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Introduction to Psychological Disorders
Learning Goals and Objectives
 Give a brief overview of the history of mental illness
 Understand the problems inherent in defining the concept of psychological disorder
 Describe what is meant by harmful dysfunction
 Identify the formal criteria that thoughts, feelings, and behaviors must be considered
abnormal and, thus, symptomatic of a psychological disorder
 Describe the basic features of the Diagnostic and Statistical Manual of Mental Disorders,
Fifth Edition
 Discuss changes in the DSM over time
Definition of a Psychological Disorder
A condition characterized by abnormal thoughts, feelings,
and behaviors.
Psychopathology is the study of psychological disorders.
Also refers to the manifestation of a psychological disorder.
Often conceptualized as inner experiences that are atypical,
distressful, dysfunctional, and even dangerous as a sign of
a disorder.
History of Mental Illness
 The timeline begins with the year 1798 and
focuses on Phillipe Pinel considered one of the
founders of Psychiatry. During this point in
history, those who suffered from mental illness
were kept from public view by locking them in
insane asylums and treating them as prisoners.
The image shows Pinel standing next to a woman
at the Pitié-Salpêtrière Hospital in Paris, France
whose restraints were being removed. He was
one of the early advocates for the mentally ill and
worked to change hospital conditions and
attitudes so more humane treatment was
provided He published his classification of mental
disorders that consisted of melancholia, mania
(insanity), dementia, and idiotism.
History of Mental Illness
 Sigmund Freud (1856-1939) Freud’s
influence on the development of the
DSM is recognized for his theory of
neuroses and the subsequent
inclusion of neurotic disorders in the
DSM-I. He also helped shape the
eventual development and inclusion
of post traumatic stress disorder in
DSM-III. (See DSM-I link on the
timeline)
History of Mental Illness
 Congress passed legislation in 1946 authorizing the
creation of NIMH. Federal funding for training mental
health professionals skyrocketed. In the pre-World War
II era, unlike our current circumstances, organized
psychiatry was not in the business of conducting
outpatient psychotherapy with the ordinary person with
problems of anxiety and depression, and clinical
psychology was not in business at all. Instead, psychiatry
was much as it had been at the end of the 19th century,
a limited profession dealing chiefly with the severely
mentally ill populations of large state hospitals. The
experience of psychiatrists in World War II changed all
of that rather spectacularly, and that change continued
into the post-World War II era. (2000) Hauts, Arthur.
Fifty Years of Psychiatric Nomenclature: Reflections on
the 1943 War Department Technical Bulletin, Medical
203
History of Mental Illness
 DSM-IV
 1994
The APA appointed Dr. Allen
Francis, committee chair, to begin
a comprehensive revision of the
DSM. Dr. Francis is currently one of
the more vocal critics of the DSM-
5.
DSM-IV-TR© 2000
 Most changes were made to the descriptive
text of the manual. Some of the diagnostic
codes were changed to reflect updates in the
ICD 9. Having realized that the next version
of the DSM would not be ready for many
years, yet wanting to maintain the currency
and value of the DSM, the APA published the
Text Revision in 2000.True to its name, the
majority of the changes were to the
descriptive text, as opposed to the symptom
lists or the diagnoses themselves. In some
instances, examples were provided for clarity,
additional instructions were given, or
changes were made to the introduction
sections.
DSM-5 2013
Thirteen workgroups
worked a full 10 years
before the publication of
the DSM-5 in May, 2013.
Changes from DSM-IV to DSM-V
 DSM-IV based on the multi-axial system of
classification
 DSM-V provides information about
comorbidity: The co-occurrence of two
disorders
 The DSM-V longer than the DSM-IV and
includes many categories of disorders
(specific symptoms required for diagnosis
(diagnostic criteria)
 Shows a lifetime prevalence rate (the
percentage of people in a population who
develop a disorder in their lifetime –of various
psychological disorders.
Cultural Expectations
 Behavior various from culture to culture
 What may be expected and considered appropriate in one culture may not
be viewed as such in other cultures.
