Transcript Chapter 16: Psychological Disorders

Mental Disorders– what are they?
 Overview of DSM & a brief history
 Overview of mental disorders


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
“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.”

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
Lifetime
prevalence of
having any DSMIV disorder is 46.4%
(and did not
include autism,
schizophrenia, or
eating disorders).
1970s– anti-diagnosis time
 Rosenhan (1973)

› https://www.youtube.com/watch?v=j6bmZ8
cVB4o

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
**gene x environment interactions (GxE)
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

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
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).




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: 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 severe
https://www.youtube.com/watch?v=zA-fqvC02oM







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
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
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