Introduction to Psychological Disorders

Syndrome Definition (American Psychiatric Association):
- A collection of symptoms causing clinically significant disturbances in an individual's cognition, emotional regulation, or behavior.
Maladaptive Thoughts and Behaviors:
- Dysfunctional cognitions, emotions, or behaviors disrupt daily life quality.
- Important to determine if disturbances lead to a noticeable impact on living quality.

Brutal Treatments of the Past:
- Trepanning (a form of drilling holes in the skull) aimed to release evil spirits believed to cause mental disorders.
Evolution from Brutality to Care:
- Philip Pinel in France stressed that madness was an illness, not possession.
- His moral treatment approach included kindness and therapy instead of brutality.
Transition to Medical Model:
- The medical model posits that psychological disorders have physical causes and can be diagnosed and treated like other diseases.
- Transition from asylums to hospitals in the West around 1900.
Syphilis Example:
- Syphilis-induced psychosis highlighted the connection between physical health and mental disorders.

Biopsychosocial Approach:
- Emphasizes the interconnectedness of biological, psychological, and social factors in understanding mental health.
- Disorders can share dynamics despite differing symptoms.
Co-Morbidity:
- Individuals diagnosed with one disorder often face a higher risk for related disorders due to overlapping genetic predispositions and environmental stressors.
Vulnerability-Stress Model:
- Individual disposition interacts with environmental stressors to influence the onset of psychological disorders.

Need for Diagnostic Classification:
- To study a disorder, it must be identified, named, and described.
Benefits of Diagnostic Labels:
- Facilitate communication among mental health professionals.
- Help clients feel less isolated when hearing they share symptoms with others.
Risks of Diagnostic Labels:
- Can impose subjective judgments or stigmas.
- Negative labels can lead to self-fulfilling prophecies.
Main Diagnostic Tool: DSM-5-TR
- The Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision.
- Utilized by mental health professionals for diagnostic codes and tracking trends.

Criteria for Insomnia Disorder (Table 48.1):
- Dissatisfaction with sleep quality or quantity
- Difficulty falling/staying asleep or returning to sleep
- Sleep disruptions causing distress or impaired functioning
- Occurrence of symptoms three or more times weekly for at least three months
- Independence from other disorders or substance effects.
Other Disorders with Flexible Criteria:
- Disorders like PTSD or major depressive disorder require meeting a fraction of criteria for diagnosis.

RDoC (Research Domain Criteria):
- A dimensional approach from the National Institutes of Mental Health introduced in 2022.
- Acknowledges that mental health problems are part of daily life, pushing for improved diagnosis and treatment methodologies.
HI TOP (Hierarchical Taxonomy of Psychopathology):
- Acknowledges varying symptom quantities and interconnections between disorders.
Dimensional Approach Benefits:
- Recognizes individuals displaying fewer symptoms still warrant treatment.
- Takes into account full range of influences on mental health, including genetics and trauma.

Categorical Approach of DSM:
- Symptoms are either present or absent, includes WHO diagnostic codes.
Risks of DSM Utilization:
- Some disorders, such as antisocial personality disorder, may not be well-supported by empirical research.
- Potential for pathologizing natural human experiences.

Global Suicide Statistics:
- Approximately 700,000 suicides annually.
- Increased risks associated with depression and anxiety disorders.
US Specifics:
- About 46,000 Americans die by suicide annually, with gun use prevalent among these deaths.
Influencing Factors:
- Family history of suicide, feelings of disconnection or being burdensome, severe life circumstances.
**Recent Examples of Triggering Events:
- COVID-19 pandemic led to increased unemployment and isolation.
- 2021 US Capitol incident correlated with increased suicide among police.
- Statistics from Britain indicate intimate partner violence significantly contributes to suicide attempts.

Improve Quality of Life:
- Build economic security through job training and public housing.
- Ensure access to mental care and community mental health resources.
Create Safe Environments:
- Reduce firearm access among at-risk populations.
- Implement policies to manage substance abuse.
Foster Social Connections:
- Implement community programs that encourage connection and involvement.
Coping Skills Training:
- Educate individuals on coping and problem-solving skills to alleviate distress.

Common Among Adolescents:
- Typically presents in younger females who may self-injure due to bullying or stress.
- Justifiable reasons can include emotional relief, attention-seeking, or self-punishment.
Self-Injury as a Coping Mechanism:
- Providing distraction from negative feelings through physical pain.
- Reinforces identity within groups of individuals experiencing similar issues.

Risk and Protective Factors (Table 48.4):
- Individual attributes (e.g., low self-esteem) vs. protective measures (e.g., confidence).
- Social factors (e.g., loneliness) and the benefits of support networks.
- Environmental factors and the need for equitable access to services.