DSM IV Diagnostic and Statistical Manual of the American Psychiatric Association now a 5 th edition but we will focus on the 4th edition o Used to diagnose people with disorders Personality disorder o Something that causes problems in your interpersonal relationships how you deal with things on an emotional level enduring long lasting not an episode present across situations an extreme deviation causes distress for the person or people they know o Deviates from cultural expectations o Inflexible o Onset in adolescence or early adulthood else something else is causing it But never diagnosed while adolescent b c changing and developing o Enduring occurs over time o Causes distress and or impairment in your functioning Narcissistic personality disorder o Pervasive pattern of grandiosity I m amazing and you re not need to feel amazing about self and others are better than others o Need for admiration o Lack of empathy o Beginning by early adulthood o Present in a variety of contexts o Preoccupation with fantasies e g success power etc one of the top people in what o Think they re special and unique and only associate with other special or unique people they do o Need excessive admiration o Feel entitled to admiration o Feel should be given more than others recognition money etc o Self involved o Exploit others o Lack empathy o Envious of others and think others are envious of them Negative feedback is interpreted as jealousy o Arrogant and haughty o Video on man with narcissistic personality disorder Man broke up with girlfriend and describes her as inadequate has nothing to offer wants someone he can depend on Considers self very intelligent Said others ostracized him because they were jealous of him Can t find people of his abilities that are his equal I Have a brilliant mind Wants extra attention Angry that others don t see his brilliance Interprets others criticism as jealousy All about him self centeredness Antisocial personality disorder psychopathy o Psychopathy not actually in personality disorder manual but antisocial personality disorder is o Both involve problems in personality and behavior o Antisocial personality disorder pervasive disregard for the law safety etc Lack remorse Manipulative Not responsible Many people in prison have antisocial personality disorder o Psychopathy personality Superficial charm slick easily convince people to do things smooth talkers Grandiosity different from narcissistic personality disorder b c they need to kind of likeable on a superficial level often put people down physically Need for stimulation like crazy and dangerous things for fun e g driving fast on Pathological lying convincing people of things that aren t actually true the wrong side of the road manipulating people No remorse don t care about how their actions affect other people No empathy can t relate as much to others Shallow affect shallow emotional experiences e g may cry and stop suddenly b c the crying has served its function Prevalence 75 in prisons antisocial personality disorder 20 psychopathic Antisocial personality disorder and psychopathy are more about personality than behavior Some say it is the inability to love or have friends Seem sane but don t have the capacity to experience the world in a normal way E g two people who got married and both were psychopaths He was already a serial rapist They killed her sister She was able to convince people that she was a victim of her husband but she was actually highly involved in the murder He went to jail Borderline personality disorder o Controversial diagnosis b c when someone is a pain people may say they have this o Volatile in how they relate to others and how they manage emotional state disorder o Significant psychological distress o Unstable moods o Episodes of aggression o Self mutilation o Suicide threats to get attention o Unstable self image o May feel empty or don t have a good sense of who they are o See others as all good or all bad e g may practically worship someone until they find flaws and then think they are all bad extreme anger o Often seek psychiatric treatment difficult b c so unstable Histrionic personality disorder o Don t diagnose that often o Overdiagnose women compared to men o Excessive need for attention over the top o Grandiose and provocative dressing and behavior o Everything is overly dramatic e g overly flirtatious o Emotions are shallow and unstable o Seem like they are on stage o Not extremely problematic for the person experiencing the disorder Introduction to Axis I Mental Psychopathological Conditions and their Treatment Advantages and disadvantages of diagnoses review of disorders Problems not good to label people but this unit discusses how to label them must be cautious However the stigma associated with mental illness is changing Labeling can be good to show what needs people have DSM IV classification system different axes don t worry about axis V o Axis I disorders treatable transient in nature E g schizophrenia mood disorders sleep disorders etc o Axis II personality disorders mental retardation considered more permanent E g antisocial borderline etc o Axis III Medical conditions E g cancer o Axis IV crises in life E g homeless in process of divorce etc Effects of labels o Helpful in facilitating communication o Can stigmatize and lead to self fulfilling prophecies Influence how you interact with people Video on David David Rosenhan s study On Being Sane in Insane Places o Many people used to be institutionalized before the 1960s o Then they realized in the 1960s and 70s that people have the right to be out in the world and that the community can manage them if they aren t dangerous o Rosenhan and a group of people got admitted into an institution claiming they were hearing voices then acted normal after they were admitted Everyone interpreted their behavior which was normal as proof that they were mentally ill o They became dehumanized and had very little contact with people very few visitors o Were diagnosed as schizophrenic even though weren t o These institutions were places people put others whom they didn t want around in society o Rosenhan emphasized the fact that people with mental disorders are human o Shows us that labels can bias our views o You shouldn t diagnose with only one symptom unless it s really extreme Mental disorder causes o Family and sociological factors o Cognitive behavioral factors what you think and how you act o Biological factors E g low