PSY 100 Ch. 12
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DSM-IV-TR also known as Diagnostic and statistical manual of mental disorder
This book is published by the American Psychological Association and is the primary book used in diagnosing psychological problems. You can think of this book as the "guide" for diagnosing psychological disorders used by clinical psychologists, counselors, and therapists. The DSM-IV has all the definitions of disorders, criteria for diagnosis, etc.
In some cultures, it is normal for women to appear in public bare breasted, but it would be abnormal for a female executive in an industrialized culture to go to work that way.
When people experience considerable emotional distress without any life experience that warrants it, they may be diagnosed as having a psychological or mental disorder. Some people may be sad and depress, and some anxious; other may be agitated or excited; and still others may be frightened, or even terrified, by delusions and hallucinations.
Some experts believe that the best way to differentiate between normal and normal behaviors is to consider whether it leads to healthy or impaired functioning. Washing your hands before you eat is adaptive; washing them 100 times a day is maladaptive.
five axis of diagnosis
- Clinical Syndromes
- Personality and Mental Retardation
- Medical Conditions
- Psychosocial and Environmental Problems
- Assessment of Functioning.
Axis I: Clinical Syndromes
This axis describes clinical symptoms that cause significant impairment. Disorders are grouped into different categories, including adjustment disorders, anxiety disorders, and pervasive developmental disorders.
Axis II: Personality and Mental Retardation
This axis describes long-term problems that are overlooked in the presence of Axis I disorders. Personality disorders cause significant problems in how a patient relates to the world and include antisocial personality disorder and histrionic personality disorder. Mental retardation is characterized by intellectual impairment and deficits in other areas such as self-care and interpersonal skills.
Axis III: Medical Conditions
These include physical and medical conditions that may influence or worsen Axis 1 and Axis II disorders. Some examples may include HIV/AIDS and brain injuries.
Axis IV: Psychosocial and Environmental Problems
Any social or environmental problems that may impact Axis I or Axis II disorders are accounted for in this assessment. These may include such things as unemployment, relocation, divorce, or the death of a loved one.
Axis V: Global Assessment of Functioning
This axis allows the clinician to rate the client's overall level of functioning. Based on this assessment, clinicians can better understand how the other four axes are interacting and the effect on the individual's life.
- Psychological disorders characterized by frequent fearful thoughts about what might happen in the future.
- The class of disorders containing any disorder in which anxiety is the primary feature or in which anxiety appears when the individual tries to resist a phobia. There are a variety of anxiety disorders including Panic Disorder, Agoraphobia, Social Phobia, Obsessive-Compulsive Disorder, Posttraumatic Stress Disorder, Generalized Anxiety Disorder, and Acute Stress Disorder. Each of these anxiety disorders has specific criteria outlined in the DSM (diagnostic and statistical manual) that must be reached before someone is diagnosed with an anxiety disorder.
Post-Traumatic Stress Disorder (PTSD)
- a prolonged and severe stress reaction to a catastrophic event or to severe, chronic.
- a psychological disorder where individuals suffer nightmares and other types of emotional distress from a traumatic past experience or set of experiences. Stimulus that reminds them of the event or events can cause flashbacks and irritability.
Generalized Anxiety Disorder (GAD)
- An anxiety disorder in which people experience chronic, excessive worry for 6 months or more.
- chronic anxiety
- a type of anxiety disorder (obviously) in which a person feels tense and apprehensive on a very regular basis (sometimes it seems like they feel this way all the time). In addition, these feelings are accompanied by actual increases in the autonomic nervous system, such as increased blood pressure, increased heart rate, increased blood flow to the muscles and away from the GI tract, etc. A person with GAD may feel tense, upset, jittery, on edge, etc. almost all the time, have a very difficult time relaxing, feel muscle aches and pains quite often, be consistently looking around for danger, hardships, and problems, and may also be depressed. Most often there isn't a definable, tangible source of the anxiety. Instead these people have anxieties about general situations and life events. They worry about situations that may arise somehow, some way in the future. But most often the source is so general that the person can't even identify it. They just know that something bad is out there and will happen to them.
- An anxiety disorder in which a person experiences recurring,
- unpredictable episodes of overwhelming anxiety, fear, or, terror.
