Respond?to?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, integr

PEER 1

Razvan F Gheorghe

Discussion 1  – Main post

     Developmental psychopathology (DP) is an interdisciplinary field that provides an integrative framework for comprehending psychopathology in the context of an individual's lifespan (Cicchetti, 1984, 2006; Cummings & Valentino, 2015; Masten, 2006). It is important to comprehend the psychopathology that occurs during various developmental stages of an individual's life, spanning from birth to death, as it has a significant impact on mental health, treatment, diagnostics, and outcome. Masten and Kalstabakken (2018) have posited that the DP integrative approach has a significant impact on various aspects of mental health and well-being research, theory, diagnosis, assessment, and practice. This approach spans across multiple disciplines and pertains to individuals of all ages throughout their developmental lifespan.

     When speaking on the development of psychopathology and the many factors that influences it, there are many different psychological assessments to consider including biological, psychological, social, and interpersonal. Lunansky et al. (2021) state identifying the different influences of symptoms in dynamic psychopathology models may hold promise for increasing treatment efficacy in clinical applications. It is important to understand in mental health the factors and how they impact a nurse practitioners’ multidimensional approach in the treatment of the patient across the lifespan.

     The biological factors influencing psychopathology can range depending on where the patient is in their lifespan. Determining a person’s psychopathology depends on the age as well as their environment they are in at the specific time. Harden et al. (2019) inform symptoms of psychopathology covary across diagnostic boundaries, and a family history of elevated symptoms for a single psychiatric disorder places an individual at heightened risk for a broad range of other psychiatric disorders. Genetics can have a huge impact on the development of psychopathology from fetus to adulthood, depending on a person’s surroundings, how they grew up and who they grew up around determines their psychopathology and its development thereof. Masten and Kalstabakken (2018) note during the course of human development, it is important to note that gene, environment, and exposure could influence and change the mental health of an individual.

      Throughout the trajectory of human development, it is crucial to acknowledge that the mental health of an individual can be impacted and altered by factors such as gene, environment, and exposure (Masten & Kalstabakken, 2018). During fetal development, various external factors such as maternal diet, trauma, or illness can modify the biology of the developing fetus prior to delivery, as noted by Boyce and Kobor (2015) and Monk et al. (2016).

      Similarly, the formative experiences of early childhood are largely governed or moderated by the nurse or other caregiving adults. As children mature, they engage with increasingly explicit systems such as peer play, school, work, social relationships, and siblings, which subsequently impact their cognitive processes and shape their interactions with particular individuals or systems (Masten & Kalstabakken, 2018). Current investigations into epigenetic mechanisms employ cutting-edge technologies to further evaluate the impact of the human genome and genetic expression on mental health.

        Psychological factors such as behavioral and cognitive processes, emotional, and developmental do influence the development of psychopathology as well. Masten and Kalstabakken (2018) inform as children grow older, they increase their active role in their development and exert more choice about their interactions with other people and the environment. How a child or adolescent chooses to spend their time and in what environment they explore whether it be sports or theatre, dating the opposite sex or same sex can have a determination on their psychopathology and where their mental health is progressed. From there to adulthood can impact their mental health when dealing with other psychological factors.

         In addition to genetic and developmental factors, the impact of interpersonal relationships is a significant contributor to an individual's developmental psychopathology, as noted by Masten (2006). The transactional model assesses the bidirectional impacts of individuals and their contextual relationships on one another, as posited by Sameroff (2009). Bandura (1997) posits that the concept of children exerting influence on the interactions that subsequently shape their own development pertains to the function of human action in the process of development. As children progress through their developmental stages, they assume a more proactive role in shaping their growth trajectory and exercise greater agency in determining their social and environmental engagements (Masten & Kalstabakken, 2018). Simultaneously, transactional models acknowledge the significant impact of external sociocultural factors in limiting or modifying the course of development, as noted by Sameroff (2009). The factors that exert an impact on individuals encompass a range of elements such as socioeconomic deprivation, prejudice, armed conflict, learning, and advantageous prospects in diverse manifestations (Masten & Kalstabakken, 2018). Sameroff (2019) informs at the same time; however, transactional models recognize the profound influences of external sociocultural conditions in constraining or altering development.

