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Psychological Disorders. K. T. Hinkle Chapter 15. Diagnostic and Statistical Manual. Axis I: Primary clinical problem Axis II: Personality disorders Axis III: General medical conditions Axis IV: Social and environmental stressors Axis V: Global assessment of overall functioning .

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psychological disorders

Psychological Disorders

K. T. Hinkle

Chapter 15

diagnostic and statistical manual
Diagnostic and Statistical Manual
  • Axis I: Primary clinical problem
  • Axis II: Personality disorders
  • Axis III: General medical conditions
  • Axis IV: Social and environmental stressors
  • Axis V: Global assessment of overall functioning
dsm iv example diagnosis
DSM-IV Example Diagnosis
  • Axis I 296.23 Major Depression Disorder, Single Episode, Severe Without Psychotic Features 305 Alcohol Abuse
  • Axis II 301.6 Dependent Personality Disorder
  • Axis III none
  • Axis IV Threat of job loss
  • Axis V GAF=35 (current)
dsm iv example diagnosis4
DSM-IV Example Diagnosis
  • Axis I 312.82 Conduct Disorder, Adolescent-Onset Type

305.20 Cannabis Abused V62.3 Academic Problem

  • Axis II 317 Mild Mental Retardation
  • Axis III 345.00 Epilepsy, petit mal
  • Axis IV Problems related to interaction with the legal system
  • Axis V GAF=55 (on admission) GAF=65 (at discharge)
explosion of mental disorders
Explosion of Mental Disorders
  • Supporters of new categories answer that is important to distinguish disorders precisely.
  • Critics point to an economic reason: diagnoses are needed for insurance reasons so therapists will be compensated.
what is abnormal
What Is Abnormal?
  • Defining mental disorders
    • Several questions can help determine what behavior is abnormal:
      • Is the behavior considered strange within the person’s own culture?
      • Does the behavior cause personal distress?
      • Is the behavior maladaptive?
      • Is the person a danger to self of others?
      • Is the person legally responsible for his or her acts?
what is abnormal7
What Is Abnormal?
  • Prevalence of psychological disorders
    • Mental disorders have a lifetime prevalence rate of nearly 50%
    • Mental disorders represent a significant source of personal misery for individuals and lost productivity for society
  • Explaining psychological disorders
    • Biological perspective
      • Views abnormal behavior as arising from a physical cause, such as genetic inheritance, biochemical abnormalities or imbalances, structural abnormalities within the brain, and/or infections
what is abnormal8
What Is Abnormal?
  • Explaining psychological disorders (continued)
    • Biopsychosocial perspective
      • Agrees that physical causes are of central importance but also recognizes the influence of biological, psychological, and social factors in the study, identification, and treatment of psychological disorders
      • Psychodynamic perspective
      • Originally proposed by Freud
      • Maintains that psychological disorders stem from early childhood experiences and unresolved, unconscious conflicts, usually of a sexual or aggressive nature
what is abnormal9
What Is Abnormal?
  • Explaining psychological disorders (continued)
    • Learning perspective
      • Psychological disorders are thought to be learned and sustained in the same way as any other behavior
    • Cognitive perspective
      • Suggests that faulty thinking or distorted perceptions can contribute to some types of psychological disorders
anxiety disorders
Anxiety Disorders
  • Generalized anxiety disorder
    • An anxiety disorder in which people experience excessive anxiety or worry that they find difficult to control
    • This disorder affects twice as many women as men and leads to considerable distress and impairment
  • Panic disorder
    • An anxiety disorder in which a person experiences recurrent unpredictable attacks of overwhelming anxiety, fear, or terror
    • Panic attacks
      • An attack of overwhelming anxiety, fear, or terror
anxiety disorders11
Anxiety Disorders
  • Phobias
    • An intense fear of being in a situation from which immediate escape is not possible or in which help is not immediately available in case of incapacitating anxiety
    • Agoraphobia
      • An agoraphobic often will not leave home unless accompanied by a friend or family member and, in severe cases, not even then
      • Women are four times more likely than men to be diagnosed with agoraphobia
anxiety disorders12
Anxiety Disorders
  • Phobias (continued)
    • Social phobia
      • An irrational fear and avoidance of social situations in which one might embarrass or humiliate oneself by appearing clumsy, foolish, or incompetent
    • Specific phobia
      • A marked fear of a specific object or situation
      • A person has three times the risk of developing a phobia if a close relative suffers from one
anxiety disorders13
Anxiety Disorders
  • Obsessive compulsive disorder (OCD)
    • An anxiety disorder in which a person suffers from obsessions and/or compulsions
    • Obsessions
      • A persistent, recurring, involuntary thought, image, or impulse that invades consciousness and causes great distress
    • Compulsion
      • A persistent, irresistible, irrational urge to perform an act or ritual repeatedly
mood disorders
Mood Disorders
  • Disorders characterized by extreme and unwarranted disturbances in feeling or mood
  • Depressive disorders
    • Major depressive disorder
      • A mood disorder marked by feelings of great sadness, despair, guilt, worthlessness, and hopelessness
mood disorders15
Mood Disorders
  • Bipolar disorder
    • A mood disorder in which manic episodes alternate with periods of depression, usually with relatively normal periods in between
    • Manic episode
      • A period of extreme elation, euphoria, and hyperactivity, often accompanied by delusions of grandeur and by hostility if activity is blocked
    • Bipolar disorder is much less common than major depressive disorder
mood disorders16
Mood Disorders
  • Causes of mood disorders
    • Biological factors such as genetic inheritance and abnormal brain chemistry play a major role in bipolar disorder and major depressive disorder
