Etiology of Psychopathological Disorders Analysis - Coursework Example

Etiology of psychopathological disorders Introduction Anthony Marsella (1982) posits that the “disease model”, which enlightened mental health practitioners’ understanding of the etiology of psychopathology disorders, as inadequate. According to him, the extensive data retrieved from cross-cultural studies gathered from diverse cultures across the globe validates the role of culture in predisposing the development of psychopathology disorders (Marsella, 1982). Over the years, contemporary scholars continue to criticize studies, which inferred that biological and psychological factors were the only variables at play in determining the causes of psychopathology disorders. These researchers lobby for the consideration of cultural/interpersonal/social factors, which they believe is a key variable in understanding the etiology of mental disorders. Key to this school of thought, the social/cultural/interpersonal perspective, is the distinction between disease and illness. Disease is defined as an abnormality in the structure or functioning of body systems and organs whereas illness is defined as an experience of discontinuity in an individual’s state of being, and or in their perceived role performances (Eisenberg, 1977). Proponents of this model theorize that psychopathology disorders have social significance and personal meaning only within the confines of a specific cultural context. As such, the term “mental illness” has ethnocentric connotations, which mental health practitioners should seek to understand, as it influences their insight on etiology, manifestation, and treatment of psychopathology disorders (Marsella, 1982). Of significance to this essay, is this model’s description of the etiology of psychopathology disorders. Theoretical frameworks (background information) Understanding any concept mandates a review of its historical background. In this case, it is pertinent to review the theoretical frameworks antecedent to theories that emphasize the importance of understanding psychopathology disorders from a multi-cultural perspective. Initially, the absolutionist position dominated mental health practitioners’ conceptualization of the etiology of mental disorders (Sam & Moreira, 2002). Theorists aligned with this position supported the bio-medical model, which presumed that a psychic unity existed. According to them, an absolute truth explained human existence whereby it was possible to understand human experiences in spite of cultural diversity. In sum, these theorists believed in the synonymy of human experiences, which in turn predisposed them to negate the role of culture in influencing the semantics or manifestation of human behaviors. Therefore, it was common for them to use standardized instruments when diagnosing or treating psychopathological disorders (Sam & Moreira, 2002). Over time, many scholars realized that the absolutionist position proved insufficient when it came to accounting for variations in the comprehension of psychopathology across diverse cultures. This led to the emergence of the relativist position that sought to bash ethnocentric biases, which were characteristic of the bio-medical model. The underlying presumption of this model holds that all behaviors exhibited by human beings are culturally patterned (Sam & Moriera, 2002). Proponents lobbied against the use of an external viewpoint when trying to understand individuals’ behaviors, and instead advocated for the analysis of behaviors within specific cultural contexts. As such, no standardized instruments were used in the identification of causes, diagnosis or treatment of psychopathology disorders. In their place, assessments seek to identify meanings and values specific to a cultural group. Due to this position, researchers were able to provide detailed accounts of onset and exhibitions of culture-bound syndromes (Sam & Moreira, 2002). On their own, the absolutionist position and the relativist position failed to explain exhaustively the etiology, manifestation and treatment of psychopathology disorders. As such, a group of scholars advanced the universalist position, which integrates the underlying presumptions from the previous positions. According to universalists, all humans display basic human characteristics however, their development and display are predominantly regulated by culture. Culture is seen as an exogenous force that defines the parameters of normal and abnormal behaviors (Sam & Moriera, 2002). Therefore, the multi-cultural model guides mental health practitioners uncover causal factors in order to give a diagnosis, and in turn formulate an appropriate treatment plan. Embedded within the socio-cultural perspective are broader contextual variables, which more often than not function to mold individuals’ standpoints (perspectives on various issues); for example, individual differences, culture, socio-economic background, and gender socialization among others. Contextual variables are pertinent in understanding the etiology of