Abnormal BehaviorDSM – 5 Version

Abnormal Behavior Abnormal

Behavior that is personally disturbing or disabling, or culturally so deviant that others just judge it as maladaptive, inappropriate, or unjustifiable.

Atypical/deviant statistically, the behavior is rear and has a very low probability of

occurring Legally Insane

Inability to determine right from wrong

Causes for Abnormal Behavior Psychoanalytic/Psychodynamic – Childhood trauma,

unconscious Behavioral – learned from reinforcement Humanist – poor self-concept Cognitive – irrational thought Evolutionary – genes change (Darwin) Biological – Neurochemical, hormonal Biopsychosocial – biological influences such as evolution,

genes etc, psychological influences such as stress, trauma, learned helplessness, social cultural influences such as roles, expectations.

The Medical Model Medical model looks at abnormal behavior as a disease,

using terms such as psychopathology, which is the study of the origin, development, and manifestations of mental or behavioral disorders. Etiology – cause and development of illness Prognosis – forecasts the probable course of an illness

Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Published 2013 Guidebook for mental health professionals 22 Major Categories of mental disorders subdivided into

hundreds of disorders

Insurance and DSM-5 Health care providers are required to use diagnosis code set

from the World Health Organization’s International Classification of Diseases and Related Health Problems (ICD-10).

DSM-5 and ICD-10 guide medical diagnoses and define who is eligible for coverage of meds, treatment, and special services

Anxiety Anxiety – impeding doom or disaster from a specific or unknown

source that is characterized by mood symptoms of tension. Anxiety disorders include:

Panic Disorder – repeated attacks of intense anxiety along with sever chest pain, tightness of muscles, choking, sweating, or other acute symptoms Few minutes – hours No apparent trigger

Generalized Anxiety Disorder – chronic anxiety not associated with any specific situation or object. Has trouble sleeping hyper vigilant and tense (Free floating – always there)

Phobias – intense, irrational fear responses to specific stimuli, irrational wish to avoid dreaded situation or object which disrupts daily life Common phobias:

Agoraphobia Acrophobia Claustrophobia Zoophobia

Obsessive-Compulsive and Related Disorders OCD – thought and behavior

Obsessions – unwanted thoughts (worries . . . dirt) Compulsions – ritualistic behaviors (hand washing) OCD Related Disorders

Hoarding – difficulty discarding or parting with possessions

Trauma and Stressor-Related Disorders Post-traumatic stress disorder (PTSD) – some trauma

experienced where victim re-experience the event in nightmares or flashbacks Natural disaster War Violent crime

Somatic Symptom & Related Disorders Somatic symptom disorders – psychiatric symptoms

associated with physical complaints i.e.; patient complain of physical problem (paralysis), and

experience anxiety or maladaptive thoughts, feelings and behavior (used to be referred to as hypochondriasis – no longer) Somatic symptom disorder (SSD) – physical symptoms including pain,

and high anxiety in these individuals about having a disease. Illness anxiety disorder (IAD) – preoccupation with a serious medical or

health condition no or mild physical (somatic) symptoms such as dizziness or nausea

Conversion Disorder – loss of some bodily function without physical damage

Dissociative Disorders Dissociative Disorders – sudden loss of memory (amnesia)

or change in identity. Possible separation of conscious awareness from previous memories/thought. Dissociative Amnesia – loss of memory for a traumatic event or

period of time that is too painful for an individual to remember Dissociative Fugue – amnesia with flight

Dissociative Identity Disorder (DID) – multiple personality disorder

Depressive Disorders Depressive Disorders – extremely sad mood and lack of

energy. Affects twice as many women than men. Common cold of psychology – diagnosed so often

Major Depressive Disorder – single and recurrent episodes (2 weeks) Depression with Season Pattern (Seasonal Affective Disorder) – is a

subtype of depression that recurs, usually during the winter months Premenstrual dysphoric disorder – women between menarche &

menopause “Premenstrual.” Persistent Depressive Disorder (Dysthymia)

Martin Seligman (cognitive) – Learned helplessness Aaron Beck (cognitive) – negative view of themselves

Bipolar and Related Disorders Bipolar Disorder – mania and depression

Rapid cycling – short periods of mania followed by immediate deep depression usually longer in duration

