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Mental Illness/Abnormal Behavior
Mental illnesses - medical conditions
that disrupt a person’s thinking, feeling,
mood, ability to relate to others and
daily functioning
- when thinking, mood, etc. is irrational,
uncontrollable, and disruptive
Diagnostic & Statistical Manual of
Mental Disorders, Fourth Edition
(DSM-IV) – Fifth Edition due out in
May, 2013
- “Bible” of psychiatrists
DSM-IV
Standardize language and
diagnosis
Five Dimensions or Axis
1. Clinical disorders, including
major mental disorders and
learning disorders
2. Personality disorders and
intellectual disabilities
3. Acute medical conditions
and physical disorders
4. Psychosocial and
environmental factors
contributing to the disorder
5. Global Assessment of
Functioning
DSM-IV
Controversies
- not reliable & valid  difficult to
diagnose in standard way
- Rosenhan experiment
- does not show causality
- cultural biases
- money maker for
pharmaceuticals
- creates more illnesses
- labels
- EXCUSE for poor behavior
- Thomas Szasz
How prevalent are mental illness?
Any Anxiety Disorder
Any Mood Disorder
Anxiety Disorders
Anxieties are common
-But becomes illness if it is:
- disruptive
- irrational
- uncontrollable
Generalized Anxiety Disorder
-pattern of frequent, constant
worry and anxiety over many
different activities and events
- symptoms include: constant
presence of worry or tension,
difficulty concentrating, fatigue,
irritability, sleeping problems,
restlessness or feeling keyed up or
“on the edge”
Chicken Little Syndrome
- constant feeling of
overwhelming dread!
Anxiety Disorders
Panic Disorder - repeated attacks
of intense fear that something bad
will occur when not expected
Symptoms include: chest pain,
dizziness, feelings of dying or
doom, nausea, breathing issues,
numbness in hands and arms,
racing hear, sweatiness, chills or
hot flashes, uncontrollable
trembling or shaking
Similar to a heart attack
Anxiety Disorders
Phobic Disorder - strong,
irrational fear of something that
poses little or no actual danger
Simple – fear of specific situation
or thing
Agoraphobia - fear of wide open
spaces, crowds, or uncontrolled
social conditions
- Both marked by panic attacks
when confronted with phobic
situation
- 2/3 of all phobias are
agoraphobics
Anxiety Disorders
Obsessive-Compulsive
Disorder – OCD
unwanted and repeated
thoughts, feelings, ideas,
sensations (obsessions), or
behaviors that make them feel
driven to do something
(compulsions)
- most common is fear of germs
and need for cleanliness
- rituals provide only
temporary relief
- not performing rituals causes
greater anxiety
Anxiety Disorders
Post-traumatic Stress Disorder
(PTSD) - anxiety occurring after
one has seen or experienced a
traumatic event that involved the
threat of injury or death
- Symptoms include:
flashbacks, feelings of
emotional numbness, feelings of
detachment, easily startled,
difficulty sleeping, emotional
outbursts, memory
impairment, lack of
concentration, sense of no
future
Mood Disorders
Four types – Major Depression, Bipolar
Disorder, Dysthymic Disorder, &
Cyclothymic Disorder
- once considered the most common form of
mental illness  now anxiety
- most common mood disorder is…
Depression
Women get depressed at twice the rate of
men – Why??
Symptoms fall into 4 categories:
Physical – weight loss, appears fatigued
Behavioral – no interest in favored activities, sleep problems,
eating problems, restless, irritable
Cognitive – inability to think, concentrate, thoughts of suicide
Emotional – feelings of worthlessness, hopelessness, helplessness,
self-loathing
Mood Disorders
Speaking of suicide…
Some facts
- Suicide is second leading cause of
death among young people 18-24
- suicide cuts across all
socioeconomic groups
- suicides occur throughout day
- women attempt suicide at higher
rate than men
- men succeed more
- few suicide victims leave a note
- always get professional help for those
with suicidal thoughts – ok to talk
about their feelings!
