Psychological Differences

DSM-IV-TRMental RetardationClinical Disorders Personality Disorders

Approaches to Psychological Disorders Biological model: Disorders have a biochemical or

physiological basis.

Psychoanalytic model: Disorders result from unconscious internal conflicts.

Cognitive-behavioral model: Disorders result from learning maladaptive ways of thinking and behaving.

Diathesis-stress model: People biologically predisposed to a mental disorder (diathesis) will tend to exhibit that disorder when particularly affected by stress.

Systems approach: Biological, psychological, and social risk factors combine to produce disorders.

Psychological Disorders“For what is it that constitutes a ‘disease entity’ or a ‘new disease’? The

physician is concerned not, like the naturalist, with a wide range of different organisms theoretically adapted in an average way to an average environment, but with a single organism, the human subject, striving to preserve its identity in adverse circumstances.”

—Ivy McKenzie

“By the deficits, we may know the talents, by the exceptions, we may discern the rules, by studying pathology we may construct a model of health. And—most important—from this model may evolve that insights and tools we need to affect our own lives, mold our own destinies, change ourselves and our society in ways that, as yet, we can only imagine.”

—Laurence Miller

Diagnostic and Statistical Manual of Mental Disorders (Text Revision)

Multiaxial System (Five Axis System)

Axis I: (Reports all disorders except Axis II) Clinical Disorders. Other Conditions that may be a focus of clinical attention.

Axis II: (First diagnosed in infancy/childhood) Personality Disorders. Mental Retardation.

Axis III: (Diabetes, heart problems, acid reflux…etc.) General Medical Conditions.

Axis IV: (Social Env., lottery, job, divorce, school…etc.) Psychosocial and Environmental Problems.

Axis V: (GAF Scale, Rank 1-10 on 10 items, 100 = Good, 1 = Bad) Global Assessment of Functioning.

Psychological Differences

Psychological Differences

Mental RetardationRequirements:

1. Significantly sub average intellectual functioning: IQ of approximately 70 or below on an IQ test.

2. Concurrent deficits or impairments in present adaptive functioning in at least two of the following areas:

Communication Self-care Home living Social/interpersonal skills Use of community resources Self-direction Functional academic skills Work, leisure, health, and safety.

3. The onset is before age 18 years.

Below 20-25 20-25 to 35-40 35-40 to 50-55 50-55 to 70______________________________________________________Profound Severe Moderate Mild

Childhood DisordersConduct Disorder: Aggression to people and animals, destruction of

property, deceitfulness or theft, serious violations of rules

Oppositional Defiant Disorder: A pattern of negativistic, hostile, and defiant

behavior lasting at least 6 months.

Pica: Persistent eating of nonnutritive substances for a period of at least 1 month.

Rumination Disorder: Repeating regurgitation and rechewing of food for a period of at least

1 month following a period of normal functioning.______________________________________________________________________Tic Disorders:Tourette’s Disorder: Both multiple motor and one or more vocal tics.

Transient Tic: Single or multiple motor and/or vocal tics.

Cognitive Disorders Delirium: Characterized by anxiety, disorientation, hallucinations,

delusions, and incoherent speech

Dementia: Deterioration of intellectual faculties (Memory, concentration, and judgment). Accompanied by emotional disturbance and personality changes. Alzheimer Type Alcoholism Type

Schizophrenia Characterization:

Withdrawal from reality, illogical thinking, delusions, and hallucinations. Accompanied by emotional, behavioral, or intellectual disturbances.

Causes: Genetic, Biological, and Psychosocial factors. Dopamine imbalances and defects of the frontal lobe.

Required Symptoms: Two (or more) of the following (each present during 1-month):

Delusions Hallucinations Disorganized speech Grossly disorganized/catatonic behavior Negative symptoms

Social/Occupational dysfunction. Duration: Disturbance persist for at least 6 months.

Schizophrenia Positive Symptoms-Increase in behavior. Negative Symptoms-Decrease in behavior.

Schizophrenia SubtypesI. Paranoid: (Preoccupation with one or more) Delusions Auditory hallucinations

II. Disorganized: (All of the following) Disorganized speech Disorganized behavior Flat/inappropriate affect

III. Catatonic: (At least two of the following) Motoric immobility (catalepsy/stupor) Excessive motor activity Extreme negativism/mutism Peculiarities of voluntary movement

Posturing, stereotyped movements, prominent mannerisms, or prominent grimacing Echolalia/Echopraxia

IV. Residual: (Absence of prominent) Delusions, hallucinations, and disorganized speech Grossly disorganized/catatonic behavior

V. Undifferentiated: (Criteria are not met) Paranoid, Disorganized, or Catatonic

Anxiety Disorders General Phobia: Irrational, intense, persistent fear of certain

situations, objects, activities, or persons. Agoraphobia: Fear of open or public places

Obsessive-Compulsive Disorder: Tendency to dwell on unwanted thoughts/ideas and to perform repetitious rituals to relieve the anxiety.

Posttraumatic Stress Disorder: (PTSD) Constant/relentless encounters with memories of a past traumatic event.

