ABNORMAL PSYCHOLOGY FINALS

SYMPTOMS

Subjective complaints of the patient about his disease. Personal perspective of a person.

SIGNS

Objective findings pf the doctor on the patient. Based on analysis of an object of observation only.

DEFINING SYMPTOMS

These are detailed in the Diagnostic and Statistical Manual of Mental Disorders Text-Revised (DSM 5-TR)

DIAGNOSTIC CRITERIA

Specific markers that must be satisfied in order to give a clinical label to the patient’s or client’s current condition based on manifestations observed and data gathered from thorough assessments.

SPEECH SOUND DISORDER

Persistent difficulty with speech sound production that interferes with speech intelligibility or prevents verbal communication of messages.

DIAGNOSTIC FEATURES

Clinical picture that provides clear descriptions of how the diagnostic criteria manifest in a client or patient in order to aid in distinguishing one disorder from other disorders.

DEVELOPMENT AND COURSE

Mentions how a disorder starts to develop or manifest in a person and the path that it takes until it reaches its maximum plight in a client’s overall functioning.

RISK AND PROGNOSTIC FACTORS

Provides details about the possible consequences that may be experienced by the patient or client diagnoses with the specific disorder.

Includes statements on possible likelihood of improvements depending on certain factors considered in the treatment plan.

DIFFERENTIAL DIAGNOSIS

Process of weighing the probability of one disorder versus that of other disorders.

PSYCHOSOCIAL STRESSORS

Might impact the kind of diagnosis made by the psychologist

NEURODEVELOPMENTAL DISORDERS

Wide range of problems that usually begin in infancy, or childhood, often before the child begins grade school.

TYPES OF NEURODEVELOPMENTAL DISORDERS

Speech Sound Disorder

Tourette’s Disorder

Attention-Deficit / Hyperactivity Disorder

Social (Pragmatic Communication Disorder)

Language Disorder

Autism Spectrum Disorder

Global Developmental Delay

Learning Disorders

SCHIZOPHRENIA SPECTRUM AND OTHER PSYCHOTIC DISORDERS

Causes detachment from reality; delusions, hallucinations, and disorganized thinking and speech.

TYPES OF SCHIZOPHRENIA SPECTRUM AND OTHER PSYCHOTIC DISORDERS

Delusional Disorder

Catatonia

Schizoaffective Disorder

Brief Psychotic Disorder

Schizophreniform Disorder

BIPOLAR RELATED DISORDERS

Alternating episodes of mania; periods of excessive activity, energy and excitement, and depression.

TYPES OF BIPOLAR AND RELATED DISORDERS

Cyclothemic Disorder

Bipolar I Disorder

Bipolar II Disorder

Other Specified Bipolar and Related Disorder

Substance/Medication-Induced Bipolar and Related Disorder

DEPRESSIVE DISORDERS

Affects how you feel emotionally, such as levels of happiness and sadness, and they can disrupt your ability to function.

TYPES OF DEPRESSIVE DISORDERS

Premenstrual Dysphoric Disorder

Disruptive Mood Dysregulation Disorder

Dysthymia

Major Depressive Disorder

Unspecified Depressive Disorder

ANXIETY DISORDERS

An emotion characterised by the anticipation of future danger or misfortune, along with excessive worrying.

TYPES OF ANXIETY DISORDERS

Selective Mutism

Specific Phobia

Agoraphobia

Panic Attack

Social Phobia

OBSSESSIVE-COMPULSIVE AND RELATED DISORDERS

Involves preoccupations or obsessions and repetitive thoughts and actions.

TYPES OF OBSESSIVE-COMPULSIVE DISORDERS

Hair-pulling disorder (trichotillomania)

Body dysmorphic Disorder

Hoarding Disorder

Excoriation (skin-picking)

TRAUMA AND STRESSOR RELATED DISORDERS

Adjustment disorders in which a person has trouble coping during or after a stressful life event.

TYPES OF TRAUMA AND STRESSOR RELATED DISORDERS

Disinhibited Social Engagement Disorder

Adjustment Disorders

Reactive Attachment Disorder

Posttraumatic Stress Disorder

Acute Stress Disorder

DISSOCIATIVE DISORDERS

Disorders in which your sense of self is disrupted

TYPES OF DISSOCIATIVE DISORDERS

Dissociative Identity Disorder

Dissociative Amnesia

Depersonalization/Derealization Disorder

Unspecified Dissociative Disorder

Other Specified Dissociative Disorder

SOMATIC SYMPTOMS AND RELATED DISORDERS

A person with one of these disorders may have physical symptoms with no clear medical cause, but the disorders are associated with significant impairment.