Mood Disorders
Bipolar Disorder – once known as Manic
Depression
Two parts – manic – elevated mood –
“high” and depression
- Abrupt mood swings
- Symptoms of manic episode include:
inflated self-esteem, racing thoughts, no
need for sleep, hyperactivity, feelings of
invincibility, agitation, reckless behavior
(incl. spending sprees, promiscuity, binge
eating & drug use)
- affects about 2½% of the population
- story of Patty Duke
Mood Disorders
2 low grade mood disorders
Dysthymic Disorder
- low grade depression with less severe
symptoms
- chronic – longer than 2 years
- able to function
Cyclothymic Disorder
-low grade bipolar – less severe mood
swings
I lied – a fifth mood disorder –
Seasonal Affective Disorder – SAD
- related to seasonal conditions
- depression symptoms
Personality Disorders
- conditions in which a person’s long-term
(chronic) behaviors, emotions, and
thoughts are very different from their
culture’s expectations and cause serious
problems with relationships and work
Paranoid Personality Disorder long-term distrust and suspicion of
others, but does not have a fullblown psychosis
- Symptoms include: concern that
other people have hidden motives,
expectation that they will be
exploited by others, inability to
work together with others,
social isolation,
detachment, hostility
Personality Disorders
Borderline Personality Disorder long-term patterns of unstable or
turbulent emotions, such as feelings
about themselves and others
Symptoms include: see things in extremes
(all good or all bad), fear of abandonment,
feelings of emptiness and boredom, displays
of inappropriate anger, impulsiveness with
money, substance abuse, sexual
relationships, binge eating, or shoplifting,
intolerance of being alone, repeated crises
and acts of self-injury, such as wrist cutting
or overdosing, intense and unstable
relationships
Personality Disorders
Narcissistic Personality Disorder inflated sense of self-importance and an
extreme preoccupation with self
1. exaggerates achievements
2. preoccupied with fantasies of wealth
& power
3. belief in uniqueness or specialness
4. requires excessive admiration
5. sense of entitlement
6. exploitative
7. lacks empathy
8. envious of others
9. arrogant
Personality Disorders
Antisocial Personality Disorder - long-term
pattern of manipulating, exploiting, or
violating the rights of others  CRIMINAL
Symptoms include:
1. failure to conform to social norms  break
laws
2. deceitfulness
3. impulsive or failure to plan ahead
4. aggressive
5. reckless disregard for safety of others
6. irresponsible – does not follow through on
obligations
7. lack of remorse
Dissociative Disorders
involve disruptions or
breakdowns of memory,
awareness, identity and/or
perception
Dissociative amnesia impairment of recall resulting
from emotional or
psychological trauma, not
physiological
- recall retrograde (old) or form
anterograde (new) memories
Dissociative Disorders
Dissociative Fugue - involves
unplanned travel or wandering, and
is sometimes accompanied by the
establishment of a new identity
- rare
- lasts for few days, but can last for
months
- precipitated by a stressful episode
- memories are recovered
Dissociative Disorders
Dissociative Identity Disorder, aka
Multiple Personality Disorder - condition
in which a person displays multiple
distinct identities or personalities, each
with its own pattern of perceiving and
interacting with the environment
- Controversial
- up to 1980 – 200 cases
reported in US
- 1980 to 1990 – 20,000
cases
- 1985-1995 – 40,000
cases
Schizophrenia
disorder that makes it difficult to tell
the difference between real and unreal
experiences, to think logically, to have
normal emotional responses, and to
behave normally in social situations
BREAK WITH REALITY
Symptoms – three types
Positive – excess; should not have them
- hallucinations - hearing, seeing, or
feeling things that are not there
- delusions - false beliefs or thoughts
Schizophrenia
Negative – loss of something you
should have
- alogia – loss of speech
- flat affect – loss of emotions &
vocal tones
- avolition – loss of ability to care
for oneself
Disorganized – random
- bizarre movements with no
relations to environment
- irrational thinking
- no focus
Schizophrenia
Four kinds – based on types of
symptoms
Paranoid - feel anxious, are more
often angry or argumentative,
and falsely believe that others are
trying to harm them or their
loved ones
- positive symptoms
Disorganized - have problems
thinking and expressing their
ideas clearly, often exhibit
childlike behavior, and
frequently show little emotion
- disorganized symptoms
Catatonic - constant state of
unrest, or no movement, rigid;
odd facial expressions and
unresponsive to others
- negative symptoms
- waxy flexibility
Undifferentiated – symptoms of
more than one type of
schizophrenia