DETERMINANTS OF PSYCHOPATHOLOGY/ETIOLOGICAL FACTORS

(What are the etiological factors (determinants/causes) of being NOTE: we don’t inherit the genes' disease; we inherit the
pathological?) predisposition/proneness

1. BIOLOGICAL (Genes or Genetic make-up) NEUROSIS vs. PSYCHOSIS

2. PSYCHOLOGICAL (stress)
3. SOCIO-CULTURAL (racial discrimination) Neurosis – mental distress that does not prevent rational thought or
daily functioning.
2 FACTORS IN HAVING PATHOLOGICAL ILLNESS
(Biological, psychological, socio-cultural) Psychosis – mental state involving the loss of contact w/reality;
causing the deterioration of normal social functioning.
1. PREDISPOSING FACTORS
- factors that make a person susceptible or vulnerable to a 1. BIOLOGICAL DETERMINANTS
particular disorder
- are constitutional traits; person at risk; susceptibility 1. Genetic make-up
- Dormant: Harder to recognize unless provoked by stressors 2. Body constitution
- Effect: remote; it took many years to manifest the depression 3. Biological deprivation
4. Noxious Agents
E.g. Students A & B failed (Precipitating factor) a subject
1.1 GENETIC MAKE-UP
Student A - not predisposed to depression - didn’t get depressed - We do not inherit the diseases/disorders
Student B - has predisposing factor to depression such as genetic - We inherit the predisposition > through chromosomes
make-up (family history) – developed depression - inherit the dominant gene (mother-->child)
- Researchers have not yet discovered the specific gene
2. PRECIPITATING FACTORS responsible for depression and schizophrenia
- Also called environmental stressor
- factor that triggers the onset of the behavior/disorder E.g. Huntington's disease
- Effect is immediate - manifested in later age like middle age
- The effect vary in time, severity, duration - Has been proven inherited; specific dominant gene
- Most individuals learn how to resist stressors w/coping strategies. - Huntington’s chorea (before)
- Symptoms: (1) Chorea & (2) Dementia
E.g. The "failing grade" is the precipitating factor - Chorea
 Motor symptom.
NOTE: In some cases--A person may have no predisposing factors  The patient is manifesting periodic, irregular course of
but the precipitating factors are so strong, the person will succumb to muscular contractions; particularly of the limbs or with
depressive episode. jerky movements of the limbs; as if dancing.
- Dementia
DISORDER (nosological entity)  general intellectual deterioration; cognitive impairment
 Progressive impairment of cognitive functioning.
Nosological – adj. a branch of mental science that deals with a  Low IQ score
classification or list of diseases
o Pseudodementia
BRIEF PSYCHOTIC DISORDER  false deterioration of intellectual capabilities/functioning;
- Sudden onset interest is not present; motivation is absent
- Lost contact with reality  e.g.: Low IQ score
- not more than 4 weeks  reason is not slow
- then will return to pre-morbid level of functioning thinking (what  he/she might be depressed
you were before you manifested BPD) or return to pre-morbid  No motivation to answer the IQ test
thinking
- Cause: Too much stress - Bender Gestalt Visual Motor Test
 Patient’s drawing is distorted because patient cannot copy
figures w/rotation.
SCHIZOPHRENIFORM DISORDER  Soft sign for brain damage (right hemisphere) or
- Limited duration schizophrenia.
- Not more than 6 months but not less than a month
1.2. BODY CONSTITUTION
SCHIZOPHRENIA -biological make-up of the individual (height, size, body built)
- loss of contact with reality
- for more than 6months (6 months and beyond) 1. Body Built (Physique)
- chronic case 2. Receptor Condition

1
Body Built (Physique) Rechmeir and Sheldon 2.1. FRUSTRATION
Example: - Can be (1) Personal or (2) Environmental
Slim: prone to schizo - Part of living, part of being human
Fat: prone to manic-depressive - If don’t get what you want to achieve
- A mood of general dissatisfaction or restlessness
Note: as a clinical psychologist, we do not use this because this is not - Discomfort: can lead to fixation (hoping for needs to be satisfied)
scientific. - may manifest anger (normal reaction to frustration especially when
coming from external)
Receptor Condition - Gives you “Dysphoria”: Feeling of unpleasantness or discomfort
- Conditions of the sense organs; for every sense of modality,
there is a specific receptor. 2.2. OVERGRATIFICATION
Example: - too much gratification
- Sight > rods and cones of retina - can lead to fixation (an arrest in the development of an
- Hearing > organ of corti/hair cells inside cochlea “inner ear” individual, does not go to the next level of development)

- maybe constitutionally strong/weak FREUD’S PSYCHOSEXUAL OF DEVELOPMENT

- Are they constitutionally weak or strong?
1.) Oral stage
E.g. Conversion Disorder a) Early phase: sucking
- Somatoform disorder - Oral- incorporative character: greedy or voracious eater
- Psychological conflicts are transformed into physical b) Late phase: biting
impairment or disability in the absence of sensory deficit. - Oral-sadistic character: sarcastic, brutally frank, fond of
Constitutionally weak are easily affected. criticizing
- Feel helpless/weak ego strength — more prone to develop
PTSD.. Strong ego — they fight.. 2.) Anal stage
- “The rope breaks where it is thinnest.” a.) Early phase: expulsion / excretion of waste / fecal matter
 Young children are susceptible than older person - Anal- expulsive character: generous people
b.) Late phase: retention
Sample situation: - Anal-retentive character: clean, orderly, tidy, perfectionistic,
2 soldiers were both subjected to traumatic event (warzone) selfish, stingy, obstinate, hard-headed, miticulous
- Soldier A: develops blindness = Eyes: constitutionally weak (Making the person at greater risk to develop OCD, OCPD)
- Soldier B: develops deafness = Ears: constitutionally weak
- Medical tests’ result: there’s nothing wrong with the visual and 2.3. EXCESSIVE USE OF DEFENSE MECHANISMS /
auditory pathways MENTAL MECHANISMS / MENTAL DYNAMISMS

