Psychological Differences
DSM-IV-TR
Mental
Retardation
Clinical Disorders
Personality Disorders
Approaches to Psychological
Disorders

Biological model: Disorders have a biochemical or physiological
basis.

Psychoanalytic model: Disorders result from unconscious internal
conflicts.

Cognitive-behavioral model: Disorders result from learning
maladaptive ways of thinking and behaving.


Diathesis-stress model: People biologically predisposed to a mental
disorder (diathesis) will tend to exhibit that disorder when particularly
affected by stress.
Systems approach: Biological, psychological, and social risk factors
combine to produce disorders.
Psychological Disorders
“For what is it that constitutes a ‘disease entity’ or a ‘new disease’? The
physician is concerned not, like the naturalist, with a wide range of
different organisms theoretically adapted in an average way to an
average environment, but with a single organism, the human
subject, striving to preserve its identity in adverse circumstances.”
—Ivy McKenzie
“By the deficits, we may know the talents, by the exceptions, we may
discern the rules, by studying pathology we may construct a model
of health. And—most important—from this model may evolve that
insights and tools we need to affect our own lives, mold our own
destinies, change ourselves and our society in ways that, as yet, we
can only imagine.”
—Laurence Miller
Diagnostic and Statistical Manual of Mental Disorders
(Text Revision)
Multiaxial System (Five Axis System)

Axis I: (Reports all disorders except Axis II)



Axis II: (First diagnosed in infancy/childhood)



General Medical Conditions.
Axis IV: (Social Env., lottery, job, divorce, school…etc.)


Personality Disorders.
Mental Retardation.
Axis III: (Diabetes, heart problems, acid reflux…etc.)


Clinical Disorders.
Other Conditions that may be a focus of clinical attention.
Psychosocial and Environmental Problems.
Axis V: (GAF Scale, Rank 1-10 on 10 items, 100 = Good, 1 = Bad)

Global Assessment of Functioning.
Psychological Differences
Psychological Differences
Mental Retardation
Requirements:
1. Significantly sub average intellectual functioning: IQ of approximately 70 or below on an IQ test.
2. Concurrent deficits or impairments in present adaptive functioning in at least two of the following
areas:

Communication

Self-care

Home living

Social/interpersonal skills

Use of community resources

Self-direction

Functional academic skills

Work, leisure, health, and safety.
3. The onset is before age 18 years.
Below 20-25
20-25 to 35-40
35-40 to 50-55
50-55 to 70
______________________________________________________
Profound
Severe
Moderate
Mild
Childhood Disorders
Conduct Disorder: Aggression to people and animals, destruction of property,
deceitfulness or theft, serious violations of rules
Oppositional Defiant Disorder: A pattern of negativistic, hostile, and defiant
behavior lasting at least 6 months.
Pica: Persistent eating of nonnutritive substances for a period of at least 1 month.
Rumination Disorder: Repeating regurgitation and rechewing of food for a period of at least
1 month following a period of normal functioning.
______________________________________________________________________
Tic Disorders:
Tourette’s Disorder: Both multiple motor and one or more vocal tics.
Transient Tic: Single or multiple motor and/or vocal tics.
Cognitive Disorders


Delirium: Characterized by anxiety, disorientation, hallucinations, delusions,
and incoherent speech
Dementia: Deterioration of intellectual faculties (Memory, concentration, and
judgment). Accompanied by emotional disturbance and personality
changes.
 Alzheimer Type
 Alcoholism Type
Schizophrenia


Characterization:
 Withdrawal from reality, illogical thinking, delusions, and hallucinations.
 Accompanied by emotional, behavioral, or intellectual disturbances.
Causes:
 Genetic, Biological, and Psychosocial factors.
 Dopamine imbalances and defects of the frontal lobe.
Required Symptoms:
 Two (or more) of the following (each present during 1-month):







Delusions
Hallucinations
Disorganized speech
Grossly disorganized/catatonic behavior
Negative symptoms
Social/Occupational dysfunction.
Duration: Disturbance persist for at least 6 months.
Schizophrenia
Positive Symptoms-Increase in behavior.
 Negative Symptoms-Decrease in behavior.

Schizophrenia Subtypes
I. Paranoid: (Preoccupation with one or more)

Delusions

Auditory hallucinations
II. Disorganized: (All of the following)

Disorganized speech

Disorganized behavior

Flat/inappropriate affect
III. Catatonic: (At least two of the following)

Motoric immobility (catalepsy/stupor)

Excessive motor activity

Extreme negativism/mutism

Peculiarities of voluntary movement


Posturing, stereotyped movements, prominent mannerisms, or prominent grimacing
Echolalia/Echopraxia
IV. Residual: (Absence of prominent)

Delusions, hallucinations, and disorganized speech

Grossly disorganized/catatonic behavior
V. Undifferentiated: (Criteria are not met)

Paranoid, Disorganized, or Catatonic
Anxiety Disorders

General Phobia: Irrational, intense, persistent fear of certain
situations, objects, activities, or persons.





Agoraphobia: Fear of open or public places
Obsessive-Compulsive Disorder: Tendency to dwell on
unwanted thoughts/ideas and to perform repetitious rituals to
relieve the anxiety.
Posttraumatic Stress Disorder: (PTSD)
Constant/relentless encounters with
memories of a past traumatic event.
Panic Disorder
Generalized Anxiety Disorder
Types of Phobias

Specific: Intense, paralyzing fear of some object or thing.

