09/09/17

What we shall cover today..

Normal & abnormal behavior
DSM 5
Phobias
Psychological Disorders Overview of Psychological disorders

Day 5

Dr. Yogesh Pahuja

CAVEAT CAVEAT
The terms and phrases used in this While reading through DSM 5 and related
presentaGon may seem too TECHNICAL or contents, do not even a8empt to analyze
IMPRESSIVE on the face of it. Kindly refrain your or others behavior.
from using them colloquially.
If you noGce someone doing it, do not
encourage it at all. It is considered very rude,
The purpose of this presentaGon and covering unethical and shows how shallow that person
this topic is to make you aware about it and
NOT EXPERT PSYCHOLOGISTS / is in his/her values and approach.
PSYCHIATRISTS. [Lets leave their job to them]

What is Abnormal Behavior? What is Normal Behavior?

Behavior that is: " Normality is O-en Confused with Reality.
" StaBsBcally unusual " Reality is That Which is Perceived by the
" Considered strange or undesirable by most Senses.
people " Normal Behavior Agrees with or Conforms to
" A source of unhappiness the Societys Accepted PaCerns of Customs,
There are biological, psychological (personal standards), & Rules, Laws, Fears, and Taboos.
socio-cultural factors involved in dening abnormal
behavior.

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The Early Historical Model of

Psychological Disorders Early Mental InsAtuAons
" The Supernatural Model " Early mental insHtuHons were places of torture
Abnormal behavior is the result of possession by demons, through where the mentally disturbed were chained and
magic, &/or the result of supernatural power. Consequently, only certain
people could remove the problem.
abused.

What is a psychological disorder? What Is the Diagnostic and Statistical Manual

(DSM)?

A psychological disorder, also known as a mental >It is used by clinicians and psychiatrists to diagnose psychiatric
disorder, is a pattern of behavioral or psychological symptoms illnesses as well as a tool for assessment.
that impact multiple life areas and/or create distress for the
person experiencing these symptoms. >Published by the American Psychiatric Association and covers all
categories of mental health disorders for both adults and children.
Several examples of each type of psychological
disorder is listed on DSM (Diagnostic and Statistical Manual ) >The manual is non-theoretical focused mostly on describing
of Mental Disorder. symptoms as well as statistics concerning which gender is most
affected by the illness, the typical age of onset, the effects of
treatment, and common treatment approaches.

Systems of classicaBons in Psychiatry. The DSM classicaBon.

- ICD by WHO In 1952, the APA published the DSM.
- DSM by APA
- Chinese ClassicaGon of Mental Disorders [CCMD] DSM-II (1968); DSM-III (1980); DSM-III-R (1987); DSM-
- LaGn American Guide for Psychiatric Diagnosis. IV (1994); and DSM-IV-TR (2000).
- The Research Domain Criteria [RDoC] by NIMH

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The DSM - 5 I n s i d e D S M - 5
Research started in 1999. Divided into three secGons.
Released May 2013.
SecGon I - DSM 5 basics
SecGon II - DiagnosGc criterion and codes
SecGon III - Emerging measures and models
and an Appendix.

1) DisrupGve Mood DysregulaGon Disorder may turn temper tantrums

into a mental disorder.

2) Normal grief may become Major Depressive Disorder.

C r i B c a l A n a l y s i s o f D S M - 5
3) The everyday forgegng characterisGc of old age will now be
misdiagnosed as Minor NeurocogniGve Disorder.

4) DSM 5 will likely trigger a fad of Adult AhenGon Decit Disorder
leading to widespread misuse of sGmulant drugs for performance
enhancement and recreaGon.

5) Excessive eaGng 12 Gmes in 3 months is no longer just a
manifestaGon of gluhony but it is a psychiatric illness called Binge
EaGng Disorder.

6) The changes in the DSM 5 deniGon of AuGsm will result in lowered

rates- perhaps by 50% according to outside research groups.

7) First Gme substance abusers will be lumped in by deniGon with
hard core addicts despite their very dierent treatment needs and
prognosis and the sGgma this will cause.

8) Behavioral AddicGons that eventually can spread to make a mental
disorder of everything we like to do a lot. Eg; New proposed internet
addicGon

9) DSM 5 obscures the already fuzzy boundary been Generalized
Anxiety Disorder and the worries of everyday life.

