When does abnormal behavior become psychopathology?

1. Doing physical harm to self or others

2. Can't hold down job (or attend school) or carry out regular responsibilities

3. Inability to enjoy life, others' company

4. Deviation from statistical norms or cultural norms

Diagnostic and Statistical Manual of Mental Disorders

Published by the American PSYCHIATRIC Association

DSM-IV - published 1994

First DSM - 1952

Difficulties with the DSM:

1. One size doesn't fit all.

2. Helps with diagnosis, but doesn't help explain cause or point to cure.

"Naming is not explaining"

3. Symptoms in the person are usually not as clear as they are described in the manual

4. Often overlap between disorders

Five Axes of the DSM

Axis I - clinical syndromes or major mental health disorders

Axis II - personality disorders (and mental retardation)

Axis III - physical disorders that might precipitate or interact with psychological disorders

Axis IV - Severity of psychosocial stressors in environment

diathesis stress model - people with an underlying vulnerability for a psychology disorders start to exhibit symptoms when put under stressful circumstances

Axis V - global assessment of person's functioning

Broad Categories of Mental Illness:

Schizophrenia

Anxiety disorders

Examples: Phobias, Obsessive Compulsive Disorder, Post Traumatic Stress Syndrome (some would argue is dissociative disorder)

Dissociative disorders

Examples: Dissociative Identity Disorder (multiple personality disorder), dissociative amnesia

Mood disorders

Examples: Major Depression, Bipolar Disorder (manic depression)

Personality disorders

Examples: Borderline Personality Disorder, Antisocial Personality Disorder

Schizophrenia

largely heritable

identical twin with schizophrenia? -> 50% chance other twin will have it.

Prevalence - 2% or less of population

diagnosis often occurs in 20's

Schizophrenia - term comes from Latin for "split mind"

NOT "split personality" - instead, split from reality

Positive (present) symptoms reflect presence, or addition of symptoms not seen in normal people -

voices

delusions

Negative (absent) symptoms reflect absence of things normally seen in normal people -

"flat" affect

social avoidance

Types of Schizophrenia

disorganized -

disturbed thinking

hallucinations

disorganized speech

bizarre behavior

catatonic schizophrenia -

withdraws from world

may sit immobile for long time

speaks very little

paranoid schiz -

hallucinations and delusions that are marked by paranoia

persecution beliefs

can be dangerous

undifferentiated -

symptoms don't allow clear diagnosis in other categories.

residual schiz -

category for people who had major episode, but now show no or minor symptoms.

Rosenhan's "Sane in Insane Places" investigation

Went to hospitals, said they heard voices, then once checked in, reported no more symptoms

Eventually released from hospitals - 7 to 52 days later, most with diagnosis of "schizophrenia in remission"

Raises issue of labeling

personality disorders - enduring, maladaptive patterns of thought, behavior, and feeling that lead to chronic disturbances in functioning

Diagnoses on Axis II of DSM-IV

Maybe 10% of population

Borderline personality disorder

Antisocial personality disorder

Obsessive compulsive personality disorder - perfectionist, high concern with rules and details.

Schizotypal personality disorder - characterized by eccentric or bizarre behavior

Anxiety Disorders

(Axis I disorders)

Estimated 15% of population in US experience at some point.

Phobias - persistent, irrational, disruptive fears

More common in women than men

Sometimes linked with initial traumatic experience with trigger

systematic desensitization - common treatment for phobias

Obsessive compulsive disorder: disorder marked by persistent, uncontrollable intrusions of unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsions)