Assessment Two: Essay

Nina Elaine Alley

Bachelors of Applied Social Sciences (Majoring in Counselling and Psychology)

South African College of Applied Psychology (Pty) Ltd.

Introduction to Psychology Two

Michael Stuart

14 August 2023

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 Table of Contents:

Introduction: 3

Definition: 3

Psychopathology: An Integrated Approach: 3

Measurements of Psychological Disorders: 4

Statistical Deviance 4

Maladaptiveness 4

Personal Distress 4

Diagnostic and Statistical Manuel of Mental Health Disorders: 5

A South African Multicultural Perspective: 5

African vs Western Perspective: 6

Similarities 6

Differences: 6

Mental Issues Plaguing South Africa: 6

Schizophrenia 7

Post Traumatic Stress Disorder 7

Conclusion: 8

Reference List: 9

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Introduction:
This essay will focus on the topic of Psychopathology. It will, firstly, define
Psychopathology. Secondly, it will look at the integrated approaches to Psychopathology. It
will then study the measurements of mental illness. The essay will then discuss the
Diagnostic Statistical Manuel of Mental Health Disorders. It will then look at the
multicultural context of Psychopathology in South Africa. Following, it will study the
similarities and differences between the African and Western Perspectives. Lastly, it will
assert the mental illnesses plaguing South Africa.

Definition:
Defining Psychopathology has been a challenge to many academics to concretely assert
(Maddux & Winstead, 2004). Synonymous terms have been used to curate an understanding
such as “mental illness” and “mental disorder” (Maddux & Winstead, 2004). These terms are
social constructs and Psychopathology is a product of Social Constructivist theory (Maddux
& Winstead, 2004), Therefore, the role of Psychopathology is to define mental illness and or
psychological disorder (Cartwright, 2016).

Key theories and approaches surrounding Psychopathology include the: Biomedical

Perspective; Cognitive Behavioural Perspective; Community Psychology Perspective; and
Psychodynamic Perspective (Cartwright, 2016). There was a shift in Psychopathology from
the Biomedical Perspective to the Psychodynamic Perspective (Cartwright, 2016). Sigmund
Freud’s Psychodynamic Perspective expresses that the causes of mental illness can be traced
to internal factors (Cartwright, 2016). Louis Pasteur’s Biomedical Perspective, however,
argues that the causes of mental illness can be traced back to biological factors (Cartwright,
2016).

Psychopathology: An Integrated Approach

There are two key integrated approaches that have emerged to provide a more holistic
understanding of mental illness (Cartwright, 2016). These approaches include: the Diathesis-
Stress Model and the Bio-Psychosocial Approach (Cartwright, 2016). Paul Meehl, an
American psychologist, introduced the Diathesis-Stress Model (Cartwright, 2016). Meehl
argued that individuals are born with predispositions to mental illness (Cartwright, 2016).
However, these predispositions need intense biological or environmental factors to be
activated (Cartwright, 2016). George Engel founded the Bio-Psychosocial Approach by
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integrating biological, social and psychological factors to determine the causes of mental
illness (Cartwright, 2016).

Measurements of Psychological Disorders:

Duncan Cartwright outlines three measures to define psychological disorders: statistical
deviance, maladaptiveness, and personal distress (Cartwright, 2016).

Statistical Deviance:
Statistical Deviance defines psychological disorders based on abnormal behaviour (Maddux
et al., 2012). It is the departure from what is considered “psychological normality” (Maddux
et al., 2012). This measure seeks to identify behaviours that are infrequent to determine
psychopathology (Maddux et al., 2012). It does so by, first, scientifically determining normal
behaviours to study and investigate abnormal deviancies (Maddux et al., 2012). Statistical
Deviance uses numerical and scientific instruments to quantify and assign statistical evidence
to base its finding (Maddux et al., 2012). Once the empirical evidence is gathered
standardised tests are created to measure the individual’s behaviours against the proven data
of normal behaviour (Maddux et al., 2012). This measure has been critiqued based on
subjectivity (Maddox et al., 2012). The understanding of “normal” does not account for
cultural diversity (Maddox et al., 2012).

Maladaptiveness:
Maladaptiveness defines psychological disorders based on their ineffective behaviour
(Maddox et al., 2012). This measure seeks to determine whether certain behaviours are
effective or ineffective as it relates to the individual’s ability to confront challenges and
achieve their goals (Maddux et al., 2012). Subjectivity is also used to critique this measure
(Maddux et al., 2012). It is not possible to concretely define what is effective or ineffective –
these meanings adapt with diverse situations and constraints that individuals find themselves
in (Maddux et al., 2012). For example, an individual with obsessive compulsive disorder
(OCD) will always know where to find an item based on their need to control where
everything is placed. However, in different circumstances where their space is compromised
this behaviour will prove to hinder their ability to rise to new challenges. In this scenario the
behaviour may wane between what seems subjectively effective or ineffective based on the
observer.

