Abnormal Psychology As A Field Of Study PDF

Chapter 1: ABNORMAL PSYCHOLOGY AS A FIELD OF STUDY ▪ Either to self or to others The study of abnormal psychology as a discipline is concerned with enormous c. Atypical or Not Culturally Expected (Deviance) – deviates from the aver...

Chapter 1: ABNORMAL PSYCHOLOGY AS A FIELD OF STUDY ▪ Either to self or to others The study of abnormal psychology as a discipline is concerned with enormous c. Atypical or Not Culturally Expected (Deviance) – deviates from the average or the norm of challenge is keeping up with the literature and integrating the many important recent findings the culture that shape our present understanding of abnormal behavior patterns and their treatment. ▪ Not just to the society but deviation from the person’s usual behavior Today, new scientific investigations and findings are being reported, new assessment techniques are being devised, and innovative methods of treatment are emerging. d. Dangerousness – creates potential harm to self (suicidal gestures) and others (excessive ABNORMAL PSYCHOLOGY DEFINED aggression) A. Abnormal psychology is the branch of science of psychology that deals with the nature, e. Duration - is this change in mental state persistent and of sufficient and significant description, causes, treatment of abnormal behavior patterns. Duration? We know that our mood, thoughts and behaviors to fluctuate constantly, moment to B. Abnormal Psychology – branch of psychology that studies unusual patterns of behavior, moment. This is normal and to be expected. However, if the change in mood and behaviors is emotions, and thought which may or may not indicate an underlying condition. sustained, persistent and pervasive (present across all contexts and situations), it is more concerning. Abnormal behavior in which psychologists and other scholars view this condition are typified by anxiety or depression, but most of us become anxious or depressed from time to E. The duration cut-off is somewhat arbitrary, is decided by expert consensus backed by time, and our behavior is not considered abnormal. It is normal to become anxious or a bit scientific research, and varies among different mental illnesses. excited in anticipation of the final examination or of an important job interview. It is alright to feel depressed when you failed a board examination or when you have lost someone close to o Psychopathology – scientific study of mental disorders you. It is normal to feel down when one failed an examination, but not when one’s grades are excellent. o Clinical Psychology – applied branch of psychology that seeks to understand, assess, and treat psychological conditions in a clinical setting. A question may be asked. When our emotions like anxiety and depression judged abnormal? These feelings may be appraised abnormal when they are not appropriate to the o Normal Behavior – one behavior that is like other people in the society situation. ▪ Normality is social conformity – some behaviors are non-conforming but normal C. Abnormal behavior can become pathological in nature and so leads to the scientific study of psychological disorders, or psychopathology. ▪ Normality is personal comfort D. Mental disorders are characterized by psychological dysfunction which causes physical ▪ Normality is a process and/or psychological distress or impaired functioning and is not an expected behavior according to societal or cultural standards. o Criteria for determining Abnormal Behavior o Psychological Disorder – psychological dysfunction within an individual associated with ✓ Norm-violation distress or impairment in functioning and a response that is not typical or culturally expected ✓ Statistical rarity ✓ Personal Discomfort o 4 D’s of Psychological Disorder ✓ Deviation a. Psychological Dysfunction – refers to a breakdown on cognitive, emotional, or behavioral ✓ Maladaptiveness functioning o Clinical Assessment – the systematic evaluation and measurement of psychological, ▪ Interferes daily functioning biological, and social factors in an individual presenting with a possible psychological disorder b. Distress or Impairment – individual is extremely upset and cannot function properly o Diagnosis – process of determining whether the particular problem afflicting the individual they become prolonged and persisted long after the source of anguish or anxiety has meets all criteria for a psychological disorder been removed. MANIFESTATION OF ABNORMAL BEHAVIOR 5. Behavior is maladaptive or self-defeating. Behavior that leads to unhappiness rather than self-fulfillment can be considered abnormal. Behavior that blocks our Abnormal behavior may be manifested by the magnitude or extent of the problem. desire and ability to function in expected roles, or to adapt to our environments may Psychologists generally agree that behavior may be perceived abnormal when it has also be regarded abnormal. Persistent alcohol consumption that usually impairs one’s some combination of these criteria: health and social or occupational functioning may be considered as abnormal. F. Behavior is unusual. Behavior that is unusual is often considered abnormal. When one Agoraphobic behavior which is characterized by intense fear of going into claims of seeing or hearing things that do not really exist, are almost considered public places is abnormal because it is uncommon. People to have misconceptions of abnormal. Becoming overcome with the feelings of panic when standing in a crowded reality may also be unable to perform their daily responsibilities to the employers and elevator is also uncommon and considered abnormal. families. Hallucination or delusions may preoccupy or confuse people when they should be preoccupied with their responsibilities on their jobs. G. Behavior is socially unacceptable or violates social norms. A person standing on elevated sidewalk and repeatedly shouting “kill” to passerby would be labeled 6. Behavior is dangerous. Behavior that is dangerous to oneself and other people abnormal. Bur shouting “kill” while watching a volleyball game is usually within may be viewed as abnormal. During wartime, soldiers who sacrifice themselves to gain normal norms. freedom with little concern for their own welfare and safety may be characterized as courageous, heroic, nationalistic and patriotic. On the other hand, those who threaten One problem in basing the definition of abnormal behavior on social norms is that or attempt to commit suicide because of problems that seem insurmountable are norms reflect relative standards, not universal truths. What is normal in one culture may be viewed as abnormal. abnormal in another. This situation is illustrated of an American executive who went to Seoul, Korea, and decided to eat local meat for dinner. But he is stunned to learn that the specialty in Abnormal behavior has multiple definitions. In most cases, a combination of Seoul is dog meat because it is believed to improve sex activity. these criteria is use to define abnormality. Some criteria may be weighed more heavily than others. These depend on the existing situation. In Ongpin, in Chinatown in Manila, is not surprising to see stores selling meat of snakes displayed on counters. The Chinese believe that these kinds of food are rich in aphrodisiac that excite sexual desire among men. Chapter 2: Psychological Disorders and Specific Symptoms based on DSM-5 H. Anxiety Disorders Thus, behavior that is deemed normal in one culture may be viewed as abnormal in Differentiating Anxiety disorders another. It is important that clinicians need to weigh cultural differences