Psychological Disorders (DSM V) A.P. Psychology

Antisocial Personality Disorder

(Must be 18- doesn't count if issues arise b/c of substance use disorder); psychopath; disregard for rules/other's rights, liars, no empathy, lack of remorse, fail to conform to societal norms, most are incarcerated, aggressive; charming; able to manipulate 1) Failure to conform to social norms; performing acts that are grounds for arrest 2) Deceitfulness (lying, using aliases, conning) others for profit/pleasure 3) Impulsivity or failure to plan ahead 4) Irritability or aggressiveness as indicated by repeated physical fights/assaults 5) Reckless regard for safety of self/others 6) Consistent irresponsibility (repeated failure to sustain consistent work behavior/honor financial responsibilities) 7) Lack of remorse indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from others

Depersonalization/Derealization Disorder

*Episodes of depersonalization are characterized by feelings of unreality, detachment from, or being an outside observer w/ respect to one's thoughts, feelings, sensations, body, or actions. The patient may describe unfamiliarity with one's self, or from aspects of the self. The patient may report experiences of feeling somehow detached from self, perhaps feeling like an outside observer watching herself in a dream or a movie. The individual may feel detached from the whole self ("I am no one/I have no self."); or the individual may feel subjectively detached from certain aspects of the self ("I know I have feelings, but I don't feel them."); thoughts ("My thoughts don't feel like my own.") The depersonalization patient may feel robotic, or feel like a "split self," with one part of the self-observing the other parts of the self. *Derealization consists of experiences of unreality or detachment w/ respect to surroundings. Individuals/objects may seem unreal, dreamlike, foggy, & lifeless. Patient may describe feeling as if she were in a fog/dream/bubble/veil/glass wall. Derealization is often accompanied by visual distortions, such as blurriness. Auditory distortions are also possible in which voices may sound muted or heightened. May have difficulty describing their symptoms and may think they are "going crazy." A commonly associated symptom is a distorted sense of time (i.e. too fast or too slow).

Schizotypal Personality Disorder

1) Ideas of reference; incorrect interpretations of causal incidents or external events as having a particular meaning specifically for that person 2) Odd beliefs/magical thinking- supersticiousness, clairvoyance, telepathy, 6th sense, paranormal phenomena, special powers; magical control over people 3) Unusual perceptual experiences (sensing another person is present) 4) Odd thinking/speech 5) Suspicious/paranoid 6) Inappropriate or constricted affect 7) Behavior or appearance that is odd, eccentric, peculiar 8) Lack of close friends 9) Social anxiety, associated w/ paranoid fears * Pick up on the fact that others mock and make fun & them & in turn have few close relationships

Manic Episode

A distinct period of at least one week of persistently elevated, expansive, or irritable mood & abnormally & persistently goal-directed activity or energy; lasting at least one week & present mood of the day nearly every day 3/9 1) Inflated self-esteem or grandiosity 2) Significantly decreased need for sleep 3) Extremely talkative; pressured, rapid speech, pressure to keep talking 4) Thoughts are racing; flight of ideas 5) Extremely distractible; can't concentrate 6) Increase in goal-directed activities 7) Excessive involvement in activities that have a high potential for painful consequences (risky behavior) 8) Disturbance is sufficiently severe to cause marked impairment in social or occupational functioning 9) At least one manic episode is required for the diagnosis of Bipolar I Disorder * lost control, views of self are extremely distorted/irrational, dramatic