      Social, cultural, and interpersonal factors also play a role in the development of psychopathology. Choudhury and Kirmayer (2019) inform culture is not simply a set of traits or characteristics shared by people with a common geographic, historical, or ethnic background and the shifting meaning of culture and psychopathology have implications for efforts to apply cultural neuroscience to psychiatry. In regard to cultural, social, and interpersonal factors related to psychopathology there are many new developments on what those are and continue to evolve today. While a person’s culture is important to understand, many new generations are forming new developments to their culture for example someone with Mexican heritage and culture may develop new social and cultural norms and even different or new interpersonal relationships as they live in America as a Mexican-American.

       Understanding how these factors may change from person to person helps the nurse practitioner understand how to better understand and treat the patient. The developmental diversity observed in infants and children can occasionally be classified as "at risk" due to factors such as family background, biological exposure, war, adversity, or early behavioral issues (Masten & Kalstabakken, 2018). The aforementioned risk factors indicate the intricate nature of developmental processes in maturing individuals. While it is true that certain children who are identified as being at risk have the potential to develop into well-adjusted and thriving individuals (Masten & Kalstabakken, 2018). The development of individuals and their potential for competence, resilience, and psychopathology in the future may be influenced by their interactions with families, schools, and cultural organizations. This has been discussed in the literature by Chen and Liu (2016), Kerig (2016), and Masten (2014c).

References:

Boyce, W. T., & Kobor, M. S. (2015). Development and the epigenome: The “synapse” of gene–environment interplay. Developmental Science, 18, 1–23.

        http://dx.doi.org/10.1111/desc.12282Links to an external site.

Chen, X., & Liu, C. H. (2016). Culture, peer relationships, and developmental psychopathology. In D. Cicchetti (Ed.), Developmental psychopathology: Vol. 4. Risk,

      resilience, and intervention (3rd ed., pp. 723–769). New York, NY: Wiley.

Choudhury, S., & Kirmayer, L. J. (2019). Cultural neuroscience and psychopathology: Prospects for cultural psychiatry. Progress in Brain Research, 263–

      283. https://doi.org/10.1016/s0079-6123(09)17820-2

Harden, K. P., Engelhardt, L. E., Mann, F. D., Patterson, M. W., Grotzinger, A. D., Savicki, S. L., Thibodeaux, M. L., Freis, S. M., Tackett, J. L., Church, J. A., &

     Tucker-Drob, E. M. (2020). Genetic associations between executive functions and a general factor of psychopathology. Journal of the American

      Academy of Child & Adolescent Psychiatry, 59(6), 749–758. https://doi.org/10.1016/j.jaac.2019.05.006

Lunansky, G., Naberman, J., van Borkulo, C. D., Chen, C., Li, W., & Borsboom, D. (2021). Intervening on psychopathology networks: Evaluating

    intervention targets through simulations. https://doi.org/10.31234/osf.io/sqhje

 Masten, A. S., & Kalstabakken, A. W. (2018). Developmental perspectives on psychopathology in children and adolescents. In J. N. Butcher & P. C. Kendall

    (Eds.), APA handbook of psychopathology: Child and adolescent psychopathology (Vol. 2). American Psychological Association.

    https://doi.org/10.1037/0000065-002

Sameroff, A. (Ed.). (2019). The transactional model of development: How children and contexts shape each other. http://dx.doi.org/10.1037/11877-00

PEER 2

Quenia Alfrenard

        “The term “psychopathology,” from the Greek ψυχη´ (psyche) for “soul” or “spirit,” πα´θoς (pathos) for “suffering,” and λoγóτυπα (logos) for “reason,” “discourse” or “opinion,” roughly translates into “teachings of the sufferings of the soul” and was coined in 1878 by the German psychiatrist Hermann Emminghaus “ (Lutter, F., Schmidt, S., & Theodoridou, A., 2018). Psychopathology explores scientifically the abnormal state of mind. The skill of being able to able precisely and carefully assess psychopathology in a qualified manner use to be a core attribute of being a mental health professional however biological, psychological and social, cultural and interpersonal factors must be considered as well.

