DSM

Abnormal Behaviour:
Abnormal Behaviour: patterns of emotion, though and action considered pathological for one or more of the following reasons:

1) Statistical Infrequency:
– Compare the frequency of an individual’s behaviour to the frequency of that behaviour in everyone else
– Can’t be used as an indicator by itself

2) Disability or Dysfunction
– If emotions, thoughts or actions interfere with a person’s ability to function in their own life and in society

3) Personal Distress
– For some disorders a person’s own evaluation of their level of functioning can be used to indicate behaviour is abnormal
– Can’t be used as an indicator by itself

4) Violation of Norms
– Behavioural that violates the cultural rules that guide behaviour can be considered abnormal
– Culture is a huge influence on what is “normal”. Can cause problems problems with analysis or behaviour

History and Culture:
– Stone Age: drilled hole in the skull to release the evil spirits that are causing behaviour abnormalities
– Middle Ages: people with mental disorders were generally mistaken for witches, or believe to be possessed by demons, and were treated in a way that would kill them (to prove they are witches / demons)
– 15th 16th centuries: asylums for mentally ill, inhumane conditions, overcrowded, kept chained
– 17th 18th centuries: people who were titled insane were put into local workhouses, and jails. Restraints and forced confinement were used for people who were thought to be dangerous
– Modern times: psychiatry, diagnosis of mental illness, specific treatment for specific illnesses, based on the medical model, most people with psychiatric illnesses can be integrated in society (some are in psychiatric facilities)

Culture – Specific Disorders:
– Gururumba: New Guinea, “wild man” episode, burglars neighbouring homes & steals objects of assumed wealth (not valuable), runs into forest, returns days later without objects & with amnesia of event
– Anorexia Nervosa: Western cultures (N. America, Europe), primarily among young women, excessive exercise & low food intake; body image is poor & goal is to achieve ideal body
– Running amok: Malaysia, Thailand, Indonesia, wild out of control, aggressive behaviour, attempt to injure / kill others
– Koro: China, delusion of penis shrinking into body, accompanied by panic / fear of dying
– Wendigo: Native Americans, intensely craves human flesh & thinks they are turning into a cannibal.

Anxiety Disorders:
Panic Disorder – panic attack: a sudden rush of intense fear discomfort which includes at least 4 symptoms:
o Racing or pounding heart
o Sweating, chills or hot flashes
o Shortness of breath
o Nausea, upset stomach, dizziness
o A sense of things being unreal
o Numbness or tingling sensations
o Fear of going crazy or fear of dying
– Panic attacks are fairly common but having one doesn’t’ mean you have a panic disorder
– Panic attacks are unexpected and unpredictable in panic disorders
Agoraphobia: fear of avoidance of situations or places where escape may be difficult
(Not always a panic disorder)
– Type of situations: being alone or away from home or enclosed, open or crowded places
– Once people start avoiding certain situations they often find themselves avoiding more and more until they avoid almost everything
– Adults with a panic disorder will often change their behaviour to feel safer
o Carrying meds, cell phone
o Having a companion
o Sitting near exits
o Avoiding physical activity
PTSD:
– No on type of trauma that can lead to PTSD, several different kinds all which have common elements:
1) The trauma was life-threatening or led to an injury
2) The individual reacted to the trauma with intense fear, helplessness or horror
– You can develop PTSD if you have been directly involved or witnessed a traumatic event
o Being in or seeing a serious car accident
o Being sexually assaulted/raped
o Being involved in a war or witnessing war violence/death
– In order to receive a diagnosis of PTSD, you need to be currently experiencing at least 1 symptom of the 3 sections
1) Symptoms of Reliving or “re-experiencing” the trauma
– Upsetting memories about the event
– Nightmares about the trauma
– Acting as if the trauma were happening again (reliving it)
– Anxiety or distress when reminded of the trauma
2) Symptoms of Avoidance
– Avoiding reminders, thoughts, feelings or memories of the trauma
– Not able to recall parts of the trauma
– Reduced interest in previously enjoyed activities
– Feeling detached or unable to experience feelings
3) Symptoms of Increased Anxiety or “hyperarousal”
– Sleep difficulties
– Anger outbursts or irritability
– Concentration difficulty
– Hyper-vigilance: “on guard” or “on alert”

