Posted: July 14th, 2022

Part 1: Examining Three Models of Psychopathology

Diagnostic Approaches
For this assignment, consider the following case vignette:

Annie is a 13-year-old Asian American girl; the youngest child in a family of four older siblings. Her parents are both high school teachers and came to United States from India to attend college and stayed to raise a family together. They travel as a family to India several weeks of every year to be with extended family. Annie understands some phrases in the dialect spoken by her extended family, but she and her sisters consistently speak to their parents in English. When Annie was 5 years old, she was hospitalized for three weeks for a serious illness. Since that time, she has been in good health, but has struggled with her fears and anxiety.

Annie is extremely shy and avoids situations in which she needs to interact with new people or large groups. She worries about making mistakes in her schoolwork and becomes extremely anxious when taking tests. Sometimes, she becomes so nervous that her heart races; she begins to tremble and has difficulty breathing. Annie is also afraid of the dark and does not want to be alone in her room at night. She often requires the presence of one of her parents or older sisters until she falls asleep. As her oldest three sisters have left home to pursue their education and careers, the family is finding Annie’s need for reassurance more burdensome.

Instructions
Download Unit 3 Assignment Template. Use it to complete your assignment.

Part I: Examining Three Models of Psychopathology
Review each of the three models of abnormality—biological, psychological, and sociocultural—and apply key principles from each model to frame what is happening to Annie and her family.
Analyze how each model explains the factors leading to Annie’s presenting behaviors.
Part II: Assessment Instruments to Aid in Diagnosis
Formulate a culturally sensitive assessment strategy using a combination of at least two measures listed below (and linked in Resources) to Help with the assessment of Annie and her family. Describe how the assessments will be administered and interpreted using scholarly sources to support the strategy.

DSM-5: Assessment Measures:
Parent/Guardian-Rated DSM-5 Level 1 Cross Cutting Symptom Measure.
DSM-5: Cultural Formulation:
Cultural Formulation Interview.
Hamilton and Carr’s “Systematic Review of Self‐Report Family Assessment Measures.”
Part III: Systemic Perspective for Diagnosis
With an assessment strategy established:

Analyze how the DSM and ICD may augment guidance for working with families from a systemic perspective.
Describe the Z code or codes that apply, noting the limitations and risks of using these codes for Annie and her family.

Submission Requirements
Written communication: Written communication must be grammatically correct and free of errors that detract from the overall message. Writing should be consistent with graduate-level scholarship.
APA formatting: Title page, main body, and references should be formatted according to the current APA style and formatting.
Number of resources: Minimum of four scholarly resources. Distinguished submissions typically exceed this minimum.
Length of paper: 4–6 typed double-spaced pages. Abstract and Table of Content pages are not necessary.
Font: Times New Roman, 12 point
Principles of Psychopathology
Student Name:
Institute:

Principles of Psychopathology
Part 1: Examining Three Models of Psychopathology
A psychopathology model helps mental health professionals understand mental illnesses and distinguish various mental illnesses. For example, some of the mental illnesses examined s through the psychopathology model include schizophrenia, paranoia, anxiety, and avoidant personality disorder (Patel, Jafferany, and Ferreira, 2020). The biological model, social-cultural mode, and psychological model are the three types of psychopathology that help identify abnormal behaviours in human beings. The biological model is important in identifying abnormal genetics, abnormal brain functioning, and brain chemical imbalances. According to the biological model, mental illness results from body functionalities, for instance, the brain chemistry and other parts of the brain.
The brain structure and chemistry are influenced by the nervous system, the neuron, communication in the nervous system, and neural transmission (Patel, Jafferany, and Ferreira, 2020). On the other hand, the biological model focuses on hormonal imbalances, genetics, and viral infections. On the other hand, the psychological model is involved in cognition, the examination of behaviours, and humanistic-existential with psychology. Social-cultural model Helps in identifying the role and impacts of social and cultural factors of individual abnormal behaviour. For example, the impact of religion, gender, and culture. Every psychopathology model is unique and provides important information for therapy.
Each model explains what’s happening to Annie and her Family. According to the biological model, Ann’s abnormal behaviour may result from hormonal imbalances, especially the cortisol hormones that Help a person in dealing with stress and fear. Elevated Cortisol hormones may cause Annie’s anxiety since an imbalance may lead to fear, depression, and anxiety (Patel, Jafferany, and Ferreira, 2020). On the other hand, Annie may be susceptible to mental illness genetically, where abnormalities or mental illnesses are linked to various genes and not a single gene. Annie may have inherited a mental illness, which has developed over time, especially after falling sick, and loneliness as the last born. On the other hand, Annie may have had a viral infection, which may have damaged her brain, causing high anxiety and fear, for instance, an infection such as strep.
Annie may be a victim of psychological issues that trigger mental illness, which can be supported through the psychodynamic theory, structure, and personality development. According to feuds personality theory, for a healthy personality, the id, superego, and ego must operate together. In case of a conflict between the three parts, abnormal behaviour can be developed. Annie’s fear and anxiety are caused by the ego’s inability to balance the id, and the superego, hence leading to fear and anxiety. Additionally, Annie lacks an ego-defence mechanism that Helps in dealing with stressful conditions and anxiety.
The ego-defence mechanism Helps deal with stress but are mostly misused, therefore leading to mental illness. Some of the ego-defence mechanisms include reaction formation, denial, rationalization, regression, intellectualization, and identification. Based on the social-cultural model, women are more suspensible to anxiety, where society and culture influence mental illness development in women. Concerning Annie’s case, being a female at the age of thirteen, she may be experiencing hormonal changes, such as pre-mental dysphoric and other hormonal changes that may lead to anxiety and fear. Annie’s abnormal behaviours could be caused by abandonment, especially where the elder siblings working and having lives of their own. On the other hand, being an Arabic person living in the United States, Annie may be a victim of racial discrimination and struggling with ethnic identity.
Part 11: Assessment Instruments to Aid in Diagnosis
The psychiatrist could Help Annie and her Family through two assessment strategies, cultural formulation interview, and Hamilton and Carr’s “Systematic Review of Self‐Report Family Assessment Measures. DSM-5 Cultural Formulation Interview (CFI) could evaluate Annie’s mental health based on cultural factors. The DSM-5 Cultural Formulation Interview (CFI) consists of various questions used to investigate the cause of anxiety, and fear, especially the life cycle of the parents and other three siblings. Additionally, the DSM-5 Cultural Formulation Interview (CFI) consists of twelve supplementary modules, which Help in diagnosing anxiety, fear, and treatment planning.
The DSM-5 Cultural Formulation Interview (CFI) would help evaluate Annie’s cultural identity, cultural explanation, illnesses, and all environmental factors that influence Annie’s behaviour. The first part, known as the cultural definition, consists of questions such as, what brings you here? How would you describe your problem to your Family, and what troubles do you get through from your problem? The questions would Help Annie to provide the necessary information. On the other hand, the cultural perception section would consist of questions such as why you think anxiety and fear are happening and the perception of other people concerning the problem. The section on the cultural conceptualization of distress, psychological stressors, and cultural features consists of questions that determine the stressors that lead to the development of anxiety, for instance, the gender, ethnic background as an Indian, or family dynamics.