10) DSM 5 has opened the gate even further to the already exisGng
problem of misdiagnosis of PTSD in forensic segngs.

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Phobias Achluophobia
Fear of darkness

General CauAon:

Some of the pictures you are
about to see may
cause you some level of
ANXIETY, FEAR or DISTRESS.


Individual discreAon is advised.
[ Simply close your eyes when that slide
appears J ]

Phobias Acrophobia Phobias Agliophobia

Fear of heights Fear of pain

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Phobias Agoraphobia Phobias Agrizoophobia

Fear of open spaces Fear of wild animals

Phobias Ailurophobia Phobias Arachnophobia

Fear of cats Fear of spiders

Phobias Arsonphobia Phobias Astraphobia

Fear of fire Fear of thunder and lightning

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Phobias Atychiphobia Phobias Autophobia

Fear of failure Fear of being alone

Phobias Aviophobia Phobias Bacillophobia

Fear of flying Fear of microbes

Phobias Barophobia Phobias Bathophobia

Fear of gravity Fear of depth

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Phobias Chiroptophobia Phobias Claustrophobia

Fear of bats Fear of confined spaces

Phobias Catoptrophobia Phobias Cenophobia

Fear of mirrors Fear of new things or ideas

Phobias Cynophobia Phobias Decidophobia

Fear of dogs or rabies Fear of making decisions

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Phobias Demophobia Phobias Dentophobia

Fear of crowds or crowded places Fear of dentists

Phobias Didaskaleinophobia Phobias Dystychiphobia

Fear of going to school Fear of accidents

Phobias Emetophobia Phobias Entomophobia

Fear of vomiting Fear of Insects

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Phobias Glossophobia Phobias Heliophobia

Fear of public speaking Fear of the Sun

Phobias Hematophobia Phobias Herpetophobia

Fear of blood Fear of reptiles or creepy, crawly things

Phobias Hylophobia Phobias Iatrophobia

Fear of forests Fear of doctors

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Phobias Katsaridaphobia Phobias Mastigophobia

Fear of cockroaches Fear of punishment

Phobias Necrophobia Phobias Nosocomephobia

Fear of death or dead things Fear of hospitals

Phobias Numerophobia Phobias Obesophobia

Fear of numbers Fear of gaining weight

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Phobias Paraskavedekatriaphobia
Fear of Friday the 13th
Phobias Pathophobia
Fear of disease

Phobias Pediophobia Phobias Pedophobia

Fear of dolls Fear of Children

Phobias Pharmacophobia Phobias Phasmophobia

Fear of taking medicine Fear of Ghosts

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Phobias Photophobia Phobias Placophobia

Fear of light Fear of tombstones

Phobias Sciophobia Phobias Selenophobia

Fear of shadows Fear of the Moon

Phobias Sophophobia Phobias Tachophobia

Fear of learning Fear of speed

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Phobias Technophobia Phobias Thalassophobia

Fear of Technology Fear of the sea

Phobias Tomophobia Phobias Triskaidekaphobia

Fear of surgical operations Fear of number thirteen

Phobias Trypanophobia Phobias Xenophobia

Fear of injections Fear of strangers or foreigners

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Phobias Zoophobia
Fear of animals

Psychological Disorders
I felt the need to clean my room would spend four
to five hours at it At the time I loved doing it. Then
I didn't want to do it any more, but I couldnt stop
The clothes hung two fingers apart I touched
my bedroom wall before leaving the house I had
constant anxiety I thought I might be nuts.
Psychological Disorders Marc, diagnosed with
obsessive-compulsive disorder
(from Summers, 1996)

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Psychological Disorders Psychological Disorders

People are fascinated by the exceptional, the To study the abnormal is the best way of
unusual, and the abnormal. This fascination understanding the normal.
may be caused by two reasons: William James (1842-1910)

1. During various moments we feel, think, and act like an 1. There are 450 million people suering from
abnormal individual. psychological disorders (WHO, 2004).

2. Psychological disorders may bring unexplained physical 2. Depression and schizophrenia exist in all cultures of
symptoms and irraBonal fears. the world.