Schizophrenia

At least 1 of these symptoms must be prevalent. 1. Delusions (disorders of thought). Delusions are bizarre thoughts or beliefs, meaning that these beliefs are clearly implausible. Delusions are fixed beliefs that are not amenable to change in the light of contradictory evidence. 2. Hallucinations (disorders of perception)- perceptual experiences that are not caused by any real sensory stimulus. (ex. hearing voices or sounds, when in reality there is no source of these sounds.) Hallucinations are perceptions that occur in the absence of any external stimulus. Auditory hallucinations are usually experienced as voices, either familiar or unfamiliar. 3. Disorganized Speech. Incoherent, peculiar speech. One of the most classic presentations of schizophrenic language involves loose associations- when the schizophrenic patient's speech wanders far away from the topic (derailment). If the schizophrenic patient's thoughts are irrelevant to the topic being discussed (tangentiality), she is engaging in loose associations. For example, asked what movie she would like to see on a field trip, a schizophrenic patient might respond that, "the movie screen that has a silk screen T shirt is just the right one." Or "the theater of the absurd, that's the one." 4. Grossly Disorganized or Catatonic Behavior. This category of symptoms may be expressed in a variety of ways, ranging from childlike silliness to unpredictable agitation. Schizophrenic individuals may exhibit a wide array of aberrations in movement. 5. Negative symptoms- problems of omission/lack or loss of function. One example of negative symptoms is diminished emotional expression - reductions in facial cues associated with emotions, eye contact, intonation of speech (prosody), and hand movements that normally give emotional emphasis to speech. Another negative symptom, avolition, refers to a decrease in motivated self-initiated purposeful behavior. The avoilitional schizophrenic patient may sit for long periods of time showing little or no interest in participating in work or social activities. They withdraw from involvement with the interpersonal environment around them.

Disruptive Mood Dysregulation Disorder

Chronic, sever, persistent irritability A) Temper outburst in response to frustration B) Persistent irritable or angry mood that present btw the severe temper outburst 1) Severe recurrent temper outbursts 2) Temper outbursts are inconsistent w/ developmental level 3) 3 or more times a week 4) Persistently irritable or angry most of the day nearly every day 5) 12+ months 6) 2/3 settings (home, school, peers); sever in at least 1 setting 7) Age 6-18; age of onset before age 10 8) Not manic/hypomanic for more than a day 9) Don't occur during episodes of major depression

Post-Traumatic Stress Disorder

Develops in a person who has experienced or witnessed an extremely stressful event or threat that causes significant fear & helplessness. Threatened death, serious injury, or sexual violence Exposure At least one intrusion symptom: - Recurrent, involuntary, & intrusive distressing memories of the traumatic event - Recurrent distressing dreams about/related to event - Flashbacks; reoccurring - Distress in response to cues resembling event - Psychological distress in reaction to cues -At least one avoidance symptom: - Avoiding distressing memories/thoughts/feelings associated w/ traumatic event - Avoiding external reminders (people/places/activities) that arouse distressing memories/thoughts/feelings associated w/ distress of event - Two or more negative alterations in cognitions & mood associated w/ traumatic event - Inability to remember important aspect(s) of the event (dissociative amnesia) - Negative/persistent & exaggerated expectations of self/others - Persistent distorted cognitions about cause or consequences of event; self-blame - Negative emotional state - Feelings of detachment/estrangement from others - Inability to experience positive emotions (happiness, love, etc.) - Two or more marked alterations in arousal/reactivity - Irritability/anger - Reckless/self-destructive behavior - Hyper vigilance - Exaggerated startle response - Problems w/ concentration - Sleep disturbance

Major Depressive Episode

During a 2 week period, patient must report either depressed mood or loss of interest or pleasure which represents a change from previous functioning. 5/9 symptoms during a 2 week period 1) Depressed mood most of the day nearly every day 2) Markedly diminished interest or pleasure in all or most daily activities most of the day every day 3) Significant weight loss/gain 4) Insomnia or hypersomnia 5) Psychomotor retardation or agitation nearly every day 6) Fatigue or loss of energy almost every day 7) Feelings of worthlessness or excessive or inappropriate guilt 8) Diminished ability to think or concentrate 9) Recurrent thoughts of death or recurrent thoughts of suicide/suicide attempt/suicide plan