in determining what I. Separation Anxiety Disorder is normal and abnormal. - concerns with real or imagined separating from attachment figures 3. Perception or interpretation of reality is faulty. Normally, our sensory systems and - separation may lead to extreme anxiety and panic attacks cognitive processes permit us to form accurate mental representations of the things - not entirely responsible for school absences or school avoidance we see in the environment. But seeing things and fearing voices or sounds that are not - do not attend school so they won’t be separated with their attachment figure present are considered hallucinations, which are often signs of mental disorder. By the - fear of possible separation is the central thought same premise, holding unfounded ideas or delusions, such as ideas of persecution that - concerned about the proximity and safety of key attachment figures the MNLF are “out to attack” our barangay again may be regarded as signs of mental - at least 4 weeks (children) or 6 months or more (adults) disturbances. J. Selective Mutism - rare childhood disorder 4. The individual is in severe personal distress. Various states of personal distress - characterized by a lack of speech in one or more setting in which speaking is socially cause by troublesome emotions, e.g., anxiety, fear, and depression, may be considered expected abnormal. Appropriate feelings of distress are not usually considered abnormal unless - restricted to a specific social situation - a child could speak in one setting but cannot/do not in another setting - not better explained by communication disorder - only diagnosed when a child has established a capacity to speak in some social situations - learn to perform avoidance and safety behaviors to avoid disasters - at least 1 month K. Specific Phobia - irrational fear of a specific object or situation that markedly interferes with an individual’s ability to function - acquired through direct experience, experiencing in false alarm, and observation - it only fears one setting, unlike Agoraphobia (which requires 3 settings), then Specific Phobia-Situational can be diagnosed - 6 months or more L. Social Anxiety Disorder - fear or anxiety about possible embarrassment or scrutiny - can have panic attacks but it is cued by social situations - typically have adequate age-appropriate social relationships and social communication - norepinephrine activities are irregular capacity - abrupt surge of intense fear or discomfort out of nowhere, with no triggers - 6 months or more - followed by persistent concerns about more attacks or the consequences of it or maladaptive change in behavior related to the attacks N. Agoraphobia - developed after a person has unexpected panic attacks - fear in two or more situations (public transportation, open spaces, enclosed spaces, standing in line, being outside of the home alone) due to thoughts that escape might be difficult or no one will help them in case panic-like symptoms would manifest - 6 months or more M. Panic Disorder - cannot be diagnosed unless full symptom panic attacks were experienced  - “the world is a dangerous place” - intense cognitive processing in the frontal lobes, particularly in the left hemisphere - intense worrying may act as avoidance - worry whether or not they are judged/evaluated - fear circuit is excessively active P. Trauma-and-Stressor Related Disorders O. Generalized Anxiety Disorder Q. Reactive Attachment Disorder - difficulty to control worry - withdrawn toward adult caregivers - excessive anxiety and worry occurring more days than not for at least 6 months, about a - evident before age 5 years number of events or activities - history of severe social neglect R. Disinhibited Social Engagement Disorder - actively approaches and interacts with unfamiliar adults - can be distinguished from ADHD by not showing difficulties in attention or hyperactivity S. Posttraumatic Stress Disorder - exposure to actual death, injury or sexual violence (direct experience, witness, learning that the event happened to a close family, repeated exposure) - more than 1 month - heightened activity in the HPA axis - requires trauma exposure precede the onset of the symptoms - too much use of dissociation T. Acute Stress Disorder - exposure to trauma (direct experience, witness, learning that event occurred to close fam, repeated exposure) - 3 days to 1 month after trauma exposure - if the symptoms persist for more than 1 month and meet the criteria for PTSD, then PTSD will be diagnosed U. Adjustment Disorder - development of emotional or behavior symptoms in response to identifiable stressors occurring within 3 months of the onset of the stressors - If symptoms persist beyond 6 months after the stressor or its consequences have ceased, the diagnosis will no longer apply - May sometimes be diagnosed instead of bereavement if bereavement is judged to be out of proportion to what would be expected or significantly impairs self-care and interpersonal relations V. Prolonged Grief Disorder - death, at least 12 months, of a person close to the bereaved individual (6 months for children) - focused on loss and separation from a loved one rather than reflecting generalized low mood - distress from a deceased person W. OCD-Related Disorders X. Obsessive-Compulsive Disorder - Obsessions: intrusive and mostly nonsensical thoughts, images, or urges that the individual tries to resist or eliminate - Compulsions: thoughts or actions used to suppress the obsessions and provide relief - Tic Disorders is common to co-occur in patients with OCD - obsessions usually do not involve real life concerns and can include one, irrational, or magical content - In BDD and Tricho, the compulsive behavior is limited to hair pulling or distortions in absence of obsessions - obsessions and compulsions are not limited to concerns about weight and food - Compulsions are usually preceded by obsessions, tics are often preceded by premonitory sensory urges Y. Body Dysmorphic Disorder - preoccupation with some imagined defect - imagined ugliness - excessive appearance-related preoccupations and repetitive behaviors that are time- consuming - can be co-morbid with eating disorders  - Prader-Willi Syndrome: characterized by severe hypotonia, poor appetite, and feeding difficulties in early infancy, followed in early childhood by excessive eating and gradual development of morbid obesity - not direct consequence of neurodevelopmental disorder, nor delusion, nor psychomotor retardation, fatigue, or loss of energy AA. Trichotillomania - should not be diagnosed when hair removal is performed solely for cosmetic reasons - diagnosis will be OCD, if there is obsession of symmetry - someone with ASD could have hair-pulling behaviors when frustrated or angry, so if it’s impairing then it can be diagnosed as stereotypic movement disorder - note the delusion or hallucination, if then, psychotic disorder BB. Excoriation - note delusion or tactile hallucination - In absence of deception, excoriation disorder can be diagnosed if there are repeated attempts to decrease or stop skin picking CC. Somatic Symptom and Related Disorders DD. Somatic Symptom Disorder - one or more symptoms cause distress and disruption of daily life - chronic, influenced by the number of symptoms, age, level of impairment, and any comorbidity - ineffectiveness of analgesics, history of mental disorders, unclear palliative factors, persistence without cessation, and stress - must be accompanied by excessive or disproportionate thoughts, feelings, or behavior - focus is on the