Panic Disorder Generalized Anxiety Disorder

Types of Phobias Specific: Intense, paralyzing fear of some object or thing.

Social: Excessive, inappropriate fears connected with social situations or performances in front of other people.

Agoraphobia: Involves multiple, intense fear of crowds, public places, and other situations that require separation from a source of security.

Mood and Factitious DisordersMood Disorders:Bipolar: Manic and depressive episodes.

Cyclothymic Disorder Type I Type II

Depressive Disorder: Inability to concentrate, insomnia, loss of appetite, anhedonia, feelings of extreme sadness, guilt, helplessness and hopelessness, and thoughts of death.

_______________________________________________________Factitious Disorders:Somatoform Disorder: Physical symptoms representing specific disorders

for which there is no organic basis or known physiological cause, but for which there is presumed to be a psychological basis.

Factitious Disorder: Any of various mental disorders in which the individual intentionally produces symptoms of illness or feigns illness.

Munchausen Munchausen by proxy

Somatoform Disorders Somatization Disorder

A somatoform disorder characterized by recurrent vague somatic complaints without a physical cause.

Conversion Disorder Somatoform disorders in which a dramatic specific disability has

no physical cause but instead seems related to psychological problems.

Hypochondriasis A somatoform disorder in which a person interprets insignificant

symptoms as signs of serious illness in the absence of any organic evidence of such illness.

Body Dysmorphic Disorder A somatoform disorder in which a person becomes so preoccupied

with his or her imagined ugliness that normal life is impossible.

Suicide

Dissociative DisordersDefined: Involve disruptions or breakdowns of memory,

consciousness or awareness, identity and/or perception.

Dissociative Amnesia: Pervasive loss of memory of significant personal information. Characterized by a blocking out of critical personal information. Not caused by trauma to the brain. The memory still exists.

Dissociative Fugue: Dropping everything and leaving.

Dissociative Identity Disorder: Multiple Personality Disorder.

ParaphiliasDefined: Sexual Desire Disorders

Exhibitionism: Compulsive exposure of the genitals in public.

Fetishism: Displacement of sexual arousal or gratification to a fetish.

Frotteurism: Achieving orgasm by touching and rubbing against a person without their consent (Usually public).

Pedophilia: Interest in prepubescent children.

Hebophilia: Interest in pubescent children.

Paraphilias Masochism: Being physically

or emotionally abused.

Sadism: Sexual gratification from inflicting pain or emotional abuse on others.

Transvestic: Receiving sexual gratification from wearing clothing of the opposite sex. Transsexual

Voyeurism: Observing others.

Gender Identity Identification with the opposite sex.

Eating Disorders Anorexia: Refusing to eat.

Bulimia: Binging and purging.

Impulse-Control Disorders Kleptomania:

Steeling

Pyromania: Burning

Pathological Gambling: Associated with drug abuse.

Trichotillomania: Pulling out your hair

3 Clusters of Personality Disorders Cluster A: odd or eccentric behavior

schizoid, paranoid Cluster B: dramatic, emotional, or erratic

behaviornarcisstic, borderline, antisocial

Cluster C: anxious or fearfuldependent, avoidant

Personality Disorders Paranoid: Distrust of others Schizoid: Personality disorder marked by extreme shyness, flat

affect, reclusiveness, discomfort with others, and an inability to form close relationships

Schizotypal: Exhibiting, or being patterns of thought, perception, communication, and behavior suggestive of schizophrenia but not of sufficient severity to warrant a diagnosis of schizophrenia

Antisocial: Criminals Borderline: Pervasive instability in moods, interpersonal

relationships, self-image, and behavior. “Borderline” of psychosis There is a high rate of self-injury without suicide intent

Personality Disorders Narcissistic: In love with oneself

Most dangerous Avoidant: Don’t like to be around others Dependent: Live off of others Obsessive-compulsive: Milder version Histrionic: Characterized by excessive emotionality and

attention-seeking behavior.

Attention-Deficit/Hyperactivity Disorder A childhood disorder characterized by inattention,

impulsiveness, and hyperactivity. More common in boys than girls.

Autistic DisorderQualitative impairment in social interaction:

Eye-to-eye gaze, facial expression, body postures, and gestures. Failure to develop peer relationships appropriate to developmental level. Lack of spontaneous seeking to share enjoyment. Lack of social or emotional reciprocity.

Qualitative impairments in communication: Delay in, or total lack of, the development of spoken language. Impairment in the ability to initiate or sustain a conversation with others. Stereotyped and repetitive use of language. Lack of make-believe play or social imitative play.

Restricted repetitive and stereotyped patterns of behavior, interests, andactivities:

Preoccupation with one or more stereotyped and restricted patterns of interest. Inflexible adherence to specific, nonfunctional routines or rituals. Stereotyped and repetitive motor mannerisms. Persistent preoccupation with parts of objects.

Asperger’s SyndromePossesses all symptoms of Autism with the exception of “qualitative

impairments in communication”.

There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior, and curiosity about the environment in childhood.

Higher Incidence of Specific Disorders

Mensubstance abuse

antisocial personality disorder

Womendepression

agoraphobiasimple phobia

obsessive-compulsive disordersomatization disorder