psychopathology disorders. i. Culture As mentioned, culture functions as an exogenous force that distinguishes between normal and abnormal behaviors. Leighton & Hughes (2005) propose ways cultural factors are likely to affect the psychopathology disorders. According to them, culture may predetermine patterns of specific mental disorders. They infer that culture-specific mental disorders exist among diverse cultures, and are referred to differently. Although the symptoms might be synonymous to those exhibited by an individual who has received a westernized diagnosis, different cultures attribute different factors for causing the disorder. For example, hysteria is attributed to an interplay of bio-psycho-social factors in the western culture, which is not the case in non-western cultures that attribute the disorder to spiritual factors such as possession by evil spirits such as “Witiko” (a cannibalistic monster among the Ojibwa Indians) (Leighton & Hughes, 2005). In addition, Leighton and Hughes hypothesized that culture might predispose basic personality types, which are more likely to increase an individual’s vulnerability towards psychopathology disorders; for example, Paranoia was common in individuals from societies that exhibited patterns of hostility, ideas of grandeur, and suspiciousness (Leighton & Hughes, 2005). Finally, these researchers also hypothesized that cultures might predispose the development of specific psychopathology disorders via certain child-rearing practices. Cultures differ in their preferred choice of child-rearing customs; for example, some cultures might rely more on the use of reinforcement and punishment to encourage or curtail behaviors whereas some cultures might gravitate towards the use of weaning and swaddling techniques that create influence attachment patterns (Leighton & Hughes, 2005). ii. Socio-economic background Another factor iii. Gender socialization Multi-cultural Therapy (MCT) Due to the socio-cultural model, scholars have placed emphasis on how pertinent it is for mental health practitioners and the other professionals they work with to understand psychopathology from a multi-cultural perspective. Just like physiological disorders, diagnosis of psychopathology disorders hinges on the proper identification of symptoms. More often than not, individuals afflicted with a certain mental disorder relay subjective information regarding the symptoms they are experiencing whereby their subjective accounts are influenced by culture, religion, gender socialization, and socio-economic factors among other contextual variables linked with the socio-cultural perspective. Under close scrutiny, it becomes apparent that symptoms of psychopathology disorders give insight on what the individual thinks is the causative agents of the disorders. As such, a diagnosis and treatment plan can only be identified, and customized to each individual’s unique needs. Nooria Mehraby (2009) infers that non-western cultures often view psychopathology disorders from a spiritual and religious framework, which makes it difficult for mental health practitioners to use western labels to diagnose and treat the disorder. According to her, psychopathology disorders in non-western cultures attract taboo, shame, and stigma, which influence sufferers’ health seeking behaviors (Mehraby, 2009). For example, among the Vietnamese, psychopathology is blamed on Karma whereby the disorder is viewed as a punishment for sins committed in a previous life. Contrastingly, in African countries such as Kenya, psychopathology is blamed on bewitchment whereas in Arab communities, it is blamed on possession by djinns (Mehraby, 2009). It is clear that the etiology of psychopathology disorders vary across diverse cultures; as such, it is prudent for mental health practitioners to adapt a multi-cultural perspective to attend to their client’s mental health needs effectively. However, it is important to take note on the role globalization has had on people’s understanding of the etiology of psychopathology disorders. Globalization has led the dissolution of diverse cultural beliefs in favor of more unified cultural beliefs, which has influenced individuals’ perception on issues such as psychopathology. For example, different media agents such as the internet have made it possible for individuals to acquire information about symptoms, diagnosis, and treatment of psychopathology disorders. Globalization continues to standardize mental health practitioners’ comprehension of the etiology, manifestation, and treatment of mental health problems. Emerging issues In order to stay relevant, scholars specializing in research endeavors strive to stay abreast with emerging socio-cultural issues likely to influence the etiology of psychopathology disorders. As such, even proponents of the socio-cultural model design their researchers to reflect knowledge gaps created by the frequently changing contextual variables, which define the socio-cultural perspective. A perfect example, centers on issues to do with the sexual orientation. In the