CLINICAL DISORDERS Disorder Description Diagnostic Criteria Anxiety, and Obsessive Compulsive and Related Disorder Anxiety - - Fear - - negative mood state characterized by bodily symptoms of physical tension and by apprehension about the future. In humans, it can be a subjective sense of unease, a set of behaviors (looking worried and anxious or fidgeting), or a physiological response originating in the brain and reflected in elevated heart rate and muscle tension. an immediate alarm reaction to danger. Like anxiety, fear can be good for us. protects us by activating a massive response from the autonomic nervous system (increased heart rate and blood pressure, for example) which, along with our subjective sense of terror, motivates us to escape ( flee) or possibly, to attack ( flight) fight or flight response Panic - sudden overwhelming reaction which came to be as panic, after the Greek god Pan who terrifies travelers with blood curdling screams. Panic Attack - In psychopathology, a panic attack is defined as an abrupt experience of intense fear or acute discomfort, accompanied by physical symptoms that usually include heart palpitations, chest pain, shortness of breath, and possibly dizziness. the frequency and severity of panic attacks vary widely. there may be moderately frequent attacks ( one/ week) or short bursts more frequent attacks (daily) separated by weeks or months without any attacks or with less frequent attacks ( two per month) - Types: - expected (cued) panic attack - unexpected (uncued) panic attack comorbidity- two or more diorders can exist in one individual possible yung depersonalization and derealizationn parasthesias- numbness treatment- grounding Generalized Anxiety Disorder Panic Disorder Time: at least 6 months - The DSM-5 criteria specify that at least 6 months of excessive anxiety and worry (apprehensive expectation) must be ongoing more days than not. Furthermore, it must be difficult to turn off or control the worry process - - Agoraphobia - - individuals experience severe, unexpected panic attacks; they may think they’re dying or otherwise losing control. Closely related with agoraphobia fear and avoidance of situations in which a person feels unsafe or unable to escape to get home or to a hospital in the event of a developing panic, panic-like symptoms, or other physical symptoms, such as loss of bladder control. People develop agoraphobia because they never know when these symptoms might occur Specific Phobia - an irrational fear of a specific object or situation that markedly interferes with an individual’s ability to function. In earlier versions of the DSM, this category was called simple phobia to decipher from agoraphobia - Separation Anxiety disorder - - characterized by children’s unrealistic and persistent worry that something will happen to their parents or other important people in their life or that something will happen to the children themselves that will separate them from their parents (for example, they will be lost, kidnapped, killed, or hurt in an accident). The fear, anxiety, or avoidance is persistent, lasting at least 4 weeks in children and adolescents and typically 6 months or more in adults. The essential feature of separation anxiety disorder is excessive fear or anxiety concerning separation from home or attachment figures. The anxiety exceeds what may be expected given the individual’s developmental level (Criterion A). Individuals with separation anxiety disorder have symptoms that meet at least three of the following criteria: They experience recurrent excessive distress when separation from home or major attachment figures is anticipated or occurs (Criterion A1). They worry about the well-being or death of attachment figures, particularly when separated from them, and they need to know the whereabouts of their attachment figures and want to stay in touch with them (Criterion A2). They also worry about untoward events to themselves, such as getting lost, being kidnapped, or having an accident, that would keep them from ever being reunited with their major attachment figure (Criterion A3). Individuals with separation anxiety disorder are reluctant or refuse to go out by themselves because of separation fears (Criterion A4). They have Social Anxiety disorder - - a fear of being around others, particularly in situations that call for some kind of “performance” in front of other people. Although the causes of social anxiety disorder are similar to those of specific phobias, treatment has a different focus that includes rehearsing or role-playing socially phobic situations. In addition, drug treatments have been effective the fear, anxiety, or avoidance is peristent, typically lasting 6 months or more Trauma and Stressor Related Disorders Posttraumatic Stress Disorder - - - - exposure to a traumatic event during which an individual experiences or witnesses death or threatened death, actual or threatened serious injury, or actual or threatened sexual violation Learning that the traumatic event occurred to a