B32.Chapter 3.docx

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18 Apr 2012
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Chapter 3
- During the nineteenth and early twentieth centuries, there was great inconsistency in the
classification of abnormal behaviour a wide diversity of classification
Current Diagnostic System of the American Psychiatric Association (DSM-IV & DSM-IV-TR)
- Mental Disorder: a clinically significant behavioural or psychological syndrome or pattern that
occurs in an individual and that is associated with present distress (i.e. a painful symptom) or
disability (i.e. impairment in one or more important areas of functioning) or with a significantly
increased risk of suffering death, pain, disability, or an important loss of freedom
- A number of conditions are excluded from consideration:
In addition, this syndrome or pattern must not be merely an expectable and culturally
sanctioned response to a particular event, for example, the death of a loved one.
Whatever its original cause, it must currently be considered a manifestation of a
behavioural, psychological, or biological dysfunction in the individual
- Five Dimensions of Classification
Differences between the third and subsequent versions: Multiaxial Classification each
individual is rated on five separate dimensions or axes
1. Axis I. All diagnostic categories except personality disorders and mental retardation
Mental health professional consulted i.e. depression or anxiety disorder
2. Axis II. Personality disorders and mental retardation
Dependent personality disorder
3. Axis III. General medical conditions
Relevant to the mental disorder in question i.e. heart patient + depression drug
implications
4. Axis IV. Psychosocial and environmental problems
i.e. occupational problems, economic problems, interpersonal difficulties
5. Axis V. Current level of functioning
i.e. social relationships, occupational functioning and use of leisure time give
information about the need for treatment
- Axis I and II compose the classification of abnormal behaviour, I and II are separated to ensure
that the presence of long-term disturbances is not overlooked
- The remaining three axis are not actually needed to make a diagnosis there to indicate that
factors other than a person’s symptoms should also be considered
Diagnostic Categories (of axis I and II)
a) Disorders usually first diagnosed in infancy, childhood, or adolescence
Child with separation anxiety disorder has excessive anxiety about being away form
home or parents
Children with conduct disorder repeatedly violate social norms and rules
Individuals with attention deficit hyperactivity disorder have difficulty sustaining
attention and are unable to control their activity when the situation calls for it
Individuals with mental retardation show subnormal intellectual functioning and deficits
in adaptive functioning
The pervasive developmental disorders include autistic disorder, a severe condition in
which the individual has problems in acquiring communication skills and deficits in
relating to other people
Learning disorders refer to delays in the acquisition of speech, reading, arithmetic, and
writing skills
b) Substance related disorders
Diagnosed when the ingestion of some substance alcohol, opiates, cocaine,
amphetamines, etc has changed behaviour enough to impair social or occupational
functioning
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These substances may also cause or contribute to the development of other Axis I
disorders, i.e. mood or anxiety disorders
c) Schizophrenia
Contact with reality is fault
Language and communication are disordered, and may shift from one subject to another
in ways that make them difficult to understand
Commonly experience delusions and hallucinations
Emotions are blunted, flattened or inappropriate
d) Mood Disorders
People whose moods are extremely high or low
Major depressive disorder the person is deeply sad and discouraged and is likely to lose
weight and energy and have suicidal thoughts and feelings of self-reproach
Mania described as exceedingly euphoric, irritable, more active than usual, distractible,
and possessed of unrealistically high self-esteem
Bipolar disorder experiences episodes of mania, or of both mania and depression
e) Anxiety Disorders
Have some form of irrational or overblown fear as the central disturbance
Individuals with phobia fear n object or situation so intensely that they must avoid it,
even though they know that their fear is unwarranted for and unreasonable and disrupts
their lives
Panic disorder the person is subject to sudden but brief attacks of intense apprehension,
so upsetting that they tremble and shake, feel dizzy, and have trouble breathing; may be
accompanied by agoraphobia, when the person is afraid of leaving familiar surroundings
Generalized anxiety disorder fear and apprehension are pervasive, persisten, and
uncontrollable, they worry constantly, on edge, and easily tired
OCD subject to persistent obsessions or compulsions; an obsession is a recurrent
thought, idea, or image that uncontrollable dominates a person’s consciousness; a
compulsion is an urge to perform a stereotyped act
Post-traumatic stress disorder experiencing anxiety and emotional numbness in the
aftermath of a very traumatic event
Acute stress disorder similar to ptsd but symptoms do not last long
f) Somatoform Disorders
The physical symptoms of somatoform disorders have no known physiological cause but
seem to serve a psychological purpose
Somatisation disorder these people have a long history of multiple physical complaints
for which they have taken medicine or consulted doctors
Conversion disorder these people report the loss of motor or sensory function, such as
paralysis, an anaesthesia or blindness
Pain disorder suffer from severe and prolonged pain
Hypochondriasis the misinterpretation of minor physical sensations as serious illness
People with body dysmorphis disorder are preoccupied with an imagined defect in their
appearance
g) Dissociative Disorders
Psychological dissociation is a sudden alteration in consciousness that affects memory
and identity
Dissociative amnesia may forget their entire past or lose their memory for a particular
time period
Dissociative fugue the individual suddenly and unexpectedly travels to a new locale,
starts a new life, and cannot remember previous identity
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