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BehavioralSocio-cultural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)Why do we diagnose?What’s the point?TreatmentResearchPredictionPatients and their FamiliesWhat 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Axis I - Clinical DisordersAxis II - Personality DisordersAxis III - Physical/medical problemsAxis IV - Psychosocial/environmental problemsAxis V - Global Assessment of FunctioningEvolution 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 changesFormatDisorders (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 DSMCompassion 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 Anxiety DisorderExcessive anxiety occurring more days than not for 6+ monthsDifficult to control worryThe worry is associated with 3 or more of following symptoms: -Restlessness -Irritability -Keyed up/on edge -Muscle tension -Easily fatigued -Sleep disturbance -Difficulty concentratingAnxiety disordersMost include irrational fear and avoidanceTypes:Specific phobiaSocial anxiety disorderGADAgoraphobiaPanic disorderPanic AttackSymptomsEmotion: intense fearPhysiological componentsHeartbeat changesSweatingTrembling, shakingShortness of breathFeeling of choking–Chest pain or discomfort–Nausea or abdominal distress–Dizzy, lightheaded, faint–Chills or hot flushes–Parasthesias•Cognitive components–Fear of losing control or going crazy–Fear of dying–Derealization or depersonalizationTrauma and stress related disordersFormerly part of the anxiety disorders in DSM-IVPTSDObsessive compulsive and related disordersOCDHoarding disorderBody Dysmorphia Disorder (BDD)OCD symptomsObsessionsCompulsionsObsessive-Compulsive DisorderGeneral types of obsessionsGeneral types of compulsionsHoarding disorderMoved from being a subtype of OCD to its own diagnosis in DSM 5Obsessive compulsive and related disorders: Body dysmorphic disorderFormerly part of “somatoform disorders” in DSM IVBody Dysmorphic Disorder (BDD)- can also have BDD by proxyEtiology (of anxiety disorders)Genetics (concordance rate)Cognitive factors Anxiety sensitivityPreparednessConditioning (Mowrer’s two factor