PSYCHOLOGICAL DISORDERS

CHAPTER 14: PSYCHOLOGICAL DISORDERS

Introduction to Psychological Disorders

  • Instructor: Darwin D. Diola, MP-IOP, CHRA, ICCC, MIEE, D.Psy, CSIOP, CMoCAR, PhD

  • Learning Objectives: At the end of the session, students shall be able to:

    • Define Psychological Disorders.

    • Differentiate between Deviant, Distress, and Dysfunctional.

    • Understand Psychological Disorders.

Defining Psychological Disorders

  • Definition of Mental Disorder: According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition), a mental disorder is described as a SYNDROME — a set of related conditions that lead to clinically significant disturbances in thoughts, feelings, or behaviors.

  • The 4Ds of Determining Mental Disorders (APA, 2013):

    1. Disturbance: of thought, emotion, or behavior.

    2. Dysfunction: of biological or developmental processes.

    3. Distress: or disability in everyday life.

    4. Deviance: thought, emotion, or behavior, only if also dysfunctional.

Major Categories of Psychological Disorders

  • Overview of 10 of the 21 Major Disorders:

    1. Neurodevelopmental Disorders

    2. Schizophrenia

    3. Depressive Disorders

    4. Bipolar Disorders

    5. Anxiety Disorders

    6. Obsessive-Compulsive Disorder (OCD)

    7. Posttraumatic Stress Disorder (PTSD)

    8. Dissociative Disorders

    9. Somatic Symptom Disorders

    10. Personality Disorders

Neurodevelopmental Disorders

  • 1. Attention Deficit Hyperactivity Disorder (ADHD)

    • Major Symptoms:

    • Inattention: Includes failure to give close attention to details, inability to sustain attention, and not listening when spoken to.

    • Hyperactivity: Fidgeting, leaving the seat inappropriately, excessive running or climbing, and talking excessively.

    • Impulsivity: Blurts out answers, cannot wait turn, often interrupts others.

  • 2. Autism Spectrum Disorder

    • Major Symptoms:

    • Impaired Social Interaction: Issues with eye contact, facial expressions, and peer relationships.

    • Impaired Communication: Delayed or stereotypic speech.

    • Repetitive and Stereotypic Behaviors: Preoccupation with certain interests or inflexible routines.

  • Causes of Neurodevelopmental Disorders:

    • ADHD: Environmental factors, including maternal smoking during pregnancy, suspected excessive sugar consumption.

    • Autism Spectrum Disorder: Though causes are largely unknown, risk factors include low vitamin D levels in utero and unusually large head size in early life.

Schizophrenia

  • Definition: A serious psychotic disorder characterized by profound disturbances in thought and emotion, especially impairments in perception, such as hallucinations. It is described as a split from reality, not a split personality.

  • Major Symptoms of Schizophrenia:

    1. Delusions: False beliefs held despite contradictory evidence.

    2. Hallucinations: Convincing sensory experiences occurring in the absence of external stimuli.

    3. Disorganized Speech: Speech that lacks structure or logical flow.

    4. Disorganized Behavior: Including catatonic behaviors, which may be immobile and unresponsive.

    5. Negative Symptoms: Symptoms such as lack of emotion or failure to speak.

Depressive Disorders

  • Overview: This broad category encompasses all forms of depression, including major depressive disorder and persistent depressive disorder.

  • Major Depressive Disorder (MDD):

    • Definition: A chronic condition marked by enduring changes in mood, motivation, and self-worth.

    • Diagnostic Criteria (DSM-5): To be diagnosed, individuals must exhibit at least five of the following nine symptoms for a minimum of two consecutive weeks:

    1. Persistent depressed mood for several days.

    2. Reduced interest or pleasure in nearly all activities.

    3. Significant weight change.

    4. Sleep disturbances.

    5. Sluggishness or restlessness.

    6. Persistent fatigue or energy loss.

    7. Feelings of worthlessness or excessive guilt.

    8. Inability to concentrate or think clearly.

    9. Recurrent thoughts of death or suicidal ideation.

  • Persistent Depressive Disorder (PDD):

    • Symptoms are similar to MDD but are less intense. The depressive mood lasts most of the day for at least two years.

Bipolar Disorder

  • Definition: Characterized by significant mood fluctuations alternating between major depressive and manic or hypomanic episodes.

  • Manic Episodes: Involve increased energy, sleeplessness, euphoria, irritability, delusions of grandeur, increased sex drive, and racing thoughts lasting at least one week.

  • Hypomanic Episodes: Similar symptoms to manic episodes but shorter in duration (at least 4 days).

  • Symptoms of Mania (acronym: DIG FAST):

    • Distractibility

    • Indiscretion

    • Grandiosity

    • Flight of ideas

    • Activity increase

    • Sleep (decreased need for sleep)

    • Talkativeness

  • Bipolar Types:

    • Bipolar I: More severe; requires meeting mania criteria (at least 7 days).

