The number of people who are challenged by mental health issues is much larger than most realize. According to the National Alliance on Mental Illness (NAMI), 1 in 5 adults in the U.S. experience mental illness each year. Furthermore, NAMI reports that 1 in 20 adults experience a serious mental illness each year. Half of mental illness cases develop by age 14, which means that it’s important to look for the warning signs early.
Mental illness has the potential to impact a person’s physical health, family and community. NAMI reports that those who are suffering from depression are 40% more likely to develop metabolic and cardiovascular diseases. Additionally, people with mental illnesses are more likely to abuse drugs and alcohol, become unemployed and drop out of school. NAMI also reports that substance abuse and mental illness are involved in approximately 1 of 8 emergency room visits.
Given the scope and impact of mental health issues, frontline health care workers need to be cognizant of the associated symptoms and problems when treating patients. To recognize and handle these cases effectively, they rely on psychopathology, which is the body of knowledge related to mental health disorders.
By learning the concepts of psychopathology, health care workers can gain a better understanding of how mental health conditions originate in patients, how they are identified and how they can be treated. For a nurse practitioner or other advanced clinician, having a thorough understanding of what psychopathology is can help them differentiate symptoms originating from a mental health disorder, symptoms that relate to other medical conditions and behaviors that are not indicative of a health problem at all.
Defining Psychopathology
Psychopathology is the in-depth study of all the different attributes that pertain to mental health. That includes the development of mental health issues, their causes, the behaviors and symptoms associated with them and the strategies used when treating patients with mental health disorders. Since psychopathology is a comprehensive discipline, it is concerned with every facet of mental health disorders, from the research process to treatment.
A broad range of health care professionals apply the principles of psychopathology in their work. Clinical psychologists, nurse practitioners, psychiatric nurses and psychiatrists all benefit from an in-depth understanding of psychopathology. Family practice physicians, pediatricians, surgeons and other health professionals rely on their background in the field from time to time. Professionals in nonmedical fields, such as criminologists and social workers, utilize psychopathology as well.
The discipline of psychopathology is what professionals in health care and beyond rely upon to identify individuals who may be experiencing a mental illness. Signs of psychopathology include:
- Inability to maintain personal relationships
- Withdrawal from school, work or social activities
- Difficulty handling daily life
- Thoughts of suicide or self-harm
- Difficulty sleeping or sleeping too much
- Fatigue or lethargy
- Drastic mood swings and irritability
- Difficulty focusing
- Feelings of hopelessness or distress
- Excessive fear, anxiety or worry
- Changes in eating habits, such as eating too much or too little
However, well-trained practitioners know that a person may exhibit one or several symptoms relating to psychopathology without the presence of a mental disorder. When evaluating a patient, they will also consider the severity or frequency of behaviors in the context of four areas of concern:
- Deviance: Refers to the degree to which behaviors, emotions and thoughts are deviating beyond what is considered normal
- Distress: Refers to the negative feelings experienced by the patient and those around them
- Dysfunction: Refers to the level of inability to perform daily functions such as going to school or work
- Danger: Refers to the risk the patient poses to themselves and those around them
Health care professionals must also consider biological and nonbiological factors that may increase risk for or exacerbate the symptoms of a mental health disorder. This includes attributes such as genetics, brain chemistry and chronic medical conditions. It also includes things like an individual’s living situation, past traumatic experiences and a lack of support from friends and family.
Considering all the factors of psychopathology can help nurses and other health care providers properly differentiate between psychopathological behaviors and typical behaviors. By extension, this can shape the health care strategy and treatment plan for the patient.
Psychopathological Diagnostic Models
Just as health care workers use diagnostic models to identify and assess physical injuries and illnesses, they rely on multiple psychopathological diagnostic models to classify mental health disorders.
Diagnostic and Statistical Manual of Mental Disorders (DSM)
Now in its fifth iteration, the DSM was created by the American Psychiatric Association to be a reliable system of assessment for mental illness. Using identifiable criteria such as symptoms and behaviors, mental health professionals are equipped to arrive at a specific diagnosis (e.g., bipolar disorder, social anxiety disorder) for each patient. As new research is conducted and more information comes to light, the DSM is amended to remain current with the modern health care landscape.
International Classification of Diseases (ICD)
The ICD and DSM are similar systems but with some very important distinctions. First, the ICD is available for free on the internet; the DSM is only available through purchase. Second, the ICD includes both medical and mental health diagnoses; the DSM only covers mental health. Third, the ICD is developed and produced by the World Health Organization, a global agency; the DSM is produced by a U.S. psychiatric association. The eleventh edition of the ICD, or ICD-11, is approved by the World Health Assembly, which consists of health ministers from nearly 200 countries.
Research Domain Criteria (RDoC)
While the ICD and the DSM are oriented around a checklist format to diagnose mental health disorders, RDoC represents an alternative methodology. Rather than grouping the symptoms and signs of psychopathology to arrive at a diagnosis, RDoC utilizes a research framework that pulls from different areas such as experimental psychology, genomics and neuroscience. Although RDoC is new and primarily aimed at planning and funding research, it may help clinicians understand how the symptoms of a mental illness can be present even when the patient does not meet the diagnosis criteria for a disorder.
The Nurse’s Role in Psychopathology
Psychopathology is essential to understanding how mental health disorders are identified and how they’re treated. Aspiring health care professionals might wonder: “What is a nurse’s role in psychopathology?”
Although it’s not a discipline taught in the typical Bachelor of Science in Nursing program, psychopathology is an important area of focus for graduate level nursing students who are specializing in the field of psychiatric-mental health.
Psychiatric-mental health nurse practitioners, or PMHNPs, are advanced practice nurses with either a Master of Science in Nursing (M.S.N.) or a Doctor of Nursing Practice (D.N.P.) degree. They rely on a foundation in psychopathology to effectively diagnose patients and build more effective care delivery strategies.
Specialized nurses like PMHNPs are better equipped to help their patients because of their expertise in psychopathology and the utilization of proven diagnostic models like the DSM. Additionally, having an in-depth understanding of psychopathology enhances essential nursing skills such as analytical and interpersonal competencies. Just as important, PMHNPs often employ leadership skills such as empathy and open-mindedness, which can bolster workplace morale and improve patient outcomes.
Provide an Essential Kind of Care
Considering the wide array of mental health disorders and the large number of people affected by them, improving access to effective psychiatric-mental health nursing is a critical priority for the health care system. Advanced practice nurses like PMHNPs can help fill the growing deficit of qualified mental health professionals in the U.S., and their education and skill set make them particularly useful at breaking down the stigma that often accompanies mental health problems.
One way to get started in the field of psychiatric-mental health is by pursuing an advanced degree, such as a Master of Science in Nursing (M.S.N.) program at the University of North Dakota. Conveniently taught 100% online, the program offers a Psychiatric-Mental Health Nurse Practitioner concentration for those who aspire to work with individuals and groups who are affected by mental health disorders. Graduates of the program will enter the field with the skills to conduct physical and mental health assessments, design holistic treatment plans and provide psychotherapy to their patients.
Begin your journey to becoming a mental health professional skilled in the discipline of psychopathology with the University of North Dakota.
Recommended Readings:
Diversity in Nursing: Benefits and Resources
Example Sources:
American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR)
The Harvard Gazette, “Nurse Practitioners Fill Care Gaps Amid Surge in Mental Health Demand”
Mental Health America, Adult Data 2022
National Alliance on Mental Illness, Mental Health by the Numbers
National Institute of Mental Health, About RDoC