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Psychopathology refers to mental disorder or illness. It maintains that mental disorders are not merely things in someone’s head but a true reality that is usually more complex than merely one explanation. Etiology for psychopathology has many multidimensional facets which professional must consider and review before giving an official diagnosis. Like any physical disease, mental disease and disorder is very broad and can cause a variety of ailments and dysfunctions. Nosology is the classification of phenomena especially in mental health and psychopathology (McRay, B.,et. al, 2026). Categorizing psychopathology, however, is not a simple process and like psychology itself has many differing opinions on what causes an issue or how differing conditions should be classified. In this blog we will take a closer look at classification of psychopathology, as well as classification and diagnosis.

Psychopathology and diagnosis is a multi tiered and multi disciplined approach usually without one clear answer

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Pathology, Assessment and Diagnosis

The American Psychological Association (APA) defines psychopathology as understanding the nature of pathologies of the mind, mood and behavior (McRay, B. , et. al,, 2016). Pathologies also share four common features or the “four Ds”. The pathology deviates from the norm, causes distress to the person, imposes some type of dysfunction to the person, and presents a clear danger to the person or others (McRay, B., et al., 2016). Differing schools of thought look to classify pathologies into different categories and emphasize one over others, but the reality is pathology has very complex origins in mental health. The DSM-5-TR, proceeds just etiology but looks to diagnose according a symptom based approach. This empirical approach looks at the manifestations of certain symptoms of individuals based off of case studies and empirical data. Mental Health Care professionals can then properly identify symptoms based on severity and frequency to determine a prognosis.

Mental Healthcare professionals utilize the clinical interview and a broad range of assessments to come to diagnostic conclusions paired with the DSM-5-TR. These assessments involve personality tests that act more as a wide reaching net or funnel that proceeds from more general to more individual questions as the presenting problem becomes more evident in the search (Barlow, D., et. al, 2023). These assessments include wide ranger personality tests, as well as more narrowing assessments on a particular type of issue. Including also are usually physical exams by the primary health provider to rule out mental disorders with origins due to physical conditions, such as thyroid, cancer, or other physical illness that portray mental symptoms. Cat scans and MRI’s are also utilized to give the provider the necessary biological information about the brain and how it is functioning (Barlow, D. et. al. 2023). The DSM-5-Tr discusses in particular the wide range cross cutting symptom measure and its broad range of questions. Also frequently used is the Minnesota Multiphasic Personal Inventory test.

Please also review AIHCP’s blog on Clinical Interviewing and Assessments. Click here.

Classifying and Etiology of Mental Disorders

Since mental health is so complex, the root cause of a particular disorder is a complex thing to understand. There are biological, psychological, spiritual and sociocultural models to consider in mental health (McRay, B. , et. al,, 2016). Biological factors include the brain, neurotransmitters, the nervous system and genetics itself. When parts of the brain are not operating properly, or due to injury, or not not properly formed or developed, then psychopathologies can occur in how the person sees and reacts with the world. When neurotransmitters such as dopamine, serotonin, glutamate, norepinephrine or GABBA are not properly transferring or in lack of proper doses and balances then an array of symptoms and cases of anxiety and depression can occur (Barlow, D., et. al, 2023). The nervous system as well, especially within the autonomic branch which encompasses both the sympathetic and parasympathetic can play key roles in how a person emotionally and mentally reacts to problems. Trauma and PTSD is closely tied to the activation to these systems. In addition, certain genes can carry powerful predispositions to certain behavioral traits and some can become activated in life. Sometimes a combination of these biological issues tied to other elements lead to an overflow to the system. The diathesis-stress model points how genetic vulnerability tied to life events and stressors can be the causing and tipping point in when a person develops the disorder and it manifest (Barlow, D., et. al, 2023).

In addition to biological, psychological issues look to the multidimensional history of psychotherapy and its numerous founders of different schools to explain pathology. Psychoanalytic identifies pathology as unresolved subconscious issues that can re-emerge in life. Behaviorism looks at conditioned and unconditioned response and how one thinks, and feels in regard to behavior itself. Human Centered approaches applies lack of self actualization as a big component leading to various pathologies. Emotion, behavior, and the subconscious play key roles, but especially when tied to biological factors. Fortunately, towards the later part of the 20th Century, psychology turned to utilizing many pharmacological medications based in the school of biological factors to supplement care beyond mere therapy and talk.