close family member or friend, or enduring repeated exposure to details of a traumatic event Victims most often avoid anything that reminds them of the trauma. They often display a characteristic restriction or numbing of emotional responsiveness, which may be disruptive to interpersonal relationships. They are sometimes unable to remember certain aspects of the event. It is possible that victims unconsciously attempt to avoid the experience of emotion itself In DSM 5, reckless or self destructive behavior Obsessive Compulsive Related Disorders Obsessive Compulsive Diso rder (OCD) - - - Obsessions are intrusive and mostly nonsensical thoughts, images, or urges that the individual tries to resist or eliminate. Compulsions are the thoughts or actions used to suppress the obsessions and provide relief. Four major types of obsessions Some other obsessive-compulsive and related disorders are also characterized by preoccupations and by repetitive behaviors or mental acts in response to the preoccupations. Other obsessive-compulsive and related disorders are characterized primarily by recurrent body-focused repetitive behaviors (e.g., hair pulling, skin picking) and repeated attempts to decrease or stop the behaviors Specify if: With good or fair insight: The individual recognizes that obsessive-compulsive disorder beliefs are definitely or probably not true or that they may or may not be true. With poor insight: The individual thinks obsessive-compulsive disorder beliefs are probably true. With absent insight/delusional beliefs: The individual is completely convinced that obsessive-compulsive disorder beliefs are true. Body Dysmorphic Disorder (BDS) - with some imagined defect in appearance by someone who actually looks reasonably normal (Fang & Wilhelm, 2015). The disorder has been referred to as “imagined ugliness” preoccupation with one or more defects or flaws in physical appearance that are not observable or appear slight to others ( mirror checking, grooming skin picking etc.) CLINICAL DISORDERS Disorder Description Diagnostic Criteria Somatic Symptoms and Related Disorders and Dissociative Disorders Somatic Symptom Disorder Illness Anxiety Disorder natatakot yung tao na magkasakit at yung takot hindi proportional doon sa nararanasang symptoms sa katawan. - In 1859, Pierre Briquet, a French physician, described patients who came to see him with seemingly endless lists of somatic complaints for which he could find no medical basis (American Psychiatric Association, 1980). - Despite his negative findings, patients returned shortly with either the same complaints or new lists containing slight variations. For many years, this disorder was called Briquet’s syndrome, but now would be considered somatic symptom disorder. - Illness anxiety disorder was formerly known as “hypochondriasis,” which is still the term widely used amongthe public. - In illness anxiety disorder as we know it today, physical symptoms are either not experienced at the present time or are very mild, but severe anxiety is focused on the possibility of having or developing a serious disease. - If one or more physical the state of being symptomatic is persistent ( typically more than 6 months) symptoms are relatively severe and are associated with anxiety and distress, the diagnosis would be somatic symptom disorder. Conversion Disorder (Functional Neurological Symptom Disorder) Factitious Disorders - The term conversion has been used off and on since the Middle Ages (Mace, 1992) but was popularized by Freud, who believed the anxiety resulting from unconscious conflicts somehow was “converted” into physical symptoms to find expression. - allowed the individual to discharge some anxiety without actually experiencing it. As in phobic disorders, the anxiety resulting from unconscious conflicts might be “displaced” onto another object. - “Functional” refers to a symptom without an organic cause (Stone, LaFrance, Levenson, & Sharpe, 2010). - fall somewhere between malingering and conversion disorders. The symptoms are under voluntary control, as with malingering, but there is no obvious reason for voluntarily producing the symptoms except, possibly, to assume the sick role and receive increased attention. - Tragically, this disorder may extend to other members of the family. An adult, almost always a mother, may purposely make her child sick for attention and pity. - When an individual deliberately makes someone else sick, the condition is called factitious disorder imposed on another. It was also known previously as Munchausen syndrome by proxy. In any case, it is really an atypical form of child abuse (Check, 1998). physical malfunctioning such as blindness or paralysis, suggesting neurological impairment but with no organic pathology to account for it MALINGERING CASE: munchausen syndrome Dissociative Disorders - When individuals feel detached from themselves or their surroundings, almost as if they are dreaming or living in slow motion, they are having dissociative experiences. - likely to happen after an