1. Psychological Disorders

2. How are Psych Disorders Diagnosed? In psychiatry & psychology, diagnostic classification aims not only to describe a disorder but also to predict its future course, imply appropriate Tx & stimulate research into its causes. The DSM-IV: This volume is the American Psychiatric Assoc.’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Many clinicians diagnose by answering the following questions from the five axes of the DSM-IV…

3. Axis I: Is a Clinical Syndrome present? Clinicians may select none, one, or more syndromes from the following: –Disorders diagnosed in infancy, childhood, adolescence –Delirium, Dementia, amnesia, & other cognitive disorders –Substance-related disorders –Schizophrenia & other psychotic disorders –Mood disorders –Anxiety disorders –Somatoform disorders –Factitious disorders (intentionally faked) –Dissociative disorders –Eating disorders –Sexual disorders –Sleep disorders –Adjustment disorders

4. Axis II:Is a Personality Disorder or Mental Retardation present? Clinicians may or may not also select one of these two conditions. Axis III: Is a General Medical Condition, such as diabetes, hypertension, or arthritis also present? Axis IV: Are Psychosocial or Environmental Problems, such as school or housing issues also present? Axis V: What is the Global Assessment of this person’s functioning? Clinicians assign a code from 0-100.

5. Anxiety Disorders *Characterized by distressing, persistent anxiety or maladaptive behaviors that reduce anxiety. Generalized Anxiety Disorder: person is continuously tense, apprehensive, & in a state of autonomic nervous system arousal. Panic Disorder: marked by unpredictable minutes-long episodes of intense dread; person experiences terror & accompanying chest pain, choking or other frightening sensations. Phobias: person feels irrationally & intensely afraid of a specific object or situation. Obsessive-Compulsive Disorder (OCD):troubled by repetitive thoughts or actions. (Hoarders, Checkers, Counters, Cleaners) Post-Traumatic Stress Disorder (PTSD):lingering memories, nightmares & other symptoms after a severely threatening, uncontrollable event.

6. Understanding Anxiety Disorders Today’s psychologists turn to two contemporary perspectives: The Learning Perspective: -Fear Conditioning - Classical Conditioning; Baby Albert -Observational Learning - Watching others’ fears The Biological Perspective: –Natural Selection - Spiders, snakes, sharks, etc.; Even modern day fears like flying may come from our biological predisposition to fear confinement & heights –Genes - One research team has id’d 17 genes that appear to be linked with anxiety disorder symptoms (Hovatta, et al., 2005).; Twin studies; Some studies point to an anxiety gene that affects levels of serotonin (Canli, 2008) & too much glutamate = brain’s alarm centers overactive (Lafleur et all, 2006). –The Brain – over arousal of brain areas involved in impulse control & habitual behaviors; i.e.: OCD patients during fMRI scans showed elevated activity in the anterior cingulate cortex in frontal lobes

7. Somatoform Disorders *Psychological disorder in which the symptoms take a somatic (bodily) form without apparent physical cause. Conversion Disorder: rare disorder where person experiences very specific genuine physical symptoms for which no physiological basis can be found; i.e.:lose sensation that makes no neurological sense, yet physical symptoms would be real – sticking pins in affected area = no response; paralysis, blindness… Hypochondriasis: relatively common where people interpret normal sensations (a stomach cramp, headache) as symptoms of a dreaded disease; they truly believe they are sick from an illness Dr.s haven’t caught yet, switching Dr.s

8. Dissociative Disorders *Rare disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings; may present as a sudden loss of memory or change in identity, often in response to an overwhelmingly stressful situation. Dissociative Amnesia: Patients suffer from a complete loss of identity; forget who they are due to trauma Dissociative Fugue: Patients suffer the identity loss as in the above, but these patients also travel away from home, often showing up as a “John/Jane Doe” in another place far away from home.

9. Dissociative Identity Disorder (DID) – [aka:multiple personality disorder]: a rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities. –Each personality has its own voice and mannerisms –Typically the original personality denies any awareness of the other(s) –Usually not violent, but there have been cases of a split into a “good” and a “bad” personality –Most famous case is “Sybil” pseudonym for Shirley Ardell Mason (1923-1998); 16 personalities incl. 2 males… –Controversial among clinicians

10. Understanding DID Skeptics are aplenty…DID patients are highly hypnotizable; DID so localized in time & space – btwn 1930 to 1960, # of DID cases = 2/decade; 1980’s when the DSM had 1 st formal code for DID, # of cases = 20,000; Practically non-existent in other cultures; Skeptics say it’s a cultural phenomenon created by therapists who fish for multiple personalities. Supporters for DID…handedness can switch; ophthalmologists have detected shifting visual acuity & eye- muscle balance; heightened activity in brain areas assoc. w/ control & inhibition of traumatic memories; symptoms are ways of dealing w/ anxiety. So…the debate continues…

11. 3 Things… 1.What 3 major psychological disorders were discussed today? 2.What are 3 new things you learned in today’s lecture? 3.What 3 pieces of information did you find most interesting?