distress that particular symptoms cause - individual’s belief that somatic symptoms might reflect serious underlying physical illness are not held with delusional intensity - with enhanced perceptual sensitivity to illness cues Z. Hoarding - difficulty discarding or parting with possessions  - People who develop these disorders tend to have a disproportionate incidence of disease in their family when they were children FF. Conversion Disorder (Functional Neurological Symptom Disorder) EE. Illness Anxiety Disorder - altered voluntary motor or sensory function - preoccupation with having or acquiring serious illness - incompatibility between the symptom and recognized neurological or medical conditions - usually minimal to no symptoms, mild intensity - unexpected neurological disease cause for the symptoms is rarely found at follow-up - interpret ambiguous stimuli as threatening - too much use of denial - develop in the context of a stressful life GG. Psychological Factors affecting other Medical Conditions - medical symptom is present - psychological or behavioral factors affect medical condition - psychological or behavioral factors are judged to affect the course of medical condition II. Dissociative Disorders - Psychological factors affecting other medical conditions are diagnosed when the JJ. Depersonalization-Derealization Disorder psychological traits or behaviors do not meet criteria for a mental diagnosis - Depersonalization: your perception alters so that you temporarily lose the sense of your HH. Factitious Disorder own reality, as if you are in a dream watching yourself - Imposed on Self: individual present himself or herself as ill - Derealization: your sense of external world is lost; thing may seem to change shape or - Imposed on Another: presents another individual as ill size; people may seem dead or mechanical - absence of obvious rewards - characterized by the presence of constellation of typical depersonalization/derealization - Malingering: false medical symptoms or exaggerating existing symptoms in hopes of symptoms and the absence of manifestations of illness anxiety disorder being rewarded - must precede the onset of major depressive epi or clearly continues even after its resolution - when symptoms occur ONLY during panic attacks, it must not be diagnosed with D/DD  - If a person experiencing PTSD cannot recall part or all of specific trauma event and that extends to beyond the immediate time of the trauma, comorbid diagnosis of DA may be warranted - there must be no true neurocognitive deficits - too much use of repression KK. Dissociative Amnesia - inability to recall important autobiographical information, usually of traumatic or stressful nature, that is inconsistent with ordinary forgetting - usually localized or selective amnesia for specific events, then generalized, if entire life history - Dissociative Fugue: memory loss revolves around specific incident, an unexpected trip; individuals just take off and later find themselves in a new place, unable to remember why LL. Dissociative Identity Disorder or how you got there - disruption of identity characterized by two or more distinct personality states - host personality: the person who becomes the patient and asks for treatment; developed later - switch: transition from one personality to another - extreme subtype of PTSD - Hypnotic Trance: tend to be focused on one aspect of their world and they become vulnerable to suggestions by the hypnotist - does not have a classic bipolar sleep disturbance - Individuals with schizophrenia have low hypnotic capacity, whilst, individuals with DID have highest hypnotic capacity among all clinical groups - appear to encapsulate a variety of severe personality disorder features - too much use of dissociation MM. Unipolar Disorders NN. Disruptive Mood Dysregulation Disorder - recurrent temper outburst (verbally or behaviorally) that are grossly out of proportion - 3 or more times/week - irritable or angry most of the day - 12 or more months, at least 2 settings - onset should be after 6 yrs-18yrs - do not occur exclusively during MDE - bipolar = episodic, DMD = persistent - diagnosis cannot be assigned to a child who has ever experienced full-duration hypomanic or manic episode (irritable or euphoric) or who has ever had a manic or hypomanic episode lasting more than 1 day - presence of severe and frequently recurrent outburst and persistent disruption in mood between outburst - severe in at least one setting and mild to moderate to second setting  - in schizoaffective, delusions or hallucinations occur exclusively for 2 weeks without MDE - Seasonal, Catatonic, Melancholic OO. Major Depressive Disorder - at least 2 weeks of either anhedonia or depressed mood - “other specified depressive disorder” can be made in addition to the diagnosis of PP. Persistent Depressive Disorder (Dysthymia) psychotic disorder - depressed mood for at least 2 years - if full criteria for a MDE have been met at some point during the period of illness, a diagnosis of MDD would apply. Otherwise, a diagnosis of “other specified depressive disorder” or “unspecified depressive disorder” should be given - a separate diagnosis of PDD is not made if the symptom occur only during the course of the psychotic disorder - Double Depression: suffer from both MDE and PDD with fewer symptoms o Seasonal Affective Disorder – episodes must have occurred for at least 2 yrs with no evidence of nonseasonal MDE during that period of time ▪ Cabin fever o Integrated Grief – acute grief, the finality of death and its consequences are acknowledged and the individual adjusts to the loss o Complicated Grief – this reaction can develop without preexisting depressed state o bipolar disorder may simply be a more severe variant of mood disorders RR. Bipolar Disorders SS. Bipolar I - at least 1 manic episode - children should be judged according to his or her own baseline in determining whether a particular behavior is normal or evidence of manic episode - first ep usually MDE QQ. Premenstrual Dysphoric Disorder - factors that should be considered: family history, onset, medical history, presence of - majority of menstrual cycles, at least 5 symptoms must be present psychotic symptoms, history of lack of response to antidepressant treatment or the emergence of manic episode during antidepressant treatment - The diagnosis is “Bipolar I disorder, with psychotic features” if the psychotic symptoms have occurred EXCLUSIVELY during manic and major depressive episodes - Symptoms of mania in BP1 occur in distinct episodes and typically begin in late adolescence or early adulthood - When any child is being assessed for Mania, it is essential that the symptoms represent clear change from the child’s typical behavior - Symptoms of mood lability and impulsivity must represent a distinct episode of illness, or there must be a noticeable increase in these symptoms over the individual’s baseline in order to justify an additional diagnosis of BP1 TT. Bipolar II - MDE + Hypomanic episodes - often begins with depressive episodes - highly recurrent - once hypomanic episode has occurred, it never reverts back to MDD - BP2 is distinguished from cyclothymic disorder by the presence of one or more hypomanic episodes and one or more MDE UU. Cyclothymic Disorder - milder but more chronic version of bipolar disorder - do not meet the complete criteria for depressive symptoms and hypomanic symptoms  - self-soothing or self-stimulating YY. Avoidant/Restrictive Food Intake Disorder - eating or feeding disturbance - lack of interest in eating food - dependence