Spiritual issues can also cause psychological issues. The spirituality of a person is at the center core of a person and goes beyond mere biological and psychological processes. Spirituality grants one meaning in life. Spirituality is tied to healthy coping but maladaptive spiritual practices can also lead to poor mental health. Spirituality can also grant for some a true etiology for disease and illness. Within Christianity, sin is seen as the source for humanity’s fall and pain. It also does not dismiss the factor of vice and evil that can play a role in mental health and the effects bad habits and actions can have on a person’s wellbeing. Many secular therapists dismiss right and wrong in psychotherapy. While one cannot expect to diagnose and treat mental illness from a spiritual standpoint void of empirical data, it can help individuals understand in their view the origin and purpose of mental illness and bad things in the world. It can grant an order to things. Those without order and understanding of their existential reality can have harder times coping with life’s problems. However, when religion and spirituality is misused it can lead to superstition, as well as dangerous views about life and reality that can harm the individuals self concept.

Sociocultural elements of a person’s family life, as well as culture and ethnic make up play key roles in how one behaves and feel mentally. Family and social support, as well as a healthy self image lead to healthier outcomes as opposed to individuals who face poverty, discrimination, and poor diet. Relationships and support are critical elements in completely understanding the origin and causes of various pathologies. The sociocultural model also expresses the importance of healthy communication and conflict management (McRay, B. , et. al,, 2016).

The DSM-5-TR

The DSM-5-TR looks to diagnose based on the most empirical evidence available and understands the multidimensional models associated with the etiology of pathology. While it strives to give the most empirical approach possible, bias can still exist in what is considered normal and abnormal according to spiritual and cultural status of a person. It is hence important to be culturally aware. For instance, individuals who believe in demons may associate an issue with the demonic. This would not constitute psychosis for these types of individuals who may think something could be demonic in nature and not natural. Whether real or not, it is not a psychosis for a believer to rationally think of such possibilities. So what would constitute an insane possible explanation to an atheist may not be a pathological expression in a believer. It is also important to understand the negative consequences of diagnosis when tied to labeling. Mental health already has a severe stigma tied to it and it is important to differentiate the diagnosis from the person’s self identity.

In the diagnosis process, mental health care providers follow a standardized and empirical process of diagnosing a certain ailment. The DSM-V-TR lists diagnostic criteria for any mental ailment and also has codes tied to the International Classification of Diseases (ICD) which was developed by the World Health Organization. This is seen in its coding procedures that correlate with the ICD. This helps tie the named mental disorder with the ICD code for purposes of consistency and also medical billing. The DSM replaced the concept of mental disorder vs physical disorder to mental disorder vs general medical condition and how they can interact (DSM-5-RT). A person will then receive in diagnosis the proper code. The first day of diagnosis deals with the presenting problem and can be seen as the principle diagnosis with a possible provisional diagnosis if current information is insignificant. The DSM-V-TR provides a section on diagnostic criteria, diagnostic features, associated features, development and course, risk and prognostic factors, differential diagnosis and comorbidity factors with each diagnosis.

With mental disorders, the diagnosis includes a broad range of issues that is ranked according to intensity and frequency much like other mental disorders found in the DSM-5-TR. The DSM-5 lists a variety of domain names starting with domain 1 as depression, followed by anger, mania, anxiety, somatic symptoms, suicidal ideation, psychosis, sleep problems, memory, repetitive thoughts or behaviors, dissociation, personality function and substance abuse. The threshold guide of symptoms is between mild to greater but has full range from none, slight, mild, moderate, severe and highest.