 Ex.: Returning a stranger’s smile is expected in the United States and considered
the social norm
 Ex: Cultural expectations in Japan involve showing reserve, restraint, and a concern
for maintaining privacy around strangers. Japanese people are generally
unresponsive to smiles from stranger.
 Other Ex: Eye contact (Considered rude in Latin Americans, African and Asian
cultures)
Harmful Dysfunction
 Dysfunction occurs when an internal mechanism breaks down
and can no longer perform normal function.
 The dysfunction must be harmful in that it leads to negative
consequences for the individual or for others, as judged by the
standards of the individual’s culture.
 The harm may include significant internal anguish (anxiety or
depression) or problems in day-to-day living.
American Psychiatric Association (APA) Definition
 Many of the features of the harmful dysfunction model are incorporated in a
formal definition of psychological disorder developed by the American
Psychiatric Association (APA). According to the APA (2013), a psychological
disorder is a condition that is said to consist of the following:
 There are significant disturbances in thoughts, feelings, and behaviors.
 The disturbances reflect some kind of biological, psychological, or developmental
dysfunction.
 The disturbance lead to significant distress or disturbance in one’s life.
 The disturbances do not reflect expected or culturally approved responses to
certain events.
Defining the presence of a psychological disorder
 Hallucinations
 Hearing Voices
 Feeling extremely depressed to the point of losing interest in activities
 Difficulty eating or sleeping
 Felt utterly worthless
 Contemplated Suicide
 (Just because something is atypical, does not necessarily mean it is
disordered)
 .
Diagnosing and Classifying Psychological Disorders
Why a classification system is needed:
 It enables professionals to use a common language with others in
the field and aids in communication about the disorder with the
patient, colleagues, and the public.
 Guides proper and successful treatment
Diagnostic and Statistical Manual of Mental Disorders
 The classification system used by most U.S. professionals is the (DSM-
V)
 It has undergone several changes; the 5th and most recent edition ,
the DSM-5 was published in 2013.
 The diagnostic manual includes a total of 237 sp0ecific diagnosable
disorders, each described in detail, including its symptoms,
prevalence risk factors, and comorbidity.
 Comorbidity is the co-occurrences of two or more disorders.

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Introduction to Psychological Disorders

  • 2. Learning Goals and Objectives  Give a brief overview of the history of mental illness  Understand the problems inherent in defining the concept of psychological disorder  Describe what is meant by harmful dysfunction  Identify the formal criteria that thoughts, feelings, and behaviors must be considered abnormal and, thus, symptomatic of a psychological disorder  Describe the basic features of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition  Discuss changes in the DSM over time
  • 3. Definition of a Psychological Disorder A condition characterized by abnormal thoughts, feelings, and behaviors. Psychopathology is the study of psychological disorders. Also refers to the manifestation of a psychological disorder. Often conceptualized as inner experiences that are atypical, distressful, dysfunctional, and even dangerous as a sign of a disorder.
  • 4. History of Mental Illness  The timeline begins with the year 1798 and focuses on Phillipe Pinel considered one of the founders of Psychiatry. During this point in history, those who suffered from mental illness were kept from public view by locking them in insane asylums and treating them as prisoners. The image shows Pinel standing next to a woman at the Pitié-Salpêtrière Hospital in Paris, France whose restraints were being removed. He was one of the early advocates for the mentally ill and worked to change hospital conditions and attitudes so more humane treatment was provided He published his classification of mental disorders that consisted of melancholia, mania (insanity), dementia, and idiotism.