        The first factor to consider is the biological contribution to mental disorders. These biological elements include genetics, brain structures, the endocrine system and lastly the neurotransmitters which all play an important role when it comes to the development of mental health disorders. Observations in psychiatric disorders started back in the 20th century. In the studies of families which confirmed substantial familial aggregation for the main psychiatric disorders to include schizophrenia, bipolar disorder, depression, alcohol dependence as well as panic disorder, ADHD, drug abuse, autism and obsessive-compulsive disorders. Another biological factor that influences mental illness is the communication between the neurons in the brain (neurotransmission). An example of neurotransmission and it’s contribution to mental illness would be individuals who have lower serotonin levels which ultimately causes depression, anxiety and ADHD.

            Another factor that contributes to mental illness is one’s social factors. This factor takes into consideration in which where people live, where the individual live and where they work . Those with lower economic status have greater risks of having lower life expectancy, higher rates of child mortality and also has a greater burden of disease. “Overall, they found that poor and disadvantaged populations are most affected by mental disorders, and that cumulative stress and physical health serve as mechanisms through which the impacts of social determinants multiply across the lifespan” (Alegría et al., 2018). So one’s social detriments does  and may contribute to one’s mental health.

            Psychological factors absolutely contribute to mental illness. Psychological factors occur because of reasons such as childhood neglect, death of close family and friends, physical emotional and sexual abuse. These experiences may cause different types of traumatic mental illnesses such as panic disorders, depression, substance use or even suicidal thoughts or acts. Traumatic events can trigger different emotions ultimately causing trauma requiring treatment for recovery.

            Lastly¸ cultural and interpersonal factors that influence the development of psychopathology. In my opinion these factors I don’t believe influence the psychopathology in the aspect of contributing factors to the development of a mental health disorder. These factors  may affect the way one receives the information in regards to having  a mental illness, deciding to start or continue with a treatment plan or seeking help with suspected mental health disorder. Poor and unequal education, food insecurity, poor housing quality and housing instability, unemployment and underemployment, limited access to healthcare, poverty, and discrimination are all reasons and ways that reception of information in regards to mental  health because people in different social, cultural and interpersonal factors may affect ones understanding, acceptance and openness to mental health as a whole. One’s culture shapes their cultural belief so it does play a significant role on how one understands and cope with mental illness ultimately affect if one decides to seek help and support.

            In conclusion, biological, psychological and social, cultural and interpersonal factors are all important when it comes to mental health.  Moleiro (2018) “These influences arise from diverse origins, not only nationality, migration status, racial and/or ethnic origin, language, religion, and spirituality, but also age, gender identity, sexual orientation, socioeconomic and educational class, and functional status.”

References:

Schultze-Lutter F, Schmidt SJ, Theodoridou A. Psychopathology-a Precision Tool in Need of Re-sharpening. Front Psychiatry. 2018 Sep 19;9:446. doi: 10.3389/fpsyt.2018.00446. PMID: 30283368; PMCID: PMC6156265.

Moncrieff, J., Cooper, R.E., Stockmann, T.  et al. The serotonin theory of depression: a systematic umbrella review of the evidence.  Mol Psychiatry (2022).  https://doi.org/10.1038/s41380-022-01661-0Links to an external site.

Alegría M, NeMoyer A, Falgàs Bagué I, Wang Y, Alvarez K. Social Determinants of Mental Health: Where We Are and Where We Need to Go. Curr Psychiatry Rep. 2018 Sep 17;20(11):95. doi: 10.1007/s11920-018-0969-9. PMID: 30221308; PMCID: PMC6181118.

Moleiro C. Culture and Psychopathology: New Perspectives on Research, Practice, and Clinical Training in a Globalized World. Front Psychiatry. 2018 Aug 10;9:366. doi: 10.3389/fpsyt.2018.00366. PMID: 30147663; PMCID: PMC6097026.

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