TYPES OF SOMATIC SYMPTOMS AND RELATED DISORDERS

Illness Anxiety Disorder

Conversion Disorder (Functional Neurological Symptom Disorder)

Factitious Disorder

FEEDING AND EATING DISORDERS

Disturbances related to eating

TYPES OF FEEDING AND EATING DISORDERS

Pica

Rumination Disorder

Avoidant/Restrictive Food Intake Disorder

Anorexia Nervosa

Bulimia Nervosa

ELIMINATION DISORDERS

Disorders that relate tl the inappropriate elimination of urine or stool by accident or on purpose

TYPES OF ELIMINATION DISORDERS

Enuresis (bedwetting)

Encopresis (Fecal Soiling)

SLEEP-WAKE DISORDERS

Disorders of sleep severe enough to require clinical attention

TYPES OF SLEEP-WAKE DISORDERS

Narcolepsy

Insomnia Disorder

Hypersomnolence Disorder

Nightmare Disorder

Restless Leg Syndrome

SEXUAL DYSFUNCTIONS

Disorders of sexual response

TYPES OF SEXUAL DISORDERS

Erectile Disorder

Female Orgasmic Disorder

Premature Ejaculation

Delayed Ejaculation

Male Hypoactive Sexual Desire Disoder

Female Sexual Interest/Arousal Disorder

GENDER DYSPHORIA

Distress that accompanies a person’ s stated desire to be another gender

• Formerly referred to as Gender Identity Disorder

DISRUPTIVE, IMPULSE CONTROL AND CONDUCT DISORDERS

Problems with emotional and behavioral self-control

TYPES OF DISRUPTIVE, IMPULSE CONTROL AND CONDUCT DISORDERS

Oppositional Defiant Disorder

Intermittent Explosive Disorder

Conduct Disorder

Pyromania

Kleptomania

SUBSTANCE-RELATED ADDICTIVE DISORDER

Problems with excessive use of alcohol, caffeine, tobacco and drugs.

• Includes gambling disorder

TYPES OF SUBSTANCE-RELATED ADDICTIVE DISORDER

Alcohol Intoxication

Caffeine Withdrawal

Inhalant Use Disorder

Tobacco Use Disorder

Gambling Disorder

NEUROCOGNITIVE DISORDERS

Affects your ability to think and reason

TYPES OF NEUROCOGNITIVE DISORDERS

Delirium

Disorders due to traumatic brain injury of Alzheimer’s disease

Major and Mild Neurocognitive Disorder

PERSONALITY DISORDERS

A lasting pattern of emotional instability and unhealthy behavior that causes problems in your life and relationships.

TYPES OF PERSONALITY DISORDERS

Antisocial

Borderline

Histrionic

Narcissistic

PARAPHILIC DISORDERS

Sexual interest that causes personal distress or impairment or causes potential or actual harm to another person

TYPES OF PRAPHILIC DISORDERS

Sexual Sadism Disorder

Voyeuristic Disorder

Exhibitionistic Disorder

Frotteuristic Disorder

Pedophilic Disorder

Fetishishtic Disorder

Transvestic Disorder

OTHER MENTAL DISORDERS

This class don’t meet the full criteria for one of the other disorders

DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS

A system for the classification of mental disorders that provides diagnostic criteria used by psychiatrists, psychologists, and other mental health experts.

AMERICAN PSYCHIATRIC ASSOCIATION

The __________________ has devised a system for diagnosing maladjusted behavior.

DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS, FIFTH EDITION, TEXT REVISION

Released in March 2022, with further updates released in September 2022.

GOALS OF THE DSM

• To provide a system for diagnosing disorders

• To improve the reliability of diagnoses

• To make diagnoses consistent with research evidence and clinical experiences.

DSM-1 (1952)

106 disorders, psychodynamic perspective on etiology

DSM-II (1968)

182 disorders, broader levels pf neurosis and psychosis

DSM-III (1980) & DSM-III-R (1987)

265 diagnoses, 292 in the latter, standardization of categories in colloquial language

DSM-IV (1994) & DSM-IV-TR (2000)

297 disorders, relatively minor updates

DSM-V (2013)

20 categories, 250 disorders, major changes

DSM 5

• Mainly incremental changes from DSM-IV

• No more Roman numerals

• May have online updates in the future (e.g. DSM-5.1) to make it a living document

PROBLEMS IN DSM IV: HIGH RATES OF CO-MORBIDITY

Simultaneous presence of two chronic diseases or conditions in a patient

PROBLEMS IN DSM IV: HIGH USE OF NOS CATEGORY

Not Otherwise Specified (too many vague diagnosis)

PROBLEMS IN DSM IV: CONCERNS ABOUT RELIABILITY AND VALIDITY

Inconsistent and questionable accuracy

GOALS FOR IMPROVING THE DSM

Changes should be based on empirical research rather than clinical consensus.

• Behavioral Science

• Neuroscience

• Molecular Genetics

Move toward a classification based on etiology.

DSM 5 STRUCTURE

Section I: Basics

Section II: Diagnostic Criteria and Codes

Section III: Emerging Measures and Models Appendix

TWO CLUSTERS OF DISORDERS: INTERNALIZING GROUP

Disorders with prominent anxiety, depressive and somatic symptoms

TWO CLUSTERS OF DISORDERS: EXTERNALIZING GROUP

Disorders with prominent impulsive, disruptive conduct, and substance use symptoms

ORGANIZATIONS OF DISORDERS

Based in developmental and lifespan considerations

diagnoses that manifest early in life, then adolescence and young adulthood and later life

CULTURE

shapes the experience and expression of the symptoms, signs, and behaviors that are criteria for diagnosis.