on enteral feeding or nutritional supplements - requires that the disturbance of intake is beyond that directly accounted for by physical symptoms consistent with medical condition; the eating disturbance may also persist after being triggered by medical condition and following resolution of the medical condition - if eating problems is the focus, then A/RFID, if weight, then Anorexia Nervosa - might precede the onset of Anorexia Nervosa ZZ. Anorexia Nervosa - fear of gaining weight - subtypes: binge-eating/purging type and restricting type - associated with stressful life event - BDD may be considered if the distortion is unrelated to body shape and size - amenorrhea and cardiovascular problems - very underweight VV. Eating Disorders WW. Pica - eating of non-nutritive, nonfood substances for at least 1 month - inappropriate to the developmental age XX. Rumination Disorder - repeated regurgitation of food for at least 1 month - re-chewed, re-swallowed, or spit-out - not attributable to gastrointestinal or other medical condition  BBB. Binge-Eating Disorder - recurrent episodes of just binge eating - do not show marked or sustained dietary restriction designed to influence body weight and shape between binge-eating episodes - usually overweight AAA. Bulimia Nervosa - recurrent episodes of binge-eating then purging to prevent weight gain - binge-eating for at least once a week for 3 months - normal weight - chronic purging can result to enlargement of salivary gland caused by repeated vomiting, causing chubby face - electrolyte imbalance that may lead to arrythmia, seizures, and renal failure  - repeated passage of feces into inappropriate places FFF. Sleeping Disorders GGG. Insomnia - difficulty initiating and maintaining sleep - early-morning awakening with inability to return to sleep - at least 3 nights/week, for at least 3 months - Rebound Insomnia: sleep problems re-appearing, but sometimes worst - situational, persistent, or recurrent, episodic HHH. Hypersomnolence Disorder - excessive sleepiness despite having at least 7 hours of main sleep - recurrent periods of sleep or lapses into sleep within the same day - take longer naps, have trouble waking from naps, and do not feel alert afterward - at least 3x/week, for at least 3 months III. Narcolepsy - recurrent episodes of irrepressible need to sleep, lapsing into sleep, or napping with cataplexy, hypocretin deficiency, and evidence from polysomnography showing REM sleep latency less than or equal to 15 mins - 3x/week, for at least 3 months JJJ. Obstructive Sleep Apnea Hypopnea - at least 4 obstructive apneas or hypopneas per hour of sleep or evidence from polysomnography of 15 or more obstructive apneas and/or hypopneas per hour of sleep - Apnea: absence of airflow - Hypopnea: reduction in airflow KKK. Central Sleep Apnea - evidence by polysomnography of 5 or more central apneas per hour of sleep - Cheyne-Stokes Breathing: an abnormal pattern of breathing characterized by progressively deeper, and sometimes faster, breathing followed by a gradual decrease that results in a temporary stop in breathing called an apnea LLL. Sleep-Related Hypoventilation - Polysomnography demonstrates episodes of decreased respiration associated with elevated CO2 levels MMM. Circadian Rhythm Sleep-Wake Disorders - persistent or recurrent pattern of sleep disruption due to alteration of the circadian system or misalignment between the endogenous circadian rhythm - leads to excessive sleepiness or insomnia, or both NNN. Non-REM Sleep Arousal Disorders - incomplete awakening from sleep: sleepwalking or sleep terrors - cannot remember anything when they woke up CCC. Elimination Disorders - occur mostly in childhood and non-rem sleeps DDD. Enuresis - produce rapid and complete awakening without confusion, amnesia, or motor activity - repeated voiding of urine in bed, voluntary or OOO. Nightmare Disorder intentional - repeated occurrences of extended, extremely dysphoric, and well-remembered dreams EEE. Encopresis that usually involve efforts to avoid threats to survival, security, or physical integrity - upon awakening, they become oriented and alert - appear in children exposed to acute or chronic psychosocial stressors - occur during REM Sleep PPP. REM Sleep Behavior Disorder - repeated episodes of arousal during sleep associated with vocalization and/or complex motor behaviors - during REM sleep - upon awakening, the individual is completely awake, alert, and not confused QQQ. Restless Legs Disorder - urge to move the legs, usually accompanied or in response to uncomfortable and unpleasant sensations of the legs - during rests - sense of relief during the movement - worse in evening - 3x/week, for at least 3 months RRR. Sexual Dysfunctions SSS.Delayed Ejaculation - delay or absence of ejaculation - at least 6 months - either lifelong or acquired, generalized or situational TTT. Erectile Disorder - difficulty having, maintaining erection and decrease in erectile rigidity - at least 6 months UUU. Female Orgasmic Disorder - delay or absence of orgasm and reduced intensity of orgasmic sensations - at least 6 months - either lifelong or acquired, generalized or situational VVV. Female Sexual Interest/Arousal Disorder - absent/reduced interest in sexual activity - no sexual thoughts or fantasies, no initiation, no sexual excitement or pleasure during sex - at least 6 months  - anxiety about anticipating vulvovaginal or pelvic pain - at least 6 months XXX. Male Hypoactive Sexual Disorder - persistently deficient or absent sexual/erotic thoughts or fantasies and desire for sexual activity - at least 6 months YYY. Premature (Early) Ejaculation - ejaculation approx. 1 min following vaginal penetration or even before the individual wishes it - at least 6 months and must be experienced on almost all or all occasions WWW. Genito-Pelvic Pain/Penetration Disorder - difficulties in vaginal penetration during intercourse ZZZ. Paraphilic Disorders - vaginal pain during intercourse or penetration attempts AAAA. Voyeuristic Disorder - intense arousal from observing an unsuspecting naked person for at least 6 months - nonconsensual - at least 18 yrs old DDDD. Sexual Masochism - intense sexual arousal from the act of being humiliated, beaten, bound, or otherwise made to suffer for at least 6 months EEEE. Sexual Sadism - intense sexual arousal from the physical suffering of another person for at least 6 months FFFF. Pedophilic Disorder - intense sexually arousing fantasies, urges, or behaviors involving prepubescent child or children for at least 6 months - has ACTED on these urges - at least 16 yrs old and at least 5 yrs older than the child or children GGGG. Fetishistic Disorder - intense sexual arousal from either the use of nonliving objects or highly specific focus on nongenital body parts for at least 6 months - not limited to cross-dressing or sex toys BBBB. Exhibitionistic Disorder - intense arousal from exposing genitals to an unsuspecting person for at least 6 months - nonconsensual CCCC. Frotteuristic Disorder - intense arousal from touching or rubbing genitals against nonconsenting person for at least 6 months - nonconsensual  IIII. Disruptive, Impulse-Control disorders, and Conduct Disorder JJJJ. Oppositional Defiant Disorder - angry irritable mood, argumentative/defiant behavior against authority figure for at least HHHH. Transvestic Disorder 6 months - intense arousal from cross-dressing for at least 6 months - annoys others - blames others for his/her mistakes - precedes the development of conduct disorder - conveys risk for the development of anxiety disorders