Specific Phobia Disorder:
– Phobias are intense fears about specific places, situations or things
5 different categories of phobias:
1) Animal (spiders, snakes, dogs, etc)
2) Natural environment (heights, thunderstorms, etc)
3) Injection injury (blood, needles, medical procedures, etc)
4) Situational (the dark, confined spaces, etc)
5) Other (choking, illness, etc)
– If you have a phobia, may feel intense emotions from mild anxiety, sever panic and even the feeling that you’re going mad
– The fear is usually expressed physically by an increase in heart rate, sweating, trembling, nausea, but most fo all, an overpowering urge to escape
– Avoidance is the most common reaction because it helps you to feel better and less afraid
How a Phobia Develops:
– Research suggests that phobias can run in families
– A phobia can develop after being exposed to a traumatic event
– Can develop a phobia after receiving frightening information
– May develop by observing the anxious response of others

– Most common type of anxiety disorder
– Adult phobias start suddenly and tend to be more persistent than childhood phobias

Generalized Anxiety Disorder – GAD
– People with GAD worry excessively and uncontrollably about daily life events and activities
– Often experience uncomfortable physical symptoms like fatigue and sore muscles, also can have trouble sleeping and concentrating
– Worry involves thoughts about negative events that might happen… “what if” questions
– People with GAD worry more than others would and find it hard to stop
– They worry about things that are minor, school, family, health, etc
– Physical Feelings:
o Feelings of anxiety of getting upset easily
o Muscle pain
o Unable to sit still or difficulty concentrating
“Chaining”: when one worry leads to others
– People with GAD like to be 100% certain, these behaviours help them fell that
o Excessive reassurance – seeking
o Checking or list making
o Refusal to delegate others
o Avoidance/procrastination
o Having others make decisions
o Distraction/keeping busy
– GAD is considered a chronic problem and usually develops in childhood
– Research suggests that almost 90% of people with GAD will have another mood or anxiety disorder
Social Anxiety Disorder – SAD
– Most common anxiety disorder, people with SAD tend to feel quite nervous or uncomfortable in social situations
– Performance situation: situations where people feel they are being observed by others
Ex. Public speaking, eating in front of others
– Interpersonal interactions: situations where people are interacting with others and building closer relationships
Ex. Dating, talking on the phone
– When faces with a feared situation people with SAD experience:
o Physical symptoms: upset stomach, sweating
o Negative symptoms: “others will think I’m stupid”
o Avoidance & Safety behaviours: drinking alcohol
– SAD can effect work/school, relationships, hobbies, etc
– SAD can develop after a stressful/humiliating experience or slowly over time
– Tends to fun in families
– SAD is associated with a number of other problems including low self-esteem, poor body image, depression and substance abuse problems
OCD:
– Occurs in all ages, often starts in childhood
– Symptoms are obsessions (constant upsetting thoughts) or compulsions (habit patterns) which happen often interfering with daily life
– Common Obsessions:
o Fear of germs
o Violent thoughts or rude mental pictures
o Fear of doing something wrong in the future/fear of having already done something wrong
o Constant self-doubting
o Need for things to be even/symmetrical
– Common Compulsions:
o Checking and counting things
o Washing hands
o Doing work over to get it “perfect”
o Making things “even”
o Asking questions to get reassurance
o Collecting, hoarding or touching things
– OCD does run in families but what causes it is unknown
– Lots of medicines work for OCD: works gradually over a period of weeks
– Complications include: not going to school, bad sleep, alcohol and drug use, family problems, becoming isolated, etc.