    • Bipolar II: Less severe; requires meeting hypomania criteria (at least 4 days).

Anxiety Disorders

  • 1. Generalized Anxiety Disorder (GAD):

    • Major Symptoms: Excessive anxiety lasting for at least six months.

    • Behavior: Difficulty relaxing.

  • 2. Panic Attack:

    • Major Symptoms: Persistent worry about having a panic attack.

    • Behaviors Related to Panic Attacks: Heart palpitations, trembling, dizziness, intense dread, fear of dying.

    • Panic Disorder: Prone to panic attacks and concerned about associated embarrassment.

  • 3. Social Phobia (Social Anxiety Disorder):

    • Definition: A persistent and unreasonable fear of humiliation in social situations.

    • Major Symptoms: Extreme self-consciousness regarding appearance or behavior.

  • 4. Agoraphobia:

    • Major Symptoms: Fear of being unable to escape or receive help in public places during a panic attack.

    • Behavior: Avoidance of leaving home.

  • 5. Specific Phobias:

    • Major Symptoms: Intense fear or panic in response to specific objects or situations.

    • Types of Phobias (according to DSM-5):

    • Fears related to animals (e.g., spiders, dogs).

    • Fears related to the natural environment (e.g., heights, thunder).

    • Fears related to blood or medical issues (e.g., injections).

    • Fears related to specific situations (e.g., flying, driving).

    • Other phobias (e.g., fear of choking, loud noises).

  • Examples of Phobias:

    • Achluophobia: Fear of darkness

    • Acrophobia: Fear of heights

    • Aerophobia: Fear of flying

    • Agoraphobia: Fear of public spaces or crowds

    • Arachnophobia: Fear of spiders

Obsessive-Compulsive Disorder (OCD)

  • Obsession: An unwanted thought, word, phrase, or image that persistently intrudes into one's mind, leading to distress.

  • Compulsion: A repetitive behavior performed to alleviate distress from obsessions or performed according to rigid rules.

    • Key Distinction: Obsessions involve thought disturbances, while compulsions entail repetitive actions.

Posttraumatic Stress Disorder (PTSD)

  • Definition: A trauma- and stressor-related disorder characterized by intrusive, persistent cognitive, emotional, and physiological symptoms following catastrophic or horrifying events.

Dissociative Disorders

  • Overview: Extreme disruptions in memory, identity, or consciousness without a clear physical cause (e.g., brain injury).

  • Dissociative Identity Disorder (DID): Characterized by the presence of at least two distinct identities or personality states, each with unique memories, behaviors, and emotions.

Somatic Symptom Disorders

  • Definition: Occurs when an individual reports multiple physical symptoms that cause distress and disrupt daily life, persisting for at least six months.

  • Main Criteria (APA, 2013):

    1. One or more distressing somatic symptoms disrupting life.

    2. Excessive thoughts, feelings, or behaviors regarding the somatic symptoms.

  • Illness Anxiety Disorder: Diagnosed when individuals exhibit anxiety about somatic symptoms without any actual somatic problems.

Personality Disorders

  • Definition: Characterized by maladaptive patterns of cognition, emotion, and behavior, typically beginning in late childhood or adolescence and continuing into adulthood.

  • Three Clusters of Personality Disorders:

    1. Odd-Eccentric:

    • Schizoid Personality Disorder: Avoids close relationships and exhibits emotional aloofness.

    • Schizotypal Personality Disorder: Isolated with odd thoughts and beliefs.

    • Paranoid Personality Disorder: Exhibits extreme suspicion and mistrust.

    1. Dramatic-Emotional:

    • Histrionic Personality Disorder: Seeks attention with dramatic behaviors.

    • Borderline Personality Disorder: Experiences intense emotions and fear of abandonment.

    • Narcissistic Personality Disorder: Displays an inflated self-image and grandiosity.

    • Antisocial Personality Disorder: Exhibits impulsive, deceptive, and violent behaviors.

    1. Anxious-Fearful:

    • Avoidant Personality Disorder: Fear of criticism and low self-esteem.

    • Dependent Personality Disorder: Fear of rejection and strong need to be cared for.

    • Obsessive-Compulsive Personality Disorder: Characterized by rigid habits and extreme perfectionism, broader than OCD.

Summary

  • Key Criteria for Psychological Disorder: The psychological community generally identifies four criteria:

    • Disruptive: Interference with daily functioning.

    • Distressing: Causes emotional anguish.

    • Dysfunctional: Impinges on normal functioning or mental health.

    • Deviant: Diverges from societal norms and expectations.

  • Diagnostic Tool: The DSM-5 serves as a major resource for diagnosing psychological disorders.