extremely stressful event, such as an accident. - It also is more likely to happen when you’re tired or sleep deprived - Because it’s hard to measure dissociation, the connection between trauma and dissociation is controversial Depersonalization: - your perception alters so that you temporarily lose the sense of your own reality, as if you were in a dream and you were watching yourself. Derealization: - your sense of the reality of the external world is lost. Things may seem to change shape or size; people may seem dead or mechanical. - Depersonalization is often part of a serious set of conditions in which reality, experience, and even identity seem to disintegrate. Disintegrated experience: - happens if we not only forget who we are but also begin thinking we are somebody else—somebody who has a different personality, different memories, and even different physical reactions, such as allergies we never had disruption of identity characterized by two or more distinct personality states which may be described in some cultures as possession. Marked discontinuity in sense of sel and sense of agency Dissociative Amnesia inability to recall important autobiographical info, usually of a traumatic or stressful nature that is inconsistent with ordinary forgetting - People who are unable to remember anything, including who they are, are said to suffer from generalized amnesia. Generalized amnesia: - may be lifelong or may extend from a period in the more recent past, such as 6 months or a year previously. Localized or Selective Amnesia - Far more common than general amnesia - A failure to recall specific events, usually traumatic, that occur during a specific period. Dissociative amnesia - common during war. Dissociative fugue - a sub-type of dissociative amnesia with fugue literally meaning “flight” Dissociative Identity Disorder - memory loss revolves around a specific incident, which may be an unexpected trip (or trips). - Mostly, individuals just take off and later find themselves in a new place, unable to remember why or how they got there. - Usually, they have left behind an intolerable situation. During these trips, a person sometimes assumes a new identity or at least becomes confused about the old identity. - People with dissociative identity disorder (DID) may adopt as many as 100 new identities, all simultaneously coexisting although the average number is closer to 15. - each with its own behavior, tone of voice, and physical gestures. But in many cases, only a few characteristics are distinct, because the identities are only partially independent, so it is not true that there are “multiple” complete personalities. CLINICAL DISORDERS Disorder Description Mood Disorders and Suicide Anhedonia - Mania / Manic Disorder - - Hypomania - - Major Depressive Episode/ Disorder The loss of energy and inability to engage in pleasurable activities or havy any “fun” More characteristic of severe episodes of depression Episodes reflect a state of low positive affect and not just high negative affect Individuals find extreme pleasure in every activity; comparable to sexual orgasm They become hyperactive, require little sleep, and may develop grandiose plans, believing they can accomplish everything they can desire Speech is typically rapid and may be incoherent Require a duration of 1 week, less if the episode is severe enough to require hospitalization Irritably is part of a manic episode near the end Being anxious and depressed are commonly parts of mania A less severe version of maniac episode that does not cause marked impairment in social/occupational functioning Need to last only 4 days Not in itself necessarily problematic, but its presence does contribute to the definition of several Symptoms: - Being suddenly, often triggered by a crisis, change, or loss - Are extremely severe, interfering with normal functioning - can be long-term if untreated - Some people have only one episode, but the pattern usually involves repeated episodes or lasting symptoms 2 weeks Diagnostic Criteria Persistent Depressive Disorder (Dysthymia) - Double Depression - There is a long-term unchanging symptoms of mild depression May last 20 to 30 years if untreated Daily functioning is not as severely affected, but impairment is cumulative over time Alternating periods of major depression and dysthymia Bipolar Mood Bipolar I Disorders - Major depression mania *not a diagnostic criteria and full Bipolar II - Major depression and mild mania Cyclothymia - Mild depression with maniac - Chronic and long-term - Often undiagnose Premenstrual Dysphoric Disorder - - mild Causes severe irritability, depression, or anxiety in the week or two before your period starts. Symptoms usually go away two to three days after your period starts Disruptive Mood Disorder - - Grief is a childhood condition of extreme irritability, anger, and frequent, intense temper outbursts. DMDD symptoms go beyond a being a “moody” child—children with DMDD experience severe impairment that requires clinical attention Separation anxiety
