David Rude, MA, CPC
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Classifying mental disorders
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Psychotic disorders
◦ Schizophrenia
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Diagnostic and Statistical
Manual for Mental Disorders
◦ First published in 1952
◦ Updated every few years
 Reflects updated research
and changing attitudes
 Term Neurosis removed
 Some disorders removed
 Some disorders added
"Internet-Use Disorder" or IAD Being Added for further
consideration to New Edition of DSM
Some people who spend a lot of time on the Internet
demonstrate similar symptoms to people diagnosed
with other addiction disorders, and that the psychiatric
community should study it and consider promoting it
to a full-blown disorder.
Are you Internet addicted…take this test or this test
1.
Disruptive mood dysregulation disorder
2.
Internet Gaming Addiction
3.
Binge-eating Disorder – at least once a week
for at least three months
4.
Negative Altruism
5.
Social Media Narcissism
In the news: Can LSD cure alcoholism?
Trials show 59 per cent of problem drinkers
improve after a single dose of powerful
hallucinogen
http://www.dailymail.co.uk/sciencetech/article2111687/LSD-alcohol-Trials-59-problem-drinkersimprove-single-dose-hallucinogen.html
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Mental Disorder:
◦ Significant impairment in psychological functioning
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Psychotic Disorder
◦ Primary problem
 Loss of contact with reality
◦ Typical signs of trouble
 You hear or see things that others don’t; your mind
has been playing tricks on you
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Watch Evaluating Patients with Brain Damage
◦ Primary problem
 Mania or depression
◦ Typical signs of trouble
 You feel sad and hopeless
 Your talk too loud and too fast
 You have a rush of ideas and feelings that others think
are unreasonable.
◦ Primary problem
 High anxiety or anxiety-based distortions of
behaviors
◦ Typical signs of trouble
 Anxiety attacks and feel like you are going to
die
 Afraid to do things that most people can do
 Spend unusual amount of time doing things like
washing your hands or counting your
heartbeats.
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Somatoform disorders
◦ Primary problem
 Bodily complaints without an organic
(physical) basis
◦ Typical signs of trouble
 Feel physically sick, but your doctor says
nothing is wrong with you
 Suffer from pain that has no physical
basis
 Preoccupied with thoughts about being
sick
◦ Primary problem
 Amnesia, feelings of unreality, multiple
identities
◦ Typical signs of trouble
 Major gaps in your memory of events
 Feel like you are a robot or a stranger to
yourself
 Others say you have done things you don’t
remember doing
◦ Primary problem
 Unhealthy personality patterns
◦ Typical signs of trouble
 Your behavior patterns repeatedly cause
problems
 At work
 School
 In your relationships with others

Watch Deep Brain Stimulation, parts 1 and 2
◦ Primary problem
 Disturbed gender identity, deviant sexual
behavior, problems in sexual adjustment
 Watch video on Transgender Professor
◦ Typical signs of trouble
 Feel that you are a man trapped in a woman’s
body (or the reverse)
 Can only gain sexual satisfaction by engaging
in highly atypical sexual behavior
 Have problems with sexual desire, arousal, or
performance
◦ Primary problem
 Disturbances related to drug abuse or
dependence
◦ Typical signs of trouble
 Drinking too much
 Using illegal drugs
 Taking prescription drugs more often than you
should
 Watch video on Addiction Transfer & Teenage
Prescription Drug Abuse
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Social Conditions
◦ Poverty, homelessness, overcrowding, stressful
living conditions
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Family Factors
◦ Parents who are immature, mentally ill, abusive, or
criminal
◦ Poor child discipline
◦ Severe marital or relationship problems
◦ Disordered family communications
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Psychological Factors
◦ Low intelligence, stress, learning disorders
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Biological Factors
◦ Genetic defects or inherited vulnerabilities
◦ Poor prenatal care
◦ Low birth weight
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Insanity
◦ A legal term
◦ Inability
 To manage one’s affairs
 To be unaware of the consequences of one’s actions
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Consequences of being judged insane (by a
court of law)
◦ Not held legally accountable for their actions
◦ Can be involuntarily committed to a psychiatric
hospital
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Many movements today are trying to abolish
the insanity plea and defense
◦ Desire to make everyone accountable for their
actions
◦ Guilty but insane/mentally ill
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How is a person declared to be insane?
