Psychological Disorders

Classifying Psychological Disorders

Diagnostic and Statistical Manual of Mental Disorders (DSM V) is the standard classification of mental disorders used by mental health providers in the United States. It contains a listing of diagnostic criteria for every psychiatric disorder recognized by the U.S. health care system. http://www.dsm5.org

What is a Psychological Disorder?

Psychological Disorders …are “harmful dysfunctions” in which behavior is judged to be atypical, disturbing, maladaptive, and/or unjustifiable

Atypical is abnormal – being different from most other people in one’s culture

Disturbing means that a behavior goes against the standards of acceptable behavior, is unnerving, grotesque, or otherwise disruptive to a generally acceptable level of comfort.

Maladaptiveness indicates that the behaviors are distressing or disabling or puts one at a greatly increased risk of suffering or death

Unjustifiable means that certain behaviors are irrational, or that a behavior lacks any mental clarity or reason

What is the nature of Psychological Disorders and their causes?

Biological Model (Medical Model) Abnormal behaviors are caused by physiological malfunctions – IE. a failure of the central nervous system, an improperly working endocrine system, an abnormal flow of a specific hormone, genetic factors, brain damage

Psychoanalytical Model Abnormal behaviors are symbolic expressions of unconscious, internal conflicts, often associated with early childhood – IE. A fear of open water due to almost drowning as a child, obsessions with women who remind you of the mother who abandoned you, serial violence against homosexuals based on your own internal orientation conflicts

Behavioral Model Abnormal behavior is the result of learned behavior – IE. you are a psychopathic killer because you watched violent programming on tv….you obsessively clean the house because Mom obsessively cleaned the house

Diathesis-Stress Model (Bio-Psycho-Social Perspective) Abnormal behavior is caused when prone individuals who otherwise may not exhibit symptoms are put into stressful situations and then exhibit symptoms

IE. You may occasionally be stressed, or drink a bit or a have trouble sleeping, but then your house burns down, your ID is stolen online, your bank accounts are emptied, your wife leaves you……thus you “snap”. An anxiety disorder emerges, a substance abuse disorder emerges, a sleep disorder emerges….

Categories of Psychological Disorders

Anxiety Disorders

Anxiety Disorders Separation Anxiety Disorder Selective Mutism Specific Phobia Social Anxiety Disorder (Social Phobia) Panic Disorder Panic Attack (Specifier) Agoraphobia Generalized Anxiety Disorder Substance/Medication-Induced Anxiety Disorder Anxiety Disorder Due to Another Medical Condition Other Specified Anxiety Disorder Unspecified Anxiety Disorder 

Anxiety Disorders Disorders characterized by an intensely distressing, persistent stress, or maladaptive behaviors that reduce stress.

Generalized Anxiety Disorder A person is continually tense, apprehensive, and in a state of autonomic system arousal

Dizziness Sweaty Palms Heart Palpitations Ringing in the Ears Edgy and Shaky Unfocused and Out-of-Control Negative Feelings Worried constantly about bad things that may happen Twitchiness and/or trembling

Panic Disorder Sufferers have acute episodes of intense anxiety without any apparent provocation

Phobias Marked by persistent, irrational fears and avoidance of a specific object or situation Some phobias are so intense that they are incapacitating Agoraphobia is a fear or avoidance of situations where one feels a loss of control and panic

Social-Anxiety Disorder It’s the extreme fear of being scrutinized and judged by others in social or performance situations. People with social anxiety disorder feel powerless against their anxiety. They are terrified they will humiliate or embarrass themselves. The anxiety can interfere significantly with daily routines, occupational performance, or social life, making it difficult to complete school, interview and get a job, and have friendships and romantic relationships.

Bipolar Disorder

Bipolar Disorder A person’s mood alternates between mania (expanded self-esteem, reduced need of sleep, talks more often and talks longer, ideas flit in quick succession, thoughts race and preoccupy the person, over indulgence in enjoyable behaviors with high risk of a negative outcome (e.g., extravagant shopping, sexual adventures or improbable commercial schemes) and depression (characterized by a pervasive and persistent low mood that is accompanied by low self-esteem and by a loss of interest or pleasure in normally enjoyable activities) 

Depressive Disorders

Depressive Disorders Disruptive Mood Dysregulation Disorder Major Depressive Disorder, Single and Recurrent Episodes Persistent Depressive Disorder (Dysthymia) Premenstrual Dysphoric Disorder Substance/Medication-Induced Depressive Disorder Depressive Disorder Due to Another Medical Condition Other Specified Depressive Disorder Unspecified Depressive Disorder

Major Depressive Disorder Symptoms may include feelings of sadness, hopelessness, and worthlessness, as well as complaints of physical pain and changes in appetite, sleep patterns, and energy level. Persistent Depressive Disorder (Dysthymia) A serious state of chronic depression, which persists for at least 2 years (1 year for children and adolescents); it is less acute and severe than major depressive disorder.