and MDD - increased risk for a number of problems in adjustment as adults - less severe than CD and do not include aggression towards people, property (IED) - co-morbid with ADHD - diagnosis should not be made if the symptoms occur exclusively during the course of a mood disorder - if criteria for DMDD are met, then DMM is given even if all criteria for ODD are met KKKK. Intermittent Explosive Disorder - behavioral outburst, failure to control aggressive impulses - verbal aggression, physical aggression twice weekly for a period of 3 months - at least 6 yrs of age - quite common regardless of the presence of ADHD or other disruptive, impulse-control, and conduct disorders - Also should not be made in children and adolescents ages 6-18 years, when the impulsive aggressive outbursts occur in the context of an adjustment disorder - A diagnosis of DMDD can only be given when the onset of recurrent, problematic, share common features that resemble some of the psychotic symptoms seen in impulsive aggressive outburst is before age of 10 years schizophrenia. - A diagnosis of DMDD should be made for the first time after 18 years PPPP. Paranoid - Aggression in ODD is typically characterized by temper tantrums and verbal arguments - excessively mistrustful and suspicious of others, without justification with authority figures, whereas IED are in response to a broader array of provocation and - more common among relatives who have schizophrenia include physical assault - maybe due to early mistreatment or traumatic childhood experiences LLLL. Conduct Disorder - associated with prior history of childhood mistreatment, externalizing symptoms, - repetitive and persistent pattern of behavior in which the basic rights of others or major bullying, and adult appearance of interpersonal aggression age-appropriate societal norms or rules are violated - “I cannot trust people” - often bullies, initiates fights, physically cruel, destroying properties, theft, serious - too much use of projection violation of rules - Onset may occur as early as the preschool years, but the first significant symptoms usually emerge during the period from middle childhood through middle adolescence - ODD is the most common precursor to the childhood-onset type - Physically aggressive symptoms = childhood - Nonaggressive symptoms = adolescence - May be diagnosed in adults, though onset is rare after age 16 years - Childhood-onset type predicts a worse prognosis and an increased risk of criminal behavior in adulthood - When criteria for both ODD and CD are met, both diagnoses can be given - When criteria for both ADHD and CD are met, both diagnoses can be given - Individuals with conduct disorder will display substantial levels of aggressive or nonaggressive conduct problems during periods in which there is no mood disturbance, either historically or concurrently - If criteria for both IED and CD has been met, the diagnosis of IED should be given only when the recurrent impulsive aggressive outbursts warrant independent clinical attention - CD is diagnosed only when the conduct problems represent a repetitive and persistent pattern that is associated with impairment in social, academic, or occupational functioning MMMM. Pyromania - purposeful fire setting on more than one occasion - arousal before the act - fascination to fire and its situational context - not done for monetary gain or etc. - separate diagnosis is not given when fire setting occurs as part of CD, manic episode, or antisocial personality disorder NNNN. Kleptomania - failure to resist impulses to steal objects that are not need for personal use - increase tension before committing the theft - pleasure after committing the theft OOOO. Personality Disorders Cluster A—Odd or Eccentric Disorders Three personality disorders—paranoid, schizoid, and schizotypal—  RRRR. Schizotypal - typically socially isolated and behave in ways that would seem unusual to many of us, and they tend to be suspicious and to have odd beliefs QQQQ. Schizoid - “ideas of reference” – false beliefs that random or irrelevant occurrences in the world - detachment from social relationships and limited range of emotions directly relate to oneself - tendency to turn inward and away from the outside world - have odd beliefs or engage in magical thinking - childhood shyness is reported as a precursor to later personality disorder - associated with childhood mistreatment and could be resulted from PTSD symptoms - “Relationships are messy and undesirable” - “It is better to be isolated from others” - tend to be overly dramatic and almost to be acting - express emotions in an exaggerated manner - histrionic and antisocial co-occur more often - “ako ang bida” - “People are there to serve or admire me” TTTT. Borderline - moods and relationships are unstable, and usually they have poor self-image - often feel empty and are great risk of dying by their own hands - often engage to suicidal behaviors - tend to have turbulent relationships, fearing abandonment but lacking control over their Cluster B—Dramatic, Emotional, or Erratic Disorders emotions SSSS. Histrionic - often intense, going from anger to deep depression in a short time - prevalent in families with history of mood disorders - if co-occurs with mood disorders, both are diagnosed - they consider themselves different from others and deserve special treatment - recovery is more difficult and less stable - unreasonable sense of self-importance and are so preoccupied with themselves that they - “I deserve to be punished” lack sensitivity and compassion - grandiosity - “I am the greatest in the world” - “Since I am special, I deserve special rules.” UUUU. Narcissistic VVVV. Antisocial - characterized as having history of failing to comply with social norms - at least 18 years of age - evidence of CD before 15 years old - irresponsible, impulsive, and deceitful - lacking in conscience and empathy, selfishly take what they want and do as they please, violating social norms and expectations - CD will be given if the criteria for Antisocial PD is not met - Underarousal Hypothesis: psychopaths have abnormally low levels of cortical arousal - Fearlessness Hypothesis: psychopaths possess a higher threshold for experiencing fear than most other individuals - “I am entitled to break rules” Cluster C—Anxious or Fearful Disorders People diagnosed with the next three personality disorders we highlight—avoidant, dependent, and obsessive-compulsive— share common features with people who have anxiety disorders. WWWW. Avoidant - extremely sensitive of the opinion of others and although they desire social relationship, their anxiety leads them to avoid - extremely low self-esteem cause them to be limited with friendships and dependent to those they feel comfy with - feel chronically rejected by others and pessimistic about their future - negative self-concept - Social Anxiety Disorder – negative evaluations - “If they knew the real me, they would reject me” YYYY. Obsessive-Compulsive - perfectionist XXXX. Dependent - rely on others to make ordinary decisions and even important ones which result in an - fixation on things being done “the right way” unreasonable fear of abandonment - this preoccupation with details prevents them from completing much of anything - need to control - agree with other people’s opinion just to be not rejected - feel uncomfortable or helpless when alone - when criteria for both OCD and OCPD are met, both can be given - “I am perfectionist, everything should be done under my control and liking” - “I need people to survive and be happy” - “People should do better, try harder.”  