  • 5. History of Mental Illness  Sigmund Freud (1856-1939) Freud’s influence on the development of the DSM is recognized for his theory of neuroses and the subsequent inclusion of neurotic disorders in the DSM-I. He also helped shape the eventual development and inclusion of post traumatic stress disorder in DSM-III. (See DSM-I link on the timeline)
  • 6. History of Mental Illness  Congress passed legislation in 1946 authorizing the creation of NIMH. Federal funding for training mental health professionals skyrocketed. In the pre-World War II era, unlike our current circumstances, organized psychiatry was not in the business of conducting outpatient psychotherapy with the ordinary person with problems of anxiety and depression, and clinical psychology was not in business at all. Instead, psychiatry was much as it had been at the end of the 19th century, a limited profession dealing chiefly with the severely mentally ill populations of large state hospitals. The experience of psychiatrists in World War II changed all of that rather spectacularly, and that change continued into the post-World War II era. (2000) Hauts, Arthur. Fifty Years of Psychiatric Nomenclature: Reflections on the 1943 War Department Technical Bulletin, Medical 203
  • 7. History of Mental Illness  DSM-IV  1994 The APA appointed Dr. Allen Francis, committee chair, to begin a comprehensive revision of the DSM. Dr. Francis is currently one of the more vocal critics of the DSM- 5.
  • 8. DSM-IV-TR© 2000  Most changes were made to the descriptive text of the manual. Some of the diagnostic codes were changed to reflect updates in the ICD 9. Having realized that the next version of the DSM would not be ready for many years, yet wanting to maintain the currency and value of the DSM, the APA published the Text Revision in 2000.True to its name, the majority of the changes were to the descriptive text, as opposed to the symptom lists or the diagnoses themselves. In some instances, examples were provided for clarity, additional instructions were given, or changes were made to the introduction sections.
  • 9. DSM-5 2013 Thirteen workgroups worked a full 10 years before the publication of the DSM-5 in May, 2013.
  • 10. Changes from DSM-IV to DSM-V  DSM-IV based on the multi-axial system of classification  DSM-V provides information about comorbidity: The co-occurrence of two disorders  The DSM-V longer than the DSM-IV and includes many categories of disorders (specific symptoms required for diagnosis (diagnostic criteria)  Shows a lifetime prevalence rate (the percentage of people in a population who develop a disorder in their lifetime –of various psychological disorders.
  • 11. Cultural Expectations  Behavior various from culture to culture  What may be expected and considered appropriate in one culture may not be viewed as such in other cultures.  Ex.: Returning a stranger’s smile is expected in the United States and considered the social norm  Ex: Cultural expectations in Japan involve showing reserve, restraint, and a concern for maintaining privacy around strangers. Japanese people are generally unresponsive to smiles from stranger.  Other Ex: Eye contact (Considered rude in Latin Americans, African and Asian cultures)
  • 12. Harmful Dysfunction  Dysfunction occurs when an internal mechanism breaks down and can no longer perform normal function.  The dysfunction must be harmful in that it leads to negative consequences for the individual or for others, as judged by the standards of the individual’s culture.  The harm may include significant internal anguish (anxiety or depression) or problems in day-to-day living.
  • 13. American Psychiatric Association (APA) Definition  Many of the features of the harmful dysfunction model are incorporated in a formal definition of psychological disorder developed by the American Psychiatric Association (APA). According to the APA (2013), a psychological disorder is a condition that is said to consist of the following:  There are significant disturbances in thoughts, feelings, and behaviors.  The disturbances reflect some kind of biological, psychological, or developmental dysfunction.  The disturbance lead to significant distress or disturbance in one’s life.  The disturbances do not reflect expected or culturally approved responses to certain events.
  • 14. Defining the presence of a psychological disorder  Hallucinations  Hearing Voices  Feeling extremely depressed to the point of losing interest in activities  Difficulty eating or sleeping  Felt utterly worthless  Contemplated Suicide  (Just because something is atypical, does not necessarily mean it is disordered)  .
  • 15. Diagnosing and Classifying Psychological Disorders Why a classification system is needed:  It enables professionals to use a common language with others in the field and aids in communication about the disorder with the patient, colleagues, and the public.  Guides proper and successful treatment
  • 16. Diagnostic and Statistical Manual of Mental Disorders  The classification system used by most U.S. professionals is the (DSM- V)  It has undergone several changes; the 5th and most recent edition , the DSM-5 was published in 2013.  The diagnostic manual includes a total of 237 sp0ecific diagnosable disorders, each described in detail, including its symptoms, prevalence risk factors, and comorbidity.  Comorbidity is the co-occurrences of two or more disorders.