Lecture 20: Psychological Disorders

What is the key component of a mental disorder?

level of distress it causes, and whether it interferes with the ability to function in everyday life

What is the standard reference book for disorders?

DSM 5-TR (2022): it's a set of criteria for every diagnosis, very descriptive

What are the problems with DSM 5-TR

• Danger of overdiagnosis
• Can create stigma
• Many of the symptoms are subjective and not objective
• Some categories have cultural/political/social implications (some cultures send u to prison or the hospital for a diagnosis)

When can you get diagnosed with a personality disorder?

Until 18

What are the 2 parts of Autism Spectrum Disorders?

1. Deficits in social interactions
2. Restricted repetitive patterns of behavior

How do you get diagnosed with autism, deficit in social interaction?

You need ALL 3:

1. no back and forth conversation
2. Lack of eye contact or gestures
3. Deficit in social relationships

How do you get diagnosed with autism, restricted repetitive patterns of behavior

ONLY NEED 2/4:

1. repetitive speech or use of objects
2. excessive need for routines/rituals including verbal
3. Restricted interests and preoccupations
4. Sensory sensitivity

What are the diff ADHD diagnosis?

ADHD predominantly inattentive presentation
ADHD predominately hyperactive/impulsive presentation
ADHD combined presentation

What is the criteria to get diagnosed w/ ADHD?

• Have to have symptoms prior to age 12
• These symptoms have to be present in two or more settings
• Clear evidence that symptoms interfere w/ functioning

ADD?

Can't get diagnosed w/ ADD anymore, it's just ADHD now

What is ADHD predominantly inattentive presentation?

fails to attend to details, difficulty organizing tasks, loses things, forgetful

What is ADHD predominately hyperactive/impulsive presentation?

fidgets, "on the go", interrupts, runs, and climbs inappropriately
(DOESN'T FIT THEIR AGE, IF THEY ARE YOUNG THEY WILL NATURALLY DO THESE THINGS)

What is the severity specifiers in ADHD?

Mild: few symptoms in excess, minor impairment in social/occupational functioning
Moderate: impairment between mild/severe
Severe: several symptoms in excess of what is required for a diagnosis, or several severe symptoms, or severe impairment in functioning

Other details w/ ADHD?

• There's a genetic link
• Multimodal treatment approach: drugs and behavioral interventions
• Girls/women are underdiagnosed

What is conduct disorder?

repetitive, persistent pattern of violating the basic rights of others or age appropriate societal norms or rules for one year or more. (sid from toy story)

• behaviors can be aggressive (rape, robbery, animal cruelty) or nonaggressive (stealing, lying, deliberately annoying people)
• may be a precursor to antisocial behavior

What is Tourette's disorder?

Multiple motor and 1+ vocal tics that occurs many times a day nearly every day or intermittently over a period of more than 1 year

• Onset before age 18
• Does not need to interfere with functioning for diagnosis

What are all the anxiety disorders?

GAD, panic disorder, social anxiety disorder, agoraphobia, specific phobias, OCD, hoarding disorder, PTSD

What is Generalized Anxiety Disorder (GAD)

continuous feelings of worry, anxiety, dread

• you have feelings of restlessness, difficultly concentrating, irritability, muscle tension, sleep disturbance

What is panic disorder?

the spontaneous and unexpected occurrence of panic attacks

• must be associated with long than 1 month of subsequent persistent worry or significant maladaptive behavioral changes related to attack

What is Social Anxiety Disorder (Social Phobia)

fear or anxiety about one or more social situations in which the individual is exposed to possible scruntiny by others

What is agoraphobia?

fear of being alone in public places from which escape might be difficult

What is OCD made up of?

An obsession and compulsion

What is the obsession portion of OCD? Example?

a recurrent, persistent, and unwished for thought
EX: contamination, need for orderliness, obsessive worry about an accident happening

What is the compulsion part of OCD? Example?

repetitive ritualized behavior in which people feel a lack of control over it
Ex: cleaning, touching the light switch a certain amount of times

What is hoarding disorder?

persistent difficulty discarding items-- even those with no or little value

• results in clutter
• severity is related to levels of insight into the disorder and its disruptions

What are the factors associated with people who develop hoarding disorder?