o Emil Kraepelin – unified the distinct categories of schizophrenia under the name Dementia Praecox ▪ Combined several symptoms of insanity that had usually been viewed as reflecting separate and distinct disorders: a. Catatonia – alternating immobility and excited agitation b. Hebephrenia – silly and immature emotionality c. Paranoia – delusions of grandeur or persecution ▪ Distinguished dementia praecox ▪ Also noted the numerous symptoms in people with dementia praecox, including hallucinations, delusions, negativism, and stereotyped behavior o Eugen Bleuler – introduced the term schizophrenia (“splitting of mind”) ▪ Associative Splitting o Positive Symptoms: 1. Delusions – misrepresentation of reality (disorder of thought content) ▪ Persecutory – belief that one is going to be harmed, harassed and so forth ▪ Referential – certain gestures, comments, environmental cues, and so forth are directed at one-self) ▪ Grandiose – when an individual believes that he or she has exceptional abilities, wealth, or fame ▪ Erotomanic – when an individual believes falsely that another person is in love with him or her ▪ Nihilistic – conviction that a major catastrophe will occur ▪ Somatic – focus on preoccupations regarding health and organ function ▪ Thought Withdrawal – thoughts have been “removed” by outside force ▪ Thought Insertion – thoughts have been put into one’s mind ▪ Delusions of Control – one’s body or actions are being acted on or manipulated by some outside force ▪ Capgras Syndrome – person believes someone he or she knows has been replaced by a double ▪ Cotard’s Syndrome – the person believes he or she is dead ▪ Clerambault Syndrome - characterized by the delusional idea, usually in a young woman, that a man whom she considers to be of higher social and/or professional standing is in love with her ▪ Fregoli Syndrome – a person holds a delusional belief that different people are in fact a single person who changes his or her appearance or is in disguise ▪ Motivational View of Delusions – look at these beliefs as attempts to deal with and ZZZZ. Schizophrenia Spectrum and Other Psychotic Disorders relieve anxiety and stress o John Haslam – superintendent of a British Hospital who outlined a description of the ▪ Deficit View of Delusions – sees these beliefs as a resulting from brain dysfunction that symptoms of Schizophrenia in his book Observations on Madness and Melancholy creates these disordered cognitions or perceptions o Philippe Pinel – French physician who described cases of schizophrenia 2. Hallucinations – experience of sensory events without any input from the surrounding o Benedict Morel – used the term demence precoce meaning early or premature loss of environment mind to describe schizophrenia ▪ Auditory Hallucination – most common form experienced by people with o Families with high expressed emotion view the symptoms of schizophrenia as schizophrenia controllable and that the hostility arises when family members think that patients just do ▪ Most active part during Hallucination is Broca’s Area (speech production) not want help themselves ▪ Autoscopic Hallucination – individual experiences, all or part of the person's own body Types: appeared within the external space, viewed from AAAAA. Delusional Disorder his/her physical body - one or more delusions for at least 1 month - persistent belief that is contrary to the reality ▪ Hypnagogic Hallucination – happens during sleep in the absence of other characteristics of schizophrenia - tend not to have flat affect, anhedonia, or other negative symptoms ▪ Ictal Hallucination – associated with temporal lobe foci - socially isolated due to being suspicious ▪ Hypnopompic Hallucinations – happens when waking up - Shared Psychotic Disorder (Folie a Deux): condition in which an individual develops o Negative Symptoms – usually indicate absence or insufficiency of normal behavior delusions simply as a result of a close relationship with a delusional individual a. Avolition – inability to initiate and persist activities - Erotomanic, Grandiose, Jealous, Persecutory, Somatic, Mixed, Unspecified b. Anhedonia – lack of pleasure - functioning is better than what is observed in Schizophrenia c. Asociality – lack of interest in social interactions - eventually develop schizophrenia d. Flat Affect/Affective Flattening – do not show emotions when you would normally - absence of active phase of schizophrenia expect them to BBBBB. Brief Psychotic Disorder o Disorganized Symptoms - presence of one of the ff: delusions, hallucinations, disorganized speech, catatonic 1. Disorganized Speech – individual may switch from one topic to another (derailment or behavior for at least 1 day but less than 1 month, with eventual full return to premorbid loose associations) or answers to questions may be related or completely unrelated level of functioning (tangentiality) - can experience relapse ▪ Word Salad - if psychotic symptoms persist for at least 1 day in PD, an additional diagnosis of Brief ▪ Clang associations – are groups of words chosen because of the catchy way they sound, Psychotic Disorder may be appropriate not because of what they mean CCCCC. Schizophreniform Disorder 2. Inappropriate Affect – laughing or crying at improper times - two or more of the following, present during a 1-month period: delusions, hallucinations, 3. Grossly Disorganized or abnormal motor behavior – childlike silliness to disorganized speech, catatonic behavior, negative symptoms unpredictable agitation - at least 1 month BUT less than 6 months o Neologisms – construction of new words in order to communicate with schizophrenics - development similar to schizophrenia thoughts DDDDD. Schizophrenia o More severe symptoms of schizophrenia first occur in late adolescence or early - two or more of the following, present during 1-month period: delusions, hallucinations, adulthood disorganized speech, catatonic behavior, negative symptoms o Prodromal Stage – 1-2 year period before the serious symptoms occur but when less - disturbance in one or more major areas severe yet unusual behaviors start to show themselves - at least 6 months o Schizophrenia is partially the result of excessive stimulation of striatal dopamine d2 - abrupt or insidious receptors - prognosis is influenced both by duration and by severity of illness and gender o It appears that several brain sites are implicated in the cognitive dysfunction observed - possible reduced psychotic experience during late life among people with schizophrenia, especially prefrontal cortex, various related cortical - too much use of regression regions and subcortical circuits, EEEEE. Schizoaffective Disorder including thalamus and the striatum - major mood ep + delusions or hallucinations for 2 or more weeks o Schizophrenogenic Mother – used for a time to describe a mother whose cold, - some individuals tend to change diagnosis into mood disorder or to schizophrenia over dominant, and rejecting nature was thought to cause schizophrenia in her children time o Double bind communication – used to portray communication style that produced conflicting messages, which cased schizophrenia to develop  - difficulties in acquisition and use of language modalities due to DEFICITS in comprehension and production - reduced vocab, limited sentence structure, impairments in discourse - regional, social, or cultural/ethnic variations must be considered when an individual is being assessed - declines in critical social communication behavior during the first two years of life are evident in most children with ASD, thus, it