SECTION III

contains Cultural Formulation

APPENDIX

Contains a Glossary of Cultural Concepts of Distress

CULTURE SYNDROME, CULTURAL IDIOM OF DISTRESS, CULTURAL EXPLANATION OR PERCEIVED CAUSE

Concepts that replaced the Culture-Bound Syndrome in DSM IV

CULTURAL SYNDROME

Cluster of invariant symptoms in a specific cultural group

CULTURAL IDIOM OF DISTRESS

A way of talking about suffering among people in a cultural group

CULTURAL EXPLANATION OR PERCEIVED CAUSE

For symptoms, illness, or distress

MULTIAXIAL SYSTEM OF THE DSM IV

the way to address “the whole person”

• we need to consider the affected person from a variety of perspectives

AXIS I

Principal disorder that needs immediate attention

• usually what brings the person “through the office door”

AXIS II

List any personality disorder that may be shaping the current response to the Axis I problem.

• indicated development disorders such as mental retardation or learning disability.

• may be predispositions of Axis I

AXIS III

List any medical or neurological problems that may be relevant to individual’s current or past psychiatric problems

AXIS IV

Codes the major psychosocial stressors the individual has faced recently

AXIS V

Codes the “level of function” the individual has attained at the time of assessment or in the past year.

FUNCTIONING CODE: 91-100

• No problems

• Superior functioning

• Admired by others due to positive qualities

FUNCTIONING CODE: 81-90

• Few or no symptoms

• Good functioning in several areas

• No more than everyday problems

FUNCTIONING CODE: 71-80

• With symptoms/problems but temporary

• Expectable reaction to stressors

• No more than slight impairment in any area of psychological functioning

FUNCTIONING CODE: 61-70

• Mild symptoms

• Difficulty in one; social, occupational, school functioning

• BUT, generally functioning well and has some meaningful interpersonal relationships.

FUNCTIONING CODE: 51-60

• Moderate symptoms

• Moderate difficulty in one; social, occupational, or school functioning

FUNCTIONING CODE: 41-50

• Serious symptoms

• Serious impairment in one; social, occupational, school functioning

FUNCTIONING CODE: 31-40

• Some impairment in reality testing

• Impairment in speech communication

• Serious impairment in several; occupational, school functioning, interpersonal relationships, judgement, thinking or mood

FUNCTIONING CODE: 21-30

• Presence of hallucinations or delusions which influence behavior

• Serious impairment in ability to communicate with others

• Serious impairment in judgement

• Inability to function in almost all areas

FUNCTIONING CODE: 11-20

• Danger or harm to self or others

• Occasional failure to maintain personal hygiene

• virtually unable to communicate to communicate with others due to being incoherent or mute

FUNCTIONING CODE: 1-10

• Persistent danger of harming self or others

• Persistent inability to maintain personal hygiene

• Person has made a serious attempt at suicide

DSM-IV

• Mutiaxial

• Not Otherwise Specified

• Coded 374 diagnosable conditions

• Listed 22 ICD-9-CM factors

• 5 abuse codes

CHANGES FROM DSM IV TO DSM 5

• No axes

• “Other Disorder” or “Unspecified Disorder”

• 324 diagnosable conditions

• 88 ICDM-9-CM V Codes

• 44 abuse codes

GLOBAL ASSESSMENT OF FUNCTIONING (GAF)

Eliminated in the DSM 5 and replaced by the World Health Organization Disability Assessment Schedule (WHODAS)

CLINICAL CASE FORMULATION

Making diagnoses requires clinical judgment, not just checking off the symptoms in the criteria.

The client’s cultural and social context must be considered.

MENTAL DISORDER

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. There is usually significant distress or disability in social or occupational activities

BASIS OF DIAGNOSES

The Assessment Process

DSM-5 text descriptions

DSM-5 criteria

Clinical Eye and Judgment

STEPS IN MAKING A DIAGNOSIS

Administer cross-cutting assessment tools

Administer WHODAS 2.0

Conduct clinical interview

Determine whether a diagnostic threshold is met

Consider subtypes and/or specifiers

Consider contextual information, disorder text, distress, clinician judgment

CAUTION FOR FORENSIC USE

The diagnosis of a mental disorder does not imply that the person meets legal criteria for the presence of a mental disorder or a specific legal standard for competence, criminal responsibility, disability, etc.

Having a diagnosis does not imply that the person is (or was) unable to control his or her behavior at a particular time.

PROLONGED GRIEF DISORDER

A disorder that applies to children, adolescents, and adults, defined as intense yearning or longing, and preoccupation with thoughts or memories of the deceased.

UNSPECIFIED MOOD DISORDER

A diagnosis that was reinstated in the DSM-5-TR. It refers to symptoms characteristic of Bipolar Related Disorders and/or Depressive Disorders but do not meet the full criteria for any of the disorders under those classes.

MAJOR OR MILD NEUROCOGNITIVE DISORDER DUE TO UNKNOWN ETIOLOGY

Was added as a mental disorder under Neurocognitive Disorders.