2.  Defining and diagnosing disorder  Anxiety disorders  Mood disorders  Personality disorders  Dissociative identity disorder  Schizophrenia

3.  Possible Models for Defining Disorders: Mental disorder as a violation of cultural standards. Mental disorder as maladaptive or harmful behaviour. Mental disorder as emotional distress.  Mental Disorder Any behaviour or emotional state that causes an individual great suffering or worry, is self-defeating or self-destructive, or is maladaptive and disrupts the person’s relationships or the larger community.

4.  Axis I: Primary clinical problem  Axis II: Personality disorders  Axis III: General medical conditions  Axis IV: Social and environmental stressors  Axis V: Global assessment of overall functioning

5.  When the manual is used correctly and diagnoses are made with valid objective tests, the DSM improves the reliability of and agreement among clinicians.  The DSM-IV included for the first time a list of culture-bound syndromes, disorders specific to a particular culture.

6.  Projective Tests Psychological tests used to infer a person’s motives, conflicts, and unconscious dynamics on the basis of the person’s interpretations of ambiguous stimuli.  Rorschach Inkblot Test A projective personality test that asks respondents to interpret abstract, symmetrical inkblots. A sample inkblot

7.  Inventories Standardized objective questionnaires requiring written responses; they typically include scales on which people are asked to rate themselves.  Minnesota Multiphasic Personality Inventory (MMPI) A widely used objective personality test.

8.  Anxiety and panic  Fears and phobias  Obsessions and compulsions

9.  Generalized Anxiety Disorder

11.  An anxiety disorder in which a person experiences: recurring panic attacks, periods of intense fear, and feelings of impending doom or death, accompanied by physiological symptoms such as rapid heart rate and dizziness.

12.  Phobia

13.  A set of phobias, often set off by a panic attack, involving the basic fear of being away from a safe place or person.

14. .

15.  Depression and Bipolar Disorder  Theories of Depression

16.  Major Depression

17.  Depressed mood  Reduced interest in almost all activities  Significant weight gain or loss, without dieting  Sleep disturbance (insomnia or too much sleep)  Change in motor activity (too much or too little)  Fatigue or loss of energy  Feelings of worthlessness or guilt  Reduced ability to think or concentrate  Recurrent thoughts of death DSM IV Requires 5 of these within the past 2 weeks

18.  Women are about twice as likely as men to be diagnosed with depression. True around the world  After age 65, rates of depression drop sharply in both sexes.

19.  Bipolar Disorder: A mood disorder in which episodes of depression and mania (excessive euphoria) occur.

20.  Bipolar disorder can have rapid mood swings  These wild changes are shown in brain activity (right)

21.  Biological explanations emphasize genetics and brain chemistry.  Social explanations emphasize the stressful circumstances of people’s lives.  Attachment explanations emphasize problems with close relationships.  Cognitive explanations emphasize particular habits of thinking and ways of interpreting events.  “Vulnerability-Stress” explanations draw on all four explanations described above.

23.  Problem Personalities  Antisocial Personality Disorder

24.  Personality Disorder  Narcissistic Personality Disorder  Borderline Personality Disorder

25.  A disorder characterized by antisocial behaviour such as lying, stealing, manipulating others, and sometimes violence; and a lack of guilt, shame and empathy.

26.  Must have 3 of these criteria and a history of behaviours Repeatedly break the law. They are deceitful, using aliases and lies to con others. They are impulsive and unable to plan ahead. They repeatedly get into physical fights or assaults. They show reckless disregard for own safety or that of others. They are irresponsible, failing to meet obligations to others. They lack remorse for actions that harm others.

27.  Abnormalities in central nervous system.  Genetically influenced problems with impulse control.  Brain damage.

28.  75% of US Soldiers who tested “drug positive” reported being addicted during their tour.  Fewer reported post- Vietnam drug use (blue bar).  Even fewer still showed dependency(green bar).  This contradicts what the biomedical model of addiction would predict.

29.  Defining identity disorders  The MPD controversy  The sociocognitive explanation

30.  A controversial disorder marked by the appearance within one person of two or more distinct personalities, each with its own name and traits; commonly known as “Multiple Personality Disorder (MPD).”

31.  First view MPD is common but often unrecognized or misdiagnosed. The disorder starts in childhood as means of coping. Trauma produced a mental splitting.  2nd view Created through pressure and suggestions by clinicians. Handful of cases to tens of thousands since 1980.

32.  MPD is an extreme form of our ability to present many aspects of our personalities to others.  MPD is a culturally acceptable way for some troubled people to make sense of their problems.  Therapists looking for MPD may reward patients with attention and praise for revealing more and more personalities.

33.  Symptoms of schizophrenia  Theories of schizophrenia

34.  Bizarre delusions  Hallucinations and heightened sensory awareness  Disorganized, incoherent speech  Grossly disorganized and inappropriate behaviour

35.  Delusions False beliefs that often accompany schizophrenia and other psychotic disorders.  Hallucinations Sensory experiences that occur in the absence of actual stimulation.

36.  Cognitive, emotional, and behavioural excesses Examples of Positive Symptoms  Hallucinations  Bizarre delusions  Incoherent speech  Inappropriate/Disorganized behaviours

37.  Cognitive, emotional, and behavioural deficits Examples of Negative Symptoms  Loss of motivation  Emotional flatness  Social withdrawal  Slowed speech or no speech

38.  Genetic predispositions  Structural brain abnormalities  Neurotransmitter abnormalities  Prenatal abnormalities  Adolescent abnormalities in brain development

39.  The risk of developing schizophrenia (i.e., prevalence) in one’s lifetime increases as the genetic relatedness with a diagnosed schizophrenic increases.

40.  Several abnormalities exist, especially when schizophrenia is characterized by primarily negative symptoms: Decreased brain weight. Decreased volume in temporal lobe or hippocampus. Enlargement of ventricles.  About 25% do not have these observable brain deficiencies

41.  Include serotonin, glutamate, and dopamine.  Many schizophrenics have high levels of brain activity in brain areas served by dopamine as well as greater numbers of particular dopamine receptors.  Similar neurotransmitter abnormalities are also found in depression and alcoholism.

42.  Damage to the fetal brain increases chances of schizophrenia and other mental disorders. May occur as a function of maternal malnutrition, maternal illness. May also occur if brain injury or oxygen deprivation occurs at birth.

43.  Normal pruning of excessive synapses in the brain occurs during adolescence.  In schizophrenics, a greater number of synapses are pruned away. May explain why first episode occurs in adolescence or early adulthood.