularity or irregularity of the cycles of mania and depression [cf., Pinel's classification system - named after the French physician Phillippe Pinel (1745-1826) who categorized mental disorders into four types: melancholic/depressive, mania/delirium, mania/no delirium, and dementia/mental deterioration; Pinel argued against the doctrine of phrenology, and he also helped in establishing more humane treatment methods in mental hospitals]. Kraepelin's nosological term dementia praecox was criticized severely for almost 50 years on the basis that the alleged irreversible behavioral deterioration in this condition was actually reversible. Later, the Swiss psychiatrist Eugen Bleuler (1857-1939) advanced Kraepelin's basic subtypes of disorder but substituted the term schizophrenia for dementia praecox. In 1945, the U.S. Army Medical Department developed a revised classification system where schizophrenic patients were no longer forced into the Kraepelin-type system. Today, the Diagnostic and Statistical Manual of Mental Disorders (developed and published by the American Psychiatric Association) is used by the majority of psychologists and psychiatrists treating the psychopa-thologies in the United States; cf., International Classification of Diseases (via the World Health Organization) as the recognized international classificatory sys-tem. The American personality theorist Theodore Millon (1967) describes a number of theories of psychopathology under the rubrics of: biophysical theories (e.g., E. Bleuler and W. Sheldon), intrapsychic theories (e.g., S. Freud, E. Erikson, K. Horney, H. S. Sullivan, E. Fromm, and C. Jung), behavioral theories (e.g., B. F. Skinner, H. Eysenck, J. Dollard, N. Miller, and A. Bandura), and existential/phen-omenological theories (e.g., C. Rogers, R. May, R. D. Laing, and A. Maslow). Millon states that the term psychopathology is defined in the context of the theory one employs (cf., network effect - relates to the interactions and relationships in a patient's environment that play a significant role in the production of psychiatric disorders). For instance, an idio-graphically-oriented humanist theorist who emphasizes the importance of phenomenol-ogical experience will include uniqueness and self-discomfort in the definition, whereas a nomothetically-oriented biochemical theorist will formulate a definition in terms of biochemical dysfunctions. According to Millon, once a particular theory has been selected, the definition of psychopathology follows logically and inevitably. No single definition of psychopathology conveys the wide range of observations and orientations with which psy-chopathology may be examined (cf., normalization principle - holds that persons with mental and/or physical disabilities should not be denied social or sexual relationships because of their maladies, where such relationships may include a range of physical and emotional contacts from friendships to sexual activity; and social stress theories of pathology - regards the relation between social class and mental illness, and states that the greater aspects of environmental stress that typically confront the poor of society lead to their greater frequency of personal and social pathology). Current models/theories in psycho-pathology and therapy include physiological/biochemical; psychoanalytic [cf., Fair-bairn 's revised psychopathology - the theory of mental disorder proposed by the Scottish psychoanalyst W. R. D. Fairbairn (18891964), including his theory of the "defensive technique;" retreat from reality hypothesis -holds that a person with a mental disorder is unable to cope with the undesirable and unpleasant aspects of life, and is able to "escape" by losing touch with reality and other people; the hypothesis states that such individuals avoid getting well because a return to reality would require them to face their problems and confront life's disappointments and unpleas-antries; sociogenic hypothesis - suggests that sociological factors, such as living in an impoverished environment, contribute to the cause of behavioral and mental disorders (e.g., criminal behavior; schizophrenia); and under-stimulation theory - holds that severe anxiety and other psychological disorders may be caused by an inadequate or insufficient stimulation in the individual's life or environment, and has been used as a rationale, as well, to explain vandalism and other crimes that occur in urban settings where youngsters lack exposure to a large variety of stimuli; cf., sensory deprivation effects]; learning; environmental (cf., the ecological-systems mod-el - speculates that mental disorders are reflections of environmental disequilibrium, not merely of personal imbalance, and may be prevented and treated by studying and modifying the environmental factors surrounding the affected individual); cognitive; humanistic; and predispositional/diathesis-stress paradigms (cf., stress-decompensation model - suggests that abnormal behavior originates as a result of stress that leads to "decompensation," i.e., a gradual progressive deterioration of normal behavior) where the definition of abnormal/abnormality yields several criteria (e.g., statistical rarity, subjective distress, disability, and norm violations), but no single criterion, by itself, is completely satisfactory. At this stage and time, too little is known about psy-chopathology and its treatment to settle conclusively on any one paradigm. See also EXISTENTIAL ANALYSIS THEORY; GOOD BREAST/OBJECT-BAD BREAST/ OBJECT THEORY; IDIOGRAPHIC/NOMO-THETIC LAWS; LABELING/DEVIANCE THEORY; MEDICAL/DISEASE MODEL; PERSONALITY THEORIES; SCHIZOPHRENIA, THEORIES OF; SENSORY DEPRIVATION EFFECTS. REFERENCES

Kraepelin, E. (1883/1907). Clinical psychiatry. New York: Macmillan. Bleuler, E. (1916). Textbook of psychiatry.

New York: Macmillan. Zilboorg, G., & Henry, G. (1941). A history of medical psychology. New York: Norton.

Fairbairn, W. R. D. (1952). Psychoanalytic studies of the personality. London: Tavistock.

Szasz, T. S. (1961/1967). The myth of mental illness. New York: Dell/Delta. Millon, T. (Ed.) (1967). Theories of psychopathology. Philadelphia: Saunders.

Zubin, J. (1967). Classification of behavior disorders. Annual Review of Psychology, 18, 373-406.

Neugebauer, R. (1979). Medieval and early modern theories of mental illness. Archives of General Psychiatry, 36, 477-483.