Mood Disorder
– A significant and lasting disruption in mood as the predominant symptom. This cause impaired cognitive, behavioural. And physical functioning.
– Different from normal moods because of longer duration, higher intensity, and absence of causes
Major Depression:
– Emotional:
o Constant sadness
o Hopelessness and worthlessness
o Empty, emotionless
o Irritated and angry
o Tired, run-down, (despite good sleep
o Reckless
– Cognitive
o Indecisive
o Hard to think concentrate
o “Things won’t get better”
o “Nothing makes me happy”
o “I’m not good enough”
o “It would be better if I wasn’t alive”
– Behavioural:
o Don’t like things I used to
o Eating more or less than usual
o Trouble sleeping or sleeping a lot
o Low motivation
– Physical:
o Aches and pains not caused by activity
o Weight gain or loss
o Slower speech and responses
o Low energy
– Occurrence:
o Over 8% of Canadians will experience depression in their lifetime
o Greatest risk is under age 20
o Women are twice as likely to be affected by depression
o 80% of Canadians treated for depression respond well
o 90% of Canadians suffering from depression never seek help
Other Depressive Mood Disorders:
– Dysthymic disorder” chronic, low-grade depression that produce discomfort but doesn’t impair ability to function
– Seasonal Affect Disorder: episodes of depression that typically recur in fall/winter
Bipolar Disorder:
– Alternating moods of major depression and mania
– Mania can last from days to a few months
– Depression typically lasts 3x longer than the manic phase
– Bipolar Type 1 – severe mania to severe depression
– Bipolar Type 2 – hypomania to severe depression
– Rapid cycling – 4 distinct mood episodes (depression, mania) in one year
– Mixed state – characteristics of mania & depression exhibited at the same time
Mania Symptoms:
– Elevated, expansive mood
– Increased energy
– Increased mental activity
– Inflated self-confidence
– Aggressive irritability/behaviour
– Rapid, unpredictable mood changes
– Sleeplessness
– Racing thoughts/racing speech
– Risk-taking behaviour/impulsivity
– Distractibility
– Poor judgement
– Increased interest in activities
– Delusions/Hallucinations (rare)

Schizophrenia Disorders
– A group of severe disorders characterized by the breakdown of personality functioning, withdrawal from reality, distorted emotions, and disturbed thoughts.
Positive symptoms (in addition to “normal” behaviour:
– Delusions
– Auditory hallucinations
– Disorganized thought processes, speech, and behaviour
– Disturbances involving extremely high or low motor activity levels or odd movements and gestures
Negative symptoms (absence of “normal” behaviour):
– Flat affect, showing little emotion
– Inability to feel pleasure
– Lack of motivation
– Lack of meaningful speech
– Cessation of personal hygiene
Types of Schizophrenia:
1) Paranoid schizophrenia
2) Disorganized schizophrenia
3) Catatonic schizophrenia
4) Undifferentiated schizophrenia
5) Residual schizophrenia
Onset:
– Men: younger than 25
Women: between 25 and 45
– Gradual onset
o 3 phases: pro-modal (few symptoms), active (full symptoms), residual (subtle symptoms: impaired functioning)
– Sudden onset: occurs early, associated with recovery with no recurrence.
Causes:
– Biological
o Genetic
o Neurotransmitter
o Brain function
– Psychosocial:
o Stress
o Family communication
Dissociative Disorder
– Condition that involves disruptions or breakdowns of memory, awareness, and identity.
Dissociation is used as a defence against the trauma
– Unlike most other disorders, there is no genetic influence here
à traumatic experience (often in childhood) is found in almost all cases
à people who tend to fantasize and become absorbed in their own personal experience are more susceptible
Types:
– Dissociative Identity Disorder
o Disorder in which two or more distinct personalities exist in the same person, and there is an extreme memory disruption regarding personal information about the other personalities
• Alternate personalities are often a different gender, race, age, or even species
• Host personality often has no awareness of the existence of other personalities
• All personalities are aware of a “loss of time”
• Diagnosed in women more often than men
o Contentious: some psychologists sceptical of DID
(despite occurrence in many cultures)

– Dissociative Amnesia
o Disorder that involves extensive, but selective, memory loss, but in which there is no physiological explanation for the forgetting
• Loss of memory of traumatic event, task memories remain, personality remains, sometimes they forget basic identity (name, age, occupation, family members)
• Memory usually is recovered with time

