mental disorders– what are they? overview of dsm & a brief history overview of mental...
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Agenda
Mental Disorders– what are they? Overview of DSM & a brief history Overview of mental disorders
“Abnormality” – “Disorder”
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
Definition used by psychologists & psychiatrists:
“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.”
DSM-5 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
www.psychiatry.org
blogs.scientificamerican.com
Prevalence
Lifetime prevalence of having any DSM-IV disorder is 46.4% (and did not include autism, schizophrenia, or eating disorders).
Anti-Labeling
1970s– anti-diagnosis time Rosenhan (1973)
› https://www.youtube.com/watch?v=j6bmZ8cVB4o
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
Anxiety: Generalized Anxiety Disorder (GAD)
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.
https://www.youtube.com/watch?v=gciDbk2jX5o
Anxiety: Panic Disorder 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)
https://www.youtube.com/watch?v=Ii2FHbtVJzc
Anxiety: Specific phobia
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).
Depression: Major Depressive Disorder
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
https://www.youtube.com/watch?v=4YhpWZCdiZc
Bipolar I and II 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 severehttps://www.youtube.com/watch?v=zA-fqvC02oM
Schizophrenia 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
https://www.youtube.com/watch?v=gGnl8dqEoPQ
https://www.youtube.com/watch?v=ZB28gfSmz1Y
Eating Disorders: Anorexia Nervosa and Bulimia Nervosa
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.https://www.youtube.com/watch?v=zWV5AxnhM_I
Personality Disorders: Antisocial & Others
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
https://www.youtube.com/watch?v=C6v8M78WEOs
**If interested, get involved in research! (Kelly Klump, Jason Moser, etc.)
http://www.counseling.msu.edu/
MSU Counseling Center
Initial screening appointments are free, no scheduled appointment necessary
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