Personality disorders include key questions regarding identity, self-direction, empathy and intimacy. In regards to identity, does the person have a strong sense of self or a weak and distorted sense of self? In regards to self-direction does the person have good goals and reachable aims or does the person have limited ability to function and meet goals and assess healthy vs unhealthy ones? In regards to empathy, does the person have the ability to feel for others, or is that reduced, or limited or non-existent? In regards to intimacy, is the personable to maintain and keep healthy relationships, or does the person fail to keep healthy relationships with others? These symptoms in personal life also fall under the level of personal functionality and differences vary according to the disorder as well as its severity

Personality disorders also possess certain domains based on severity as well as manifestation within certain disorders.

Negative Affectivity vs Emotional Stability looks at a persons’ negative range of emotions such as guilt, worry, shame, anger, as well as emotional liability, anxiousness, separation insecurity, submissiveness, hostility, perseveration, depressivity, and suspiciousness.

Detachment vs extraversion looks at issues of avoidance, lack of interpersonal activities, withdrawl, intimacy avoidance, anhedonia, depressivity and suspiciousness.

Antagonism vs Agreeableness includes behaviors that are at odds with other people, manipulation, deceitfulness, grandiosity, attention seeking, hostility, and callousness or lack of empathy

Disinhibition vs Conscientiousness lists irresponsibility, impulsivity, distractibility, risk taking and rigid perfectionism.

Finally, Psychoticism vs Lucidity includes incongruent, odd or eccentric behaviors or cognitions, unusual beliefs or experiences, eccentricity, and cognitive and perceptual dysregulation.

Conclusion

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Diagnosis regarding mental health is a tiered process with numerous multidimensional factors that need to be considered before diagnosis. The DSM-5-TR supplies an empirical based catalogue based on symptoms to better narrow down a condition. It is important to follow the interviews, assessments, and possible other physiological conditions before ruling on anything. It is also important to understand the detrimental aspect of labeling someone and the care that needs to be done when helping someone with a condition as not to tie that individual’s identity with the pathology.

Remember as well, that only licensed mental health professionals can diagnose. While many AIHCP members may have certifications in certain behavioral health domains, this does not constitute licensure. Only certified members with AIHCP who are ALSO licensed can diagnose issues in grief, stress, and crisis.

Please also review AIHCP’s Behavioral Healthcare Certification which include grief counseling, crisis intervention, anger management, trauma informed care, stress management, and spiritual and Christian counseling programs.

References

Barlow, D, Durand, V.M., & Hofmann, S. (2023). Psychopathology: An integrative approach to mental health (9th Ed). Cengage

DSM-5-TR. APA (2022).

McRay, B., Yarhouse, M., & Butman, E. (2016). Modern Psychopathologies: A comprehensive Christian appraisal (2nd, Ed). Intervarsity Press.

Additional Resources

DSM-5. Cleveland Clinic. Access here

Casali, B. (2025). “How Mental Disorders are Assessed and Diagnosed”. MentalHealth.com. Access here

7 Core Pathological Personality Traits. (2020). Psychology Today. Access here

What Is Considered Pathology in Psychology? (2025). BiologyInsights.com. Access here

Everyone in life has something mentally not balanced or perfect. Neurotransmitters can be slightly off for a period of time or someone may even have a life time of imbalance and require medication to rectify it. Some suffer minor issues without need of medication but only require counseling and better coping strategies. Many have minor mental diagnosis with things such as ADHD, OCD, depression, or anxiety. Depending on the severity will determine the strength and duration of the care.

Many mental illness symptoms are minor such as ADHD, OCD or anxiety but they can become severe unless treated

Others may have suffered trauma in life and require more intensive care and treatment. Those with PTSD may require more intense care to help manage symptoms and triggers, while others may experience issues later in life from early childhood trauma, such as Bi-Polar Disorders, Borderline Personality Disorders and Attachment Disorders. In addition, some individuals may experience deeper rooted mental illness within family history and due to genetic issues. Psychosis and delusions can result from Schizophrenia or other mental maladies. Others may inherit through lack of discipline or consequences behavioral mental illnesses that are anti-social in nature. These individuals will manifest little care or regard for others, norms or values.

