Psychology 100:12

• Abnormal Psychology
– Perspectives
– DSM IV
> Classification and diagnosis
– Anxiety disorders
• Describe the 5 axis of the Diagnostic and Statistical
Manual (DSM IV)
4/2/09

Disorders
• Perspectives on Mental disorders
– Psychodynamic perspective
>Intrapsychic conflict between Id, Ego, & Superego
– Medical perspective
>Dominant approach to treatment
>Physical/genetic basis for mental illness
>Treat mental illness like physical illness
~Drugs, surgery, etc.

Disorders
• Perspectives on Mental disorders
– Cognitive-behavioural perspective
>Mental disorders are learned
>Environmental factors
>Perception of events
– Humanistic perspective
>Growth needs
>Unconditional positive regard
~Perception that positive regard must be earned

Disorders
• Perspectives on Mental disorders
– Socio-cultural perspective
>Influence of cultural variables
>Interpretation of mental disorders
– Diathesis-stress mode
>Genetics and learning leads to a predisposition
>Stressor triggers the disorder

Disorders
• Diagnosis of mental disorders
– Symptoms, signs, and syndromes
> Symptoms : Patient’s complaints
> Signs : Patient’s behaviours
> Syndromes : Patterns of signs and symptoms
– Psychoses and Neuroses
> Psychoses : Marked distortions in perception and behaviour.
> Neuroses : Underlying conflict and anxiety

Disorders
• Diagnosis of mental disorders
– Diagnostic and Statistical Manual IV (DSM IV)
>Emphasis on describing the disorder.
>Five axes (criteria)
~Axis I: Major clinical syndromes .
~Axis II: Personality disorders
~Axis III: Physical Disorders.
~Axis IV: Severity of stress (over last year):
~Axis V: Global Assessment of Functioning:

Disorders
• Diagnosis of mental disorders
– Diagnostic and Statistical Manual IV (DSM IV)
>Axis I: Major clinical syndromes .
~ Disorders appearing in infancy and childhood.
» e.g., ADHD, Autism, Speech, Aggression, Mental retardation.
~Delirium, Dementia, and Amnesia
» Deterioration of brain due to aging, disease or toxic substances.
e.g., Alzheimer’s disease, lead poisoning.
~Psychoactive substance abuse
» Abuse of alcohol and other drugs

Disorders
• Diagnosis of mental disorders
– Diagnostic and Statistical Manual IV (DSM IV)
>Axis I: Major clinical syndromes.
~Schizophrenia and Psychosis
» loss of contact with reality - hallucinations, delusions.
~Mood disorders
» Extreme deviations from normal moods
~Anxiety disorders
» Phobias, Obsessive-Compulsive, Panic attacks,
Post-traumatic stress

Disorders
• Diagnosis of mental disorders
– Diagnostic and Statistical Manual IV (DSM IV)
>Axis I: Major clinical syndromes.
~ Somatophorm disorders
» Pain, paralysis, blindness with no physical causes
~ Dissociative Disorders
» Amnesia & Fugue, Multiple Personality Disorder
~Other Axis I disorders
» Sexual disorders (e.g., gender identity)
» Sleep disorders, eating disorders, impulse control disorders

Disorders
• Diagnosis of mental disorders
– Diagnostic and Statistical Manual IV (DSM IV)
>Axis II: Personality disorders:
~Long term, maladaptive personality traits that impair normal functioning.
~Antisocial personality disorder
» Two criteria:
1) Long-standing (conduct disorder < age of 15)
2) Antisocial behaviour exhibited in 3 classes
~Paranoid personality disorder
» Long-standing, pervasive distrust of others

Disorders
• Diagnosis of mental disorders
– Diagnostic and Statistical Manual IV (DSM IV)
>Axis II: Personality disorders:
~ Narcissistic personality disorder
» Outlandish sense of self importance
~Avoidant personality disorder
» A pervasive pattern of social inhibition.
~Obsessive-Compulsive personality disorder
» A pervasive pattern of striving for perfection, order, and control

Disorders
• Diagnosis of mental disorders
– Diagnostic and Statistical Manual IV (DSM IV)
> Axis III: Physical Disorders:
~ Medical problems relevant to the psychological ones.
> Axis IV: Severity of stress (over last year):
~ Psychosocial and environmental problems.
» Sources of difficulty over the past year
» Anticipated difficulties
> Axis V: Global Assessment of Functioning:
~ Individuals often return to their highest level of functioning.
1) Relations with family and friends
2) Occupational functioning
3) Use of leisure time

Disorders
7
2
1
6
5
4
3
Phobia Panic Obsessive-
Compulsive
Anxiety Disorders
Alcohol Other drugs
Substance abuse or dependence
Dysthymia Major depression
Manic
Episode
Schizophrenia Antisocial
Personality
Mood Disorders

Disorders
• Anxiety, somatoform, and dissociative disorders
– Anxiety Disorders
>Generalized anxiety disorder.
~Difficulty controlling anxiety and worry (at least six months)
~Symptoms:
» Restlessness, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance

Disorders
• Anxiety, somatoform, and dissociative disorders
– Anxiety Disorders
> Obsessive-Compulsive Disorder (OCD)
~ Obsession: An irrational and intruding thought
~ Compulsion: A repetitive action
~ Most common obsessions
» Death, disease, disfigurement
~ Most common compulsions
» Rituals: Checking, cleaning (e.g., hand-washing)
» Mental acts: Counting, praying, silently repeating words

Disorders
• Anxiety, somatoform, and dissociative disorders
– Anxiety Disorders
> Panic disorder
~ Panic Attack
» Three reactions.
~ Emotional reaction:
- Intense fear, apprehension, and terror.
~ Physical reaction:
- Racing heart, trembling, dizziness, etc.
» Cognitive reaction:
- having heart attack, going crazy, losing control

Disorders
• Anxiety, somatoform, and dissociative disorders
– Anxiety Disorders
> Phobia disorders
~ Phobia : A persistent fear reaction strongly out of proportion to the reality of the danger
» Two classes
» Specific Phobias (simple phobias)
Animals, Inanimate objects, Illness & injury, blood
» Social Phobias
Fear of specific social situations