Assesment of mental disorders

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Assesment of mental disorders

• Psychological Aspects of Anxiety-, Mood-, and
  Personality Disorders

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What Does Disorder Mean?

• Three perspectives
• Society
• Individuals social network
• Individual
• Thus, disorders must
• Violate cultural norms
• Cause some degree of discomfort
• Involve some degree of destructiveness

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The DSM

• Diagnostic Statistical Manual
• First pub (1952), current edition is DSM-IV-R
  (2000)
• Organizes diagnoses by categories based on a
  number of symptoms
• Diagnoses have exploded from 100 to 400 in 50
  years why?

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Why Some Dont Like the DSM

• Danger of overdiagnosis
• The power of labeling
• Shifting definitions of normal
• The myth of objectivity

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An Overview of the Disorders

• Anxiety disorders (e.g., panic, OCD)
• Mood disorders (e.g., depression)
• Personality disorders (e.g., antisocial,
  borderline)
• Dissociative disorders (e.g., DID)

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Anxiety Disorders

• Generalized anxiety disorder
• Continuous, low-grade anxiety
• Triggers may be unknown consciously
• Usually does not interfere drastically with
  necessary functioning
• Posttraumatic stress disorder (PTSD)
• Extended symptoms beyond event
• Inability to sleep, nightmares, obsessions
• May be connected to smaller hippocampus

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Anxiety Disorders

• Panic disorder
• Attacks of intense fear, feeling of imminent doom
• Usually short-lived (lt 15 minutes) but can last
  for hours
• Triggers may be unconscious
• Phobias
• Exaggerated fear of specific target
• Some more disabling than others
• May be concomitant with other anxiety disorder

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Phobias

• Just for fun some rarer phobias
• Ergophobia ? work
• Barophobia ? gravity
• Ambulophobia ? walking
• Phagophobia ? eating
• Phronemophobia ? thinking
• Vestiphobia ? clothing
• Coitophobia ? sexual intercourse
• Cacophobia ? ugly things
• Pentheraphobia ? your mother-in-law

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Anxiety Disorders

• Obsessive-compulsive disorder (OCD)
• Obsession ? persistent unwanted thought
• Compulsion ? behavior in response to obsession
• Low levels of serotonin in the prefrontal
  cortices AND overactivity in the amgydala

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OCD

• Common obsessions
• Fear of infection and germs
• Perfectionism
• Violent images of others deaths
• Common compulsions
• Hand washing
• Checking doors, ovens, etc.
• Ritualized counting or organizing
• Hoarding

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Anxiety Disorders - Treatment

• Drugs
• SSRIs
• Benzodiazepines
• Therapy
• Cognitive restructuring
• Systematic desensitization

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Mood Disorders

• Major depressive disorder
• Severe negative affect and despair, loss of
  functioning
• Must last for extended time (gt 6 weeks)
• Women twice as likely to be diagnosed why?
• Bipolar disorder
• Mania ? state of exhilaration, feeling of great
  power and activity
• Alternations are fairly unpredictable and may
  last for days/weeks

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Why Does Depression Happen?

• Genetic link ? immediate family member increases
  risk considerably
• Life experiences
• History of separations and losses
• Bad cognitive habits
• Explanatory styles
• Rumination

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Depressive Disorders - Treatment

• Drugs
• SSRIs
• Tricyclics
• Lithium
• Therapy
• Cognitive behavioral therapy
• Rational-emotive therapy

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Personality Disorders

• Extreme, inflexible and distressing traits that
  cause decreased functioning
• Some examples
• Borderline ? pervasive instability in moods,
  interpersonal relationships, self-image, and
  behavior
• Histrionic ? excessive emotionality, need for
  attention, an excessive need for approval,
  inappropriate sexuality
• OCPD ? similar to OCD but milder

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Personality Disorders

• Narcissistic ? inflated sense of self-importance,
  need for admiration, extreme self-involvement,
  lack of empathy for others
• Paranoid ? suspiciousness, jealousy,
  secretiveness, delusions
• Schizotypal ? eccentric believe that public
  messages are directed at them, magical thinking,
  vague speech
• Antisocial ? disregard for law, excellent liar,
  aggressive and reckless, irresponsible, lack of
  conscience must be diagnosed by 15y.

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Antisocial Personality Why?

• Genetics
• CNS abnormalities
• No fear of punishment
• Tolerance of pain
• No empathy for others
• Impaired frontal lobe functioning
• Right prefrontal cortex
• Inhibitions either weak or absent

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Dissociative Disorders

• Dissociative amnesia ? memory holes
• Dissociative fugue ? loss of time with flight
  from reality
• Dissociative identity disorder
• Fragmenting of personality into ego and
  alters
• Some feel that DID is underdiagnosed and a
  natural coping mechanism
• Others think that DID is a fad (the
  sociocognitive explanation