Editing Causes of mental disorders (section)

==Theories==

===General theories===
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Several [[theories]] or [[scientific modelling|models]] seek to explain the causes ([[etiology]]) of [[mental disorder]]s. These theories may differ in regards to how they explain the cause of the disorder, how to treat the disorder, and how they [[classification of mental disorders|classify mental disorders]]. Theories also differ about the [[philosophy of mind]] they accept; that is, whether the [[mind]] and [[brain]] are identical or not. {{cn|date=October 2024}}

During most of the 20th century, mental illness was ascribable to problematic relationships between children and their parents. This view was held well into the late 1990s, in which people still believed this child-parent relationship was a large determinant of severe mental illness, such as depression and schizophrenia. In the 21st century, additional factors have been identified such as genetic contributions, though experience also plays a role. So, the perceived causes of mental illness have changed over time and will most likely continue to alter while more research develops throughout the years.

Outside the West, community approaches remain a focus.{{cn|date=October 2024}}

A practical mixture of models will explain particular issues and disorders, although there may be difficulty defining boundaries for indistinct psychiatric [[syndromes]].

===Medical or biomedical model===
An overall distinction is also commonly made between a "medical model" (also known as a biomedical or disease model) and a "social model" (also known as an empowerment or recovery model) of mental disorder and [[disability]], with the former focusing on hypothesized disease processes and symptoms, along with latter focusing on hypothesized [[social constructionism]] and social contexts.

[[Biological psychiatry]] has tended to follow a [[biomedical]] model focused on organic or "hardware" pathology of the brain,<ref name="Ghaemi 2006">{{cite journal | vauthors = Ghaemi SN | title = Paradigms of psychiatry: eclecticism and its discontents | journal = Current Opinion in Psychiatry | volume = 19 | issue = 6 | pages = 619–624 | date = November 2006 | pmid = 17012942 | doi = 10.1097/01.yco.0000245751.98749.52 | s2cid = 22068456 }}</ref> where many mental disorders are conceptualized as disorders of [[brain circuits]] shaped by a complex interplay of genetics and experience.<ref name=Insel>{{cite journal | vauthors = Insel TR, Wang PS | title = Rethinking mental illness | journal = JAMA | volume = 303 | issue = 19 | pages = 1970–1971 | date = May 2010 | pmid = 20483974 | doi = 10.1001/jama.2010.555 | s2cid = 8210144 }}</ref>

The social and medical models of mental disorders each work to identify and study distinct aspects, solutions, and potential therapies of disorders. The intersection and cross reference between the two models can further be used to develop more holistic models of mental disorders. Many criticisms historically of each model is the exclusivity of the other perspective. Therefore, intersectional research improved the impact and importance of future findings.<ref>Hogan A. J. (2019). Social and medical models of disability and mental health: evolution and renewal. CMAJ: Canadian Medical Association journal, 191(1), E16–E18. https://doi.org/10.1503/cmaj.181008</ref>

===Biopsychosocial model===
The primary model of contemporary mainstream Western psychiatry is the [[biopsychosocial model]] (BPS), which integrates biological, psychological, and social factors.<ref name="Ghaemi 2006" /> The Biopsychosocial model was first conceptualised by George Engel in 1977,<ref>{{cite journal | vauthors = Engel GL | title = The need for a new medical model: a challenge for biomedicine | journal = Science | volume = 196 | issue = 4286 | pages = 129–136 | date = April 1977 | pmid = 847460 | doi = 10.1126/science.847460 | bibcode = 1977Sci...196..129E }}</ref> suggesting that to understand a person's medical condition it is not simply the biological factors to consider, but also the psychological and social factors . The biopsychosocial approach systematically considers biological, psychological, and social factors and their complex interactions in understanding health, illness, and health care delivery. Biological, psychological, and social factors exist along a continuum of natural systems. The factors within the model contain the following:

* Biological (physiological pathology)
* Psychological (thoughts emotions and behaviours such as psychological distress, fear/avoidance beliefs, current coping methods and attribution)
* Social (socio-economical, socio-environmental, and cultural factors such as work issues, family circumstances and benefits/economics)