    • In one twin study, researchers found that 50% of the identical twins of bipolar sufferers had also been diagnosed with a mood disorder, compared to only 7% of fraternal twins
mood disorders17
Mood Disorders
  • Suicide and race, gender, and age
    • Whites are more likely to commit suicide than African Americans
    • Native American suicide rates are similar to those of whites; rates for Hispanic Americans are similar to those of African Americans
    • Suicide rates are far lower for both white and African American women than for men
    • Older Americans are at far greater risk for suicide than younger people
  • A severe psychological disorder characterized by loss of contact with reality, hallucinations, delusions, inappropriate or flat affect, some disturbance in thinking, social withdrawal, and/or other bizarre behavior
  • Positive symptoms of schizophrenia
    • Positive symptoms are the abnormal behaviors that are present in people with schizophrenia
    • Hallucinations
      • A sensory perception in the absence of any external sensory stimulus; an imaginary sensation
  • Delusions
    • A false belief, not generally shared by others in the culture, that cannot be changed despite strong evidence to the contrary
  • Delusions of grandeur
    • A false belief that one is a famous person or a person who has some great knowledge, ability, or authority
  • Delusions of persecution
    • A false belief that a person or group is trying in some way to harm one
  • Types of schizophrenia
    • Paranoid schizophrenia
      • A type of schizophrenia characterized by delusions of grandeur or persecution
      • Paranoid schizophrenics often show exaggerated anger and suspiciousness
    • Disorganized schizophrenia
      • The most serious type of schizophrenia, marked by inappropriate affect, silliness, laughter, grotesque mannerisms, and bizarre behavior
      • Tends to occur at an earlier age than the other types
  • Types of schizophrenia (continued)
    • Catatonic schizophrenia
      • A type of schizophrenia characterized by complete stillness or stupor and/or periods of great agitation and excitement; patients may assume an unusual posture and remain in it for long periods
    • Undifferentiated Schizophrenia
      • A term for people who display symptoms of schizophrenia but who do not fit into other categories
  • Risk factors in schizophrenia
    • Schizophrenia develops when there is both a genetic predisposition toward the disorder and more stress than a person can handle
    • Schizophrenia is more likely to strike men than women
    • The earlier age of onset of the disorder among males appears to be independent of culture and socioeconomic variables
somatoform and dissociative disorders
Somatoform and Dissociative Disorders
  • Somatoform disorders
    • Disorders in which physical symptoms are present that are due to psychological rather than physical causes
    • Hypochondriasis
      • A somatoform disorder in which persons are preoccupied with their health and convinced they have some serious disorder despite reassurance from doctors to the contrary
    • Conversion disorder
      • A somatoform disorder in which a person suffers a loss of motor or sensory functioning in some part of the body (blind, deaf, or unable to speak)
somatoform and dissociative disorders24
Somatoform and Dissociative Disorders
  • Dissociative disorders
      • A disorder in which, under stress, one loses the integration of consciousness, identity, and memories of important personal events
      • Dissociative amnesia
      • A dissociative disorder in which there is a loss of memory of limited periods in one’s life or of one’s entire identity
somatoform and dissociative disorders25
Somatoform and Dissociative Disorders
  • Dissociative disorders (continued)
    • Dissociative fugue
      • A dissociative disorder in which one has a complete loss of memory of one’s entire identity, travels away from home, and may assume a new identity
    • Dissociative identity disorder (DID)
      • A dissociative disorder in which two or more distinct personalities occur in the same person, each taking over at different times; also called multiple personality
somatoform and dissociative disorders26
Somatoform and Dissociative Disorders
  • Dissociative disorders (continued)
    • Dissociative identity disorder (continued)
      • The alternate personalities may differ radically in intelligence, speech, accent, vocabulary, posture, body language, hairstyle, taste in clothes, manners, and even handwriting and sexual orientation
      • There is the common complaint of “lost time”—periods for which a given personality has no memory because he or she was not in control of the body
other psychological disorders
Other Psychological Disorders
  • Sexual disorders
    • Disorders that are destructive, guilt- or anxiety-producing, compulsive, or that cause discomfort or harm to one or both parties involved
    • Perhaps the most common of all of the sexual disorders are the sexual dysfunctions
    • Drug treatment for sexual dysfunctions in both men and women have proven successful
other psychological disorders28
Other Psychological Disorders
  • Sexual disorders (continued)
    • Paraphilias
      • Disorders in which recurrent sexual urges, fantasies, and behaviors involve nonhuman objects, children, other nonconsenting persons, or the suffering or humiliation of the individual or his/her partner
    • Gender Identity Disorders
      • Disorders characterized by a problem accepting one’s identity as male or female
      • An individual may feel so strongly that she or he is psychologically of the other gender that sex-reassignment surgery is sought
other psychological disorders29
Other Psychological Disorders
  • Personality disorders
    • A continuing, inflexible, maladaptive pattern of inner experience and behavior that causes great distress or impaired functioning and differs significantly from the patterns expected in the person’s culture
    • Characteristics of personality disorders
      • People who suffer from other disorders, especially the mood disorders, are often diagnosed with personality disorders as well
      • People with personality disorders are extremely difficult to get along with