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 Personal Distress:
Personal Distress defines psychological disorders based on the fears certain behaviours
inspire (Maddux et al., 2012). These fears manifest themselves as anxiety and depression
(Cartwright, 2016). Therefore, Personal Distress acts as a defining characteristic of mental
illness (Cartwright, 2016). There are, however, exceptions to this measure (Cartwright,
2016). Individuals with Antisocial Personality Disorder (APD) are not affected by extensive
Personal Distress (Cartwright, 2016). A critique of this measure is that Personal Distress is
not an effective measure because it would imply that all forms of Personal Distress is
abnormal (Cartwright, 2016). Personal Distress is normal in certain situations as individuals
respond fearfully in certain situations (Cartwright, 2016).

Diagnostic and Statistical Manuel of Mental Health Disorders:

The fifth edition of the Diagnostic and Statistical Manuel of Mental Health (DSM-5) is the
model used to categorise psychological disorders (Cartwright, 2016). This model is used to
aid clinicians in the diagnosis of their clients (Cartwright, 2016). The DSM-3 to DSM-5
earmarks the transition from the influence of the Psychodynamicc Approach (in DSM-1 to
DSM-2) to the Biomedical Model (Cartwright, 2016). The DSM-5 has shown an emphasis on
grouping signs and systems to characterise pathological cause (Cartwright, 2016).

There are five key reasons for the categorisation of mental illness (Cartwright, 2016). Firstly,
it provides a framework for clinicians to communicate with each other regarding illness
(Cartwright, 2016). Secondly, it creates a foundation for research and discussion surrounding
mental illness (Cartwright, 2016). Thirdly, by outlining and grouping characteristics it allows
clinicians to study commonalities between mental illnesses (Cartwright, 2016). Fourthly, it
creates a way to study the causes of mental illness using statistical data (Cartwright, 2016).
Lastly, it allows a way for the clinician and their patient to understand the course of treatment
for the patient’s particular mental disease (Cartwright, 2016).

A South African Multicultural Perspective:

In South Africa culture plays a role in treating mental illness (Cartwright, 2016). Treatment
for South African clients are multicultural (Cartwright, 2016). Within this context clients may
be treated by their clinicians with medicine and programs for the mental illness – and at the
same time be encouraged by their clinicians to seek consultation with traditional healers
(Cartwright, 2016).
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In 2004, the South African government implemented the Traditional Health Practioners Bill
to protect traditional healers and their clients (Cartwright, 2016). Following from the
implementation of this bill, Brian Robertson conducted a study to investigate the effects of
traditional healers on their South African clients (Robertson, 2006). It showed that, 70% of
South Africans make use of traditional healers (Robertson, 2006). His study showed that
while Western practioners use the DSM-5 to categorise illnesses against a bio-psychosocial
system South African practioners interpret the symbolic meaning of these symptoms
(Robertson, 2006). His study concluded that there was overwhelming consensus of the
benefit of traditional healers by their South African clients (Robertson, 2006). He further
argued, a collaboration between the Western and African Perspective to Psychopathology for
the betterment of South African clients (Robertson, 2006).

African vs Western Perspective:

Similarities:
The African Perspective, like the Western Perspective, places emphasis on diagnosis and
intervention when creating a solution-focused treatment to mental illness (Nwoye, 2015). It
first uses Western medicines and treatment before investigating their symbolic factors
(Nwoye, 2015). Therefore, both the Western and African Perspective are similar as they rely
on medicine and treatment to administer to clients (Nwoye, 2015).

Differences:
The Western Perspective attributed mental illness to biological, psychological and social
factors to explain abnormal behaviour (Nwoye, 2015). African Psychopathology seeks to
identify epidemiology of mental illness by investigating “symbolic illness” (Nwoye, 2015).
This seeks to uncover the mysteries of abnormal behaviour instead of identifying these
behaviours as a general illness (Nwoye, 2015). The elders do not just rely on the physical
manifestations of the illness but search deeper to uncover “who” is communicating through
the mental illness (Nwoye, 2015). Family members also play a role in investigating the
“invisible force” behind their family member’s behaviour (Nwoye, 2015). Therefore, while
the Western Perspective seeks to identify the biological, psychological or social factors; the
African Perspective acknowledges the possibility of a spiritual or ancestral factors accounting
for the illness (Nwoye, 2015).

