Mental Disorders and Used Treatment Paradigms

Introduction

The diagnosis of mental disorders has evolved significantly in the last few decades as researchers continue to come up with different ways to address the issue. Disparate procedures may be involved in the diagnosis process to determine the type of mental disorder that one is suffering from and identify the appropriate treatment method. For instance, a doctor may perform physical exam to rule out injury to the brain. In addition, laboratory tests may be performed to establish different aspects like the functionality of different hormones or presence of drugs and alcohol among others. However, the commonly used method of diagnosing mental disorders is psychological evaluation. This method relies on the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) for detailed diagnosis procedure. Under psychological evaluation, as a way of diagnosis, different paradigms can be used. This paper outlines neuroscientific, diathesis-stress, and psychoanalytic paradigms that are used in the diagnosis and treatment of mental disorders. The advantages and disadvantages of each paradigm will be highlighted. Finally, the most useful paradigm will be stated.

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The Diathesis-Stress Paradigm

The diathesis-stress paradigm diagnoses a mental disorder by explaining the interaction between one’s predisposition to vulnerability and stress occasioned by life experiences. The term diathesis in this context is used to describe the level of vulnerability to a certain disorder (Edmondson et al., 2014). Such susceptibility can occur due to biological, psychological, genetic, or situational factors among others. On the other hand, stress is defined as any condition that can interfere with one’s psychological balance, and thus it may contribute to the development of different disorders (Edmondson et al., 2014). As such, the way an individual responds to disparate stress levels coupled with his or her susceptibility determines whether a certain mental condition will develop. For instance, if a combination of one’s capacity to handle stress under the inherent predisposition to a given condition exceeds the threshold, a disorder develops (Patten, 2013). Research indicates that stress increases the production of cortisol and acts on preexisting susceptibility to trigger or aggravate the symptoms of schizophrenia (Pruessner, Cullen, Aas, & Walker, 2016).

Advantages

The diathesis-stress model recognizes the role of nature and nurture in mental illnesses. Psychologists agree that life events like losing a loved one, becoming bankrupt, or going through any form of abuse among other occurrences may contribute significantly to the development of mental disorders (Pruessner et al., 2016). Therefore, this paradigm considers these factors in the diagnosis procedure. Such factors are normally overlooked in other approaches like the cognitive neuroscientific model. In addition, the diathesis-stress paradigm explains the outcomes of twin studies in psychology, which plays an important role in the diagnosis of mental disorders (Reinelt et al., 2013). For instance, if twins are separated at birth and brought up in different environments and they both have the same mental condition, it points to genetic causes of the illness (Reinelt et al., 2013).

Disadvantages

The problem with this model is the subjectivity of stress (Chang, Yu, Chang, & Hirsch, 2016). As such, while a given condition may cause stress in one person, it may not have the same effects on another individual. Consequently, the varying stress thresholds and vulnerabilities cannot be generalized and used for diagnosis in different individuals. Additionally, people’s predispositions affect life choices and experiences, which may lead to different mental disorders.

The Neuroscientific Paradigm

The cognitive neuroscientific paradigm involves the study of how different brain structures and processes affect one’s cognitive behavior. This approach works under the premise that “all human mental events occur as the result of neural information processing” (Beugre, 2018, p. 84). This premise is commonly known as the computational theory of mind. This approach is supported by different findings like the evidence that damage to the focal brain leads to the inability to process certain forms of information like recognizing discrete human faces (Beugre, 2018). According to Graham and Madigan (2016), cognitive neuroscience seeks to “determine how the brain creates the mind and the link between thoughts/processes (cognition) and the biological (neuroscience) aspect” (p. 674). Therefore, this paradigm focuses on studying how different ways of neural information processing affect brain activity. For instance, when diagnosing anxiety-related conditions, the serotonin pathway is studied to establish the underlying causes of the mental illness. Different techniques are used in the study of brain structure and function including magnetic resonance imaging (MRI) and electroencephalography among others.

Advantages

One of the many advantages of cognitive neuroscience is the non-invasive nature of some of the techniques used (Morgenstern, Naqvi, Debellis, & Breiter, 2013). For instance, functional magnetic resonance imaging (fMRI) is one of the safest ways of diagnosing mental illnesses as it is non-invasive and it does not use harmful radiation like other methods. Additionally, fMRI produces high-resolution images, thus allowing easy identification of the affected brain areas. One of the challenges of other psychological evaluation methods in the diagnosis of mental disorders is that they cannot be used in children or infants. However, the cognitive neuroscientific paradigm can be used with this group of patients.

Disadvantages

Reductionism is one of the outstanding limitations of this approach in the diagnosis of mental disorders. According to Krakauer, Ghazanfar, Gomez-Marin, MacIver, and Poeppel (2017), reductionism describes the oversimplification of human behaviors. As such, the cognitive neuroscientific paradigm does not consider other factors that may influence one’s mind and the subsequent behavior. In this approach, individual differences are overlooked under the assumption that all aspects of neural information processing are the same for different people (Irvine, 2016). Therefore, other factors like genetics, biological, and environmental influences are not considered, which may lead to the wrong diagnosis.