Hamilton and Carr’s “Systematic Review of Self‐Report Family Assessment Measures helps identify various psychometric properties in a person (Hamilton, and Carr, 2016). Some of the instruments that could be used to assess Annie’s mental issues and the Family include the McMaster family assessment, family assessment measures, family relation scale, and family environment scale. The most important instrument that could be carried out for Annie and the Family is the parental boding instrument, which evaluates the bond between Annie and the family members to identify the cause of anxiety and fear. According to Hamilton and Carr, flexibility, communication, and cohesion are the three factors that impact a family setup.
The instruments, however, Help test whether Annie’s Family has the three attributes. The method is very important, especially in Annie’s therapy, especially in evaluating the changes that may have taken place in family functioning, for instance, a shift in attention. The self-report assessment techniques explain how culture varies in Annie’s environments and in understanding Annie’s psychopathology (Hamilton, and Carr, 2016). However, the self-report assessment measures help identify the impacts of family therapy, especially on stress management and the development of a care plan. Through evaluating the Family’s emotional bond, the therapists can identify whether the Family is separated, enmeshed, disengaged, and connected through the family cohesion technique. The assessment could also provide a report on marital quality, mental illness beliefs, and parental role performance.
Part III: Systemic Perspective for Diagnosis
The ICD, having existed for more than a century since the mid-nineteenth century, has been a world health organization’s responsibility (Clark, et, al., 2017). ICD and DSM are the two main mental health classification systems that Help in developing treatment decisions. According to research, sixty percent of psychologists use the two classification systems; forty-four percent use the DSM, and fifty-one percent the ICD. However, the DSM is a national professional association product, and ICD a product of a global and public health agency. Both the classification has been used to reduce mental health issues and a tool for the united states psychiatrists as a multidisciplinary tool. DSM, and ICD systems for family therapy, through their ability to classify various mental diagnoses (Clark, et, al., 2017). The systems also enhance formulation, allow code cross walking, and use almost similar methods and codes for diagnosis.
Z codes are used as diagnostic codes for patients who are not yet diagnosed or patients with unknown diagnoses (Shackelford, and Zeigler-Hill, 2017). However, the Z code can be used in a situation in dealing with a problem that influences the patients or the individual’s health status. Z-codes are usually three to six characters, for instance, Z03.2, Z09.3, and Z50.4, commonly used by psychiatrists. Z5.4 is a common code used for psychotherapy, while Z04.6 is commonly used in psychiatric examination. Z codes are not usually recommended, especially the fact that the codes may be time-consuming. Mostly the Z codes have no insurance because most insurance companies have rejected them, hence not accepted by most therapists (Shackelford, and Zeigler-Hill, 2017). Adjustment disorder codes are used instead of the Z codes, especially in identifying emotional behaviours in a person. Using the Z code would be risky for Annie and the Family to use the Z code, since most insurance companies may reject the claim. I would advise the Family to use the adjustment disorder codes.

References
Clark, L. A., Cuthbert, B., Lewis-Fernández, R., Narrow, W. E., & Reed, G. M. (2017). Three approaches to understanding and classifying mental disorder: ICD-11, DSM-5, and the National Institute of Mental Health’s Research Domain Criteria (RDoC). Psychological Science in the Public Interest, 18(2), 72-145.

Hamilton, E., & Carr, A. (2016). Systematic review of self‐report family assessment measures. Family Process, 55(1), 16-30.
Patel, A., Jafferany, M., & Ferreira, B. R. (2020). Basic Principles of Psychopathology Applied to Psychodermatology. In the Essentials of Psychodermatology (pp. 29-36). Springer, Cham.
Shackelford, T. K., & Zeigler-Hill, V. (Eds.). (2017). The evolution of psychopathology. Springer International Publishing.

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