- classified as an Anxiety Disorder that includes a panic
- attack. During the attack, the person suffers from unexpected and repeated periods of strong fear and physical symptoms such as chest pain, heart palpitations, shortness of breath, dizziness, or abdominal problems.
It's not uncommon for these symptoms to lead the person to think they are 'going crazy', having a heart attack, or are going to die. Afterwards, the individual may become so afraid of having another panic attack and not being able to get help or medical care, that they insist on having a trusted person with them at all times, are afraid to leave the house, or are afraid to be in places or situations where they would be unable to get help.
Obsessive-compulsive disorder (OCD)
- an anxiety disorder in which a person has recurrent obsession and/or compliments.
- An anxiety disorder where individuals are unable to stop thinking the same thoughts or performing the same tasks over and over again. A common obsessive-compulsive disorder is frequent hand washing. Individuals attempt to alleviate their fear or anxiety by performing certain rituals (e.g.., washing hands 63 times before leaving the house). These rituals are to the extent that they have trouble carrying on with their daily activities.
- a persistent, irrational fear of some specific object, situation, or activity, that poses little or no real danger.
- unsound or illogical fears of objects or events. It is thought that phobias are learned or conditioned responses from early childhood experiences. For example, I know of a person who is uncontrollably afraid of birds (known as Ornithophobia - not bad, eh?). After speaking about her fear, I found that her mother used to put bird feathers on furniture, in rooms and other areas where she was not allowed. To this day, she refuses to go into pet stores where there are birds or sleep on a down pillow. Her mother unknowingly conditioned her to believing that birds are dangerous!
- Disorders characterized by extreme and unwarranted disturbances in emotion or mood.
- Psychological disorders involving intense and prolonged shifts in mood. A person with a mood disorder might feel very happy or very sad for long periods of time and for no apparent reason. Because of this, their moods affect they way perceive everything in their daily lives, making it very difficult to function well. There are two main categories of mood disorders; Depressive Disorders (major depression, dysthymia) and Bipolar Disorders (also known as manic depression; mood swings from euphoria to depression).
- a mood disorder marked by feelings of great sadness, despair, and hopelessness as well as the loss of the ability to experience pleasure.
- a mood disorder that is characterized by an extended period of sadness. Most people are saddened by certain events in their lives (e.g., doing poorly on a pop quiz) but if the depression is constant and long lasting, an individual could be diagnosed with major depression. People who suffer from major depression feel that their mood is permanent.
- The key symptoms of major depressive disorder are psychomotor disturbances. For example, body movement, reaction time, and speech may be also so slowed that some depressed people seem to be doing everything in slow motion.
- a mood disorder in which manic episodes alternates with periods of depression, usually with relatively normal periods in between.
- Also known as manic depression, this is a mood disorder in which the person's mood swings from euphoric, manic stages to depressed (from one "pole" to the other). This is not simply being happy and then sad, but rather periods of uncontrollable, clinical mania and longer periods of depression. Although there are many different perspectives about the basis of bipolar disorder, the most popular view is that it is caused by a chemical imbalance. During periods of mania, the person may become incoherent, become irrational, hyperactive, unrealistic about themselves and others, and act in sexually, socially, and physically unhealthy ways (sleeping with many people, going on shopping sprees which they can't possibly afford, etc.).
A severe psychological disorder characterized by loss of contact with reality, hallucinations, delusions inappropiate or flat affect, some disturbance in thinking, social withdrawal, and/or other bizarre behavior.
- a psychological disorder, thought to be caused by imbalances in brain chemistry, which involves delusions and faulty perceptions of the world. People suffering from schizophrenia often hear voices in their head and have delusions of grandeur. It's not uncommon for people with schizophrenia to believe that they are Jesus or other prominent figures. There are several types of schizophrenia including disorganized, catatonic, paranoid, undifferentiated, and residual.
positive symptoms of schizophrenia
hallucination or imaginary sensation. delusion or false belief. delusion of grandeur, who believe they are famous person or powerful or important. Delusion of persecution, they have false notion that some people or agency is trying to harass, cheat, spy on, conspire against, injure, kill, or in some other way harm them.
negative symptoms of schizophrenia
a loss of or deficiency in thoughts and behaviors that are characteristic of normal functioning. Negative symptoms include social withdrawal, apathy. Loss of motivation, lack of goal-directed activity, very limited speech, slowed movements, poor hygiene and grooming, poor problem-solving abilities, and distorted sense of time.
false sensory (visual, auditory, etc.) experiences, such as seeing something a person although nobody is really there, hearing a voice although nobody is speaking, feeling someone touch who despite being alone, etc.
false beliefs, often of persecution or grandeur. For example, a schizophrenic may insist they he is a great football player who has won many awards and has been the hero of many games, even though in reality, he was never even been on a football team.
