Psychopathology is a branch of psychology that deals with the study of mental disorders and illnesses. It seeks to understand a mental condition by putting it within the realms of biological, sociocultural, and psychological frameworks. The focus of the study will be to explore literature materials to examine the model of psychopathology as regards the provided case study of Annie. Part of the paper will deal with assessment instruments that are culturally sensitive and also help in creating a rationale for the treatment of Annie. Finally, the discussion will also center on the assessment instruments and the value of measuring outcomes.
Examining Models of Psychopathology
The biological model primarily employs a medical perspective. Marsella & Yamada, (2010) asserted that it treats psychological abnormalities as an illness that results from the malfunctioning of different parts of the brain. Research has also established a close relationship between psychological disorders and problems in specific brain regions. For instance, neurotransmitter problems have been associated with disorders such as anxiety and depression. Annie asserts that she suffers from anxiety and fear. From a biological point of view, the high chances are that Annie has abnormal norepinephrine and serotonin levels, all of which contribute to her anxiety and depression. Nolen-Hoeksema et al., (2017) asserted that a positron emission tomography (PET) scan would, therefore, be essential in checking the amounts of these neurotransmitters in her central nervous system.
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The psychological approach is premised on the fact that individuals suffer mental health issues as a result of an interplay of various psychological factors that an individual is not aware of. Sigmund Freud explained this using the three parts of the human psyche including the Id, Ego, and the Superego. Psychological problems would occur if these three parts engaged in conflict (Nolen-Hoeksema et al., 2017). From a psychological perspective, Annie would need to uncover her causes of inner conflicts and trauma that could have resulted in the instability in her Id, Ego, and Superego.
The sociocultural model is premised on the fact that the mental health of an individual is dependent on the social and cultural forces affecting a person. Therefore, understanding the abnormal behavior of a person requires a keen assessment of a person’s social norms (Marsella & Yamada, 2010). Some of the critical aspects to look into including the culture, family structure, and the role played by social networks. Annie constantly travels to India where she is exposed to a culture that she is not familiar with. She can only speak English as she is not fluent with the local Indian dialect. Applying the sociocultural model requires an assessment of how Annie feels when she is in India, a place she is not accustomed to.
Assessment Instruments to Aid in Diagnosis
From the case study, it remains crucial to note that Annie is 13 years of age and has been hospitalized for three weeks as a result of a severe mental illness. Although she has shown good health, she has experienced bouts of fears and anxiety. She avoids meeting new people and shows extreme anxiety while doing tests. Also, she avoids large groups of people. Several culturally appropriate assessments instruments could be used in her therapy. The first tool to be used is known as the DSM-5 Parent/Guardian-Rated Level 1 Cross-Cutting Symptom Measure (Paniagua, 2014). It is an appropriate tool for children aged between 6 years and 17 years. The device takes a self-reporting approach to assess not only the presence but also the severity of between 12 and 13 anxiety disorders and their symptoms including sleep disturbance, anxiety, personality function, and depression. The tool has a total of 25 items that assess the presence and severity of mental health symptoms within the last two months (Nolen-Hoeksema et al., 2017). It utilizes a 5-point scale where higher scores denote a higher frequency of occurrence and increased severity.
The second intervention used is known as the Cultural Formulation Interview (CFI). The tool is vital because it assists professionals to collect and gather culturally-relevant information that could help in clinical assessment. Paniagua, (2014) asserted that the CFI consists of a set of 14 questions which could be used by clinicians to gather information during mental health assessment regarding the patient's culture. This will be significant given that Annie's parents are natives of India and have traveled continuously with her back to the country. Therefore, it remains crucial to note that CFI emphasizes the perspective of the client in solving the problem. It also seeks to explore the cultural background of the patient to assess how it possibly affects the patient. Hamilton and Carr (2015) in their work "Systematic Review of Self-Report Family Assessment Measures" postulate an assessment tool known as the McMaster Family Assessment Device (FAD). According to the authors, the model can be applied to assess mental health using seven scales that measure, "problem-solving, communication, roles, affective responsiveness, affective involvement, behavior control, and general functioning" (Hamilton & Carr, 2015). With Annie having problem with relationships and general function, the tool will also give a scope of the severity of a problem in the context of a family.
Systemic Perspective for Diagnosis
Annie presents to the clinic where the parents complain of fear and anxiety. In assessing Annie's behavior and the relationship she has with her parents, the code that best suits her condition is V61.12 and Z62.820. The V and Z code refers to family issues. All families must be able to provide three cardinal needs that include love, support, and comfort. However, all these needs could be disrupted by illness, anxiety, relocation, and school among others. In the case of Annie, she has previously suffered from an illness and her family has relocated from one place to the other. She has also experienced anxiety which is an example of a mental health disorder. As such, a combination of these factors has created a problem between Annie and her parents. The DSM-5 utilizes both the V-codes and the Z-codes and any other significant factor that might be of benefit to the clinical assessment. It remains critical to note that the DSM-5 direct clinicians to consider culture variables before diagnosing a patient with a particular disorder under this manual.
The DSM-5 model provides culturally specific guidelines offer specific guidelines on cultural features that could impact an individual's mental health problem. With regards to the ICD-10, it has a particular place indicated "culture-specific disorders" which informs mental caregivers of the need to assess the position of culture in the mental health of the person. The case of Annie calls for the assessment of both codes as the parent and the child in question have issues (Marsella & Yamada, 2010). The parent must remain cognizant of her condition and accept her manifestations. Since social and cultural factors have significantly impacted Annie's life, the use of culturally competent codes becomes significantly essential.
Conclusion
Annie primarily suffers from the anxiety that affects her life in entirety. With her condition, it remains obvious that she needs immediate therapy. However, the diagnosis must be systematic and must begin by putting her condition within the biological, psychological, and sociocultural aspects. Secondly, the clinician must remain keen to use the relevant assessment tools that measure the severity and frequency of her condition. Lastly, the systemic perspective for the diagnosis will follow where predetermined codes will be used to assess the patient's relationship with her social environment including family members.
References
Hamilton, E., & Carr, A. (2016). A systematic review of self‐report family assessment measures. Family Process, 55(1), 16-30.
Marsella, A. & Yamada, A. (2010). Culture and psychopathology: Foundations, issues, directions. Journal of Pacific Rim Psychology, 4(2), 103-115.
Nolen-Hoeksema, S., & Marroquin, B. (2017). Abnormal psychology. New York, NY: McGraw-Hill Education.
Paniagua, F. A. (2014). Assessing and treating culturally diverse clients: A practical guide (4th ed.). Thousand Oaks, CA: Sage.