Social: Excessive, inappropriate fears connected with social
situations or performances in front of other people.

Agoraphobia: Involves multiple, intense fear of crowds,
public places, and other situations that require separation
from a source of security.
Mood and Factitious Disorders
Mood Disorders:
Bipolar: Manic and depressive episodes.
 Cyclothymic Disorder
 Type I
 Type II
Depressive Disorder: Inability to concentrate, insomnia, loss of appetite,
anhedonia, feelings of extreme sadness, guilt, helplessness and
hopelessness, and thoughts of death.
_______________________________________________________
Factitious Disorders:
Somatoform Disorder: Physical symptoms representing specific disorders
for which there is no organic basis or known physiological cause, but for
which there is presumed to be a psychological basis.
Factitious Disorder: Any of various mental disorders in which the individual
intentionally produces symptoms of illness or feigns illness.


Munchausen
Munchausen by proxy
Somatoform Disorders




Somatization Disorder
 A somatoform disorder characterized by recurrent vague somatic complaints
without a physical cause.
Conversion Disorder
 Somatoform disorders in which a dramatic specific disability has no physical cause
but instead seems related to psychological problems.
Hypochondriasis
 A somatoform disorder in which a person interprets insignificant symptoms as signs of serious illness
in the absence of any organic evidence of such illness.
Body Dysmorphic Disorder
 A somatoform disorder in which a person becomes so preoccupied with his or her imagined ugliness
that normal life is impossible.
Suicide
Dissociative Disorders
Defined: Involve disruptions or breakdowns of memory,
consciousness or awareness, identity and/or perception.

Dissociative Amnesia: Pervasive loss of memory of
significant personal information.



Characterized by a blocking out of critical personal information.
Not caused by trauma to the brain.
The memory still exists.

Dissociative Fugue:
Dropping everything and leaving.

Dissociative Identity Disorder: Multiple Personality
Disorder.
Paraphilias
Defined: Sexual Desire Disorders

Exhibitionism: Compulsive exposure of the genitals in public.

Fetishism: Displacement of sexual arousal or gratification to a fetish.

Frotteurism: Achieving orgasm by touching
and rubbing against a person without their
consent (Usually public).

Pedophilia:
Interest in prepubescent children.

Hebophilia:
Interest in pubescent children.
Paraphilias

Masochism: Being physically
or emotionally abused.

Sadism: Sexual gratification from
inflicting pain or emotional abuse
on others.

Transvestic: Receiving sexual gratification from
wearing clothing of the opposite sex.


Transsexual
Voyeurism: Observing others.
Gender Identity

Identification with the opposite sex.
Eating Disorders

Anorexia: Refusing to eat.

Bulimia: Binging and purging.
Impulse-Control Disorders

Kleptomania:


Pyromania:


Burning
Pathological Gambling:


Steeling
Associated with drug abuse.
Trichotillomania:

Pulling out your hair
3 Clusters of Personality Disorders

Cluster A: odd or eccentric behavior
 schizoid,

paranoid
Cluster B: dramatic, emotional, or erratic
behavior
 narcisstic,

borderline, antisocial
Cluster C: anxious or fearful
 dependent,
avoidant
Personality Disorders





Paranoid: Distrust of others
Schizoid: Personality disorder marked by extreme shyness, flat
affect, reclusiveness, discomfort with others, and an inability to
form close relationships
Schizotypal: Exhibiting, or being patterns of thought, perception,
communication, and behavior suggestive of schizophrenia but not
of sufficient severity to warrant a diagnosis of schizophrenia
Antisocial: Criminals
Borderline: Pervasive instability in moods, interpersonal
relationships, self-image, and behavior.
 “Borderline” of psychosis
 There is a high rate of self-injury without suicide intent
Personality Disorders





Narcissistic: In love with oneself
 Most dangerous
Avoidant: Don’t like to be around others
Dependent: Live off of others
Obsessive-compulsive: Milder version
Histrionic: Characterized by excessive emotionality and
attention-seeking behavior.
Attention-Deficit/Hyperactivity
Disorder


A childhood disorder characterized by inattention, impulsiveness, and hyperactivity.
More common in boys than girls.
Autistic Disorder
Qualitative impairment in social interaction:




Eye-to-eye gaze, facial expression, body postures, and gestures.
Failure to develop peer relationships appropriate to developmental level.
Lack of spontaneous seeking to share enjoyment.
Lack of social or emotional reciprocity.
Qualitative impairments in communication:




Delay in, or total lack of, the development of spoken language.
Impairment in the ability to initiate or sustain a conversation with others.
Stereotyped and repetitive use of language.
Lack of make-believe play or social imitative play.
Restricted repetitive and stereotyped patterns of behavior, interests, and
activities:




Preoccupation with one or more stereotyped and restricted patterns of interest.
Inflexible adherence to specific, nonfunctional routines or rituals.
Stereotyped and repetitive motor mannerisms.
Persistent preoccupation with parts of objects.
Asperger’s Syndrome
Possesses all symptoms of Autism with the exception of “qualitative
impairments in communication”.
There is no clinically significant delay in cognitive development or in the
development of age-appropriate self-help skills, adaptive behavior, and
curiosity about the environment in childhood.
Higher Incidence of Specific
Disorders
Men
substance abuse
antisocial personality disorder
Women
depression
agoraphobia
simple phobia
obsessive-compulsive disorder
somatization disorder