Chapter 12 Mental Disorder

Madeline Carter | Psychology, Unit 4

Factors that contribute to the progression and development of mental disorders

Health is influenced by many determinants that can fluctuate over time and combine to influence the health of
individuals and communities

4P Factor model
Predisposing factors increases susceptibility
Increases a person’s vulnerability to developing a mental health problem. These factors occur during conception and
are reliant on genetic inheritance and may occur early in life.

Biological
Environmental exposures before birth – stressor, inflammatory conditions, toxins, alcohol or drugs while in the womb.
Physical illness – there is a link between depression and other mental illnesses and chronic illnesses (arthritis, cancer, dementia).
Family history and genetic vulnerability
Neurotransmitter dysfunction
Brain abnormality or dysfunction
Developmental disorders

Psychological
Poor self-efficacy – the individual’s belief that they will be able to accomplish a specific task
Personality traits
Sensitivity to stress and anxiety
Poor self esteem

Social
Neglect, abuse or trauma
Disorganised attachment – instability in a caregiving relation can interfere with sense of trust and security and increases a child’s vulnerability
to developing a mental illness
Parental modelling
Poverty and adversity

Precipitating factors increases susceptibility and exacerbates problem

Triggers the onset or exacerbation of mental health problem.

Biological
Poor sleep
Substance use/misuse
Physical health problem
Head injury
Hormonal Shift

Psychological
Life event stress
Trauma

Social
Confronting news
Losing a job
Loss of a significant relationship
Social stress
Changing family/social dynamic

Perpetuating factors something

Prolong the course of the disorder, inhibit recovery

Biological
Poor response to medication
Substance use/misuse to self-medicate
Long term potentiation
Psychological
Impaired reasoning/thinking
Rumination – overthinking
Avoidance

Social
Avoidance behaviour
Role of stigma as a barrier to accessing treatment
Lack of support
Unemployment
Family involvement and accommodation
Cultural background
Inability to attend therapy

Protective factors something

Have a positive effect on the health of the individual, the may help minimise the occurrence of mental health
problems.

Biological
Adequate diet
Adequate sleep
Exercise
Reduced substance abuse

Psychological
Resilient attitude
Cognitive behavioural strategies
Psychotherapeutic treatments
High resilience
Effective coping skills
High self esteem
High self-efficacy
Personality traits

Social
Positive social group
Satisfying job
Suitable accommodation
Positive relationship
Social competence
Stable family and social dynamics
Cultural dynamics
Psycho-education

Biological risk factors

A biological predisposition to develop a certain disorder or disease (genes, hormones or chemicals). Genetic
vulnerability for mental health disorders such as schizophrenia and depression.

Pharmacogenetics
Poor response to medication due to genetic factors
Pharmacogenetics: the study of genetic differences in drug metabolic pathways

Substance abuse
Substance use disorders are a major cause of mental illness and account for around 18% of the burden of disease from
mental illness.

Rumination
Rumination is when people over think or obsess about situations or life events

Impaired reasoning and memory

Sufferers of schizophrenia have been found to have difficulty with probabilistic reasoning (judgements about
something happening or being true). Sufferers of schizophrenia have also been found to have impaired memory
ability (episodic with the greatest impairment).

Stress
A significant contributor to many mental health disorders, physiological and psychological side effects of stress on an
individual. Chronic or acute stress

Self-efficacy
Self-efficacy is the belief in our own ability to succeed and overcome, it has a large influence on how we approach
challenges. People with poor self-efficacy are less likely to seek help.

Social Risk Factors

Disorganised Attachment
A child needs a secure base of attachment. If this base is threatening, abusive or not there, the base is a source of
distress. This can lead to disorganised attachment. Disorganised attachment = avoidant personality. As adults they can
struggle with relationships, trust and seeking help from others.

Loss of significant relationship

Social connections are one of our greatest protective factors. The loss of these networks can be devastating. Grief
(bereavement disorders).

Stigma
Stigma is a mark of disgrace or disgust that sets someone apart from others. Stigma as a barrier to accessing treatment.
25-50% of sufferers do not seek treatment.

Cumulative Risk
A combination of multiple risk factors at the one time. The accumulation of risk factors makes mental illness more
likely.

Learning Activity 12.2

1. The risk of a person developing schizophrenia is increased by 17% if one of their biological parents has or had
the disorder.
2. The risk of a person of developing schizophrenia is increased by 45% if both of their biological parents has or
had schizophrenia

Learning Activity 12.6

Psychological Risk Factor Description of risk factor Example Explanation of the risk
Rumination Rumination is when Overthinking how a
people over think or person speaks to you and
obsess about situations or believing they hate you
life events, and spiralling into more
destructive thoughts.
Impaired reasoning and
memory
Stress Stress is a state of
psychological and
physiological arousal
produced by an internal or
external stressor perceived
by that individual as
challenging, exceeding
their resources to cope or
exceeding their abilities to
cope.
Poor self-efficacy Self-efficacy is the belief
 in our own ability to
succeed and overcome.

4P factor model a description and explanation of the development and progression of mental health disorders with reference to
four types of influences (‘factors’) — predisposing risk factor, precipitating risk factor, perpetuating risk factor, protective risk
factor
Additive model (cumulative risk) proposes that as the number of risk factors increases, there is also a corresponding increase in
the likelihood of developing a mental disorder.
Attachment the emotional bond which forms between an infant and another person, usually their main caregiver
Biological risk factor originate or develop within the body and consequently may not be under our control
Cumulative risk the aggregate risk to mental health from the combined effects of exposure to multiple biological, psychological
and/or social factors
Disorganised attachment a type of attachment that is characterised by inconsistent or contradictory behaviour patterns in the
presence of a primary caregiver
Genetic vulnerability in relation to the 4P factor model, a biological risk factor for developing a specific mental disorder due to
one or more factors associated with genetic inheritance
Perpetuating risk factor in the 4P factor model, maintains the occurrence of a specific mental disorder and inhibits recovery
Precipitating risk factor in the 4P factor model, increases susceptibility to and contributes to the occurrence of a specific mental
disorder; present at the time of onset
Predisposing risk factor in the 4P factor model, increases susceptibility to a specific mental disorder
Protective factor in the 4P factor model, any characteristic or event that reduces the likelihood of the occurrence or recurrence of
a mental disorder, either on its own or when risk factors are present
Rumination repeatedly thinking about or dwelling on undesirable thoughts and feelings, such as problems or bad moods, without
acting to change them
Self-efficiency an individual’s belief in their capacity to execute behaviours necessary to succeed in specific situation or
accomplish a specific task
Self-stigma the stigmatising views that individual’s hold about themselves.
Social risk factor for mental disorders originate in the external environment and interact with biological and psychological
factors in influencing our mental health state
Social stigma any aspect of an individual’s identity that is devalued in a social context
Stigma a mark or sign of shame, disgrace or disapproval typically associated with a particular characteristic or attribute that sets a
person apart, such as skin colour, cultural background, a disability or a mental health disorder
Substance use the use or consumption of legal or illegal drugs or other products