Chapter 15: Psychological Disorders

Agenda

Mental Disorders– what are they? Overview of DSM & a brief history Overview of mental disorders

“Abnormality” – “Disorder”

Combination of:› Suffering› Violation of societal standards› Social discomfort› Irrationality/unpredictability› Dangerousness

Psychological disorder: deviant, distressful, and dysfunctional patterns of thoughts, feelings, or behaviors.

**harmful dysfunction

Definition used by psychologists & psychiatrists:

“A mental disorder is a syndrome characterized by clinically

significant disturbance in an individual’s cognition, emotion

regulation, or behavior that reflects a dysfunction in the

psychological, biological, or developmental processes underlying

mental functioning. Mental disorders are usually associated with

significant distress or disability in social, occupational, or other

important activities. An expectable or culturally approved response

to a common stressor or loss, such as the death of a loved one, is not

a mental disorder. Socially deviant behavior (e.g., political, religious,

or sexual) and conflicts that are primarily between the individual and

society are not mental disorders unless the deviance or conflict

results from a dysfunction in the individual, as described above.”

DSM-5 American Psychiatric

Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition

No axes; ASD added

High hopes for change! But pretty close to DSM-IV

www.psychiatry.org

blogs.scientificamerican.com

Prevalence

Lifetime prevalence of having any DSM-IV disorder is 46.4% (and did not include autism, schizophrenia, or eating disorders).

Anti-Labeling

1970s– anti-diagnosis time Rosenhan (1973)

› https://www.youtube.com/watch?v=j6bmZ8cVB4o

Spitzer (1975)› Feisty response

Anxiety Disorders: Generalized Anxiety

Disorder (GAD) Panic Disorder Specific phobia [not Post-traumatic

stress disorder, no longer considered an anxiety disorder]

[not OCD]

Mood Disorders: Major Depressive

Disorder (MDD)

Bipolar Disorder (I and II)

Schizophrenia

Eating Disorders: Anorexia nervosa Bulimia nervosa

Personality Disorders: Antisocial Personality

Disorder

Etiology (causes/origin):Biopsychosocial model

**gene x environment interactions (GxE)

Anxiety: Generalized Anxiety Disorder (GAD)

Excessive anxiety and worry occurring more days than not over a wide variety of issues; difficult to control; causing significant distress or impairment

3 or more of following symptoms, must be present more days than not for the past 6 months: › Restlessness/feeling on edge; being easily

fatigued; difficulty concentrating or mind going blank; irritability; muscle tension; sleep disturbance.

https://www.youtube.com/watch?v=gciDbk2jX5o

Anxiety: Panic Disorder Panic attack (cued and uncued):

An abrupt (there’s no ramping up) surge of intense fear or intense discomfort that reaches a peak within minutes and during which time four or more of the following symptoms are present: physical symptoms (13 of these to choose from)-- sweating,

trembling, feeling like you’re going to vomit, feeling like you’re going to choke, fear of dying, losing control, going crazy, etc.

Disorder:› 2+ uncued panic attacks, with a month or more

of rumination and significant maladaptive change in behavior (e.g., avoiding places, exercise, requiring a companion)

https://www.youtube.com/watch?v=Ii2FHbtVJzc

Anxiety: Specific phobia

Anxiety: Specific phobia

Marked fear/anxiety about a specific object/situation

The phobia almost always provokes immediate fear or anxiety; it is actively avoided or endured with intense fear or anxiety; it is out of proportion to the actual danger posed and to the sociocultural context; it lasts for 6 months or more; and it causes significant distress or impairment in important areas of functioning (social, occupational).

Depression: Major Depressive Disorder

All symptoms must be present for at least 2 weeks, most of the day nearly every day.

Must have either depressed mood or markedly diminished interest in all/almost all activities

At least 5: depressed mood, loss of interest, eating/appetite disturbance, sleep disturbance, loss of energy, feelings of worthlessness or inappropriate guilt, concentration difficulties, and (at least twice) thoughts of death/recurrent suicidal ideation

https://www.youtube.com/watch?v=4YhpWZCdiZc

Bipolar I and II Bipolar I: At least one manic episode with or without a

major depressive episode Bipolar II: At least one hypomanic episode + a major

depressive episode Manic episode:

› Manic OR irritable mood & increased goal-directed activity, at least one week most every day [hypomanic = 4 days]

› 3 or more: Increase in dangerous pleasurable activities; decreased need for

sleep; more talkative or pressure to keep talking; increase self-esteem/grandiosity; increase in goal-directed activity; distractibility; flight of ideas

› Marked impairment: typically hospitalization or very significant negative change (e.g., loses job, spends all inheritance); hypomanic episode is less severehttps://www.youtube.com/watch?v=zA-fqvC02oM

Schizophrenia 2 or more, each present for at least 1 month, 1 has to

be delusion/hallucination/disorganized speech: Delusion: persecutory, reference, grandeur, etc. Hallucinations: auditory, visual, tactile, etc. Disorganized speech: tangentiality, loose

associations, word salad, clang associations Disorganized/catatonic behavior: grossly

impaired hygiene, inappropriate sexual behavior, etc. Negative symptoms: don’t want to do anything,

and flat/blunted affect

Functioning is markedly below prior-to-illness functioning

https://www.youtube.com/watch?v=gGnl8dqEoPQ

https://www.youtube.com/watch?v=ZB28gfSmz1Y

Eating Disorders: Anorexia Nervosa and Bulimia Nervosa

Anorexia: Restricting, with low body weight, intense fear of gaining weight, and disturbance in the way body weight/shape is experienced

Bulimia: Binge eating, with re-occurring inappropriate behaviors to prevent weight gain, both at least once a week for at least 3 months, with self-evaluation dependent on body shape/weight.https://www.youtube.com/watch?v=zWV5AxnhM_I

Personality Disorders: Antisocial & Others

Must be inflexible, maladaptive, stable, and cause impairment/distress

Antisocial: “sociopaths”– 3+ of: failure to conform to social norms, deceitfulness, impulsivity, irritability, reckless disregard for safety, consistent irresponsibility, lack of remorse

https://www.youtube.com/watch?v=C6v8M78WEOs

**If interested, get involved in research! (Kelly Klump, Jason Moser, etc.)

http://www.counseling.msu.edu/

MSU Counseling Center

Initial screening appointments are free, no scheduled appointment necessary