AP Mental Disorders Intro-Neurodevelopmental

Defining the problem Starting in 1952, the American Psychiatric Association created the Diagnostic and Statistical Manual of Mental Disorders, better known as the DSM. The manual lists and describes all known mental illnesses and disorders. Attempts to make diagnosis uniform across the mental health profession Current edition: DSM 5 (2013) Changes are determined by vote.

Format of the DSM 5 The new edition changes the set-up of the manual. First section describes the new organization of the manual Second section describes all diagnostic criteria and coding for mental health disorders Third section addresses the use of emerging methods of assessing mental health Starting 10/1/2014 the Federal government wil require mental health professionals to use International Classification of Disease (ICD) criteria for billing purposes.

Mental Health Statistics 57 Million Americans suffer from a mental health disorder (NIMH). Mental Health is the mostcommon reason for disability (WHO). 49% of adult Americans with serious psychological/substance abuse issues do not get treatment (Substance Abuse and Mental Health Agency). Number of visits to medical professionals with mental health as primary reason (2010): 63.3 million (CDC). Percentage of nursing home patients with mental disorders: 66.7% 105 people commit suicide daily (CDC). 20% of Americans believe there is a stigma to receiving mental health treatment (APA).

What is it? Different ideas exist on what it means to be to be mentally abnormal Deviance: displaying behavior outside of the norm. “Problems in living” that cause labeling to occur(Szaz) Failure to adjust to situations Inability to function successfully within society

Neurodevelopmental Disorders Characterized by impairment/disruption of normal development of the brain/CNS during infancy/childhood Reasons for impairment can be genetic and/or environmental. Major change in DSM 5 is that the term “mental retardation” has been replaced with “intellectual delay(intellectual development disorder”.

Types of Neurodevelopmental Disorders Trisomy 21 (Down Syndrome) People with the disorder have an extra 21st Chromosome No known cause for the disorder Characteristics of Down Syndrome include intellectual disability, flattened face, strong tendency to bond, strong drive to eat. Estimated that up to 90% of fetuses detected with Down Syndrome are aborted

2. Autism Persistent communication and social interaction deficits in multiple situations; restricted, repetitive behavior and interests, originally manifested in the early developmental period and causing significant impairment. - As a spectrum, symptoms can range from moderate to severe. Will be seen by the age of three.

Symptoms of Autism Signs will appear in at least one of three areas of development: social skills, language, and/or behavior Social Skills Lack of eye contact Resists cuddling/holding Withdrawn, retreats to own world Fails to respond to name -appears unaware of feeling of others

Language doesn’t speak/delay in speech Seems to not understand simples directives/inquiries Loses acquisition of language Echolalia Cannot start/continue conversation

Behavior Repetitive movements, such as rocking and spinning Constant movement Self-harming behaviors (e.g. headbanging) Not interested in imitative play Can be fascinated by small details sensitive to light, sound touch, but not to pain

Other Issues in Autism Appears to have a genetic basis, but not with a single gene Most austistics will be slow in developing new skills, with a few being exceptionally skilled in particular areas (savants). There is no correlation nor connection between autism and immunizations.

3. Specific Learning Disorders Based on biological factors Persists for a period of at least six months Results in academic skills markedly below age level, seen in early years of school Not attributed to other neurological, motor, or intellectual disorders Separated into difficulties with writing, reading , or math Also divided into mild, moderate, and severe

4. ADHD (Attention Deficit Hyperactivity Disorder) -”Persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development" -Beginning in childhood -Present across more than one setting[3]

ADHD Symptoms/Facts Difficulty paying attention Excessive talking Frequent disorganization/forgetfulness Easily distracted/ taken off task Up to 25% suffer from dyslexia/other learning disabilities Cause: unknown Increased risk drug/alcohol abuse and delinquency

5. Tourette’s Syndrome - Characterized by involuntary repetitive movements/vocalizations known as tics Diagnosed typically between 3-9 years of age, more common in males Behavior may be simple or complex in nature Although seen in only 15% of those with Tourette’s, a stereotype is that those afflicted curse (coprolalia). Echolalia (repeating what others say) may also be present Stress triggers the behaviors Behaviors may decrease with time Those afflicted may learn coping strategies, but strategies may result in increased stress