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Mental Issues Plaguing South Africa:
Two mental illnesses that are prevalent in South Africa are: Schizophrenia and Post
Traumatic Stress Disorder (Cartwright, 2016).

Schizophrenia:
Schizophrenia is defined as muddled emotions, behaviours and thoughts (Cartwright, 2016).
In South Africa, schizophrenia shares commonalities with local illnesses such as
“ukuthuwasa” and “amafufunyana” (Cartwright, 2016). Annelise de Wet, Leslie Swartz and
Bonginkosi Chiliza conducted a study of seven Cape Townian clients’ experiences of
recovery following from their first episode of psychosis in schizophrenia (de Wet et al.,
2015). The study concluded that there were four cultural and social indicators that contributed
to their recovery (de Wet et al., 2015). Firstly, “support” played a vital role in contributing to
their recovery (de Wet et al., 2015). This support came from family and work friends and
made a positive impact on the recovery of these clients (de Wet et al., 2015). Secondly,
“spirituality” also played a role in their recovery (de Wet et al., 2015). According to the
clients, spirituality was responsible for their resilience against the negative feelings their
mental illness created (de Wet et al., 2015). Thirdly, stigmas surrounding mental illness has
contributed negatively to clients (de Wet et al., 2015). Participants have disclosed how they
feel ostracised because of their illness and further asserted that other medical illnesses do not
garner such negative views (de Wet et al., 2015). Lastly, a positive attitude towards their
mental illness has contributed positively to their recovery (de Wet et al., 2015). The positive
attitude creates a renewed sense of agency in the client and that leads to them becoming
stronger as they live with their schizophrenia (de Wet et al., 2015).

Post Traumatic Stress Disorder:

Post Traumatic Stress Disorder (PTSD) is defined as reexperiencing, emotional numbing,
dissociative behaviour, and increased arousal as a result of a life-threatening experience
(Cartwright, 2016). There are many contributing factors to South Africans facing PTSD
(Edwards, 2005). Firstly, it is important to acknowledge the historic presence of Apartheid
and the hate crimes against people of colour (Edwards, 2005). This history has a lot of
violence, and many individuals are surrounded by the trauma they endured because of the
racial violent crimes (Edwards, 2005). Secondly, it is also important to acknowledge the
crime that plagues South Africa (Edwards, 2005). These crimes include gang violence;
murder; attempted murder; assault; rape; kidnapping abduction and robbery (Edwards, 2005).
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Conclusion:
This essay has, firstly, defined Psychopathology. Secondly, it has set out the integrated
approaches to Psychopathology: Diathesis-Stress Model and Bio-Psychosocial Approach.
Thirdly, it has outlined the measurements of mental illness and their critiques: Statistical
Deviance, Maladaptiveness and Personal Distress. It has explained the DSM-5 and the shift
from a Psychodynamic Perspective to the Biomedical Model. The essay has shown the role of
traditional healers in South Africa within a multicultural context. Following, the essay has
discussed the similarities and differences between the African and Western Perspective.
Lastly, it has argued the cultural and social effects of Schizophrenia and Post Traumatic
Stress Disorder in South Africa.

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Reference List:
Cartwright, D. (2016). Psychopathology. In L. Swartz, C. de la Rey, N. Duncan, L.
Townsend, & V. O’Niell (Eds.), Psychology: An Introduction (4th ed., Ch. 24). Oxford
University Press Southern Africa.

de Wet, A., Swartz, L., & Chiliza, B. (2015). Hearing their voices: The lived experience of
recovery from first-episode psychosis in schizophrenia in South Africa. International Journal
of Social Psychiatry, 61(1), 27-32.

Edwards, D. (2005). Post-traumatic stress disorder as a public health concern in South

Africa. Journal of psychology in Africa, 15(2), 125-134.

Maddux, J. E., & Winstead, B. (2004). Psychopathology: Foundations for a contemporary

understanding. Routledge.

Maddux, J. E., Gosselin, J. T., & Winstead, B. A. (2012). Conceptions of

psychopathology. Psychopathology: Foundations for a contemporary understanding, 3-22.

Nwoye, A. (2015). African Psychology and the Africentric Paradigm to Clinical Diagnosis

and Treatment. South African Journal of Psychology, 45(3), 305-317.

Robertson, B. A. (2006). Does the evidence support collaboration between psychiatry and

traditional healers? Findings from three South African studies. African Journal of

Psychiatry, 9(2), 87-90.

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