Main Discussion Post: Factors that influence the development of psychopathology

Needless to say, this is a broad, multifactorial, and very complex subject! Numerous factors are involved in the development of psychopathology, and a thesis could be written, so I will expound on a few of them. Biological, social, psychological, cultural, ethnic, socioeconomic, genetic, developmental, cognitive, age, gender, gender identity, experiential, familial, endophenotype (characteristics not seen), and environmental are some factors involved that increase the risk of psychopathology.

It is well known that there is a genetic component to psychiatric illness and physiologic differences in parts of the brain and with neurotransmission that affect personality, temperament, cognition, sensory input interpretation, and behavior. Psych disorders can be associated with specific genes and probably a combination of effects from multiple genes. Cognition influences psych disorders and psych disorders influence cognition. Abnormal anatomy and circuitry have been observed. There is a pattern of reduced neocortical thickness common across all psychiatric disorders and is a feature of general psychopathology. A thinner neocortex has been associated with numerous negative outcomes throughout life, such as brain age vs. chronological age associated with lower intelligence in midlife. A thinner cortex has also been associated with the internalization, externalization, and thought disorder aspects of psychiatric illness and the progression of symptoms with Alzheimer’s disease (Romer et al., 2021).

The role of age and development in stages of life, especially during childhood and adolescence, impact psychopathology. Minor changes in life circumstances impact mental health and behavior due to a lack of communication and coping skills. Symptoms are often unrecognized or overlooked as part of childhood that will be outgrown. Prenatal and perinatal influences, injuries, and illnesses, parenting styles, genetic predispositions, epigenetics, and environmental factors shape what and how the predispositions are ultimately expressed. Mood and anxiety disorders in childhood lead to persistent psychiatric issues in adulthood. Traumatic experiences, gender, and social expectations and the stress that accompanies the expectations, access to services, sibling influences, polypharmacy, overmedication, and inappropriate use of antipsychotics for anxiety, religious, cultural, and ethnic factors that influence thoughts and behaviors, substance use, and abuse and environmental factors all influence and increase the risk of psychopathology (Butcher & Kendall, 2018).

Sociocultural influences, especially related to immigrants and refugees, are contributing factors. Adapting to a different culture, parental and family separation, lower socioeconomic status and poverty, unemployment, and lack of education lead to minority stress related to discrimination and/or perceived discrimination and disparities in treatment and access to care. The DSM-5 has begun to address this in the Outline for Cultural Formulation, but it is still lacking (Cheung & Mak, 2018). Diagnosticians can get it wrong, which skews incidence and prevalence.

A study done by Class et al. has discussed the p factor, a general factor of psychopathology. It manifests individual differences in one or more expressed traits, but especially negative emotionality, which is tied to risk for all psychopathology, not including psychosis or personality disorders. `It was a 12-year study which observed a link between child temperament and stress, family transitions, and parenting styles and predicted future psychopathology (2019).

Research has also connected poverty and socioeconomic status to changes and variations in brain structure and function on self-regulation. Gaps in socioemotional domains and cognition are linked to poverty. Neurobiology connected to self-regulation, poverty, and its effects on neurodevelopment increase the risk for psychopathology (Palacios-Barrios & Hanson, 2019).

Environment and non-genetic cumulative exposures beginning at conception have brought about an “exposome paradigm” akin to genomics research to help understand the role of environmental factors such as psychological trauma, exposures to noise and air pollution, and weather, among other things that can predispose, precipitate, and perpetuate both risk and protective factors that influence psychiatric outcomes. It has been found that biological pathways can induce epigenetic changes that can modify behavioral phenotypes and increase susceptibility to stress and even alter presynaptic dopaminergic functioning (Erzin, & Gülöksüz, 2021).

References

Butcher, J. N., & Kendall, P. C. (2018). Introduction to childhood and adolescent

psychopathology. In J.N. Butcher & P. C. Kendall (Eds.), APA handbook of

psychopathology: Child and adolescent psychopathology., Vol. 2. (pp. 3-14). American

Psychological Association. https://go.openathens.net/redirector/waldenu.edu?

url=https://doi.org/10.1037/0000065-001

Cheung, F. M., & Mak, W. W. S. (2018). Sociocultural factors in psychopathology. In J. N.

Butcher & J. M. Hooley (Eds.) APA handbook of psychopathology: Psychopathology:

Understanding, assessing, and treating adult mental disorders., Vol. 1 (pp.127-147).

American Psychological Association. https://goathens.net/redirection/waldenu.edu?

url=https://doi.org/10.1037/0000064-006

Class, Q. A., Rathouz, P. J., Zald, D. H., Van Hulle, C. A., Applegate, B., & Lahey, B. B. (2019).

Socioemotional dispositions of children and adolescents predict general and specific

second-order factors of psychopathology in early adulthood: A 12-year prospective study.

Journal of Abnormal Psychology, 128(6), 574–584. https://doi.org/10.1037/abn0000433

Erzin, G., & Gülöksüz, S. (2021). The exposome paradigm to understand the environmental

origins of mental disorders. Alpha Psychiatry, 22(4), 171–176. \

https://doi.org/10.5152/alphapsychiatry.2021.21307

Palacios-Barrios, E. E., & Hanson, J. L. (2019). Poverty and self-regulation: Connecting

psychosocial processes, neurobiology, and the risk for psychopathology. Comprehensive

Psychiatry, 90, 52–64. https://doi.org/10.1016/j.comppsych.2018.12.012

Romer, A. L., Elliott, M. L., Knodt, A. R., Sison, M. L., Ireland, D., Houts, R., Ramrakha, S.,

Poulton, R., Keenan, R., Melzer, T. R., Moffitt, T. E., Caspi, A., & Hariri, A. R. (2021).

Pervasively thinner neocortex as a transdiagnostic feature of general

psychopathology. American Journal of Psychiatry, 178(2), 174–182.

https://doi.org/10.1176/appi.ajp.2020.19090934