– Dissociative Fugue
o Disorder in which an individual loses complete memory of their identity and may even assume a new one, often far from home
• Associated with large-scale traumatic event like war or a natural disaster
• Person loses memory of event, wanders from home, & often adopts new personality
• State can last from hours to several weeks

Personality Disorder
– Disorder characterized by inflexible patterns of thinking, feeling, or relating to others that causes problems in personal, social, and work situations.
o Symptoms are seen in at least two of these areas: impulse control, thought patterns, emotions, interpersonal interactions.
o Symptoms can vary in intensity over time, although usually do stay within a narrow range
Types
Antisocial Personality Disorder
– Disorder characterized by pervasive pattern of violation of the rights of others that begins in childhood or early adolescence and continues into adulthood.
o Failure to conform to society’s norms & expectations
o Impulsive & egocentric
o Inability to feel empathy for others
o Lack of remorse, little distress for the pain they cause others
o Intensity often peaks in 20s, then may decrease over time
o Often also have drug &/or alcohol abuse issues
o Diagnosed more often in males
o Can also be called sociopath, or psychopath
– Borderline Personality Disorder
o Disorder characterized by a prolonged disturbance of personality accompanied by mood swings, unstable personal relationships, identity problems, threats of self-destructive behaviour, fears of abandonment, and impulsivity
o View people in absolutes à perfect or worthless
– Comorbidity
o Occurrence of 2 more disorders in the same person at the same time
– Substance-related disorder
o Drug or alcohol abuse
Somatoform disorder
• Somatoform disorder = disorder related to the experience or expression of real physical symptoms
– Somatization Disorder
o Disorder in which a person experiences numerous long-lasting but seemingly unrelated physical ailments that have no identifiable physical cause
 Chronic, severe disorder with recurring physical symptoms that cannot be fully explained by a physical disorder.
 Symptoms include pain & some combination of digestive, sexual and neurological symptoms
 Symptoms are more likely to appear when a person is under stress and naturally dissipate over time
 People with this disorder tend to have a history of doctor visits, medical tests & even surgeries
Conversion Disorder
– Disorder in which patients experience specific neurological symptoms such as numbness, blindness, or paralysis, but where no neurological explanation is observed or possible
o Examples: hand paralysis; Tommy?
o Old name: Hysteria
o More common in women
Body dysmorphic Disorder
– Disorder accompanied by an imagined or exaggerated defect in body parts or body odour.
o Occurs equally in males & females
 Males: body build, genitals, hair loss
 Females: breasts, body shape
Hypochondriasis
– Disorder focussed on preoccupation, accompanied by excessive worry about having a serious illness
o Misinterpret normal body sensations / processes as signs of illness
o Concerns remain even after medical evaluation and assurance of health
– Somatoform disorders are almost always comorbid with another psych disorder (anxiety, depression, dissociation).
Treatment:
Psychotherapy:
– refers to a range of treatments that can help with mental health problems, emotional challenges and some psychiatric disorders
– Is sometimes called “talking treatment” because it uses talking rather than medications
Biological Treatment:
– Attempts to alter brain functioning with chemical or physical interventions, including drugs that act directly on the brain and body, surgery, and electroconvulsive therapy
– Includes psychopharmacology, biomedical psychosurgery, and electroconvulsive therapy (ECT)
Social Treatment:
– Is based in groups and is an intervention based on the roles of an individual in that group
– The therapy was developed to help someone who is experiencing psychological issues or anxiety to regulate their emotions and build connections to others by participating in a group therapy setting.

Work Cited

Augury, O. (2019, November 20). History of mental disorders. Retrieved from https://en.m.wikipedia.org/wiki/History_of_mental_disorders.

Brazier, Y. (2017, May 23). Psychotherapy: What to expect and how it works. Retrieved from https://www.medicalnewstoday.com/articles/156433.php.

Educational Foundation. (2001). Approaches in Practice. Retrieved from https://www.learner.org/series/discoveringpsychology/therapeutic/biological.html.

Stern, K. (2011). Social Therapy. Retrieved from https://www.cerebralpalsy.org/about-cerebral-palsy/treatment/therapy/social-therapy.