Mental illness
ABNORMALITY
ECCENTRIC OR
MENTAL ILLNESS?
Stereotypes of
Psychological Disorders
• Psychological Disorders are a sign of
personal weakness.
• Psychological disorders are incurable.
• People with psychological disorders are
often violent and dangerous.
• People with psychological disorder
behave in bizarre ways and are very
different from normal people.
The Medical Model Applied
• It is useful to think of abnormal behavior
as a disease.
Psychodiagnosis: The
Classification of Disorders
DSM-IV-TR (text revision)
Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition, Text
Revision
• criteria, descriptions and other information to guide
the classification and diagnosis of mental disorders
was published in 2000 replacing DSM-IV. It is
expected that DSM-V will replace DSM-IV-TR
sometime in the future. This revision of the fourth
edition of the manual published by the American
Psychiatric Association to set forth diagnostic
History of the DSM
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DSM-I 1952 (describe 60 disorders)
DSM-II 1968
DSM-III 1980 (Multiaxial system)
DSM-III-R 1988
DSM-IV 1993
DSM- IV-TR 2000 (Over 200 disorders)
Multiaxial System
• Axis I: Major clinical syndrome
• Axis II: Personality and developmental
disorders
• Axis III: Physical Disorders and conditions
• Axis IV Severity of psychosocial stressors
• Axis V Global Assessment of Functioning
(GAF) Scale
A multiaxial evaluation
Patient: 58 year old male
• Axis I: Major depression, alcohol
dependence
• Axis II: Dependent Personality disorder
• Axis III: Alcoholic cirrhosis of live
• Axis IV: Severity: 3 (moderate)
Anticipated retirement and change in residence,
with loss of contact with friends
• Axis V:GAF 44 Highest in in past year :55
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Axis I Major Clinical
Syndrome
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Disorders usually first evident in infancy , childhood or
adolescence.(ADD, Bulimia and anorexia)
Organic Mental disorder: Temporary or permanent dysfunction of
brain tissue caused by diseases or chemicals.
Psychoactive substance use disorders
Schizophrenic Disorders: (Grossly disorganized behavior,
delusions, and hallucinations)
Delusional disorder:
Mood Disorder
Anxiety disorders
Somatoform disorders
Dissociative disorders
Psychosexual disorder
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Axis II: Personality and
Developmental Disorders
• Personality Disorders:
Disorders are patterns of personality
traits that are longstanding, maladaptive,
and inflexible and involve impaired functioning
or subjective distress
http://behavenet.com/capsules/disorders/
prsnltydsrdr.htm
• Specific Developmental disorders
:
Autism, Mental retardation, reading, writing
and arithmetic disorders
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Axis III
Physical disorders and
conditions
• Physical disorders or conditions are
recorded on this axis.
• Examples: Diabetes, arthrities, and
hemophilia
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Axis IV
Severity of Psychosocial
stressors (back)
Code
Term
Adult Example
1
None
No Relevant
events
2
Mild
Starting or
graduating school
3
Moderate
Loss of job
4
Severe
Divorce
5
Extreme
Death of loved
one
6
Catastrophic
Devastating natural
disaster
Axis V
Global Assessment of Functioning
Scale
• 90-Absent or minimal symptoms, good
functioning in all areas
• 60 Moderate symptoms or difficulty in social ,
occupational, or school functioning.
• 30 Behavior considerably influenced by
delusions or hallucinations, serious impairment
in communication or judgment, or inability to
function in almost all areas
• 10 Persistent danger of severely hurting self or
others
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Mood Disorders
• Class of disorders marked by emotional
disturbances of varied kinds that may spill
over to disrupt physical, perceptual,
social, and thought processes.
• Major Depression, bipolar disorder,
dysthymic disorder and cyclothymic
Sample Case Study
for Major Depressive Episode
DSM-IV Diagnostic Criteria
Examples from Case study
(An example for 5 different
symptoms)
1. Depressed mood most of the “… she has been depressed ever
day, nearly every day, …
since she had a fight with her mother
2 years ago.” “Cindy says that her
mood has been much worse in the
last 6 months.” ”She feels depressed
almost every day, all day long.”
Anxiety Disorders
• Disorders characterized by physiological
signs of anxiety (for example,
palpitations) and subjective feelings of
tension, apprehension, or fear. Anxiety
may be acute and focused (panic
disorder) or continual and diffuse
(generalized anxiety disorder)
Sample Case Study
for Major Depressive Episode
DSM-IV Diagnostic Criteria
Example from Case study
(5 examples from each)
1. Depressed mood most of the day, nearly every day, …
“… she has been depressed ever since she had a fight with her mother 2
years ago.” “Cindy says that her mood has been much worse in the last 6
months.” ”She feels depressed almost every day, all day long.”
2. Markedly diminished interest or pleasure in all, or almost all,
activities most of the day, nearly every day.
“She has lost interest in school and social activities and has not really paid
attention to her schoolwork for the last 6 months.”