◦ Established by testimony from expert witnesses
◦ A danger to themselves or to others, or severely
mentally disabled
◦ Most often occurs when people are brought to
emergency rooms
◦ If two doctors agree
 Person will either
 Commit suicide
 Or hurt someone else
 They are put into a hospital
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Two core features
◦ Hallucinations
 Imaginary sensations
 Seeing, hearing, or smelling things that do not exist in
the real world
◦ Delusions
 Holds a false belief regardless of the facts
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Depressive delusions
◦ Feel they have committed horrible crimes or sinful
deeds
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Somatic delusions
◦ Concern the body
◦ One’s body is “rotting away” or emitting foul odors
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Delusions of grandeur
◦ Thing they are an extremely important person
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Delusions of influence
◦ They feel they are being controlled or influenced by
others or unseen forces
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Delusions of persecution
◦ Others are “out to get them”
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Delusions of reference
◦ Unrelated events are given personal significance
◦ A newspaper article or television program is giving
a special personal message
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Most common
◦ Hearing voices
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Others
◦ Tactile
 Things crawling on skin
◦ Extreme sensitivity to heat, cold, pain, or touch
◦ Anesthesia - a loss of normal sensitivity
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Note:
◦ Olfactory hallucinations sometimes occur with
seizure disorder (epilepsy)
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Disturbed emotions
◦ Mood Swings
 Elation to depression
◦ Flat Affect
◦ Lack of emotional responsiveness
 Flat affect
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Disturbed Verbal Communication
◦ Garbled and chaotic speech; word salad
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Problems with thought, memory, actions or
attention
Personality Disintegration
◦ When a person’s thoughts, actions and emotions
are no longer coordinated
◦ “Lost touch with person, place or time.”
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Psychosis caused by brain injury or disease
◦ Toxic chemical poisoning (lead, mercury)
◦ Steroid psychosis
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Dementia
◦ Serious mental impairment in old age
◦ Caused by brain deterioration
◦ Circulatory problems, repeated strokes, general
brain shrinkage or atrophy
◦ Results in disturbances in memory, reasoning,
judgment, impulse control, and personality
◦ Alzheimer’s Disease is most common form
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Characterized by
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◦
◦
◦
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Hallucinations
Delusions
Apathy
Thinking abnormalities
“Split” between thoughts and emotions
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Symptoms
◦ Emotions may become blunted or very
inappropriate
◦ Withdrawal from contact with others
◦ Loss of interest in external activities
◦ Breakdown of personal habits
◦ Inability to deal with daily events
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Does NOT refer to having split or multiple
personalities
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Disorganized Schizophrenia
◦ Near complete personality disintegration
◦ Incoherence, grossly disorganized behavior, bizarre
thinking, and flat or grossly inappropriate emotions
◦ Typically develops in adolescence or young
adulthood
◦ Improvement is limited
◦ Impairment is extreme
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Catatonic Schizophrenia
◦ Marked by stupor where victim may hold same
position for hours or days
◦ Period of rigidity resemble tendency to “freeze” at
times of emergency or panic
◦ Mute and unresponsive
◦ may sometimes show agitated, purposeless
behavior
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Paranoid Schizophrenia
◦ Preoccupation with delusions of persecution
◦ Also involves hallucinations that are related to a
single theme, especially grandeur or persecution
◦ Most common
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Undifferentiated
◦ Prominent psychotic symptoms
◦ None of the specific features of catatonic,
disorganized or paranoid types.
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Environment
◦ Exposure to influenza or rubella virus during
pregnancy
◦ Malnutrition during pregnancy
◦ Complications during birth
◦ Early Psychological Trauma
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Some individuals inherit a potential for
developing schizophrenia
Makes them more vulnerable to the disorder
Evidence from twin studies