Abnormal Behavior * A psychological disorder, causing distress, disability, or dysfunction. Defined symptomatically by the DSM.

Statistics on Disorders 1 in 4 affected each year Each year prevalence: 18.1% anxiety disorders; 1% schizophrenia; 4.4% alcohol use disorder More lower SES Mentally ill stigmatized Many disorders comorbid. Comorbid = more than one disorder at a time Most severe disorders in a small group of people 6% of population have 3 or more disorders

DSM * Diagnostic and Statistical Manual American Psychiatric Association Currently DSM-5 Common language and standard criteria for classifying mental disorders Controversies include: Cultural bias (e.g. sexual disorders) Medical rather than behavioral model Diagnosing, e.g. ADHD, autism.

Diagnosing Disorder: The DSM The DSM organizes disorders by category. Within a diagnostic category, clinicians may also identify specifiers and rate severity.

Categories of Disorders include: Obsessive Compulsive and Related Disorders Neurodevelopmental Disorders Dissociative disorders Substance Related and Addictive Disorders Depressive Disorders Bipolar and related disorders Schizophrenia spectrum and other psychotic disorders Anxiety Disorders Somatic Symptom and Related Disorders Trauma and Stressor-Related Disorders Feeding and Eating Disorders Sexual Dysfunction Personality Disorders Autism Spectrum Disorders Neurocognitive Disorders

Biopsychosocial Model * biological factors come from the body e.g., genes; neurotransmitters psychological factors come from the individual e.g., patterns of negative thinking; stress responses social factors come from society and culture e.g., socioeconomic status, homelessness, abuse Key concept is Interaction.

Anxiety Disorders Anxiety – irrational fear, dread, or agitation; physiological arousal 1. Phobias: unreasonable fear; avoidance a. Specific phobia – clearly defined object or situation, e.g. dogs Video‬‏ b. Social phobia – extreme shyness or discomfort in social situations 2. Panic Disorder * Sudden attacks of terror leading to behavioral changes & physical symptoms

Post Traumatic Stress Disorder * Obsessive Compulsive Disorder * a. Obsessions * Repetitive, distressing or frightening thoughts b. Compulsions * Repetitive behaviors (an attempt to calm the thoughts)

Dissociative Identity Disorder * 2 or more distinct personalities in the same person Memory disruption regarding the “alter” Rare Some psychologists don’t believe the disorder really exists NOT the same as Schizophrenia DID Video‬‏

Depressive Disorders * Major depressive disorder * Low mood (despair) - withdrawal, loss of interest & pleasure; eating & sleeping disturbance Video‬‏ More than 2 weeks Impaired functioning Twice as many women May have psychotic features Suicidal thoughts or attempts

Bipolar and related disorders * Video‬‏ Mood & energy swings from low (depression) to high (mania); near normal in between Mania * Exceptional energy, enthusiasm, agitation, irritability, reckless behavior.

Risk Factors for Suicide * Diagnosable psychiatric disorder Male, esp. older and physically ill Method (guns succeed more than pills) Prior attempts, family history, exposure History of being abused Incarceration High risk behavior Adolescence 2% attempt

Schizophrenia * Video – Gerald Psychosis: loss of contact with reality Positive symptoms – hallucinations, delusions, inappropriate affect, disorganized speech and behavior Negative symptoms – social withdrawal, deterioration of adaptive behavior, flat affect, poor problem solving abilities Cognitive symptoms – problems with focus, memory, problem-solving; control

Possible Causes of Schizophrenia * Genes – runs in families Brain– loss of neurons; enlarged ventricles Neurotransmitters – e.g. excess dopamine Poverty, malnutrition, disease Prenatal damage – e.g. viruses Stress Substance Abuse may trigger Interactions between items above

Personality Disorders * Inflexible patterns of thinking, feeling or relating to others These patterns cause problems in personal, social & work situations. Inability to understand needs of others Three “clusters” A) Odd, eccentric B) Dramatic/erratic, BPD Video C) Anxious/inhibited

Antisocial Personality Disorder * Pervasive pattern of violating the rights of others 3x more males Alcohol, drug abuse Egocentric, impulsive Lie, cheat, steal, criminal behavior Biological and environmental factors

Somatic Symptom Disorders * Substantial physical symptoms May have no documented illness or may have a real illness with “overreaction”. Stress-related More females Distressing and disruptive Contrast with illness anxiety disorder –exaggerated “normal” physical sensations and no real physical illness.

Discussion Questions Why is lower SES associated with mental illness? Should treatment for mental illness be required? Should the homeless, alcoholic mentally ill be institutionalized? Should mental health “check-ups” be part of yearly physicals for children? Adults?