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Chapter 16
Psychological Disorders
DSM-IV
• Diagnostic and Statistical Manual of
Psychiatric Disorders
• Criteria for diagnosis
• Normal vs. abnormal behavior
– Interferes with daily life
– Severity of behavior
Mental Retardation
• IQ and adaptive functioning
• Mild MR: 55-70 IQ (simple job, live in
community with supervision)
• Moderate MR: 40-55 IQ (Self-care skills)
• Severe MR: 25-40 IQ (Assistance with
skills)
• Profound IQ: IQ below 25: often nonverbal
Learning Disorders
• Reading, writing, math
• Average or above average IQ
• Assess intelligence, achievement,
cognition
Autistic Disorder
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Social impairment, oblivious to others
Poor peer relationships
Lack of social/emotional reciprocity
Delay in spoken language
Stereotyped mannerisms
Adherence to routines
Asperger’s is a milder form with no delay
in language
ADHD
• Attention-Deficit/Hyperactivity Disorder
– Predominantly inattentive type,
– Predominantly hyperactive-impulsive type
– Combined type
Conduct Disorder
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Aggression to people and animals
Fighting
Destruction of property
Deceitfulness or theft
Serious violation of rules (truancy, running
away)
Oppositional Defiant Disorder
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Loses temper
Argues with adults
Defiant, noncompliant
Blames others
Dementia
• Memory impairment
Substance-Related Disorders
• Substance Abuse: recurrent use; failure to
fulfill obligations at work, school, home
• Substance Dependence
– Tolerance: need increased amount of
substance to achieve desired effects
Substance-Related Disorders
• Alcohol, amphetamines, caffeine-induced
anxiety, cannabis, cocaine, hallucinogens,
inhalants, nicotine, opioids, sedative,
hypnotic, anxiolytics
Schizophrenia
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Delusions
Hallucinations, usually auditory
Disorganized, incoherent speech
Grossly disorganized or catatonic behavior
Flat affect
Social/work dysfunction
Very severe form of mental illness
Types of Schizophrenia
• Paranoid: frequent delusions,
hallucinations
• Disorganized: prominent features of
disorganized speech, disorganized
behavior, flat or inappropriate affect
• Catatonic: motoric immobility, rigid
posture, mutism or echolalia
Delusional Disorder
• Nonbizarre delusions (poisoned, deceived)
– Erotomanic: someone is in love with them
– Grandiose: special powers, special
relationship with God
– Jealous
– Persecutory: treated poorly
– Somatic: physical defect
– Therapy is difficult because they don’t trust
the therapist and don’t think there is problem
Mood Disorders
• Major Depression
• Dysthymia
• Bipolar disorder
Major Depression
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Depressed mood
Anhedonia
Changes in appetite or sleep
Feelings of guilt, worthlessness
Problems with concentration
Suicidal thoughts or behavior
Manic Episode
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Inflated self-esteem or grandiosity
Decreased need for sleep
Increased talking
Flight of ideas, racing thoughts
Distractibility
Impulsivity, without regard for
consequences
Anxiety Disorders
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Panic Attacks
Agoraphobia
Social phobias
Obsessive-Compulsive Disorder
PTSD
Generalized Anxiety Disorder
Panic Attack
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Pounding, racing heart, chest pain
Sweating
Nausea
Dizziness
Fear of losing control, “going crazy”
Fear of dying
Phobias
• Specific phobia
– Excessive, unreasonable fear (heights, flying)
– Interferes with life
• Social phobia
– Fear of social situations
– Avoidance of social situations
Obsessive-Compulsive Disorder
• Either obsessive or compulsive
• Obsessions: recurrent thought that are
intrusive, inappropriate
• Compulsions: repetitive behaviors (handwashing, counting)
PTSD
• Post-traumatic stress disorder
• Experience or witness event that involved
actual or threatened death or injury
• Symptoms: distressing recollections,
avoidance of similar stimuli, irritability,
difficulty sleeping, nightmares, startle,
hypervigilant
Generalized Anxiety Disorder
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Excessive, uncontrollable worry
Restless, irritable
Sleep disturbance
Problems concentrating
Somatoform Disorders
• Somatization Disorder
– Many physical complaints before age 30
– Seeking of medical treatment
– Symptoms are not explained medically
• Hypochondriasis
– Fear of having serious disease, preoccupation
with symptoms that persists in spite of
medical reassurance
Dissociative Disorders
• Dissociative amnesia
– Forget personal information
• Dissociative fugue
– Travel from home
– Can’t remember your past
– May assume new identity
• Dissociative identity disorder
– Multiple personality disorder
– 2 or more personalities
– Loss of time
Sexual Dysfunctions
• Sexual arousal disorder
– Failure to maintain arousal through
completion of sex act, compared to someone
of similar age, health, etc.
• Orgasmic disorder
– Under conditions of adequate arousal
• Premature Ejaculation
• Vaginismus
Paraphilias
• Exhibitionism
• Fetishism (non-living objects for sexual arousal)
• Frotteurism (touching, rubbing, a non-consenting
person)
• Pedophilia
• Sexual masochism
• Sexual sadism
• Voyeurism
Gender Identity Disorder
• Stated desire or insistence that you are
opposite sex
• Preference for cross sex roles or fantasies
of being the other sex
• Pass as the other sex
Eating Disorders
• Anorexia nervosa
• Bulimia nervosa
Sleep Disorders
• Primary Insomnia: difficulty initiating or
maintaining sleep
• Primary hypersomnia: excessive
sleepiness, prolonged sleep
• Narcolepsy: daily irresistible sleep attacks
• Nightmare disorder
• Sleep Terrors: intense fear, physiological
reaction to nightmares
• Sleepwalking disorder
Impulsive Disorders
• Intermittent explosive disorder: assaultive
or destructive behavior out of proportion to
stressor
• Kleptomania
• Pyromania
• Pathological gambling: preoccupation with
gambling, can’t stop, lie to conceal
gambling
Personality Disorders
• Enduring pattern that deviates markedly
from expectation of culture
• May affect
– Cognition: perceive, interpret events
– Affect
– Interpersonal functioning impulse control
Paranoid Personality Disorder
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Suspect others trying to harm you
Preoccupied with doubts of loyalty
Reads hidden meaning into things
Bears grudges
Schizoid Personality Disorder
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Can’t enjoy close relationships
Prefer solitary activities
Little interest in sex
No close friends, except family
Detached, indifferent to praise
Antisocial Personality Disorder
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Unlawful behavior
Lying, con artist
Disregard for others
Lack of remorse
Irresponsible
Borderline Personality Disorder
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Avoids abandonment by others
Unstable, intense relationships
Impulsive
Suicidal threats or gestures
Labile
Inappropriate anger
Narcissistic Personality Disorder
• Grandiose sense of self
• Sees self as special, only understood by
important people
• Requires excessive admiration
• Sense of entitlement
• Takes advantage of others
• Lacks empathy
Histrionic Personality Disorder
• Needs to be center of attention
• Dramatic, seductive behavior
• Shallow expression of emotion
Avoidant Personality Disorder
• Unwilling to associate unless certain of
being liked
• Fear of being criticized, rejected
• Sees self as inept
Dependent Personality Disorder
• Needs assurance to make everyday
decisions
• Others needed to take responsibility for
them
• Difficulty expressing disagreement
Obsessive-Compulsive Personality
• Perfectionistic
• Preoccupied with rules
• Morally inflexible