Major Depressive Disorder

During a 2 week period, the patient must report either depressed mood or loss of interest in pleasure which represents a change from previous functioning: 5/9 symptoms during a 2 week period: 1) Depressed mood most of the day nearly every day as indicated by subjective report 2) Markedly diminished interest or pleasure in all or most daily activities most of the day nearly every day 3) Significant weight loss or gain 4) Insomnia or hyper insomnia 5) Psychomotor retardation or agitation nearly every day 6) Fatigue or loss of energy almost every day 7) Feelings of worthlessness or excessive or inappropriate guilt 8) Diminished ability to think or concentrate 9) Recurrent thoughts of death or suicide; suicide attempt; or suicide plan

Bipolar Disorder I

Essential feature is mood swings that interfere w/ adjustment and involve the occurrence of 1+ manic episode; patient also may have episodes of major depression Examples: * Patient has unstable moods, & in his distant past had 1 single manic episode * Patient never experienced depression, only manic episodes * Patient has never experiences a mixed episode * Patient's mood swings from normal mood to repeated manic episodes * Patient's moods swing from major depression to manic or mixed episodes

Somatic Symptom Disorder

Excessive thoughts, feelings, or behaviors related to health concerns 1) Disproportionate & persistent thoughts about serious of one's symptoms 2) Anxiety about health/symptoms 3) Time & energy devoted to heath or symptoms

Narcissistic Personality Disorder

Grandiose sense of self importance, unrealistic expecatations to be treated as special, arrogant, envy, lack of empathy, want to be worshipped, poor potential partner, hypersensitive about image (denial, devaluation, suicide- if ego is threatened) 1) Has a grandiose sense of self-importance (exaggerates achievements/talents) 2) Preoccupied w/ fantasies of unlimited power, success, brilliance, beauty 3) Believes he is special & unique 4) Requires excessive admiration 5) Has a sense of entitlement (favorable treatment) 6) Interpersonally exploitative (takes advantage of others to achieve own ends) 7) Lacks empathy 8) Envious of others/believes others are envious of him 9) Shows arrogance

Borderline Personality Disorder

Impulsive, emotionally intense, all good or all bad, thoughts determined by mood, cannot be alone, lacks stable sense of self, excessive anger 1) Frantic efforts to avoid real or imagined abandonment 2) Unstable/intense interpersonal relationships characterized by alternating idealization & devaluation 3) Identity disturbance characterized by markedly & persistently unstable self-image or sense of self 4) Impulsivity in at least 2 areas that is potentially self-damaging (spending, sexual behavior, substance abuse, reckless driving) 5) Recurrent suicidal behavior, gestures, threats, or self-mutilation 6) Affective instability due to marked reactivity of mood 7) Chronic feelings of emptiness 8) Inappropriate, intense anger or difficulty controlling anger 9) Transient, stress-related paranoid ideation

Dissociative Identity Disorder (Multiple Personality Disorder)

Involves the disruption of identity characterized by the presence of 2 or more distinct identities or personality states recurrently taking control of the patient's behavior. The disruption in identity involves marked discontinuity in sense of self accompanied by related alterations in mood, behavior, consciousness, memory, perception, and cognition. When in 1 personality state (referred to as an "alter") the patient may or may not be able to recall other personality states that he has been in. Recurrent gaps in the recall of every day events and/or important personal information are inconsistent w/ ordinary forgetting. Usually, history of extreme and traumatic child abuse.

Schizoid Personality Disorder

Lack desire to form social relationships, little need for emotional ties, socially unresponsive 1) Neither desires nor enjoys close relationships 2) Chooses solitary activities 3) Little if any interest in having sexual experiences w/ another person 4) Takes pleasure in few activities 5) Lacks close friends other than 1st degree relatives 6) Indifferent to praise/criticism 7) Emotional coldness/detachment/flat affect

Histrionic Personality Disorder

Lively, dramatic, attention seeking, charming, lack emotional depth, vague speech 1) Uncomfortable in situations in which she is not the center of attention 2) Interaction w/ others is inappropriate sexually seductive or provocative 3) Shallow expression of emotions 4) Consistently uses physical appearance to draw attention to oneself 5) Style of speech is excessively impressionistic & lacking in detail 6) Self-dramatization, theatricality, exaggerated expression of emotion 7) Suggestible; easily convinced 8) Considers relationships to be more intimate than they actually are