With this in mind, it is obvious that mental illness is a broad spectrum term. Like all health, it is important to identify and not neglect. Many feel stigma and shame associated with it because most of society labels mental health as one thing. Instead mental health can be tied to very minor and everyday disorders to severe issues. Some cases can be minor, while some very serious. Hence it is important to not neglect one’s mental health, feel stigmatized by it, or ignore the symptoms that may arise.

Some mental illnesses have their own types of symptoms, but for everyday individuals not suffering from severe past trauma, dealing with delusions, or possessing an anti-social personality, most can find cope and medicate if necessary and find balance in daily life. Many with bi-polar depression, clinical depression, anxiety, ADHD, or OCD are able to function at high levels with the proper counseling and guidance.

Most mental illness usually manifest in the teen age years or grows as result of trauma, especially if left untreated. Many individuals ignore their mental health and later in early adulthood can face multiple issues they may not understand. Those with attachment issues, or borderline personality disorders, or even bi-polar may find it very hard to function and maintain relationships and jobs. It is hence important to track one’s moods seriously to see if anything unhealthy may be manifesting. Most experts agree that one should not permit a mental or emotional symptom to persist longer than 2 weeks without seeking mental health assistance.

Symptoms of mental illness can be mental, emotional and physical. Please also review AIHCP’s Healthcare Certification programs

Some of the more common mental health changes are in mood. Some common changes include anxiety, lack of interest, sudden and dramatic mood shifts, apathy, suicidal ideation, and withdraw from life. Mental health also affects physical health. Hormones and neurotransmitters can become imbalanced leading to mood shifts, but also affect physical energy levels, sensory perception, increase fatigue or even cause the opposite and prevent one from sleeping. It can also negatively effect appetite. In addition, individuals habits may change. One may enter into a manic state, or withdraw, while others may turn to substance abuse, or abrupt sexual encounters. Sudden changes like this in personality are signs of a problem. Other changes can include negative effects on logical thinking processes. Individuals may contemplate ridiculous and over exaggerated thoughts about self, or even become delusional and enter into states of psychosis in regards to reality. Confusion, loss of time, worry, or fear can be signs of a pending problem.

All of these signs can vary in severity, frequency, or intensity, but if persistent over time represent some type of mental change that needs to be addressed. Something may be resurfacing from the past, or something may be developing that needs addressed. Sometimes it may even be physiological and connected to a physical issue. Tumors on the brain are an example.

Like physical symptoms telling oneself our body has a cold or the flu, we need to also notice these symptoms and not merely displace them or move on. With physical symptoms, one makes an appointment with a doctor. If something does not seem right, one finds the help they need to correct it. Mental health requires the same focus and care. Symptoms are a result of an issue that needs addressed. While many may be minor, some may not be and looking into it and finding the help one needs can be a the difference between life and death.

Conclusion

Mental health is as important as physical health. They are actually very much interconnected. Ignoring it due to shame or stigma can lead to greater issues. Usually most mental health issues are minor and require temporary medication and learning ways to cope, but sometimes they can be more serious pointing to one’s past, a serious emerging problem, or something that is related to physical health. It is important to find help to reduce the possibility of more severe illness.

Never put aside mental illness for feelings of shame or stigma. Instead treat it like any physical health issue and see a professional.

Please also review AIHCP’s multiple mental health certifications for mental health care professionals and those in ministry and human services. The certifications are online and independent study and open to qualified professionals seeking a four year certification. AIHCP offers certifications for mental health care professionals and those in human services in Grief Counseling, Anger Management, Stress Management, Substance Abuse Counseling, ADHD Consulting and Crisis Intervention Consulting. Please review any of AIHCP’s healthcare certifications

Remember certified and pastoral counselors can only help with non pathological issues. Licensed professional counselors can help with deeper issues regarding pathology, but many licensed counselors also enhance their resume with certifications.

Additional Resources

“Signs of Mental Illness”. Frysh, P. (2022). WebMD. Access here

“Warning Signs and Symptoms”. NAMI. Access here

“Mental health: What’s normal, what’s not”. Mayo Clinic. Access here

“Mental Health Diagnosis: Symptoms, Types, and Treatments”. Morin, A. (2023). VeryWellMind. Access here

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Diagnosing Psychopathology