Dissociative Disorders

Dissociative Disorders Involve disturbances in a person’s consciousness, memories, identity, and perception of the environment

Dissociative Identity Disorder A person has two or more distinct personalities that alternate in their control of the person’s behavior

Amnesia Loss or impairment of memory. Anterograde Amnesia – Cannot create new memories Retrograde Amnesia – Cannot access old memories Amnesia with a physical cause is called organic amnesia, whereas amnesia of psychological origin is called functional amnesia

Elimination Disorders

Enuresis Encopresis An inability to control urination The repeated passage of feces into inappropriate places (e.g., clothing or floor) whether voluntary or unintentional, at least one such event a month for at least 3 months, and at or beyond the chronological age of at least 4 years

Feeding and Eating Disorders

Anorexia is essentially a form of self-starvation in order to lose weight, Bulimics partake in binge and purge behaviors in order to maintain body weight

Pica Binge Eating Disorder Characterized by an appetite for substances largely non-nutritive, such as ice, clay, chalk, glass, hair, urine, dirt, or sand. Binge Eating Disorder An eating disorder characterized by binge eating without subsequent purging episodes

Gender Dysphoria

Gender Dysphoria or Gender-Identity Disorder is a formal diagnosis to describe people who experience significant dysphoria (discontent) with the sex they were assigned at birth and/or the gender roles associated with that sex.

Impulse-Control, Conduct and Disruptive Disorders

Kleptomania – compulsive stealing Pyromania – setting fires Trichotillomania The compulsive urge to pull out one's own hair leading to noticeable hair loss, distress, and social or functional impairment.

Neurocognitive Disorders

Dementia A serious loss of cognitive ability in a previously unimpaired person, beyond what might be expected from normal aging. It reduces the ability to learn, reason, retain or recall past experience and there is also loss of patterns of thoughts, feelings and activities. 

Neurodevelopmental Disorders

Intellectual Disorders Communication Disorders Intellectual Development Disorder Communication Disorders Child Onset Fluency Disorder (Stuttering) Attention Deficit/ Hyperactivity Disorders AD/HD Autism Spectrum Disorder Motor Disorders Tourette’s Disorder

Obsessive-Compulsive and Related Disorders

Obsessive-Compulsive and Related Disorders Obsessive-Compulsive Disorder Body Dysmorphic Disorder Hoarding Disorder Trichotillomania (Hair-Pulling Disorder) Excoriation (Skin-Picking) Disorder Substance/Medication-Induced Obsessive-Compulsive and Related Disorder Obsessive-Compulsive and Related Disorder Due to Another Medical Condition Other Specified Obsessive-Compulsive and Related Disorder Unspecified Obsessive-Compulsive and Related Disorder 

Obsessive-Compulsive Disorder Characterized by unwanted repetitive thoughts (obsessions) or actions (compulsions) Checking to see if a door is locked is normal. Doing it 30 times or “I will die” is not. Washing your hands is normal. Washing them until your hands are raw so that “all of the germs are gone” is not.

Body-Dysmorphic Disorder A preoccupation with an imagined or minor defect in appearance which causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Paraphilic Disorders

PARAPHILIAS INCLUDE FANTASIES, BEHAVIORS, OR SEXUAL URGES FOCUSING ON UNUSUAL OBJECTS, ACTIVITIES, OR SITUATIONS

EXHIBITIONISM SEXUALLY EXPOSING ONESELF (GENITALS) TO OTHERS FETISHISM SEXUAL URGES AND BEHAVIORS TYPICALLY ASSOCIATED WITH NON-LIVING OBJECTS

Specific Fetishes Agriozoophilia – wild animals Alektorophilia – chickens Anthophilia – flowers Autodysomophilia – bad smells Bibliophilia – books Chaetophilia – hair Coimetrophilia – cemeteries Coprophilia – feces

Specific Fetishes Daimonophilia – ghosts Didaskaleinophilia – school Dontophilia – teeth Ecclesiophilia – church Emetophilia – vomit Epistaxiophilia – nosebleeds Geniophilia – chins Gerontophilia – old people Heliophilia – sun

Specific Fetishes Hoplophilia – guns Ichthyophilia – fish Lachanophilia – vegetables Leprophilia – leprosy Lutraphilia – otters Melophilia – music Necrophilia – dead Nephophilia – clouds

Specific Fetishes Nosophilia – terminal illness Ombrophilia – rain Ophidiophilia – snakes Peladophilia – baldness Pogophilia – beards Thassophilia – sitting Urophilia – urine

FROTTEURISM SEXUAL URGES RELATED TO TOUCHING OR RUBBING AGAINST UN-SUSPECTING, NON-CONSENTING, AND UNFAMILIAR PEOPLE OF THE OPPOSITE SEX

SADISM SEXUAL PLEASURE DERIVED FROM MISTREATING OTHERS MASOCHISM SEXUAL PLEASURE DERIVED FROM BEING HURT OR HUMILIATED VERBALLY AND/OR PHYSICALLY

TRANSVESTITISM CROSS-DRESSING VOYEURISM SEXUAL PLEASURE IS DERIVED FROM SECRETLY OBSERVING OTHERS

Personality Disorders

Personality Disorders Maladaptive ways of behaving that negatively affect a person’s ability to function in society.