This model is commonly used for case conceptualization of psychological disorders as well as chronic pain,<ref>{{cite journal | vauthors = Miaskowski C, Blyth F, Nicosia F, Haan M, Keefe F, Smith A, Ritchie C | title = A Biopsychosocial Model of Chronic Pain for Older Adults | journal = Pain Medicine | volume = 21 | issue = 9 | pages = 1793–1805 | date = September 2020 | pmid = 31846035 | doi = 10.1093/pm/pnz329 }}</ref> with the view that the pain is a psychophysiological behavior pattern that cannot be categorised into biological, psychological, or social factors alone. 

A related view, the [[diathesis-stress model]], posits that mental disorders result from genetic dispositions and environmental stressors, combining to cause patterns of distress or dysfunction.<ref>{{cite book | vauthors = Murthy RS |display-authors= etal |title=The World Health Report 2001: Mental Health, New Understanding, New Hope|orig-year=2001 |date= 2002 |publisher=World Health Organization|location=Geneva|edition= Reprint|url=https://books.google.com/books?id=GQEdA-VFSIgC&q=mental+health+comes+from+genetics&pg=PR9 |isbn= 9789241562010}}</ref> The model is one way to explain why some individuals are more vulnerable to mental disorders than others. Additionally, it explains why some people may develop a mental disorder after exposure to stressful life events while others do not.

===Psychoanalytic theories===
[[Psychoanalytic]] theories focus on unresolved internal and relational conflicts. These theories have been predicated as explanations of mental disorders. Many psychoanalytic groups are said to adhere to the biopsychosocial model and to accept an eclectic mix of subtypes of psychoanalysis. [[Sigmund Freud]] developed the psychoanalytic theory. This theory focuses on the impact of unconscious forces on human behavior. According to Freud, a personality has three parts: the [[Id, ego and super-ego|id]], [[Id, ego and super-ego#Ego|ego]], and [[superego]]. The id operates under the [[Pleasure principle (psychology)|pleasure principle]], the ego operates under the [[reality principle]], and the superego is the "conscience" and incorporates what is and is not socially acceptable into a person's value system.<ref>{{Cite book | vauthors = Nyongesa A |url=http://www.jstor.org/stable/j.ctvh9vxtv |title=Tintinnabulation of Literary Theory: Traversing Genres to Contemporary Experience |date=2018-09-23 |publisher=Mwanaka Media and Publishing |isbn=978-1-77906-514-8 |doi=10.2307/j.ctvh9vxtv.8|jstor=j.ctvh9vxtv |s2cid=239252932 }}</ref> According to the psychoanalytic theory, there are five stages of psychosexual development that everyone goes through the [[oral stage]], [[anal stage]], [[phallic stage]], [[latency stage]], and [[genital stage]]. Mental disorders can be caused by an individual receiving too little or too much gratification in one of the psychosexual developmental stages. When this happens, the individual is said to be in that developmental stage.<ref>{{cite journal | vauthors = Saygin D, Tabib T, Bittar HE, Valenzi E, Sembrat J, Chan SY, Rojas M, Lafyatis R | display-authors = 6 | title = Transcriptional profiling of lung cell populations in idiopathic pulmonary arterial hypertension | journal = Pulmonary Circulation | volume = 10 | issue = 1 | pages = 54–77 | date = 2005 | pmid = 32166015 | doi = 10.1111/j.1527-2001.2005.tb00373.x | pmc = 7052475 | s2cid = 143641177 }}</ref>

