Understanding Psychological Disorders: The Neuropsychosocial Approach

© Sergey Sukhorukov/Kalium/age fotostock. Photo for illustrative purposes only; any individual depicted is a model.

As we saw in Chapter 1, clearly the Beale women had odd thoughts and feelings and engaged in unusual behaviors. As we asked in Chapter 1, were they merely eccentric? Did Big Edie or Little Edie (or both of them) have a psychological disorder? Could either of them have had more than one psychological disorder? If one or both had a disorder, how could we understand why? The neuropsychosocial approach allows us to consider the factors that lead someone to develop a psychological disorder, which is known as its etiology.

Let’s consider the Beale women in terms of the neuropsychosocial approach. First, we can ask about neurological factors: Was something abnormal about their genes or brains? Perhaps their neurons or neurotransmitters functioned abnormally, and that led to their odd behavior. Second, we can ask about psychological factors: How might their thoughts and feelings have motivated them, and what role might their mental processes have played? And third, we can ask about social factors, such as their financial circumstances, their family relationships, the straitlaced society they were members of, and other cultural forces affecting them.

At any moment in a day of the beales’ lives (or anyone’s life, for that matter), all three types of factors are operating: neurological, psychological, and social. Depending on the state of a person’s brain (which is affected, for example, by various chemicals produced by the body), social factors (such as an angry friend or a stressful job interview) have a greater or lesser impact. This impact in turn affects psychological factors (the person’s thoughts, feelings, and behaviors) in different ways. And then the psychological factors can affect both neurological factors and social factors, continuing the interaction among these different influences. Thus, considering only one type of factor would lead to an incomplete understanding of psychological disorders. That is why we consider each type of factor—neurological, psychological, and social—in detail (see Figure 1.4 in Chapter 1). It is important to note, however, that the neuropsychosocial approach does not focus on each type of factor individually; rather, we must always consider how the three factors interact and affect one another via feedback loops.