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Chapter 16

Chapter 16. Psychological Disorders. DSM-IV. Diagnostic and Statistical Manual of Psychiatric Disorders Criteria for diagnosis Normal vs. abnormal behavior Interferes with daily life Severity of behavior. Mental Retardation. IQ and adaptive functioning

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Chapter 16

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  1. Chapter 16 Psychological Disorders

  2. DSM-IV • Diagnostic and Statistical Manual of Psychiatric Disorders • Criteria for diagnosis • Normal vs. abnormal behavior • Interferes with daily life • Severity of behavior

  3. Mental Retardation • IQ and adaptive functioning • Mild MR: 55-70 IQ (simple job, live in community with supervision) • Moderate MR: 40-55 IQ (Self-care skills) • Severe MR: 25-40 IQ (Assistance with skills) • Profound IQ: IQ below 25: often non-verbal

  4. Learning Disorders • Reading, writing, math • Average or above average IQ • Assess intelligence, achievement, cognition

  5. Autistic Disorder • Social impairment, oblivious to others • Poor peer relationships • Lack of social/emotional reciprocity • Delay in spoken language • Stereotyped mannerisms • Adherence to routines • Asperger’s is a milder form with no delay in language

  6. ADHD • Attention-Deficit/Hyperactivity Disorder • Predominantly inattentive type, • Predominantly hyperactive-impulsive type • Combined type

  7. Conduct Disorder • Aggression to people and animals • Fighting • Destruction of property • Deceitfulness or theft • Serious violation of rules (truancy, running away)

  8. Oppositional Defiant Disorder • Loses temper • Argues with adults • Defiant, noncompliant • Blames others

  9. Dementia • Memory impairment

  10. Substance-Related Disorders • Substance Abuse: recurrent use; failure to fulfill obligations at work, school, home • Substance Dependence • Tolerance: need increased amount of substance to achieve desired effects

  11. Substance-Related Disorders • Alcohol, amphetamines, caffeine-induced anxiety, cannabis, cocaine, hallucinogens, inhalants, nicotine, opioids, sedative, hypnotic, anxiolytics

  12. Schizophrenia • Delusions • Hallucinations, usually auditory • Disorganized, incoherent speech • Grossly disorganized or catatonic behavior • Flat affect • Social/work dysfunction • Very severe form of mental illness

  13. Types of Schizophrenia • Paranoid: frequent delusions, hallucinations • Disorganized: prominent features of disorganized speech, disorganized behavior, flat or inappropriate affect • Catatonic: motoric immobility, rigid posture, mutism or echolalia

  14. Delusional Disorder • Nonbizarre delusions (poisoned, deceived) • Erotomanic: someone is in love with them • Grandiose: special powers, special relationship with God • Jealous • Persecutory: treated poorly • Somatic: physical defect • Therapy is difficult because they don’t trust the therapist and don’t think there is problem

  15. Mood Disorders • Major Depression • Dysthymia • Bipolar disorder

  16. Major Depression • Depressed mood • Anhedonia • Changes in appetite or sleep • Feelings of guilt, worthlessness • Problems with concentration • Suicidal thoughts or behavior

  17. Manic Episode • Inflated self-esteem or grandiosity • Decreased need for sleep • Increased talking • Flight of ideas, racing thoughts • Distractibility • Impulsivity, without regard for consequences

  18. Anxiety Disorders • Panic Attacks • Agoraphobia • Social phobias • Obsessive-Compulsive Disorder • PTSD • Generalized Anxiety Disorder

  19. Panic Attack • Pounding, racing heart, chest pain • Sweating • Nausea • Dizziness • Fear of losing control, “going crazy” • Fear of dying

  20. Phobias • Specific phobia • Excessive, unreasonable fear (heights, flying) • Interferes with life • Social phobia • Fear of social situations • Avoidance of social situations

  21. Obsessive-Compulsive Disorder • Either obsessive or compulsive • Obsessions: recurrent thought that are intrusive, inappropriate • Compulsions: repetitive behaviors (hand-washing, counting)

  22. PTSD • Post-traumatic stress disorder • Experience or witness event that involved actual or threatened death or injury • Symptoms: distressing recollections, avoidance of similar stimuli, irritability, difficulty sleeping, nightmares, startle, hypervigilant

  23. Generalized Anxiety Disorder • Excessive, uncontrollable worry • Restless, irritable • Sleep disturbance • Problems concentrating

  24. Somatoform Disorders • Somatization Disorder • Many physical complaints before age 30 • Seeking of medical treatment • Symptoms are not explained medically • Hypochondriasis • Fear of having serious disease, preoccupation with symptoms that persists in spite of medical reassurance

  25. Dissociative Disorders • Dissociative amnesia • Forget personal information • Dissociative fugue • Travel from home • Can’t remember your past • May assume new identity • Dissociative identity disorder • Multiple personality disorder • 2 or more personalities • Loss of time

  26. Sexual Dysfunctions • Sexual arousal disorder • Failure to maintain arousal through completion of sex act, compared to someone of similar age, health, etc. • Orgasmic disorder • Under conditions of adequate arousal • Premature Ejaculation • Vaginismus

  27. Paraphilias • Exhibitionism • Fetishism (non-living objects for sexual arousal) • Frotteurism (touching, rubbing, a non-consenting person) • Pedophilia • Sexual masochism • Sexual sadism • Voyeurism

  28. Gender Identity Disorder • Stated desire or insistence that you are opposite sex • Preference for cross sex roles or fantasies of being the other sex • Pass as the other sex

  29. Eating Disorders • Anorexia nervosa • Bulimia nervosa

  30. Sleep Disorders • Primary Insomnia: difficulty initiating or maintaining sleep • Primary hypersomnia: excessive sleepiness, prolonged sleep • Narcolepsy: daily irresistible sleep attacks • Nightmare disorder • Sleep Terrors: intense fear, physiological reaction to nightmares • Sleepwalking disorder

  31. Impulsive Disorders • Intermittent explosive disorder: assaultive or destructive behavior out of proportion to stressor • Kleptomania • Pyromania • Pathological gambling: preoccupation with gambling, can’t stop, lie to conceal gambling

  32. Personality Disorders • Enduring pattern that deviates markedly from expectation of culture • May affect • Cognition: perceive, interpret events • Affect • Interpersonal functioning impulse control

  33. Paranoid Personality Disorder • Suspect others trying to harm you • Preoccupied with doubts of loyalty • Reads hidden meaning into things • Bears grudges

  34. Schizoid Personality Disorder • Can’t enjoy close relationships • Prefer solitary activities • Little interest in sex • No close friends, except family • Detached, indifferent to praise

  35. Antisocial Personality Disorder • Unlawful behavior • Lying, con artist • Disregard for others • Lack of remorse • Irresponsible

  36. Borderline Personality Disorder • Avoids abandonment by others • Unstable, intense relationships • Impulsive • Suicidal threats or gestures • Labile • Inappropriate anger

  37. Narcissistic Personality Disorder • Grandiose sense of self • Sees self as special, only understood by important people • Requires excessive admiration • Sense of entitlement • Takes advantage of others • Lacks empathy

  38. Histrionic Personality Disorder • Needs to be center of attention • Dramatic, seductive behavior • Shallow expression of emotion

  39. Avoidant Personality Disorder • Unwilling to associate unless certain of being liked • Fear of being criticized, rejected • Sees self as inept

  40. Dependent Personality Disorder • Needs assurance to make everyday decisions • Others needed to take responsibility for them • Difficulty expressing disagreement

  41. Obsessive-Compulsive Personality • Perfectionistic • Preoccupied with rules • Morally inflexible

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