- a false belief that one is famous person or powerful or important.
Delusion of persecution
- a false belief that some person or agency is trying to harass, cheat, spy on, conspire against, injure, kill, or in some other way harm them.
- A long-standing, inflexible, maladaptive pattern of behaving and relationg to others, which usually begins in early childhood or adolescene.
- personalities that are outside social norms. Very often these people are not even aware that their maladaptive behaviors and personalities are so different than those of other members of their society. In addition, these behaviors are personalities are usually so ingrained that the person accepts them as completely normal and has no desire to change them. There are many different personality disorders, including, paranoid personality disorder, obsessive-compulsive personality disorder, schizophrenic personality disorder, and more.
Cluster A: Odd/eccentric
classified in schizoid, paranoid, schizotypal.
Cluster B: Erractic/dramatic
classified in narcissistic, anti-social, borderline, histrionic.
Cluster C: Fearful/anxious
classified in dependent, avoidant, obsessive-compulsive.
Schizoid Personality Disorder
- individual isolates self from others; appears unable to form emotional attachment; behavior may resemble that of autistic children.
- cluster A: odd behavior
- a classification used for people who are withdrawn and are not bothered by their lack of social relationships (and they really do lack social relationships). It is common for these people to have inappropriate or flat emotional responses which make them seem cold and/or withdrawn.
Schizotypal Personality Disorder
- Individual dresses in extremely unusual ways; lacks social skills; may have odd ideas resembling the delusions of schizophrenia.
- cluster A: odd behavior
Narcissistic Personality Disorder (narcissism)
- Individual has exaggerated sense of self-importance and entitlement; is self-centered, arrogant, demanding, exploitive, envious; craves admiration and attention; lacks empathy.
- Cluster B: erratic, overly dramatic behavior
- A person with a narcissistic personality is totally centered on his or her own needs and feelings while ignoring the needs and feelings of others. An example would be an infant or small child. They see themselves as the center of their world. In their case, this is essential for survival or their basic needs would not get met. Even though children are self-centered, they are not defined as being narcissitic because their behavior is expected for their developmental stage.
Borderline Personality Disorder
- Individual is unstable in mood, behavior, self-image, and social relationships; has intense fear of abandonment; exhibits impulsive and reckless behavior and inappropriate anger; makes gestures and performs self-multilating acts.
- Cluster B: erratic, overly dramatic behavior
- characterized by unpredictable and impulsive behavior as well as sudden changes or shifts in mood. Because of this instability, people with this disorder have a difficult time maintaining relationships, and keeping a stable and positive self image. Some psychologists have suggested that this disorder hugs the line between mood disorders and personality disorders, which may cause some confusion when diagnosing people. The primary characteristics include (not all of these symptoms have to be present for a person to be diagnosed with the disorder): unstable and intense interpersonal relationships chronic fears of abandonment chronic intense anger and loneliness self-destructive behavior a range of cognitive problems or distortions such as suspiciousness, unusual feelings of having a sixth sense, and unusual superstitiousness unstable social relations and repeated failures in job situations impulsive behavior such as fighting, running away, drug abuse, alcohol abuse, promiscuity, and binge eating
Antisocial Personality Disorder
- Individual disregards right and feeling of others; is manipulative, impulsive, selfish, agressive, irresponsible, reckless, and willing to break the law, lie, cheat, and exploit others for personal gain, without remorse; fails to hold jobs.
- Cluster B: erratic, overly dramatic behavior
- the person has impulsivity, an inability to live by the rules, customs, and laws of the society in which they live, and a lack of anxiety or guilt about their behavior. It is synonymous with sociopathic personality and sociopath.
Dependent Personality Disorder
- Person overly dependent on others for advice and approval; may cling to lovers and friends, fearing abandonment.
- cluster C: Anxious. fearful behavior
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