Social Anxiety Disorder

Marked by persistent fear of social interaction or performance situations, 1) Public scrutiny, conversation, meeting unfamiliar people, being observed, performing 2) Social situations almost always provoke fear/anxiety 3) Social situations are avoided or endured w/ intense fear/anxiety 4) Fear out of proportion to actual threat 5) Fear is persistent (6+ months)

Dependent Personality Disorder

Need to be taken care of (submissive/clingy); fear of separation; begin in early adulthood 1) Difficulty making everyday decisions w/o excessive amount of advice & reassurance from others 2) Needs others to assume responsibility for major areas of life 3) Difficulty expressing disagreement w/ others b/c of fear of loss of support/approval 4) Difficulty initiating projects or doing things on his own b/c of lack of confidence in judgment or abilities 5) Goes to excessive lengths to obtain nurturance & support from others; could include volunteering to do things that are unpleasant 6) Feels uncomfortable/helpless when alone b/c of exaggerated fears of being unable to care for self 7) Seeks another relationship as a source of care & support when a close relationship ends 8) Is unrealistically preoccupied w/ fears of being left to take care of self

Obsessive Compulsive Disorder

Obsessions, compulsions, or both Obsessions- persistent, unwanted, intrusive, repetitive, mental events that arouse anxiety or distress - Anxiety provoking thoughts, memories, wishes, urges, feelings, impulses, and images - Excessive & inappropriate (often in head; not visible); patient knows but can't find ways to control; individual attempts to ignore/suppress/neutralize w/ some other thoughts/actions (ex. Performing compulsions) Compulsions- repetitive behaviors or mental acts that OCD patients feel driven to do in order to reduce anxiety; aimed to neautralize anxiety; anxiety is prevented from doing said acts; most likely realize what's going on ; becomes uncomfortable if you stop them - Repetitive behaviors (ex. Hand washing, rechecking) that person feels driven to perform in response to obsession or according to rules that must be applied - Aimed at preventing/reducing anxiety; or preventing some dreaded act; excessive

Agoraphobia

Often paired w/ panic disorder; involving physical space; lower level of functioning; affects work, store, etc. 2/5 situations 1) Using public transportation 2) Being in open spaces 3) Being in enclosed spaces 4) Standing in line or being in a crowd 5) Being outside of the home alone * must show avoidance behavior; avoids b/c of the thought that escape might be difficult

Generalized Anxiety Disorder

Ongoing worry about multiple things that interferes with everyday activities; chronic tension; exaggerated startle response; symptoms: 1) Restlessness 2) Being easily fatigued 3) Difficulty concentrating or mind going blank 4) Irritability 5) Muscle tension 6) Sleep disturbance (falling/staying asleep)

Schizoaffective Disorder

Patient has an uninterrupted period of mental illness during which there is a major mood episode (major depressive or manic). Additionally, delusions or hallucinations are present *Essential Features: 1. An uninterrupted period of illness during which the individual continues to display schizophrenia symptoms concurrent with symptoms of a major mood disturbance (Major depressive episode or Manic episode) 2. Delusions or hallucinations *Subtypes: • Bipolar Subtype- in cases in which the patient experiences a manic or mixed episode • Depressive Subtype- in which the patient experiences only major depressive episodes.

Body Dysmorphic Disorder

Patient is preoccupied w/ a perceived physical defect; however to objective observer there is no defect 1) Preoccupation w/ one or more perceived defect/flaw in physical appearance that isn't observable or appear slight to others 2) At some point, individual has performed repetitive behaviors (mirror checking, grooming, skin picking) or mental acts (comparing appearance to others) in response to appearance concerns 3) Significant impairment/distress * May undergo cosmetic surgery to "fix" problem * Once one problem is "fixed" another is likely to arise * 16-17 age of onset, more prevalent in US * Specify w/ muscle dysmorphia- body build is perceived to be too small or insufficiently muscular * Specify w/ good/fair, poor, or absent/delusional insight (in relation to how true their beliefs are)

