 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 blogs.scientificamerican.com

Lifetime prevalence of having any DSM- IV disorder is 46.4% (and did not include autism, schizophrenia, or eating disorders).

 1970s– anti-diagnosis time  Rosenhan (1973) › cVB4o 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.

 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)

 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

 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

 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

 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.

 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

**If interested, get involved in research! (Kelly Klump, Jason Moser, etc.) MSU Counseling Center Initial screening appointments are free, no scheduled appointment necessary