Psychological Disorders DSMIV What is it A book

Psychological Disorders

DSM-IV What is it? • A book (manual) that includes the most common mental disorders including: a description, criteria for diagnosis, treatment and research findings.

DSM-IV Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV), was published by the American Psychiatric Association, Washington D. C. , in 1994.

A word of warning……. “medical student syndrome” Students can come to believe that they suffer from almost all of the disorders with which they are made familiar because the symptoms of disorders usually overlap with experiences that are universal to the human condition. For example, feelings of sadness are not uncommon among people with healthy minds, even though they are a symptom of depression.

Psychological Disorders • Diagnosis/categorization of mental illnesses can be very subjective… – Homosexuality until 1973 – Body Dysmorphic Disorder • While in the DSM-IV, is not recognized by HMO’s – Koro – Southeast Asia • Men can develop a fear that one’s penis will withdraw into one’s abdomen, causing death – Winigo – Algonquin Indian hunters • Intense fear of being turned into a cannibal by supernatural monster

Psychological Disorders • Diagnosis/categorization of mental illnesses can be very subjective… – Rosenhan (1973) study • Mentally healthy confederates were admitted with schizophrenia into psychiatric hospitals • They then behaved normally in the hospitals, but their normal behavior was interpreted as pathological based on previous diagnosis

DSM-IV The mental disorders in the DSM-IV are listed in 17 categories. The Five most common are: • Mood disorders • Psychotic Disorders • Anxiety Disorders • Eating Disorders • Somatoform Disorders

Mood Disorders • Major Depressive Disorder (Depression) • Bipolar Depression

Major Depressive Disorder • Overwhelming feelings of sadness, despair, hopelessness • Loss of interest in pleasurable activities

Bipolar Disorder • Manic episodes & extreme depression mixed with normal affect • Mania involves delusional levels of optimism, euphoria, & energy • Equally common in both sexes • Sufferers make poor decisions while manic, withdraw when depressed

Genetic Connection • Moderate in major depressive disorder • Strong in bipolar depression

Causes & Treatments Depression: • low norepinephrine&serotoninlevels Mania: • high norepinephrinelevels Major Depressive Disorder: • Antidepressants (serotoninselective reuptake inhibitors, e. g. Prozac)

Causes & Treatments Bipolar Depression: • lithium carbonate • Neurotransmitter levels may be symptomatic of depression, not causal

Cognitive Theory • Cognitive theory attributes depression to distorted thinking • Distorted thinking includes negative views of the world, the future, and the self • Tied to poor reality testing, learned helplessness

Suicide Facts • 10 -14% of those who attempt suicide will eventually succeed in a later attempt • Suicide rates are highest among the elderly • Most suicidal people leave clues of their intentions

Suicide Facts • Most suicidal people have not made a definite decision to die • Suicide is less frequent for married people and women with children • The majority of suicide victims are suffering from depression

Eating Disorders • Anorexia Nervosa • Bulimia • Compulsive Overeating

Quick Facts • An estimated 7, 000 women & 1, 000 men in the U. S. suffer from eating disorders. • 41% of high school students suffer from an eating disorder. • Of all psychological diseases, eating disorders have the highest mortality rates. • Men and women, both young and old, rich and poor, all minorities, suffer from eating disorders. • Eating disorders are more common in women than in men.

What is an eating disorder? • The term “Eating Disorder” is used to describe a variety of eating patterns which are considered abnormal and potentially harmful. • These behaviors may be expressed in the following ways… – Overeating. – Binge eating/eating large amounts of food in a short period of time. – Refusing to eat/self-starvation. – Compulsive exercising. – Overusing diet pills. – Overusing laxatives. – Vomiting.

Anorexia Nervosa • Anorexia Nervosa is a serious, potentially livethreatening eating disorder where an individual refuses to maintain a minimally normal body weight by self-starvation tactics. • Those who suffer from anorexia nervosa often: – Have an irrational fear of becoming fat. – See themselves as fat no matter how much they weigh. – Strive for perfection and set high standards for themselves. – Feel a need for control in their lives. – Suffer from low self-esteem. – Suffer from depression. – Withdraw from social interactions.

Anorexia Nervosa Characteristics • • • Self-starvation with weight loss. Refusal to eat, except in tiny portions. Food preoccupation and rituals. Denial of hunger. Absence or irregular menstrual cycles. Compulsive exercising. Distorted body image. Intense fear of gaining weight. Hair loss. Sensitivity to cold. Lanugo - Light hair covering face and forearms that appears after someone has lost a great amount of weight due to inadequate protein in the diet. • Denial of any unusual eating behaviors. • Lack of concentration. Some or all of these characteristics may be present

Anorexia Nervosa Health Effects • • • Lowered body temperature. Decreased heart rate. Iron deficiency. Depressed immune system. Dehydration. Constipation. Low Blood Potassium - this is the most common cause of death in a long-time anorexic as it an contribute to an irregular heart beat. Swelling or puffiness often in ankle and feet. Bloating.

Bulimia Nervosa • Bulimia Nervosa is a serious, potentially lifethreatening eating disorder where an individual binges and purges, usually in secret, in an attempt to avoid weight gain. – Binge - Eating abnormally large amounts of food. – Purge - Self-induced vomiting, abuse of laxatives or diuretics or periods of “fasting” to get rid of consumed food. • People suffering from Bulimia often: – Suffer from depression. – Have low self-esteem. – Strive for the approval of others. – Do realize they have a problem. – Have shame and guilt - and mood swings. – Withdraw from usual social interactions.

Bulimia Nervosa Characteristics • • Binge eating, usually in secret. Preoccupation with food. Vomiting after binging. Abuse of laxatives, diuretics, diet pills or drugs to induce vomiting. Feeling a lack of control. Depression/Isolation. Usually normal weight or slightly above normal.

Bulimia Nervosa Health Effects • Broken blood vessels in the eyes - a result of the pressure from vomiting. • Tooth/gum erosion due to the stomach acid from vomiting. • Russell’s sign - scar tissue on the knuckle of finger used to induce vomiting. • Swollen salivary glands. • Dehydration. • Constipation. • Low blood potassium. • Poisoning. • Tears in the esophagus. • Ruptured stomach. • Ulcers. • Serious heart, kidney and liver damage.

Causes of Eating Disorders • Generally, there is more than the issue of wanting to be thin that leads to eating disorders. Eating disorders are a sign that deeper personal/ emotional problems exist. • Some issues that lead to an eating disorder include: – Depression, anxiety, anger & loneliness. – Low self-esteem. – Feelings of inadequacy or lack of control in life. – Troubled family or personal relationship. – History of being teased based on size or weight. – History of physical or sexual abuse.