Narcissistic Personality A grandiose sense of self-importance. They seek excessive admiration from others and fantasize about unlimited success or power. They believe they are special, unique, or superior to others.

Paranoid personality disorder is characterized by irrational suspicions and mistrust of others. Avoidant personality disorder is characterized by social inhibitions, feelings of inadequacy, extreme sensitivity to negative evaluation, and exaggerated emotions.

Antisocial Personality Disorder Acting in a way that disregards the feelings and rights of other people. Antisocial personalities often break the law, and they may use or exploit other people for their own gain. They may lie repeatedly, act impulsively, and get into physical fights. They may even kill other people.

Schizophrenia

Hallucinations Perceptions that occur without connection to an appropriate source; hearing voices or seeing objects are the two most common hallucinations.

Delusions False personal beliefs that are not subject to reason or contradictory evidence patients suffering from paranoid-type symptoms often have delusions of persecution, or false and irrational beliefs that they are being cheated, harassed, poisoned, or conspired against. In addition, delusions of grandeur, in which a person may believe he or she is a famous or important figure, may occur in schizophrenia

Disorganized Thinking Schizophrenia often affects a persons ability to think straight. Thoughts may come and go rapidly; the person may not be able to concentrate on one thought for very long and may be easily distracted, unable to focus attention.

Inappropriate Effect Expressing improper emotions, related to the environmental context they are presented in, or a person with schizophrenia may not show the signs of normal emotion, perhaps may speak in a monotonous voice, have diminished facial expressions, and appear extremely apathetic

Causes of Schizophrenia? Chromosomes 13 and 6 are suspect. Abnormally high levels of dopamine in the brain.

Sleep-Wake Disorders

Affect normal sleep patterns Affect normal sleep patterns. They may include Insomnia (lack of sleep), Apnea (stop breathing), and Narcolepsy (excessive daytime sleepiness).

Sexual Dysfunctions

Common Male and Female Disorders Men Erectile dysfunction refers to the inability of a man to have or maintain an erection. Premature ejaculation occurs when a man is not able to postpone or control his ejaculation. Inhibited male orgasm occurs when a man cannot have an orgasm despite being highly aroused. Women Female Orgasmic Disorder refers to a woman’s delayed or inability to achieve orgasm.

Somatoform Disorders

Somatoform Disorders Characterized by the presence of physical symptoms that cannot be explained by a medical condition or another mental illness

Somatoform disorder is a condition in which the physical pain and symptoms a person feels are related to psychological factors. These symptoms can not be traced to a specific physical cause. Their symptoms are similar to the symptoms of other illnesses and may last for several years. People who have somatoform disorder are not faking their symptoms. The pain that they feel is real.

Hypochondriasis refers to an excessive preoccupation or worry about having a serious illness. Hypochondria is often characterized by fears that minor bodily symptoms may indicate a serious illness, constant self-examination and self-diagnosis, and a preoccupation with one's body.

Conversion Disorder Patients present with symptoms such as numbness, paralysis, blindness, etc. The diagnosis of conversion disorder involves three elements - the exclusion of neurological disease, the exclusion of feigning, and the determination of a psychological mechanism.

Substance-Related and Addictive Disorders

Addictive substances include alcohol, caffeine, cannabis, hallucinogens, inhalants, opiods, sedatives, stimulants and tobacco… Non-substance addictions include issues like gambling.

Trauma and Stressor Related Disorders

Trauma- and Stressor-Related Disorders Reactive Attachment Disorder Disinhibited Social Engagement Disorder Posttraumatic Stress Disorder Acute Stress Disorder Adjustment Disorders Other Specified Trauma- and Stressor-Related Disorder Unspecified Trauma- and Stressor-Related Disorder

Post-Traumatic Stress Disorder Usually involves flashbacks or nightmares following a person’s involvement in or observation of an extremely troubling event, such as a war or a natural disaster

Adjustment Disorders An inability or maladaptive reaction to an identifiable stressful life event/ stressor (divorce,  death, a family move, etc.). Symptoms must occur within three months of the event/stressor and persisted for no longer than six months. Usually includes depression, withdrawal, or a rebellion against society, family, or the law.

Other Mental Disorders

Other Specified Mental Disorder Due to Another Medical Condition Unspecified Mental Disorder Due to Another Medical Condition