Avoidant Personality Disorder

Pervasive, persistent social inhibition, hypersensitive to negative evaluation 1) Avoids occupational activities that involve significant interpersonal contact b/c of fear of criticism, disapproval, rejection 2) Unwilling to get involved w/ people unless certain of being liked 3) Shows restraint w/in intimate relationships b/c of fear of being shamed or ridiculed 4) Preoccupied w/ being rejected or criticized in social situations 5) Inhibited in new interpersonal situations b/c of feelings of inadequacy 6) Views self as socially inept, personally unappealing, or inferior to others 7) Usually reluctant to take personal risks or engage in any new activities b/c they might prove embarrassing

Obsessive Compulsive Personality Disorder

Preoccupation w/ orderliness, perfectionism, & mental/interpersonal control, at the expense of inflexibility, openness & efficiency; Rules, lists, high standards, rigid thinking/morals, stubborn, stinginess 1) Preoccupied w/ details, rules, lists, order, organization, schedules to the extent that the major point of the activity is lost 2) Perfectionism that interferes w/ task completion 3) Excessively devoted to work to the exclusion of leisure activities/friendships 4) Over conscientious, scrupulous, & inflexible about matters of morality, ethics, values 5) Unable to discard worn-out worthless objects even when they have no sentimental value 6) Reluctant to delegate tasks or to work w/ others unless they submit exactly his way of doing things 7) Adopt a miserly spending style towards self/others; money is viewed as something to be hoarded for future catastrophes 8) Shows rigidity and stubbornness

Panic Disorder

Presence of recurrent unexpected intense anxiety attack; uncomfortable/unpredictable anxiety attacks; surge of discomfort/fear 1) Palpitations/pounding heart/accelerated heart rate 2) Sweating 3) Trembling/shaking 4) Sensations of shortness of breath 5) Feelings of choking 6) Chest pain/discomfort 7) Nausea/abdominal distress 8) Feeling dizzy/unsteady/light-headed/faint 9) Chills/heat sensations 10) Parasthesias (numbness/tingling) 11) Derealization/depersonalization 12) Fear of losing control 13) Fear of dying

Specific Phobia

Problematic anxiety/fear of a specific object or situation: 1) Excessive, unreasonable fear caused by anticipation or presence of a specific object (snake, heights) 2) Patient understands fear is excessive/unreasonable 3) Much energy is expended to avoid phobic stimulus 4) Phobic object/situation almost always provokes immediate fear/anxiety 5) Fear out of proportion to real danger 6) Fear causes distress/impairment and/or other areas of functioning

Bipolar Disorder II

Serious mental illness, but typically less devastating than BDI b/c the patient never experienced any manic episodes 1) Presence or history of one or more Major Depressive Episodes 2) Presence or history of Hypomanic episode 3) There has never been a Manic or Mixed Episode * Indicate severity; mild, moderate, severe

Paranoid Personality Disorder

Suspicious/distrust, grudges, reading into nonexistent threats/messages, "ordinary concerns" just not actually happening 1) Suspects w/o sufficient basis others are exploiting, harming/deceiving him 2) Preoccupied w/ unjustified doubts about loyalty/trust 3) Reluctant to confide in others b/c of fear info will be used against him 4) Reads hidden demeaning/threatening means into benign remarks/events 5) Bears grudges 6) Perceives attacks on character/reputation that are not apparent to others; reacts angrily 7) Recurrent suspicion w/o justification regarding fidelity of spouse/partner * Projection- sees their own repressed problems in others; may join hate groups, etc.

Dissociative (Psychogenic) Amnesia

The Dissociative Amnesia patient is unable to recall important personal information, often related to a trauma or significant stressor. The memory loss is almost always anterograde- memory loss is for time after the trauma or stressor. Specify if with fugue state.

Delusional Disorder

The presence for 1 month or longer of 1 or more delusions; delusions seem odd but can live a relatively normal life; *, grandiose, jealous, persecutory, somatic

Conversion Disorder

loss or altered voluntary motor or sensory function without neurological or medical condition cause; looks like neurological problem; possible stress converted to physical ailments