- May become mental symptoms/symptoms of psychopathology

1.3. BIOLOGICAL DEPRIVATION
- Defense Mechanism
- deprived from food, water, sleep  Unconscious in nature/ not aware of its employment
 Must be employed in moderation/right amount/following
1.4. NOXIOUS AGENTS the golden rule of mean
(Harmful, negative, not desirable)  Bec. over use can lead to psychopathology
- We use defense mechanism to
1. Toxic Chemicals (drugs, alcohol, led, mercury)  Preserve the integrity of the ego by warding off anxiety
2. Injury/Accident (precipitating) - EGO
 Analyze, organize id and superego
Example:  Executive of personality-ego functions must be carried out
- Damaged medial temporal lobe = “anterograde amnesia” efficiently
(Is a loss of the ability to create new memories after the event that caused the  Reality principle
amnesia, leading to a partial or complete inability to recall the recent past, - EGO STRENGTH — extent to which the ego functions are
while long-term memories from before the event remain intact.)
carried out efficiently
- Amygdala-emotional memory (anger, sadness)  Carried efficiently: strong
- Hippocampus - memory (consolidates short term to long term  not carried efficiently: weak
memory) - EGO FUNCTIONS — makes compromise of the demands
between id and superego
2. PSYCHOLOGICAL DETERMINANTS - Intellectualization

1. Frustration Example:
2. Overgratification Schizophrenia (disorganized)
3. Excessive use of defense mechanisms or mental mechanisms or - Formerly called as Hebephrenia
mental dynamisms  "hebe"-goddess of youth "young"
4. Psychological stress  "Phrenia"- mind
5. Trauma
6. Psychological deprivation Reaction Formation

2
- OCD (Obsessive Compulsive Disorder) - can lead to psychosomatic disturbances/behavior problems

EXAMPLE SITUATION: Example:

1. Essential hypertension
1.) Denial – refusal to admit the reality or painful truth.  Psychological in nature
 Psychogenic in origin/nature
Conversion Disorder 2. Skin rashes, hair falling (alopecia), migraine, impotent and
Soldier A: develops blindness diarrhea
Soldier B: develops deafness  Because of body-mind interaction; pain without any
anatomical or physiological cause.

2.) Regression – unconscious return to an earlier and less mature 2.5 TRAUMA
level of adaptation. - Something that is shocking to the person
- Can lead to: PTSD & ASD
Having a low score in exam  Acute Stress Disorder (1 month or 4 weeks)
- Throw tantrums  Post Traumatic Stress Disorder (beyond 1 month)

Behaving Life an Infant most of the day 2.6 PSYCHOLOGICAL DEPRIVATION

- Depression / being depressed - Deprived of Psychological or Psychosocial needs (love,
- Hypersomnia – excessive sleepiness attention, recognition, power)
- Insomnia- difficulty going to sleep - Can lead to attention-getting behavior

3.) Reaction Formation – the individual does the direct opposite of
what he/she is feeling.
1st: represses that is unacceptable (forgetting)
2nd: assumes an opposite behavior or attitude to what was regressed
Example:
A student got poor grades.
It attracts the attention of a teacher.
Then the teacher will ask the student.
This behavior is called reinforcement.

Overprotective mother Student getting no attention engage in attention-getting behavior

- Rejection of child: repressed--making the mother overprotective Teacher: gives reinforcement to attention by getting mad.
of her offspring
- Reaction formation now become symptom - Others may lead to maladaptive behaviors/attempts to adjust to
- Overuse: obsessive-compulsive disorder the ungratified psychological needs. (Ex. Drugs, alcohol, sexual
- EGO DYSTONIC promiscuity)
 something unacceptable to ego - Maladaptive Patterns – Conduct Disorder
 can produce anxiety
Possessiveness — anything in excess is a reflection of reaction 3. SOCIO-CULTURAL DETERMINANTS
formation (case to case basis) 1. War
2. Poverty
4.) Isolation – in which memory of an unacceptable act or impulse is 3. Unemployment
separated from the emotion originally associated with it. 4. Racial discrimination
5. Residential mobility (in connection with work)
- Idea or thoughts or action attached to affect 6. Rural/urban setting (urban stressors/more stress)
- Prominent in OCD (detached/separated)  Causes of Psychopathology or Abnormal Behavior
- interplay of many determinants
Pathological Gambling (impulsive control disorder) -
- No control of gambling to the extent of selling everything Predisposing - far ; Precipitating – immediate
- Difficulty resulting gambling Example: A person with depression or with family history of
- Isolation was overuse depression living in an urban setting.

NOTE: it is difficult to pinpoint one cause of abnormality, it is

Cheating always mixed factors.
- You are guilty.
- So you isolate affect to the idea/action.
- Eventually the feeling of guilt or anxiety will diminish.
- You can do the same thing repeatedly (like in case of OCD)

NOTE: Defense mechanisms must be use in moderation to be

EFFECTIVE. If excessively used, it becomes a symptom.

2.4. PSYCHOLOGICAL STRESS

- Different stresses that we encounter in our everyday life.
3