Lifespan Psychopathology

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• Lifespan Psychopathology
• Other Psychotic Disorders Dissociative Disorders
  Impulse Disorders
• Duane E. Dede, Ph.D.
• Clinical and Health Psychology

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Brief Psychotic Disorder

• Psychotic for at least a day and then return to
  baseline
• At least one symptom (delusions, hallucinations,
  disorganized speech)
• Not due to mood disorder, Schizophrenia or
  Schizoaffective Disorder

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Shared Psychotic Disorder

• Someone closely associated with a delusional
  person also develops similar a delusion
• Content of delusion similar to that of the 1st
  persons delusion
• Not explained by other Psychotic disorders or GMC

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Psychotic Disorder NOS

• Charles Bonnet syndrome
• Postpartum psychosis
• Auditory hallucinations

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Dissociative Amnesia

• One or more episodes of an inability to recall
  important personal information that cannot be
  attributed to ordinary forgetfulness.
• Usually related to gaps in memories related to
  traumatic events
• A chronic, yet reversible amnesia

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Dissociative Fugue

• Abrupt, unexpected travel away from home or work
  with an inability to recall some or all of ones
  past.
• Individuals exhibit confusion about his/her
  personal identity or a partial or total
  assumption of new identity.
• May seem normal during the fugue, but following
  recovery, the person may not recall events that
  took place during the fugue
• Very rare and occurs most during wartime or
  following a natural disaster

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Dissociative Identity Disorder

• Existence in one individual of two or more
  distinct identities or personality states that
  each has its own pattern of perceiving, relating
  to, and thinking about the environment and self.
• At least 2 of the personalities take control of
  the persons behavior in sequence, with gaps in
  recent past memories for personal information.
• Personalities are typically unique and change
  abruptly occasionally triggered by stress or
  external cues.

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Depersonalization Disorder

• One or more episodes of depersonalization, which
  involves a feeling of detachment or estrangement
  from oneself.
• Reality testing is intact
• Symptoms are severe enough to cause significant
  distress or functional impairment

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Dissociative Disorders NOS

• Derealization without depersonalization
• Brainwashing
• Coma/Loss of consciousness
• Gansers Syndrome (80 of cases are males)
• Dissociative Trance Disorder

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Differentials

• Gasner Syndrome
• Formerly a factitious disorder. a Dissociative
  disorder that is characterized by nonsensical
  responses to questions.
• AKA-nonsense syndrome, balderdash
  syndrome, syndrome of approximate
  answers, pseudodementia or prison psychosis. 
• Charles Bonnet Syndrome
• people with sight problems start to see things
  which they know aren't real. Sometimes called
  'visual hallucinations', the things people see
  can take all kinds of forms from simple patterns
  of straight lines to detailed pictures of people
  or buildings. Usually aware of hallucinations and
  remit in a year

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Intermittent Explosive Disorder

• Several occasions of losing control of aggressive
  impulses, leading to serious assault or property
  destruction
• Aggression is markedly out of proportion to the
  seriousness of any social or psychological
  stressors
• Not due to PDO or GMC

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Kleptomania

• A repeated pattern of an irresistible impulse to
  steal unneeded objects.
• Produces a buildup of tension and release once
  action is performed
• Thefts are not committed out of anger, revenge,
  or in response to hallucination or delusions
• Not better explained by APDO, Conduct DO or Manic
  Episode

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Pyromania

• A repeated and irresistible urge to set or be
  attracted to fires
• Produces a buildup of tension and release once
  action is performed
• Not better explained by APDO, Conduct D/O, or
  Manic Episode

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Trichotillomania

• Recurrent failure to resist pulling out ones own
  hair.
• Produces a buildup of tension and release once
  action is performed

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Pathological Gambling

• Repeated gambling (and associated activities)
  usually to the point of losing money, job, and
  friends.
• Produces buildup of tension and release once
  action is performed

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Summary

• Specify the exact symptoms of the psychotic
  disorders
• Clarifying the symptoms and exact course for the
  dissociative disorders will allow for a good
  differential diagnosis
• The cardinal feature of the impulse disorders is
  that there is a build up of tension that is
  relieved by the action

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Implications for testing

• May need to be as patient and flexible as with
  Schizophrenic patients with these psychotic
  patients
• Otherwise these disorders may be less impaired in
  testing unless certain aspects of testing trigger
  distress
• Use your internal baserates to help determine the
  degree of impulsivity or aggression for some of
  the impulse disorders