An Overview of Psychopathology

The origin of the term "psychopathology" dates back to 1913 when this scientific discipline was first introduced by Karl Jaspers, a German/Swiss philosopher and psychiatrist. This new framework for understanding the mental experience of individuals followed a long history of varied attempts at making meaning out of the "abnormal experiences" of individuals.

History of Understanding of Mental Illness

We've come a long way since the earliest beginnings of trying to make sense of mental illness. Although individuals with mental health issues still face stigma and a lack of understanding, things were very different in the past.

Hippocrates, the 4th century BC Greek physician, rejected the notion of evil spirits and argued instead that mental illness was a disease of the brain relating to imbalances of bodily fluids. Around the same time, the philosopher Plato argued that distress resulted from an imbalance in the mind-body-spirit connection.

If you lived in the 16th century with a mental health problem, chances are you would not have been treated very well. At that time, mental illness was often viewed from a religious or superstitious point of view. Accordingly, it was assumed that people demonstrating strange behavior must have been overtaken by evil spirits or demons. The cure? You would have been tortured to bring you back to sanity. If that didn't work? Execution.

Later, in the 18th century, interest surged in the role of childhood and trauma in the development of mental illness. Following on the heels of this era, Sigmund Freud introduced talk therapy in the 19th century to deal with unresolved issues.

As of present day, our understanding of mental illness has broadened, and so, thankfully, have the treatments.

Definition of Psychopathology

How do we currently define psychopathology? In short, it can be thought of as the in-depth study of problems related to mental health. Just like pathology is the study of the nature of disease (including causes, development, and outcomes), psychopathology is the study of the same concepts within the realm of mental health (or illness).

This study of mental illness can include a long list of elements: symptoms, behaviors, causes (genetics, biology, social, psychological), course, development, categorization, treatments, strategies, and more.

In this way, psychopathology is all about exploring problems related to mental health: how to understand them, how to classify them, and how to fix them. Because of this, the topic of psychopathology extends from research to treatment, and at every step in between. The better we can understand why a mental disorder develops, the easier it will be to find effective treatments.

Professionals Involved in Psychopathology

Which professionals are involved in the understanding of psychopathology? Just as this area is broad ranging from research to treatment, so too is the list of types of professionals who tend to be involved.

At the research level, you will find research psychologists, psychiatrists, neuroscientists, and others trying to make sense of the different manifestations of mental disorders that are seen in clinical practice.

At the practical level, you will find many types of professionals attempting to apply the diagnostic systems that are in place to provide effective treatments to individuals living with psychopathology. These can include the following and more:

Diagnostic Systems of Psychopathology

Professionals engaged in research and treatment of psychopathology must use systems to arrive at conclusions regarding the best course of action for treatment. Systems such as these are used to classify what are considered to be mental health disorders or problems that occur in an individual and that are not within their cognitive control.

Currently, the most widely used systems for classifying mental illness in the United States are the following:

Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

The DSM-5 is created by the American Psychiatric Association as an assessment system for mental illness. The DSM-5 includes identifiable criteria that professionals use to arrive at a specific diagnosis for an individual that aids treatment planning.

The criteria and list of disorders sometimes change as new research emerges. Some examples of disorders listed in the DSM-5 include major depressive disorder, bipolar disorder, schizophrenia, paranoid personality disorder, and social anxiety disorder.

International Classification of Diseases (ICD-11)

The ICD-11 is a system similar to the DSM-5. The ICD was developed over a century ago and was taken over by the World Health Organization (WHO) when it was founded in 1948. How does the ICD-11 differ from the DSM-5?

First, the ICD-11 is produced by a global agency, while the DSM-5 is produced by a national professional association (the American Psychiatric Association). It is approved by the World Health Assembly composed of health ministers from 193 WHO member countries.

Second, the goal of the ICD-11 is to reduce disease burden globally. Third, the ICD-11 is freely available on the Internet. In contrast, the DSM costs money, and the American Psychiatric Association derives revenue from sales of the book and related products.

Still, the DSM-5 is the standard for classification among psychologists and psychiatrists and is generally used for treatment and insurance purposes.

Research Domain Criteria (RDoc)

Beyond these standard systems for classifying mental disorders, there also exists a burgeoning area of research and theory that moves away from the checklist format of making diagnoses. Since it's possible to have symptoms of a mental illness but not meet criteria for a diagnosis, studies of descriptive psychopathology hold promise for a better system of understanding.

The RDoC is based on translational research from areas such as neuroscience, genomics, and experimental psychology. In this way, the RDoC is involved in describing the signs and symptoms of psychopathology rather than grouping into disorders as has been historically done with the DSM-5 and ICD-11. The RDoC is primarily aimed at planning and funding research.

Distinguishing Psychopathology vs. Normal Behavior

How do psychologists and psychiatrists decide what extends beyond normal behavior to enter the territory of "psychopathology?" Psychiatric disorders can be conceptualized as referring to problems in four areas: deviance, distress, dysfunction, and danger.

For example, if you were experiencing symptoms of depression and went to see a psychiatrist, you would be assessed according to a list of symptoms (most likely those in the DSM-5):

  • Deviance refers to thoughts, emotions, or behaviors that are unacceptable or not common based on currently held cultural beliefs. In the case of depression, you might report thoughts of guilt or worthlessness that are not common among other people.
  • Distress refers to negative feelings either felt within a person or that result for people around that person. In the case of depression, you might report extreme feelings of distress over sadness or guilt.
  • Dysfunction refers to the inability to achieve daily functions like going to work. In the case of depression, you might report that you can't get out of bed in the morning or that daily tasks take you much longer than they should.
  • Danger refers to violent behavior toward yourself or others. In the case of depression, this could include reporting that you are having thoughts of suicide or harming yourself.

In this way, you can see that the distinction between normal versus psychopathological behavior comes down to how issues are affecting you or the people around you. Often, it is not until things come to a crisis point that a diagnosis is made, because this is when these aspects really show themselves.

Dimensional vs. Categorical Definitions

It's easy to see that there is some disagreement historically about what constitutes mental illness. At the same time, even in the current field, there is disagreement about how mental illness should be conceptualized.

Do different disorders really exist, such that a person with attention-deficit disorder (ADHD) can be strictly differentiated from someone else with an anxiety disorder? Or, are there higher-order overarching factors that play a role in mental illness and that might better explain why some people are diagnosed with many illnesses (called comorbidity)? Some research shows that this could indeed be the case, with categories such as "general risk," "internalizing risk," and "externalizing risk" being helpful.

Some have noted these problems inherent in the "checklist" approach to mental health.

It might be misleading to group disorders as separate when there can be so much overlap between people diagnosed with different disorders (and so many dissimilarities among people diagnosed with the same disorder).

Unfortunately, we are not currently any closer to resolving this issue. Hopefully, in the future, better systems will be developed that will take all these issues in the field of psychopathology into account.

A Word From Verywell

Are we any closer to an appropriate understanding of psychopathology? That remains to be debated. However, we've certainly moved forward from primitive attempts and moved toward a program of research that holds promise for describing symptoms in a helpful way, rather than classifying and categorizing to the detriment of actually understanding the development of problems and the best ways to treat them.

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