=== Attachment theory ===
[[Attachment theory]] is a kind of evolutionary-psychological approach sometimes applied in the context of mental disorders, which focuses on the role of early caregiver-child relationships, responses to danger, and the search for a satisfying reproductive relationship in adulthood. According to this theory, a child's attachment is to a nurturing adult, the more likely that child will maintain healthy relationships with others in their life.<ref>{{cite journal | vauthors = Keller H | title = Universality claim of attachment theory: Children's socioemotional development across cultures | journal = Proceedings of the National Academy of Sciences of the United States of America | volume = 115 | issue = 45 | pages = 11414–11419 | date = November 2018 | pmid = 30397121 | pmc = 6233114 | doi = 10.1073/pnas.1720325115 | bibcode = 2018PNAS..11511414K | doi-access = free }}</ref> As found by the [[Strange situation|Strange Situation experiment]] run by [[Mary Ainsworth]] based on the formulations of [[John Bowlby]], there are four patterns of attachment: [[secure attachment]], [[Attachment styles|avoidant attachment]], [[disorganized attachment]], and [[ambivalent attachment]].<ref name=":0">{{cite journal | vauthors = Waters E, Hamilton CE, Weinfield NS | title = The stability of attachment security from infancy to adolescence and early adulthood: general introduction | journal = Child Development | volume = 71 | issue = 3 | pages = 678–683 | date = 2000 | pmid = 10953933 | doi = 10.1111/1467-8624.00175 | jstor = 1132385 }}</ref> Later research found the fourth pattern of attachment is known as [[Disorganized attachment|disorganized disoriented attachment]].<ref>{{cite journal | vauthors = Fearon RP, Bakermans-Kranenburg MJ, van Ijzendoorn MH, Lapsley AM, Roisman GI | title = The significance of insecure attachment and disorganization in the development of children's externalizing behavior: a meta-analytic study | journal = Child Development | volume = 81 | issue = 2 | pages = 435–456 | date = 2010 | pmid = 20438450 | doi = 10.1111/j.1467-8624.2009.01405.x | jstor = 40598991 | url = https://centaur.reading.ac.uk/17513/1/Fearon_et_al.%2C_2010.pdf }}</ref> Secure attachments reflect trust in the child-caretaker relationship while insecure attachment reflects mistrust. The security of attachment in a child affects the child's emotional, cognitive, and social competence later in life.<ref name=":0" />

===Evolutionary psychology===
{{See also|Evolutionary psychiatry}}
[[Evolutionary psychology]] and [[evolutionary psychiatry]] posit that mental disorders involve the dysfunctional operation of [[mental module]]s adapted to [[ancestral]] physical or social environments but not necessarily to modern ones. Behavioral abnormalities that resemble human mental illness have been found in related species ([[great apes]]).

Other theories suggest that mental illness could have evolutionary ''advantages'' for the species, including enhancing creativity<ref>{{Cite journal |last1=Nettle |first1=Daniel |last2=Clegg |first2=Helen |date=2006-03-07 |title=Schizotypy, creativity and mating success in humans |journal=Proceedings of the Royal Society B: Biological Sciences |language=en |volume=273 |issue=1586 |pages=611–615 |doi=10.1098/rspb.2005.3349 |issn=0962-8452 |pmc=1560060 |pmid=16537133}}</ref> and [[Stress (biology)|stress]] to enhance survival by activating the [[flight-or-fight response]] in anticipation of danger.

[[Mania]] and [[Depression (mood)|depression]] could have benefited from seasonal changes by helping to increase energy levels during times of plenty and rejuvenating energy during times of scarcity. In this way, mania was set in motion during the spring and summer to facilitate energy for hunting; depression worked best during the winter, similar to how bears [[hibernate]] to recover their energy levels.<ref>{{Cite journal |last1=Rantala |first1=Markus J. |last2=Luoto |first2=Severi |last3=Krams |first3=Indrikis |last4=Karlsson |first4=Hasse |date=2018-03-01 |title=Depression subtyping based on evolutionary psychiatry: Proximate mechanisms and ultimate functions |url=https://www.sciencedirect.com/science/article/pii/S0889159117304683 |journal=Brain, Behavior, and Immunity |language=en |volume=69 |pages=603–617 |doi=10.1016/j.bbi.2017.10.012 |pmid=29051086 |s2cid=3975281 |issn=0889-1591}}</ref> This may explain the connection between circadian genes and [[Bipolar Disorder]] and explain the relationship between light and [[seasonal affective disorder]].