• being raised in a chaotic home
• challenges w/ decision making n problem solving
• ADHD
• anxiety/depression
• Guilt about waste
• Effort to "protect" and comfort w/ objects/items

What is PTSD?

trauma/stress related disorder following a traumatic event

What is reexperiencing symptoms in PTSD?

spontaneous intrusions of traumatic memory in the form of images or nightmares

What are avoidance symptoms in PTSD?

avoiding places and reminders of the traumatic event

What are hyperarousal symptoms of PTSD?

insomnia, irritability, impaired concentration, hypervigilance, and increased startle responses

What are the symptoms in mood disorders? (major depressive disorder, persistent depressive disorder, premenstrual dysphoric disorder, prolonged grief, and unspecified mood disorder)

Sadness: lethargy, inactivity
Behavioral changes: slower motor reactions, social withdrawal
Cognitive changes: cognitive distortions, diff concentrating
Physical changes: alters immune functioning, sleep disturbances

What is mania?

• inflated self-esteem
• decreased need for sleep
• pressured speech (talking fast)
• goal-oriented
• thoughts racing

What is mania vs hypomania?

Mania: severe, disruptive episode (lasting 1+ week), often needing hospitalization
Hypomania: milder, shorter (4+ days) form that doesn't impair functioning

What is bipolar disorder?

Bipolar I: characterized by at least 1 manic episode or mixed episode (manic and depressive in the same episode)
Bipolar II: 1 or more depressive episodes, together with at least 1 hypomanic episode

Other info w/ bipolar disorder?

• Responsive to mood stabilizers
• Challenges w/ treatment compliance
• Can be adaptive, healthy, and contributing members of society

What is the severity indicators for Manic Episodes?

Mild: if only minimum symptom criteria are met
Moderate: if there is a significant increase in activity or impairment in judgement
Severe: if almost continual supervision is required

What are somatic symptoms and related disorders?

somatic symptom disorder, illness anxiety disorder, functional neurological symptom disorder

What is somatic symptom disorder?

You have real physical symptoms, but your reaction to them is excessive or out of proportion. (anxiety abt the symptoms themselves)

What is illness anxiety disorder? What did it used to be called?

excessive preoccupation with health concerns/worry about developing illnesses (anxiety about the disease itself)
used to be called hypochondria

What is functional neurological symptom disorder? What did it used to be called?

loss of motor or sensory function with no organic basis, usually specific area or symptom affected (ex: can't walk but all scans show you should be able to)
used to be called conversion disorder

What are personality disorders?

rigid, maladaptive traits that cause great distress or lead to an inability to get along with others or to function well in the world

What are the different clusters identified in personality disorders and their definitions?

• Odd/Eccentric: paranoid, schizoid (prefers to be alone, distant, daydreamer, poor social skills), schizotypal (strange beliefs, magical thinking ex: believing in telepathy)
• Dramatic/Erratic: antisocial (no remorse for people), borderline (unstable moods, mood changes), histrionic (attention seeking, believes everyone loves them), narcissistic
• Anxious/Inhibited: ocpd (don't feel the distress, you feel it should be organized), dependent, avoidant

What is the one psychotic disorder we went over?

Schizophrenia

What is schizophrenia? What is the other info abt schizophrenia?

psychosis or conditions involving distorted perceptions of reality and an inability to function in most aspects of life

• onset age is 17-25
• strong genetic component (stiles)

What are the positive symptoms of schizophrenia?

presence of a distortion or bizarre behavioral symptom

• bizarre delusions
• hallucinations
• grossly disorganized speech/behavior

What are the negative symptoms of schizophrenia?

loss of functioning or ability, behavioral deficits

• poverty of speech (blunt words)
• emotional flatness
• loss of motivation, apathy
• social withdrawal

What are the cognitive symptoms of schizophrenia?

deficits in cognitive abilities

• impairment in executive functioning such as working memory and attention

What are dissociative disorders?

consciousness, behavior, and identity are split off

• may develop in response to traumatic events

What is amnesia?

inability to remember important personal information; cannot be explained by ordinary forgetfulness

What is fugue state?

no concept of self/can take on a whole new identity/life

What is Dissociative Identity Disorder (DID)? What was it formally known as?

the appearance of 2 or more distinct identities within one person (fight club)

• At least two recurrently take control over behavior
• Inability to recall important information
  used to be called multiple personality disorder