Mental Disorders PDF

Mental Disorders Psychopathology– a sickness/disorder of the mind - How should we understand it? Treat it? What are its causes? - Stats we don’t need to know on the test: - One in four Americans over age 18 has a diagnosable mental disorder in a given year. - 1 in 5 American adults r...

Mental Disorders Psychopathology– a sickness/disorder of the mind - How should we understand it? Treat it? What are its causes? - Stats we don’t need to know on the test: - One in four Americans over age 18 has a diagnosable mental disorder in a given year. - 1 in 5 American adults receives treatment over any two-year period. - Nearly 1 in 2 people will have some form of mental disorder at some point in their lives. - Mood Disorders (depression) - Impulse Control Disorders (hyperactivity/attention problems) - Anxiety Disorders (Most common mental disorder worldwide) - Substance Abuse Disorders The experience ranges in severity– 7% of US population is seriously, severely affected - Needing treatment - Gender and cultural differences - Gender– women are more likely to suffer from mood and anxiety disorders - Men are more likely to suffer from antisocial personality disorder and autism - Is depression more common in women? Yes. - Why? Is it social roles? Is it coping styles? Different experience? Diagnosing differences? - Mental illness is common, varies in severity, and most people have symptoms of mental illness at some point in their life - What behaviors are a part of life? What are indicative of a mental disorder? - Same behavior within different contexts. - In Africa, some people spread feces in their hair - Some Native American and East Asian cultures consider it an honor to hear the voices of spirits - psychopathology is increasingly defined as thoughts and behaviors that are maladaptive rather than deviant. - maladaptive behaviors– get in the way of someone moving through their lives effectively and healthily - A deviant behavior in society is one that goes against social norms or laws established by society. - Ex: excessive hand washing– can be deviant but can prevent illness - It’s adaptive - But can become maladaptive if they can’t stop - Interferes with their life  - Diagnosis: The symptoms of a disorder must interfere with some aspect of their lives in at least one of these, eg: - Work - Social relations - Self care - 1952– categorizing mental disorders - Diagnostic and Statistical Manual of Mental Disorders (DSM) was published in 1952 - DSM is still the guide for recognizing and diagnosing mental disorders today - Early versions focused on the presumed causes of mental disorders, but beginning with the DSM-III, in 1980, there was a shift to classifying psychopathology based on observable symptoms Current edition– DSM-5-TR - There are specific criteria that patients need to fit in order to meet the diagnostic. - Patient being diagnosed doesn’t just get one label, but they will be evaluated on different levels– multi-axial system (based on the growing realization that various factors affect mental health) - The DSM-5 regards mental disorders as analogous to medical diseases; it borrows the terms “symptom” and “syndrome” from medicine. - Symptom: Any characteristic of a person’s thoughts or actions or feelings that could be a potential indicator of a mental disorder. - Ex: sleeplessness, lack of apetite - Syndrome: A constellation of interrelated symptoms manifested by a given individual. This definition of a syndrome as a mental disorder specifies three critical criteria that must be met for the condition to qualify as a mental disorder. Here's a breakdown of what it means: 1. Clinically Significant Detriment: ○ The syndrome must cause serious harm or distress to the individual. This could manifest as emotional pain, physical impairment, or significant disruption in daily functioning, such as in relationships, work, or health. 2. Originating from an Internal Source: ○ The symptoms must arise from something within the person—either their biological makeup (e.g., genetic predispositions, neurochemical imbalances) or their mental structures (e.g., thought patterns, emotional regulation issues). This excludes conditions caused primarily by external factors, like societal pressure or immediate circumstances. 3. Not Subject to Voluntary Control: ○ The individual cannot simply "choose" to stop or start the behavior. For example:  Anorexia nervosa: Even though someone may appear to make a choice about restricting food, the disorder stems from internal compulsions and mental health issues, not a voluntary decision. Hunger strike: This is a deliberate, conscious choice based on external factors, such as protest, and would not qualify as a mental disorder. Together, these criteria help differentiate mental disorders from other conditions or behaviors. It emphasizes the medical and psychological nature of the disorder rather than framing it as a simple choice or situational issue. - But all behavior involves an interaction between the person and the environment…how can we disentangle these to see which is primary? - How do we know whether we can believe someone who claims they have made a deliberate choice regarding their behavior? - Who has the right to decide if someone is mentally disordered? - Most North American health insurance companies require an approved diagnosis before they will pay for treatment. The Process of diagnosis 1. Client Responses: ○ The client completes assessments or answers a series of questions that gather information about their thoughts, feelings, and behaviors. ○ These questions are designed to identify patterns and severity of symptoms. 2. SCID-5 (Structured Clinical Interview for DSM-5): ○ A tool clinicians use to systematically evaluate symptoms and behaviors. ○ It helps sort reported symptoms into potential syndrome categories for diagnosis. ○ Ensures that the diagnosis aligns with the criteria laid out in the DSM-5. 3. Matching Symptoms to Syndromes: ○ The clinician identifies specific clusters of symptoms and matches them to one or more of the 19 syndromes in the DSM-5. Examples include: Social Phobia (Social Anxiety Disorder): Fear of humiliation and embarrassment in social situations. Conduct Disorder: Persistent rule-breaking or antisocial behavior, often beginning in childhood or adolescence. Criticism: Is the DSM-5 Too Broad? Critics argue that the DSM-5 casts a wide net, leading to several issues:  1. Pathologizing Normal Behavior: ○ Everyday behaviors or struggles could be labeled as disorders. For example: Feeling shy or self-conscious could be diagnosed as social phobia. A teenager acting out could be diagnosed with conduct disorder. ○ This raises concerns about overdiagnosis and unnecessary medicalization of normal life challenge 19 clinical syndromes 1. Neurodevelopmental disorders - Ex: intellectual disability, communication disorder, speech disorder, autism spectrum disorder, some motor disorders like tourettes 2. Schitzophrenia spectrum and other psychotic disorders - Schizophrenia used to be broken down into paranoia, etc etc but now we don’t do those subtypes 3. Bipolar and related disorders - Involve unpredictable and mood changes 4. Depressive disorders - Seasonal depression, persistent depression disorder, postpartum, etc 5. Anxiety disorders - Social anxiety, phobias, separation anxiety 6. Obsessive compulsive disorders - Used to be combined with anxiety disorders - Hair pulling, skin picking, etc 7. Trauma and stressor related disorders - Ex: PTSD 8. Dissociative disorders - Amnesia or loss of memory – dissociative fugue– temporary amnesia 9. Somatic symptom and related disorders - Ex: conversion disorder– feels physical symptoms - Intrusive thoughts about physical things– somatic symptom disorder - Ex: hypochondria– but it’s not called that anymore 10. Feeding and eating disorders– anorexia, bulemia 11. Elimination disorders 12. Sleep-wake disorders– narcolepsy, insomnia, etc 13. Sexual disfunctions– lack of interest/arousal, pain 14. Gender dysphoria – pulled away from sexual disorders in general - There are arguments about whether it’s a disorder - Having this category helps separate out the symptoms 15. Disruptive, Impulse-Control, and Conduct Disorders - Anti-social personality disorder - Conduct disorder  - Not ADHD, it’s in the neurodevelopmental disorders 16. Substance abuse and addictive disorders 17. Neurocognitive disorders– demensia, delirium, cognititive impairment 18. Personality disorders– narcissistic personality disorder, dependent, borderline, etc 19. Paraphillic disorders– people suffering from violent sexual urges, fantasies about inappropriate sex There’s controversy. Some critics say the DSM has gotten too broad.