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The Psychoanalytic Paradigm

Sigmund Freud came up with the psychoanalytic paradigm of diagnosing and treating mental disorders (Yakeley, 2018). According to this approach, the unconscious part of human beings acts as a reservoir of memories, thoughts, and desires. As such, Freud believed that these unconscious forces could lead to mental illnesses (Yakeley, 2018). Therefore, in therapy, psychoanalysis seeks to help an individual to release repressed thoughts, emotions, or experiences. After such release, one undergoes catharsis by bringing the unconscious thoughts to the conscious mind, thus gaining awareness (Paris, 2017). During the diagnosis of mental disorder, emotions, experiences, and thoughts from childhood are brought to the conscious mind and examined to establish the cause and nature of the problem being investigated. As a treatment method, a therapist listens to patients and identifies patterns or important events that may have contributed to the mental condition. The patient is then helped to transfer repressed thoughts into the conscious mind. The therapist then uses different techniques to help the patient to face such issues. As one starts being comfortable and less resistant to issues from his or her past, the healing process starts.

Advantages

The psychoanalytic paradigm offers in-depth understanding of the origin of a problem (Ravitz, 2017). Addressing a mental problem without understanding its causes may not yield desirable results and this model covers such issues. Consequently, therapists can broaden their understanding of the patients’ struggles and obstacles. Therefore, a therapist will know how to handle a given patient to achieve the desired results. Additionally, this approach can be used together with others in the diagnosis and treatment of mental illnesses.

Disadvantages

The majority of people with mental illnesses may not have the capacity to transfer unconscious emotions and thoughts into the conscious mind (Howard & Levine, 2014). Additionally, this form of therapy takes a long time, and most clients may not be patient enough to complete the process (Corey, 2017). Finally, a patient’s behavior may be subject to other factors apart from repressed emotions and thoughts that are not considered in this paradigm.

Conclusion

Different approaches can be used in the diagnosis and treatment of mental illnesses. This paper has focused on three paradigms, which include neuroscientific, diathesis-stress, and psychoanalytic models. I feel that the diathesis-stress paradigm is the most useful in the diagnosis and treatment of mental disorders. This model incorporates different other approaches, thus increasing the accuracy levels of diagnosis. For instance, examining a patient’s past events to determine diathesis converges with the psychoanalytic paradigm. On the other side, the use of twin studies to highlight genetic causes of mental illnesses covers some aspects of the neuroscientific model. Additionally, this approach allows a therapist to understand the cause of certain behaviors, which plays a major role in choosing the appropriate method of treatment.

References

Beugre, C. (2018). The neuroscience of organizational behavior. Cheltenham, UK: Edward Elgar Publishing.

Chang, E., Yu, T., Chang, O., & Hirsch, J. (2016). Hope and trauma: Examining a diathesis-stress model in predicting depressive and anxious symptoms in college students. Personality and Individual Differences, 96, 52-54.

Corey, G. (2017). Theory and practice of counseling and psychotherapy (10th ed.). Belmont, CA: Cole Books.

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Edmondson, D., Kronish, I., Wasson, T., Giglio, F., Davidson, W., & Whang, W. (2014). A test of the diathesis-stress model in the emergency department: Who develops PTSD after an acute coronary syndrome? Journal of Psychiatric Research, 53, 8–13.

Graham, S., & Madigan, S. (2016). Bridging the gaps in the study of typical and atypical cognitive development: A commentary. Journal of Cognition and Development, 17(4), 671-681.

Howard, B., & Levine, M. (2014). Psychoanalysis and trauma. Psychoanalytic Inquiry, 34(3), 214-224.

Irvine, E. (2016). Model-based theorizing in cognitive neuroscience. The British Journal for the Philosophy of Science, 67(1), 143–166.

Krakauer, J., Ghazanfar, A., Gomez-Marin, A., MacIver, M., & Poeppel, D. (2017). Neuroscience needs behavior: Correcting a reductionist bias. Neuron, 93(3), 480-490.

Morgenstern, J., Naqvi, H., Debellis, R., & Breiter, C. (2013). The contributions of cognitive neuroscience and neuroimaging to understanding mechanisms of behavior change in addiction. Psychology of Addictive Behaviors, 27(2), 336–350.

Paris, J. (2017). Is psychoanalysis still relevant to psychiatry? Canadian Journal of Psychiatry, 62(5), 308–312.

Patten, S. B. (2013). Major depression epidemiology from a diathesis-stress conceptualization. BMC Psychiatry, 13(19), 1-10.

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Pruessner, M., Cullen, A., Aas, M., & Walker, E. (2016). The neural diathesis-stress model of schizophrenia revisited: An update on recent findings considering illness stage and neurobiological and methodological complexities. Neuroscience & Biobehavioral Reviews, 73, 191-218.

Ravitz, P. (2017). Contemporary psychiatry, psychoanalysis, and psychotherapy. The Canadian Journal of Psychiatry, 62(5), 304-307.

Reinelt, E., Stopsack, M., Aldinger, M., John, U., Grabe, H., & Barnow, S. (2013). Testing the diathesis-stress model: 5-HTTLPR, childhood emotional maltreatment, and vulnerability to social anxiety disorder. American Journal of Medical Genetics, 162(3), 253-61.

Yakeley, J. (2018). Psychoanalysis in modern mental health practice. The Lancet, 5(5), 443-450.

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