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.
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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.
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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
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