Etiologies Of Psychological Disorders

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In your role as a human services professional, it is imperative you understand the etiologies of psychological disorders as you work with justice-involved individuals. Identifying the cause of a psychological disorder, whether intrinsic, extrinsic, or idiopathic, provides you with a basis for determining the root cause of the disorder.

Anna had a long history of severe mental illness dating back more than 20 years. During her first depressive episode, she had killed her baby while suffering psychotic symptoms. She also made two serious suicide attempts. Anna has been divorced twice and now lives alone in federally subsidized home. She has an adult daughter who is deaf and severely handicapped. Prior to her last arrest, her daughter lived at home, and Anna cared for her with help from local social services. Her daughter was placed in residential care when Anna was incarcerated. Because of the previous infanticide, social services had always monitored the situation regarding risk factors for her daughter’s safety; however, this was less of an issue now that her daughter was an adult. Anna’s illness history is characterized mainly by depressive episodes with psychotic features. She had experienced episodes of paranoid thoughts when she believed her neighbors knew all about the past and she was reluctant to go out because she felt persecuted. Anna felt extreme guilt at having killed her child. When psychotic, she would shout that she was evil and deserved to be punished. It seemed that the guilt had affected her considerably to manifest in a negative self-concept. Even when well, Anna never spontaneously talked about herself in a positive manner.

Primary Diagnosis:
Major Depressive Disorder – recurrent, severe, with psychotic features. DSM-5 296.35, ICD-10 (F33.3)
Generalized Anxiety Disorder (GAD). DSM-5 300.02, ICD-10 (F41.1)
You are continuing in your role as a human services professional working at a psychological treatment center in a local correctional facility. You will be sitting in on a session between the individual from your chosen scenario in the case study and their psychiatrist, and your supervisor wants to ensure you understand the complexities of the disorder before the session. Your supervisor has asked you to prepare an analysis of the etiologies of the disorder development to review before the session.

Research the disorder diagnosed in the scenario you chose to learn more about symptomology and etiology.

700 word analysis of the symptoms presented by the individual in the scenario to determine a possible etiology. If necessary details are missing from the case study, fill in the gaps with information from your research. In your analysis, you should:
Describe the symptoms presented by the client.
Analyze symptom development within the client. Consider these guiding questions:
When did the symptoms begin?
How often do the symptoms occur?
How long do the symptoms last? Have they changed over time?
Analyze possible risk factors presented by the client that could have led to the diagnosis. Consider these guiding questions:
Are men or women more commonly diagnosed with this disorder?
Are there situational factors that commonly contribute to this diagnosis?
Analyze the etiology of disorder development from a biological, psychological, and social perspective

Sample Solution

Analysis of Possible Etiologies for Anna’s Major Depressive Disorder with Psychotic Features

Anna’s case study presents a complex picture of Major Depressive Disorder (MDD) with psychotic features, along with Generalized Anxiety Disorder (GAD). Understanding the potential etiologies (causes) of her disorders requires examining the presented symptoms, possible risk factors, and a multi-perspective approach considering biological, psychological, and social factors.

Analysis of Presented Symptoms:

  • MDD Symptoms:
    • Depressive episodes lasting over 20 years.
    • Feelings of extreme guilt related to the infanticide incident.
    • Negative self-concept, not speaking positively about herself.
    • Suicidal ideation and attempts.
    • Difficulty caring for her daughter due to her illness.
  • Psychotic Features:
    • Paranoid thoughts believing neighbors know about the past.
    • Auditory hallucinations (hearing voices) – shouting that she is evil and deserves punishment.
    • Reluctance to go out due to fear of persecution.
  • GAD Symptoms:
    • Generalized anxiety not focused on any specific threat.

Symptom Development Analysis:

  • MDD: The onset of MDD symptoms is not explicitly mentioned, but the case study states a “long history” of over 20 years.
  • Psychotic features: It is unclear when the psychotic features began; however, the case study mentions them occurring during depressive episodes.
  • GAD: No specific timeline is provided for the development of GAD symptoms.

Possible Risk Factors:

  • Gender: While MDD is more prevalent in women, men can also be diagnosed.
  • Situational factors: The infanticide incident, subsequent social service involvement, and daughter’s placement in care could be significant situational stressors contributing to her MDD and possibly GAD.
  • Family history: The case study does not mention any family history of mental illness, but it is a potential risk factor for MDD and other mental health conditions.

Etiology Analysis:

1. Biological Perspective:

  • Neurotransmitters: Imbalances in neurotransmitters like serotonin, norepinephrine, and dopamine are linked to MDD and may contribute to the negative self-concept and anhedonia (inability to experience pleasure) sometimes seen in MDD.
  • Genetics: While not conclusive, research suggests a genetic predisposition may increase susceptibility to MDD, though environmental factors are likely necessary for its development.
  • Brain structure and functioning: Studies suggest potential abnormalities in brain regions involved in mood regulation and emotion processing in individuals with MDD.

2. Psychological Perspective:

  • Cognitive factors: Negative thinking patterns, such as rumination (focusing on negative thoughts) and hopelessness, can contribute to and maintain depressive episodes.
  • Learned helplessness: Repeatedly experiencing negative events without a sense of control can lead to feelings of helplessness, potentially contributing to MDD.
  • Early life experiences: While not mentioned in the case study, childhood trauma, neglect, or abuse can increase the risk of developing MDD later in life.

3. Social Perspective:

  • Stressful life events: As mentioned earlier, the infanticide, social service involvement, and daughter’s placement could be significant stressors contributing to her MDD and GAD.
  • Lack of social support: Social isolation and loneliness can worsen symptoms of depression and anxiety.
  • Socioeconomic factors: Poverty, unemployment, and lack of access to healthcare can contribute to the development and maintenance of mental health disorders.

It is important to note that MDD with psychotic features is a complex disorder, and the specific etiology in Anna’s case is likely due to a combination of factors from all three perspectives (biological, psychological, and social). Further evaluation by a qualified mental health professional is necessary to determine a more specific diagnosis and develop a comprehensive treatment plan.

Additional Considerations:

  • The case study mentions Anna’s diagnosis of GAD. While not the focus of this analysis, it is important to acknowledge that co-occurring disorders are common, and their interactions can influence symptom presentation and treatment approaches.
  • The information available in the case study is limited. A more comprehensive understanding of Anna’s situation, including her family history, personal experiences, and past treatment attempts, would be crucial for a more complete analysis of the potential etiologies of her disorders.

By understanding the possible etiologies of Anna’s MDD with psychotic features, the human services professional can better work with her psychiatrist to develop a treatment plan that addresses the underlying causes of her disorder and helps her manage her symptoms effectively.

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