Drug to help: Lithium carbonate I – more severe II – Less severe with less mania

Schizophrenia Spectrum & other Psychotic Disorders Psychosis – reality is highly disordered in thought process Schizophrenia Causes:

Positive – hallucinations and delusions are from excessive neurotransmitter levels of dopamine

Negative – lack of emotion, social withdrawal are from lack of neurotransmitter levels of glutamate

Brain scans show abnormalities in numerous brain regions of individuals with Schizophrenia. These abnormalities may result from teratogens such as viruses or genetic predispositions

Diathesis-stress model people predisposed to schizophrenia are more vulnerable to stressors than other people. Therefore, those predisposed and also stressed are likely to develop schizophrenia.

DSM-V: Schizophrenic Spectrum Disorders

Criterion A lists the five key symptoms of schizophrenic spectrum disorders:

1. delusions,

2. hallucinations,

3. disorganized speech

4. disorganized or catatonic behavior

• Echolalia – repeat sounds

5. negative symptoms Must present 2 of the 5 and one must

be from the first three presented above.

Personality Disorders Personality Disorders – longstanding, maladaptive thought

and behavior patterns that are troublesome to others, harmful, or illegal. 3 Clusters:

Odd/eccentric (including paranoid, schoizoid, schizotypal) Dramatic/emotionally problematic (including histrionic, narcissistic,

borderline, and antisocial) Chronic fearfulness/avoidant (including avoidant, dependent, and

obsessive-compulsive)

Personality Disorders: Odd/Eccentrict Paranoid – pervasive, unwarranted suspiciousness and

mistrust; overly sensitive; often envious (common in males) Schizoid – Poor capacity for forming social relationships; shy,

withdrawn behavior; considered “cold” (common in males) Schizotypal – Odd thinking; often suspicious and hostile

Personality Disorders: Dramatic/emotionally problematic Histrionic – Excessively dramatic; seeking attention and

tending to overreact; egocentric (common in females) Narcissistic – Unrealistically self-important; manipulative;

lacking empathy; expects special treatment; can’t take criticism (common in males)

Borderline – Emotionally unstable; impulsive; unpredictable; irritable; prone to boredom (common in females)

Antisocial – (sociopaths/psychopaths) Violate others rights with out guilt or remorse. Manipulative, exploitive, self-indulgent, irresponsible; can be charming. (common in males)

Personality Disorders: Chronic fearfulness/avoidant Avoidant – excessively sensitive to potential rejection,

humiliation, desires acceptance but is socially withdrawn Dependent – Excessively lacking in self-confidence;

subordinates own needs; allows other to make all decisions (more common in females)

Obsessive-compulsive – Usually preoccupied with rules, schedules, details; extremely conventional; serious; emotionally insensitive

Neurodevelopmental Disorders Neurodevelopmental Disorders – disorders of infancy,

childhood, adolescence including intellectual disability, ADHD, and autism spectrum disorder Attention-deficit/hyperactivity disorder (ADHD)

Symptoms: difficulty paying attention, and stay focus, difficulty controlling behavior Subtypes: predominantly hyperactive-impulsive, predominantly inattentive, and

combined hyperactive-impulsive and inattentive Most children with ADHD have combined, while the inattentive/ inappropriate

lead to inappropriate behavior to more personal, social, and academic/work problems

More common in boys (4x) than girls

Autism Spectrum Disorder Neurological disorder first diagnosed in childhood 3 primary symptoms: lack of responsiveness to others, both verbal and

non-verbal communication impairment, limited activities/interests Others: hand flapping, repeating sounds/phrases More common in boys than girls

Organic/Neurocognitive Disorders Neurocognitive Disorders – decline from previous levels of

neurocognitive function ICD-10 labels them as organic disorders – loss of function may

involve complex attention, executive function, learning and memory, language, motor skills

DSM-5 categorizes disorders as major to mild May be linked to specific disease or brain damage such as Alzheimer,

traumatic brain injury, HIV infection, and Parkinson’s disease. All of these can result in dementia, the loss of mental ability

Alzheimer’s Disease – degenerative disease in which the brain neurons progressively die Loss of memory, reasoning, emotion, bodily functions

Delirium – impaired attention and lack of awareness of the environment. Loss of recent memory or orientation, language issues (ramble,

mumble), perceptual disturbances