Etiology: causal pattern of abnormal behavior

• Distal Cause (Predisposing Factors)

  • past

  • a condition that occurs relatively early in life but may not show its effect may contribute to a predisposition to develop a disorder

  • Distal: long time ago

  • when it happened, it did not show an effect on the person but it now contributes to the predisposition or risk or tendency

• Proximal Cause (Precipitating Factors)

  • present

  • a condition that proves too much for a person and triggers a disorder

  • Proximal: very near; condition or event is very close to the onset of the symptoms; triggering effect

• Reinforcing Cause (Perpetuating Factors)

  • future

  • a condition that tends to maintain maladaptive behavior that is already occurring

  • Reinforcing: disorder is already present, however, there is something that is happening that is maintaining the symptoms; continuing

Examples:

• Situation: A vase was broken and repaired.

  • Distal Cause: Vase has a hairline.

  • Proximal Cause: Someone sings and the vase breaks again.

  • Reinforcing Cause: Vase is continuously in danger of breaking.

• Situation: The child is left alone by mom. Child used to be very attached to the mother, 30 years later, he was supposed to get married but the bride left him.

  • Distal Cause: abandonment of female attachment figure

  • Proximal Cause: rejection

  • Reinforcing Cause: becomes a regular user of dating apps to prevent loneliness

Linear Causal Model vs Multiple Causal Model

Linear Causal Model: x → y

Multiple Causal Model:

x1, x2, x3→ y

Diathesis-Stress Model

• Diathesis: a predisposition toward developing disorder that can derive from biological, psychological, and/or sociocultural causal factors

  • Many mental disorders are conceived as a product of stressor operating on a person who has a diathesis for the type of disorder that emerges,. Distal causal factors interact with proximal causal factors.

  • Loaded Gun Metaphor:

    • bullet (distal) → diathesis (biological, psychological, and sociocultural disposition)

    • Diathesis will only be triggered if there is a stressor (trigger → proximal)

    • reinforcing: there is now a disorder

  • Protective Factors: influences that modify a person’s response to an environmental stressor, lessening the impact of stress

    • biological, psychological, sociocultural, that will lessen or protect the impact of the stressor

• Primary Gain: getting out of responsibilities

• Secondary Gain: sympathy from others

• Vulnerability: adaptation < stress

• Resilience: adaptation > stress

Biological Viewpoint or Perspective

• mental disorders are viewed as diseases

• focused on the role of biological factors in explaining disorders

• disorders of the CNS, biochemistry, or the endocrine system are either inherited or caused by some pathological causes

• Biological Causal Factors:

  • neurotransmitter and hormonal imbalances

  • genetic vulnerabilities

    • faulty genes

  • brain dysfunction and neural plasticity

    • there are still aspects of the brain that are malleable, can change even with dysfunction

Psychological Perspective

• the development of mental disorders is affected by early experiences, social influences, and psychological processes within an individual

  • early childhood, social relationships

1. Psychodynamic Perspective

   • focuses on inner dynamics and motives (primarily unconscious), the personality of individuals, and early childhood experiences in explaining disorders

   • from a psychoanalytic perspective, psychological problems develop out of an inadequate resolution of conflicts that develop in one of stages of development

   • Classical Psychoanalysis (Freud)

     • Anxiety: generalized feelings of fear and apprehension which warns of impending danger and painful experience so it forces a person to take corrective action

       • Types of Anxiety: reality anxiety, neurotic anxiety, moral anxiety

     • For the ego to manage the anxiety from inner, unconscious conflicts, ego defense mechanisms are used. However, the ego defenses (unconscious processes that distort reality to reduce ego anxiety) undermine the capacity of the ego to deal with reality.

2. Behavioral Perspective

   • emphasizes the influence of environmental conditions (e.g., stimuli, consequences) in how individuals learn maladaptive behavior

   • learning of maladaptive behavior is influenced by environmental conditions (e.g., stimuli, consequences)

   • learning is not adaptive to the environment

   • maladaptive behavior is the result of:

     • failure to learn necessary adaptive behavior

     • learning ineffective or maladaptive responses

   • Learning Principles

     • Generalization: “I was ghosted by one so I will not love again.”

     • Discrimination: “Women are all different.”

     • Observational Learning

3. Cognitive Perspective or Cognitive-Behavioral Perspective

   • posits that distorted thought patterns and information processing lead to maladaptive emotions and behavior

   • starts with the head, logical reasoning, way of interpretation → emotions are adaptive

   • usually allied with behavioral

   • thinking affects emotions

   • Aaron Beck: Negative Triad

• looking at the self, world, and future in a negative way (pattern over time → disorder [depression])

• Non-Suicidal Self-Injury (NSSI): anything you do that can physically harm yourself is self-harm; maladaptive behavior

• Acting Out Behavior: self-destructive behavior that harms yourself

4. Humanistic Perspective

   • emphasizes the unique capacities of the individual and the fulfillment of potentials

   • problematic behavior develops as result of social and cultural factors that impede the growth, self-actualization, and full expression of the personality

   • emphasize that each individual is unique; actualizing motive: realizing own potential

   • “How can you be adaptive if you do not know who you are?”

   • awareness is important

   • more positive

• Existential Perspective

  • views maladaptive behavior as a product of an individual’s failure to deal consecutively with existential despair and frustration

  • coupled with humanistic

    • dark

    • sees reality and suffering as it is

    • depression, anxiety develops

  • Existential Givens

    • Freedom (and personal responsibility)

      • free to choose to become whoever or whatever you want but you are responsible for it

    • Existential Isolation: we are existentially alone; born alone and die alone

      • Interpersonal Isolation: lonely, estranged from other people

    • Meaningless

    • Death: death is certain but where and how is not certain

5. Family Systems or Systemic Perspective

   • the problem shown by an “identified patient” is often a symptom of a larger family problem or dysfunctional family dynamics

   • we can view a person with a problem in a systemic way (thinking in terms of systems)

   • Dysfunctional Family: dysfunction in the dynamics of the family

   • “Identified Patient”: who manifests mental disorder

Psychosocial Causal Factors

1. Schema and Self-Schema

   • cognitive

   • Schema: mental representation of something

   • Self-Schema: mental representations of yourself

2. Early Deprivation or Trauma

   • experience of deprivation or trauma in life

3. Inadequate Parenting Styles

   • Parental Psychopathology: parent who has a mental disorder can affect the children (biologically and they will not be equipped to parent a child; behavior might be erratic or emotions are not stable)

   • Parenting Styles: If parenting styles do not match with parents, children will have a hard time

   • Inadequate, Irrational, Angry Communication (e.g., double-bind communication): problematic communication with parent or children

4. Maladaptive Peer Relationships

Sociocultural Perspective or Viewpoint

• focuses on social and cultural factors that influence the development of maladaptive behavior of individuals

• sociocultural causal factors:

  • gender

  • low socioeconomic status and unemployment

  • non-conducive environments

  • social change and uncertainty

  • social and interpersonal factors on health and behavior

  • cultural attitudes about health and behavior

Biopsychosocial Model

• An interactive model that views most disorders as the result of many interacting causal factors -- biological, psychological, and sociocultural. The particular combination of causal factors may be relatively unique for an individual.

  • each person will have a unique combination of these factors