past, heterosexuality was considered the only normal form of sexual orientation, which meant that any other form of sexual orientation was regarded as a sexual psychopathology disorder. In fact, the Diagnostic Statistical Manual listed sexual orientations such as homosexuality as a mental disorder. Then, different researchers blamed environmental and biological factors for causing the disorder. In 1962, Klintworth advanced the “Balanced Superior Heterozygote Fitness Theory”, which presumed that the preservation of homosexual genes predisposed the development of an individual’s homosexual orientation (Rutter, 2006). He theorized that homosexuality resulted from the union of recessive homosexual alleles that form a homozygote. A couple of years later in 1987, Ellis and Ames advanced the “Gestational Neurohormonal Theory”, which to date, remains one of the most profound neurohormonal theory of homosexuality. They theorized that the predetermination of an individual’s sexual orientation hinged on the exposure of the nervous system to sex hormones such as testosterone and estradiol among others while neuro-organization is taking place. The fundamental implication of biological theories of homosexuality is that homosexuality is not a learnt behavior. On the contrary, these theories infer that it is an innately predetermined disposition that is permanent and change-resistant. Contrastingly, the profound implication of environmental theories of homosexuality is that homosexuality results from learning, which is the relatively permanent change in behavior or knowledge due to experiences. In his theory named “Exotic becomes Erotic”, Daryl Bem suggests that some children will prefer activities that are typical of the other sex (Bem et al, 2000). Choice of activity consistent with societal defined gender roles will make a gender-conforming child feel different from opposite-sex children. Gender-nonconforming children, on the other hand, will feel different from children of their own sex. In either case, this feeling of difference may evoke physiological arousal when the child is near members of the sex that it considers as being "different". This will later transform into sexual arousal (Rieger et al, 2008). In 1973, homosexuality was removed from the DSM, as it was no longer considered a deviant sexual disorder. A decision informed by changes in society’s perception of what qualified as a normal sexual behavior. Conclusion In conclusion, it is prudent to acknowledge the role of socio-cultural factors in uncovering the etiology of psychopathological disorders. In the past, researchers relied heavily on the “disease model”, as they tried to uncover antecedent factors that were responsible in triggering the onset of psychopathology disorders. At the time, this model offered mental health practitioners a standardized point of analysis; however, it soon dawned upon scholars that it was prudent for them to consider the interplay of other non-biological factors in predisposing the development of psychopathology disorders. First was the psychological perspective, which was then followed by the socio-cultural perspective. The latter sought to examine broader contextual factors responsible for causing psychopathological disorders. Culture remains the most predominant contextual factor, as it provides a more comprehensive explanation about the etiology, manifestation and treatment of psychopathology disorders. In contemporary society, mental health practitioners are expected to orient themselves with multi-cultural competence guaranteed to aid them in the diagnosis and treatment of mental health disorders. Finally, there has been need to keep abreast with emerging socio-cultural issues, which in turn influence the etiology, manifestation, and treatment of psychopathology disorders. Works Cited Bem D. J., Herdt G., McClintock M. (December 2000). "Exotic becomes erotic: interpreting the biological correlates of sexual orientation". Archives Sex Behaviour 29 (6): 531–48. Eisenberg, L. (1977). Disease and illness Distinctions between professional and popular ideas of sickness. Culture, Medicine and Psychiatry, 1(1); 9-23. Leighton, A. H., & Hughes, J. M. (2005). Cultures as a Causative of Mental Disorder. Milbank Quarterly, 83(4): 468. Marsella, A. J. (1982). Cultural Conceptions of Mental Health and Therapy. New York: Springer Science & Business Media p. ix. Mehraby, N. (2009). Possessed or crazy? Mental illness across cultures. Psychotherapy in Australia, 15(2): 43. Rieger G., Linsenmeier J. A., Gygax L., Bailey J. M. (Jan 2008). "Sexual orientation and childhood gender nonconformity: evidence from home videos". Dev Psychol 44 (1): 46–58. Rutter, M. (2006). Genes and Behavior. Oxford, UK: Blackwell Publishing. Sam, D. L., & Moreira, V. (2002). The mutual embeddedness of culture and mental illness. In W. J. Lonner, D. L. Dinnel, S. A. Hayes, & D. N. Sattler (Eds.), Online Readings in Psychology and Culture (Unit 9, Chapter 1), Center for Cross-Cultural Research, Western Washington University, Bellingham, Washington USA. Read More