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

2. 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

3. DSM * Diagnostic and Statistical Manual American Psychiatric Association Currently DSM IV-TR 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, asperger’s.

4. Diagnosing Disorder: The DSM The DSM organizes the diagnosis of disorder according to five dimensions (or axes) relating to different aspects of disorder or disability. * * The axis system is no longer being used as of 5/22/13 Source: Adapted from American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

5. Categories of Disorders include: Disorders Diagnosed in Infancy/Early Childhood * Delirium, dementia, & amnesia * Dissociative disorders * Substance Abuse Disorders * Schizophrenia & other Psychotic Disorders Mood Disorders * Anxiety Disorders * Somatoform Disorders * Eating Disorders * Sexual Disorders * Personality Disorders Impulse Control Disorders/ * * Major Changes in DSM V pub. date May 2013

6. 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.

7. 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 Video‬‏ b. Social phobia – extreme shyness or discomfort in social situations 2. Panic Disorder * Sudden attacks of terror leading to behavioral changes & physical symptoms

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

9. 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 Video‬‏DID Video‬‏

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

11. Mood Disorders, cont. Dysthymia * Mild, chronic depression, more than 2 yrs. Bipolar disorder * Video‬‏Video‬‏ Swings from low (depression) to high (mania); near normal in between Mania * Exceptional energy, enthusiasm, agitation, irritable

12. 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

13. 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

14. Types of Schizophrenia * Disorganized * Language and/or behavior chaotic, illogical Catatonic * Extreme disorder of movement or no movement Paranoid * Hallucinations or delusions most prominent symptom Undifferentiated * Mixed; symptoms from 2-3 other types

15. 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

16. 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 BPD Video C) Anxious/inhibited

17. Antisocial Personality Disorder * Pervasive pattern of violating the rights of others Begins in childhood or early adolescence Continues through adulthood 3x more males Alcohol, drug abuse Egocentric, impulsive Lie, cheat, steal, criminal behavior Biological and environmental factors

18. Somatoform Disorders * Real physical symptoms Not explained by medical condition. Stress-related More females Ex: conversion disorder, hypochondriasis * Hypochondriasis = excessive worry about having a physical illness Contrast with factitious disorder – no real physical illness, just imagined or faked

19. 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?