McReynolds, P. (1989). Diagnosis and clinical assessment: Current status and major issues. Annual Review of Psychology, 40, 83-108.

Wakefield, J. C. (1992). The concept of mental disorder: On the boundary between biological facts and social values. American Psychologist, 47, 373-388.

Wilson, M. (1993). DSM-III and the transformation of American psychiatry: A history. American Journal of Psychiatry, 150, 399-410.

(Eds.) (1999). Oxford textbook of psychopathology. New York: Oxford University Press.

American Psychiatric Association. (2000).

Diagnostic and statistical manual of mental disorders. 4th edition TR. Washington, D. C.: American Psychiatric Press.

Widiger, T. A., & Sankis, L. M. (2000). Adult psychopathology: Issues and controversies. Annual Review of Psychology, 51, 377-404.

Plomin, R., & McGuffin, P. (2003). Psychopa-thology in the post-genomic era. Annual Review of Psychology, 54, 205-228.

PSYCHOPHYSICAL LAWS/THEORY.

See FECHNER'S LAW; STEVENS' POWER

LAW; WEBER'S LAW.

PSYCHOPHYSICAL PARALLELISM,

DOCTRINE OF. See MIND-BODY THEORIES.

PSYCHOSEXUAL DEVELOPMENT,

THEORY OF. See DEVELOPMENTAL

THEORY; ERIKSON'S THEORY OF PERSONALITY; FREUD'S THEORY OF PERSONALITY.

PSYCHOSEXUAL NEUTRALITY THEORY. See DEVELOPMENTAL THEORY.

PSYCHOSOCIAL/PSYCHOLOGICAL THEORIES OF PERSONALITY. See DEVELOPMENTAL THEORY; ERIKSON'S THEORY OF PERSONALITY.

PSYCHOSOMATICS THEORY. The term psychosomatics (i.e., interactions between psychological behaviors, such as feelings/ thoughts and physical illness) was coined in the early 1800s and has undergone several terminological and theoretical changes (cf., Dunbar, 1943; Margetts, 1950; Lipowski, 1968; Henker, 1982). Originally, psychoso-matics referred to particular disturbances, such as obsessions and phobias. Today, however, psychosomatics may be characterized as a "holistic" medical approach and includes investigations of the scientific relationship between psychological and biological events, as well as the consultation activities between mental health workers and physically ill clients. Contemporary theories concerning psychosomatics may be classified into specificity theories and nonspecificity theories. Specificity theories state that definite psychological patterns/symptoms produce each psychosomatic disorder, where there are four general groups of specificity hypotheses: personality-specific - holds that definite personality traits lead to specific physical symptoms (e.g., the "A-type" behavior pattern and its link to coronary artery disease); conflict-specific - an extension of the psychoanalytic concept of "conversion" where unconscious conflicts are resolved via "conversion" into bodily/somatic symptoms, such as peptic ulcers, bronchial asthma, rheumatoid arthritis, and hypertension; emotion-specific - suggest that specific emotions lead to definite somatic changes or disturbances (e.g., anxiety may be distinguished from anger; cf., specific-attitudes theory - holds that certain psychosomatic disorders are associated with particular attitudes on the part of the sufferer); and response pattern-specific - emphasize individual differences in stress-response patterns (e.g., blood-pressure reactors are prone to hypertension; cf., specific-reaction theory - states that psychosomatic symptoms result from an innate ten dency of the autonomic nervous system to react to a stressful situation in a particular way). In the organ specificity hypothesis, it is held that the individual suffering from psychosomatic disorders unconsciously chooses a particular organ, or part of the body (such as the skin for hives, or the stomach for ulcers), to be the physical locus or manifestation of her/his tension or stress that has not been discharged in other more customary or healthy ways. The associated specificity theory states that through learned mediation or "accidental conditioning," an association may be formed between a physiological response and an idea, emotion, or thought. Research gives only partial support to all the specificity hypotheses, and does not support completely any single approach. The nonspecificity theories maintain the etiological primacy of psychological factors in at least some cases of certain physical diseases, but do not attempt to explain symptom choice; rather, the term "organ vulnerability" may be employed as an "explanation." An example of a nonspecificity theory is the alexithymia hypothesis, which states that certain individuals find it difficult to express or experience emotions as do most other people. As with the specificity theories, the non-specificity theories of psychosomatics may only partially explain some behaviors, but not all instances of such behavior. See also MO-RITA THERAPY THEORY; ORTHOMO-LECULAR THEORY; SELYE'S THEORY/MODEL OF STRESS; SOMATOPSY-CHICS THEORY. REFERENCES

Dunbar, H. F. (1943). Psychosomatic diagnosis. New York: Hoeber. Alexander, F. G., & French, T. M. (1948).

Studies in psychosomatic medicine. New York: Ronald Press. Margetts, E. L. (1950). The early history of the word "psychosomatic." Canadian Medical Association Journal, 63, 402-404. Lipowski, Z. J. (1968). Review of consultation psychiatry in psychosomatic medicine. III. Theoretical issues. Psychosomatic Medicine, 30, 395-422. Christie, M. J., & Mellett, P. G. (Eds.) (1981).

Foundations of psychosomatics. New York: Wiley.

Henker, F. O. (1982). Conflicting definitions of the term "psychosomatic." Psy-chosomatics, 23, 8-11.

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Responses

  • kati rautavaara
    What are the theories of psychopathology?
    2 years ago
  • renato
    What is the psychopathology of the choice theory?
    9 months ago
  • daniel
    What are the theories of psychosomatic disorders?
    5 months ago

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