Transcript Multiple Personality Disorder - Agajanian-Psychology

Mental illness
What is Normal?
• Psychopathology: Scientific study of mental, emotional, and
behavioral disorders.
• Subjective Discomfort: Feelings of anxiety, depression, or
emotional distress.
• Statistical Abnormality: Having extreme scores on some
dimension, such as intelligence, anxiety, or depression.
• Social Nonconformity: Disobeying societal standards for normal
conduct: usually leads to destructive or self-destructive behavior.
• Situational Context: Social situation, behavioral setting, or
general circumstance in which an action takes place
• Cultural Relativity: Judgments are made relative to the values of
one’s culture
• The Medical Model: Mental Illness is treated as a physical
disease.
Diagnosing Mental Illness
• Difficult for even professionals
• Case Study
General Risk Factors for
Contracting Mental Illness
• Social Conditions: Poverty, homelessness,
overcrowding, stressful living conditions.
• Family Factors: Parents who are immature,
mentally ill, abusive, or criminal: poor child
discipline: severe marital or relationship
problems
• Psychological Factors: Low intelligence,
stress, learning disorders .
• Biological Factors: Genetic defects or
inherited vulnerabilities: poor prenatal care,
head injuries, exposure to toxins, chronic
physical illness, or disability
Stereotypes of
Psychological Disorders
• Psychological Disorders are a sign of
personal weakness.
• Psychological disorders are incurable.
• People with psychological disorders are
often violent and dangerous.
• People with psychological disorder
behave in bizarre ways and are very
different from normal people.
Psychodiagnosis: The
Classification of Disorders
DSM-IV-TR (text revision)
Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition, Text
Revision
• criteria, descriptions and other information to guide
the classification and diagnosis of mental disorders
was published in 2000 replacing DSM-IV. It is
expected that DSM-V will replace DSM-IV-TR
sometime in the future. This revision of the fourth
edition of the manual published by the American
Psychiatric Association to set forth diagnostic
guidelines.
History of the DSM
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DSM-I 1952 (describe 60 disorders)
DSM-II 1968
DSM-III 1980 (Multiaxial system)
DSM-III-R 1988
DSM-IV 1993
DSM- IV-TR 2000 (Over 200 disorders)
Multiaxial System
• Axis I: Major clinical syndrome
• Axis II: Personality and developmental
disorders
• Axis III: Physical Disorders and conditions
• Axis IV Severity of psychosocial stressors
• Axis V Global Assessment of Functioning
(GAF) Scale
A multiaxial evaluation
Patient: 58 year old male
• Axis I: Major depression, alcohol
dependence
• Axis II: Dependent Personality disorder
• Axis III: Alcoholic cirrhosis of liver
• Axis IV: Severity: 3 (moderate)
Anticipated retirement and change in residence,
with loss of contact with friends
• Axis V:GAF 44 Highest in in past year :55
Overview of Mental Disorders
in DSM-IV
Disorders of Infancy, Childhood, or Adolescence
Mental Retardation, Pervasive Developmental Disorders,
Attention-Deficit and Disruptive Behavior Disorders
Delirium, Dementia, and Cognitive Disorders
Medical emergencies, Alzheimer’s, Amnesia
Mental Disorders due to a General Medical Condition
“Organic”; Hypothyroidism, Infection, Anemia, Cancer
Substance-Related Disorders
Abuse vs. Dependence, Intoxication, Withdrawal , Persisting
Schizophrenia and other Psychotic Disorders
Schizophrenia subtypes, Delusional Disorder, Psychosis NOS
Overview of Mental Disorders in
DSM-IV (cont’d)
Mood Disorders
Major Depression, Bipolar Disorder
Anxiety Disorders
Panic Disorder, Obsessive-Compulsive Disorder, PTSD,
Phobias, Generalized Anxiety Disorder
Somatoform Disorders
Conversion Disorder, Hypochondriasis, Pain Disorder
Factitious Disorders
Munchausen’s vs. Malingering
Overview of Mental Disorders
in DSM-IV (cont’d)
Dissociative Disorders
“Multiple Personality Disorder”, Fugue, Amnesia
Sexual and Gender Identity Disorders
Dysfunction, Paraphilias, Transvestite vs. “Transsexual”
Eating Disorders
Anorexia, Bulimia
Sleep Disorders
Dyssomnia, Narcolepsy, Parasomnia (Terrors, Sleepwalking)
Impulse-Control Disorders
Kleptomania, Pyromania, IED, Pathological Gambling
Axis I Major Clinical
Syndrome
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Disorders usually first evident in infancy , childhood or
adolescence.(ADD, Bulimia and anorexia)
Organic Mental disorder: Temporary or permanent dysfunction of
brain tissue caused by diseases or chemicals.
Psychoactive substance use disorders
Schizophrenic Disorders: (Grossly disorganized behavior,
delusions, and hallucinations)
Delusional disorder:
Mood Disorder
Anxiety disorders
Somatoform disorders
Dissociative disorders
Psychosexual disorder
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Axis II: Personality and
Developmental Disorders
• Personality Disorders:
Disorders are patterns of personality
traits that are longstanding, maladaptive,
and inflexible and involve impaired
functioning or subjective distress
• Specific Developmental disorders
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Autism, Mental retardation, reading, writing
and arithmetic disorders
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Axis III
Physical disorders and
conditions
• Physical disorders or conditions are
recorded on this axis.
• Examples: Diabetes, arthrities, and
hemophilia
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Axis IV
Severity of Psychosocial
stressors (back)
Code
Term
Adult Example
1
None
No Relevant
events
2
Mild
Starting or
graduating school
3
Moderate
Loss of job
4
Severe
Divorce
5
Extreme
Death of loved
one
6
Catastrophic
Devastating natural
disaster
Axis V
Global Assessment of Functioning
Scale
• 90-Absent or minimal symptoms, good
functioning in all areas
• 60 Moderate symptoms or difficulty in social ,
occupational, or school functioning.
• 30 Behavior considerably influenced by
delusions or hallucinations, serious impairment
in communication or judgment, or inability to
function in almost all areas
• 10 Persistent danger of severely hurting self or
others
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