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.mental disordersDSM-IVDSM-VAmerican Psychiatric Association

History of the DSM 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 disordersAxis II: Personality and developmental disorders Axis III: Physical Disorders and conditions Axis IV Severity of psychosocial stressors Axis V Global Assessment of Functioning (GAF) ScaleAxis 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 past year :55 Back

Axis I Major Clinical Syndrome 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 Back

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 prsnltydsrdr.htm prsnltydsrdr.htm Specific Developmental disorders: Autism, Mental retardation, reading, writing and arithmetic disorders Back Back

Axis III Physical disorders and conditions Physical disorders or conditions are recorded on this axis. Examples: Diabetes, arthrities, and hemophilia Back

Axis IV Severity of Psychosocial stressors (back)(back CodeTermAdult Example 1NoneNo Relevant events 2Mild Starting or graduating school 3ModerateLoss of job 4SevereDivorce 5ExtremeDeath of loved one 6Catastrophic 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 BACK

Mood Disorders Class of disorders marked by emotional disturbances of varied kinds that may spill over to disrupt physical, perceptual, social, and thought processes. Major Depression, bipolar disorder, dysthymic disorder and cyclothymic

Sample Case Study for Major Depressive Episode DSM-IV Diagnostic CriteriaExamples from Case study (An example for 5 different symptoms) 1. Depressed mood most of the day, nearly every day, … “… she has been depressed ever since she had a fight with her mother 2 years ago.” “Cindy says that her mood has been much worse in the last 6 months.” ”She feels depressed almost every day, all day long.”

Anxiety Disorders Disorders characterized by physiological signs of anxiety (for example, palpitations) and subjective feelings of tension, apprehension, or fear. Anxiety may be acute and focused (panic disorder) or continual and diffuse (generalized anxiety disorder)

Sample Case Study for Major Depressive Episode DSM-IV Diagnostic CriteriaExample from Case study (5 examples from each) 1. Depressed mood most of the day, nearly every day, …“… she has been depressed ever since she had a fight with her mother 2 years ago.” “Cindy says that her mood has been much worse in the last 6 months.” ”She feels depressed almost every day, all day long.” 2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day. “She has lost interest in school and social activities and has not really paid attention to her schoolwork for the last 6 months.”