Stress disorders can complement biological vulnerability to cause psychotic disorders. Stress is a reaction that arises because someone is in an environment with pressure that cannot be tolerated by that person. This means that the ability of people in stress resistance will be very different. When psychotic disorders have arisen, the person with the disorder becomes very vulnerable to stress. They are more reactive to various stressors faced in everyday life. Hirsch et al. (1996) found that increased life stress increased their recurrence.
Another theory that can complement the biological causes of psychotic disorders is cognitive view. This view gives an understanding that so-called psychotic symptoms are not always caused by organic disorders. This disorder arises because of cognitive distortion or irrational beliefs in a person’s mind which results in emotional and behavioral conditions that are considered strange or crazy.
Sometimes those who are labeled as psychotic people actually do not really experience the disorder, but only seen as a symptom of disturbance and the problem stemming from cognitive errors. This makes the need for careful and accurate assessment or diagnosis. Labels such as crazy, psychotic, or schizophrenia given in a hurry will lead to mismanagement.
Behavior loses contact with reality, disorientation of mind, disorganization between thoughts and feelings is psychotic simpton. There are certain conditions in which a person experiences such conditions as during poisoning, under the influence of an anesthetic or hallucinogenic drugs, or very sleep deprivation. Screening, assessment, or diagnosis needs to consider the cognitive conditions of people with disorders. If there is someone who is considered to have strange behavior, it must be remembered that it is very important to understand the situation from the perspective of the person with problems by considering the various circumstances, pressures, values, and belief systems of the person with the problem.
It has been mentioned previously that stress disorders can complement biological vulnerability to create psychotic disorders and people with psychotic disorders become very vulnerable to stress. While stress itself can be triggered by cognitive errors. Zastrow (1979, 1993, 2003) theorizes that self talk (content of cognition) is part of the chronic causes of stress, and chronic stress causes a variety of health problems. Thus biological vulnerability when combined with stressful conditions will facilitate the appearance of psychotic mental disorders.
Nearby Environmental Factors
The cause of stress is due to the stressors (triggers) that come from the surrounding environment. This stress phenomenon describes how psychological aspects are influenced by environmental conditions. Psychosocial perspectives in social work can explain how people with psychotic disorders are involved with risky environmental conditions that put them in a bad situation.
Assuming that the psychological state is considered to be unable to stand alone but continues to interact with biological systems and social systems (Woods & Robinson, in Turner, 1996), then the root of the problem can be traced from these three factors. If the biology factor has been explained before, then the next situation will be explained which risks creating psychotic disorders.
Environmental factors related to piskotic disorders can be categorized into two categories: nurturing environment and wider social structure. In parenting conditions, the family environment is an important factor in contributing to this disorder.
Risk factors of family factors associated with the appearance of psychotic disorders are problems with communication deviations (Singer & Wayne, 1965) and emotional expression / EE (Vaughn & Leff, 1976) in the family. Research has shown that family dynamics interfere as a factor that contributes to schizophrenia both at the beginning of the appearance of the disorder and at the onset of the disorder (Nichols, 2006). Several studies have found a link between communication deviations and schizophrenia (Doane et al. 1989; Goldstein 1987). Poor patterns of communication between children and parents such as denouncing, ignoring feelings and concerns, confusing, coupled with high levels of conflict play a role in the etiology of schizophrenia.
Other studies have shown emotional expressions including critical communication and hostile tone contributing to schizophrenia (Rosenferb & Miklowitz, 2004), and high emotional expression in the family proves to be consistently associated with greater risk to clients to relapse after undergoing treatment (Parker & Pavlovic, 1990). In general, it can be said that the state of relationships within the family, the quality of care, including the pattern of parent and child relationships can contribute to mental disorders. Absence of empathy, rigidity, violence, rejection and neglect, poor management of conflicts, can be contributors that cannot be ignored.
Economic and Social Difficulties
Based on socioeconomic strata, in general mental disorders occur more in low socioeconomic strata. The consistent correlation between socioeconomic status and the occurrence of mental illness has been revealed by many research results (Lauer & Lauer, 2002). Although the reasons for the high incidence in the low strata have not been carefully identified, this is understandable considering that people from marginal groups are more exposed to various life difficulties.
Some assumptions of difficult conditions faced by low socio-economic groups related to their relationship to mental disorders include having more problems, having greater levels of family disorganization, stress due to the economic situation, and lack of access to various services (Feinstein, 1993; Esminger, 1995) They also face more work problems. Some of them are not only stressed to experience unemployment, but also because of inadequacy, and may experience unhealthy and dangerous work situations (Ross & Wu 1995).
In addition to being faced with various socio-economic difficulties, changes that create unwanted conditions can also contribute to a state of mental disorder. The events related to this change include changes in roles caused by the death of a spouse, divorce and marriage, a situation of quitting work or a stressful new job situation. Research results have shown that changes that are considered large and not expected can result in illness. Certain events can result in conditions such as panic attacks, injury, decreased ability of the body to ward off disease, and various physical and emotional disorders (Lauer & Lauer, 2002).