Psychological DisordersOverview and general terms1 Year Prevalence RatesGender Differences from NCS StudyDefining mental disordersPerspectivesCognitive Theory of EmotionThe Basic Cognitive PrincipleFig131Why do we diagnose?What is the DSM?DSM-IV (still in use)Evolution of the DSMDSM-5 changesDSM Expansion DiagnosesPros of the DSMCons of the DSMCompassion FatigueComorbidity from the NCS-R StudyOverlap of symptomsSlide 21PowerPoint PresentationSlide 23Slide 24Anxiety disordersPanic Attack SymptomsTrauma and stress related disordersObsessive compulsive and related disordersOCD symptomsObsessive-Compulsive DisorderHoarding disorderObsessive compulsive and related disorders: Body dysmorphic disorderEtiology (of anxiety disorders)Slide 34Slide 35Stroop testSlide 37Slide 38Slide 39Mood disordersSlide 41Major Depressive DisorderManic EpisodeMood disorders: EtiologyFig147Becks Cognitive Model: 3 LevelsCognitive Theory of DepressionTypes of Cognitive Distortions/Automatic thoughtsOther cognitive modelsSlide 50Other disordersSchizophreniaSchizophrenia: Causal factorsFig149Anorexia NervosaSlide 56Anorexia Nervosa: Medical ProblemsBulimia NervosaSlide 59Bulimia Nervosa: Compensatory BehaviorsEating disorders: EtiologyPsychology 101David L. Penn, Ph.D.Overview and general termsPrevalence-Point prevalence: How common a mental illness is over a one year period-Life time prevalence: What percentage of ppl are diagnosed with illness at some point in their lives ( How common is menatl illness? Findings from the National Comorbidity Survey (2005) )Etiology: what is the cause of something Prognosis: what is the long term outcome Ego-syntonic versus; symptoms of mental illness are part of who you are you don’t see them as outside yourself. They don’t view them as wrong ex: someone with a personality disorderego-dystonic: you have symptoms of a mental illness but recognize the symptoms as not part of who you are ex: you start smoking and then start hearing voices: you weren’t always like that1 Year Prevalence RatesDisorderDisorderECAECANCS-RNCS-RNarrowNarrowMoodMood9.5%9.5%9.5%9.5%5.1%5.1%AnxietyAnxiety12.6%12.6%18.1%18.1%11.8%11.8%SchizSchiz1.1%1.1%--1.0%1.0%AlcoholAlcohol9.5%9.5%3.1%3.1%6.0%6.0%Any Any DisorderDisorder28.1%28.1%26.2%26.2%18.5%18.5%Gender Differences from NCS StudyFemales have higher rates of:Depression (2x)Anxiety (3x)Somatization disordersMales have higher rates of:Alcohol & Substance abuse (4x) usually with alcohol Antisocial Personality disorder Why do you think these gender differences exist?Defining mental disordersCluster of symptoms and longevity of symptoms Functional (behavioral) problems ex: are you starting to perform poorly in your daily rolesPerspectivesMedical: psychological disorders have some sort of biological origin/biological factors (make a significant contribution to understanding biological disorders)-Reductionism: taking something broad Behavioral: psyco disorders are result of learning or conditioning ex: traumatic experience can create phobias Socio-cultural: certain disorders you might expect to see across all cultures-Cultural general and cultural specific -Ex: Ataques de NerviosCognitive (cognitive-behavioral)Diathesis-stressEvent(Antecedent)Cognition(Belief)Emotion(Consequence)The Basic Cognitive PrinciplePeople are upset not because of events or situations which occur, but by the meaning that people give to events or situationsWhen the meaning is negative, negative emotions result(Beck, 1976)Fig13156Precursors Diathesis Stress OutcomeGeneticfactorsBrain diseaseEarly learningexperiencesBad familydynamicsPoor self-understandingStressful familydynamicsSocial stressesVulnerabilityDisorder (e.g.schizophrenia)Diathesis-stressWhy do we diagnose?What’s the point?Treatment: can’t pick without diagnosis-Medication-Therapy-Insurance coverage: sometimes need diagnosis in order for coverage Research: you have people who belong in the same group Prediction: you can derive risk factors , have a sense of prognosis Patients and their Families: comforting to patient when there is a name associated with symptomsWhat is the DSM?Diagnostic and Statistical Manual of Mental DisordersOfficial manual for diagnosing mental disorders in the US, outlines criteria to meet to be diagnosed with each disorderPublished by American Psychiatric Association Lists approximately 400 disordersCurrent edition: DSM-V (May 2013)DSM-IV (still in use)Diagnostic and Statistical Manual – IV: still being used but not most recent version Axis I - Clinical Disorders: everything but personality disordersAxis II - Personality Disorders: dis. You think the person has had their whole life extreme maladaptive personality styles; ego syntonic (vocab from before) ex: cereal killers - Clip about Bundy: antisocial characteristics cereal killerAxis III - Physical/medical problems: factoring in medical factorsAxis IV - Psychosocial/environmental problems: what kind of current stressor are present in their lifeAxis V - Global Assessment of Functioning: numerical rating 0-100Evolution of the DSMHas gotten longer, more diagnoses in each editionMore specific criteria- but still imperfectDSM-IV is what our textbook uses, is old news nowDSM-IV was “multiaxial” DSM-VDSM-5 changesFormat-Multiaxial system removed -Dimensional assessment introduced -Reorganization of the disordersDisorders (some highlights- multiple changes!)DSM Expansion Diagnoses182265365106292050100150200250300350400I (1952) II (1968) III (1980) III-R (1987) IV (1994)Edition of the DSMNumber of DiagnosesPros of the DSMCons of the DSMOverpathologizes: are we putting a label on normal behavior?Overlap of symptoms: high levels of Comorbidity (multiple disorders) and misdiagnosis Labeling individuals: (e.g. Rosenhan 1973) stigmatisms - Clip: me, myself and irene; pairing mental illness with aggression Diagnostic criteria for various disorders change each edition, but mental disorders arguably don’t. Implications?Compassion FatigueHere I was, all this time, worrying that maybe I’m a selfish person, and now it turns out I’ve been suffering from compassion fatigue.Comorbidity from the NCS-R StudyNumber of DisordersNumber of Disorders% of Sample% of Sample1155%55%2222%22%3+3+23%23%Overlap of symptomsMajor Depressive Disorder (MDD)5 or more of the following over 2 weeks:Overlap of symptomsGeneralized