must be not confused with LD JJJJJ. Speech Sound Disorder - difficulty in speech sound production - children’s progression in mastering speech sound production should result in most intelligible speech by 3 years old - continuous use of immature phonological simplification processes when the child has already passed the age wherein most of them can now produce words clearly - when LD is present, Speech Sound Disorder has poorer prognosis - selective mutism may develop KKKKK. Childhood-Onset Fluency Disorder (stuttering) - disturbances in normal fluency and time patterning of speech that are inappropriate for the individual’s age and language skills - can be insidious or more sudden LLLLL. Social (Pragmatic) Communication Disorder - difficulties in the social use of verbal and nonverbal communication - deficits in using communication for social purposes in a manner that is appropriate for the social context - difficulties in following the rules of conversating and do not understand metaphors, etc. - current symptoms or developmental history fails to reveal evidence that could meet the restrictive/repetitive patterns of behavior, interests, or activities of ASD FFFFF. Neurodevelopmental Disorders MMMMM. Autism Spectrum Disorder GGGGG. Intellectual Developmental Disorder - deficient Communication, Restrictive/Repetitive Actions/Behaviors, Impaired Social - includes both intellectual and adaptive functioning deficits in conceptual, social, and Interaction practical domains - evident in early childhood - difficulties with day-to-day activities to an extent that reflects both severity of their - failure to develop age-appropriate social relationships, social reciprocity, nonverbal cognitive deficits and the type and amount of assistance their receive comms, and initiating and maintaining social relationships - difficulties in conceptual, social, and judgement - inability to engage in joint attention - causes: deprivation, abuse, neglect, exposure to disease or drugs during pre-natal, - maintenance of sameness difficulties during labor and delivery, infections, and head injury - The developmental course and absence of restrictive, repetitive behaviors and unusual - Phenylketonuria, Lesch-Nyhan Syndrome, Down Syndrome, Fragile X Syndrome interests in ADHD help in differentiating ASD and ADHD - generally nonprogressive, there are period of worsening, then stabilization, and in others - A concurrent diagnosis of ADHD should be considered when attentional difficulties or progressive of intellectual function in varying degrees hyperactivity exceeds that typically seen in individuals - lifelong of comparable mental age HHHHH. Global Developmental Delay - ADHD is one of the most common comorbidities in ASD - for children under 5 years old when they fail to meet expected developmental milestone - A diagnosis of ASD in individual with IDD is appropriate when social communication and in several areas of functioning interaction are significantly impaired relative to the IIIII. Language Disorder developmental level of the individual’s nonverbal skills - IDD is appropriate diagnosis when there is no apparent discrepancy between the level of TTTTT. Delirium social communicative skills and other intellectual skills - characterized by impaired consciousness and cognition during the course of several - The diagnosis of ASD supersedes that of social communication disorder whenever the hours or days criteria for ASD are met, and care should be taken to enquire carefully regarding past or - appear confused, disoriented, and out of touch with their surroundings current restricted/repetitive behavior - effects may more lasting NNNNN. Rett Disorder - can be experienced by children who have high fevers or taking certain medication - genetic condition that affects mostly females and is characterized by hand wringing and - reversible poor coordination - occurs during the course of dementia - Clear genetic component - full recovery with or without treatment - Evidence of brain damage combined with psychosocial influences UUUUU. Major Neurocognitive Disorder OOOOO. Attention-Deficit/Hyperactivity Disorder - gradual deterioration of brain functioning that affects memory, judgement, language, and - pattern of inattention and/or hyperactivity-impulsivity that interferes functioning for at other advanced cognitive process least 6 months VVVVV. Mild Neurocognitive Disorder - dislikes organization, focused work - early stages of cognitive declines - often losses things, forgets daily activities, and easily distracted - most impairments in cognitive abilities but can, with some accommodations - fidgets a lot, stands up when seating is expected, always “on the go” o Dementia – describe a group of symptoms affecting memory, thinking, and social - present in two or more settings abilities severely enough to interfere daily life - difficulty sustaining their attention on task or activity WWWWW. Alzheimer’s - in pre-school, main manifestation is hyperactivity – most common type of neurocognitive disorder, usually occurring after the age 65, - Fidgetiness and restlessness in ADHD are typically generalized and not characterized by marked most prominently by memory impairment repetitive stereotypic movements - Usually begins with mild memory problems, lapses of attention, and difficulties in - A diagnosis of ADHD in IDD requires that inattention or hyperactivity be excessive for language and communication mental age Specific Learning Disorder - Excessive senile plaques (sphere-shaped deposits of beta-amyloid protein that form in - difficulties learning and using academic skills for at least 6 months, despite interventions the spaces between certain neurons and in certain blood vessels of the brain as people - academic skills are substantially and quantifiably below those expected for the age) and neurofibrillary tangles (twisted individual’s chronological age, IQ, and education protein fibers that form within certain neurons) PPPPP. Developmental Coordination Disorder - includes multiple cognitive deficits that develop gradually and steadily - acquisition and execution of coordinated motor skills are below expected given the - inability to integrate new information results to failure to learn new association chronological age - Anomia, Apraxia, Agnosia, Amnesia, Aphasia - clumsiness, slowness, and inaccuracy of performance of motor skills - cognitive deterioration is slow during the early and later stages but more rapid during QQQQQ. Stereotypic Movement Disorder middle stages - repetitive, seemingly driven, and apparently purposeless motor behavior XXXXX. Vascular Injury - may result in self-injury - when the blood vessels in the brain are blocked or damaged and no longer carry oxygen RRRRR. Tic Disorders and other nutrients to certain areas of brain tissues, damage - Tourette’s: both motor and one or more vocal tics for more than 1 year results - Persistent: single or multiple motor or vocal tics, but NOT BOTH for more than 1 year - declines in speed of information processing and executive functioning - Provisional: single or multiple more and/or vocal tics for less than 1 year since the first YYYYY. Frontotemporal Degeneration onset - categorize a variety of brain disorders that damage the frontal or temporal regions of the - Motor Stereotypies are defined as involuntary rhythmic, repetitive, predictable brain – areas that affect personality, language, and behavior movements that appear purposeful but serve no obvious adaptive function; often self- - declines in appropriate behavior or language soothing or pleasurable and stop - Pick’s Disease: rare neurological condition that produces symptoms similar to with distraction Alzheimer’s, usually occurring in relatively early in life (40s or 50s) ZZZZZ. Traumatic Brain Injury SSSSS. Neurocognitive Disorders - symptoms must persist for at least a week following the trauma, including executive dysfunction and problems with learning and memory AAAAAA. Lewy Body Disease - involves the buildup of clumps of protein deposits called Lewy Bodies, within many neurons - Features significant movement difficulties, visual hallucinations, and sleep disturbances - Second most common neurocognitive disorder - gradual and include impairment in alertness and attention, vivid visual hallucinations, and motor impairment BBBBBB. Parkinson’s Disease - slowly progressive neurological disorder marked by tremors, rigidity, and unsteadiness - motor problems, tend to have stooped posture, slow body movements (bradykinesia), tremors, and jerkiness - damage in dopamine pathways CCCCCC. HIV Infection - HIV infection seems to be responsible for the neurological impairment - early symptoms: cognitive slowness, impaired attention, and forgetfulness - clumsy, repetitive movements, and become apathetic and socially withdrawn - sometimes referred as Subcortical Dementia - more likely to experience depression and anxiety DDDDDD. Substance-Use - use of different psychoactive substances + poor diet - include memory impairment, aphasia, apraxia, agnosia, or disturbance in executive o Physiological Dependence – meaning the use of increasingly greater amounts of the functioning drug to experience the same effect (tolerance) and a negative physical response when the EEEEEE. Huntington’s substance is no longer ingested (withdrawal) - inherited progressive disease in which memory problems, along with personality changes Alcohol – produced when certain yeast reacts with sugar and water, then fermentation and mood difficulties, worsen over time takes place - Have movement problems too, such as severe twitching and spasms - depressant FFFFFF. Prion Disease - inhibitions are reduced and we become more outgoing - caused by prions (proteins that can reproduce and cause damage to brain cells leading to - with more drinking, alcohol depresses the brain which impedes the functioning neurocognitive decline - Withdrawal Delirium (Delirium Tremens): condition that can produce frightening - no treatment but not contagious hallucinations and body tremors - Creutzfeldt-Jakob Disease: symptoms include spasms of the body caused by slow acting - Breathalyzer: measures levels of intoxication virus that may live in the body for years before the disease develops - GABA seems to be particularly sensitive to alcohol - The Glutamate system is involving why alcohol affects our cognitive abilities GGGGGG. Substance-Related and Addictive Disorder - Two types of organic brain syndromes may result from long-term alcohol use: Dementia o Substance – chemical compounds that are ingested to alter mood or behavior and Wernicke-Korsakoff Syndrome (Confusion, loss of muscle coordination, and o Psychoactive substances – alter mood, behavior, or both unintelligible speech, believed to be cause by a deficiency of thiamine) o Substance Use – ingestion of psychoactive substances in moderate amounts that does - Fetal Alcohol Syndrome not significantly interfere with social, educational, or - Alcohol Dehydrogenase: metabolize alcohol occupational functioning - Korsakoff syndrome: is a chronic memory disorder caused by severe deficiency of o Substance Intoxication – physiological reaction to ingested substances thiamine (vitamin B-1). o Substance Use Disorders – how much of a substance is ingested is problematic - Korsakoff syndrome is most caused by alcohol misuse, but certain other conditions also can cause the syndrome Caffeine – most common psychoactive substance - “gentle stimulant” o Positive and Negative Reinforcement - found in tea, coffee, soda, and cocoa products o Opponent-Process Theory – an increase in positive feelings will be followed shortly by Cannabis (Marijuana) – reactions include mood swings or even dream-like experiences an increase in negative feelings and vice versa - chronic and heavy users report tolerance, especially to euphoric high: they are unable to o Expectancy Effect – expectancies develop before people actually use drugs, perhaps as a reach the levels of pleasure they experienced earlier result of loved one’s use, advertising, etc. Hallucinogens – most common, “LSD” produced synthetically in the laboratory o Treatment: Nicotine replacement therapy, Bupropion, Naltrexone, Acamprosate, - others: psilocybin (mushroom), lysergic acid amide (seeds of morning glory plant), Disulfiram, Methadone, Buprenorphine, Aversion Therapy, Inpatient treatments, Aversion dimethyltryptamine (DMT), and mescaline Therapy, etc. - Phencyclidine (PCP) is snorted, smoked, or injected intravenously, and it causes o Cross-Tolerance – tolerance for a substance has not taken before as a result of using impulsivity and aggressiveness another substance similar to it o Synergistic Effect – an increase of effects that occurs when more than one substance is Inhalant – solvents, aerosol sprays, gases, nitrites, usually found at home or workplace acting on the body at the same time Opioid – natural chemicals in the opium poppy that have narcotic effect (relieves pain and HHHHHH. Gambling Disorder induce sleep) - persistent and recurring gambling behavior - at least 4-symptoms within 12 months - includes natural opiates, synthetic variation, and the comparable substances that occur - Onset can occur during adolescence or young adulthood but in other individuals it naturally in the brain manifests during middle or even older adulthood - also includes Heroin - Progression appears to be more rapid in women than in men Sedative-, Hypnotic-, or Anxiolytic- - calming, sleep-inducing, and anxiety-reducing - An additional diagnosis of gambling disorder should be given only if the gambling - includes barbiturates and benzodiazepines behavior is not better explained by manic episodes - barbiturates and benzodiazepines relax the muscles and can produce mild feeling of well being - combining alcohol with these substances can be fatal (Manilyn Monroe case) Stimulant – most commonly consumed psychoactive drugs in US - includes caffeine, nicotine, amphetamines, and cocaine - Amphetamine: can induce feelings of elation and vigor and can reduce fatigue; prescribed to people with narcolepsy and ADHD - another variants of Amphetamine are Methylenedioxymethamphetamine or ecstasy club drug (makes you feel euphoric) and methamphetamine (crystal meth) - Cocaine: increases alertness, produces euphoria, increases blood pressure and pulse, and causes insomnia and loss of appetite - Intranasal use and oral use of substances result in more gradual progression occurring over months to years Tobacco – contains nicotine - linked with signs of negative affect such as depression, anxiety, and anger - being depressed increases your risk of becoming dependent on nicotine and, at the same time, being dependent will increase your risk of becoming depressed o Acute alcohol withdrawal occurs as an episode usually lasting 4-5 days and only after extended periods of heavy drinking o Withdrawal is rare for individuals younger than 30 years o The symptoms of an alcohol-induced mental disorder are likely to remain clinically relevant as long as the individual continues to experience severe intoxication or withdrawal o Genetic factors may affect how people experience and metabolize certain drugs