83 84

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Defining Psychological Disorders Deviant, Distressful & Dysfunctional

1. Deviant behavior (going

Mental health workers view psychological naked) in one culture may
disorders as persistently harmful thoughts, be considered normal,
feelings, and acBons. while in others it may lead
to arrest.
2. Deviant behavior must
When behavior is accompany distress.
deviant, distressful, and dysfuncAonal psychiatrists 3. If a behavior is
and psychologists label it as disordered (Comer, dysfuncBonal it is clearly a In the Wodaabe tribe men wear
2004). disorder. costumes to aPract women. In Western
society this would be considered
abnormal.

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Understanding
Psychological Disorders The Medical Model
Ancient Treatments of psychological disorders Philippe Pinel (1745-1826) from France, insisted that
include trephination, exorcism, being caged like madness was not due to demonic possession, but an
animals, being beaten, burned, castrated, mutilated,
ailment of the mind.
or transfused with animals blood.

TrephinaBon (boring holes in the skull to remove evil forces) Dance in the madhouse.

87 88

Medical Model The Biopsychosocial Approach

Assumes that biological, socio-cultural, and
psychological factors combine and interact to produce
When physicians discovered that syphilis led to mental psychological disorders.
disorders, they started using medical models to review the
physical causes of these disorders.
1. EBology: Cause and development of the disorder.
2. Diagnosis: IdenBfying (symptoms) and disBnguishing
one disease from another.
3. Treatment: TreaBng a disorder in a psychiatric hospital.
4. Prognosis: Forecast about the disorder.

89 90

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Types of Psychological Disorders
1. Anxiety Disorders
characterized by excessive and abnormal fear, and anxiety.
Generalized Anxiety Disorder - is a prolonged and exaggerated
worry that has few or no specific sources.
Agoraphobia -sufferer perceives certain environments as
dangerous or uncomfortable, fear in public places.
Social Anxiety Disorder -characterized by intense fear in social
situations and interactions.
Phobias-irrational and excessive fear of an object or situation.
Panic Disorder
-rapid heart rate due to extreme and frequent
panic attacks.
Dissociative Identity Disorder-an extremely complex disorder
that results in two or more split identities
Depersonalization- is characterized as the sensation of being
disengaged from your surroundings, making life seem
dreamlike and less real.
3. Eating Disorders
obsessive concerns with weight and disruptive eating patterns
that negatively impact physical and mental health.
Anorexia Nervosa -pattern of self-starvation & high risk
for suicide attempt.
Bulimia Nervosa
- significant overeating, uses various Ganser Syndrome-
nonsensical or wrong answers to questions,
methods such as vomiting or laxative abuse to prevent weight
gain.
5. Impulse-Control Disorders
involve an inability to control impulses, resulting in harm
to oneself or others.
and personality
Kleptomania -stealing
Pyromania -fire-starting
Trichotillomania -hair-pulling & thinks of being psychosis
Pathological Gambling or Ludomania gamble despite of
harmful negative consequences or a desire to stop.
Intermittent Explosive Disorder extreme expressions of
anger, often to the point of uncontrollable rage.
Dermatillomania - skin-picking, repeated urge to pick at
one's own skin, often to the extent that damage is caused.
done by the HIV/AIDS Viruses.
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Post-traumatic Stress Disorder post trauma or after being
involve in traumatic situations.
Separation Anxiety separation from home or people with strong
emotional attachment
2. Dissociative Disorders
involve a dissociation or interruption in aspects of
consciousness, including identity and memory.
Multiple Personality Disorder-conditions that involve disruptions
or breakdowns of memory, awareness, identity or perception
Dissociative Fugue-rare condition in which a person suddenly,
without planning or warning, travels far from home or work and
leaves behind a past life.
Rumination Disorder -occurs when people constantly
regurgitate and either vomit or re-swallow their food or drink
soon after eating.
4. Factitious Disorders
individual acts as if he or she has an illness, often be
deliberately faking or exaggerating symptoms or even
self-inflicting damage to the body.
Munchausen Syndrome- hospital addiction syndrome.
Munchausen Syndrome by Proxy-exaggeration or fabrication of
illnesses or symptoms by a primary caretaker.
act like having physical or mental illness.
6. Mental Disorders Due to a General Medical Condition
caused by an underlying medical condition. Medical
conditions can cause psychological symptoms such as
catatonia (neurogenic motor immobility)
changes.
Psychotic Disorder due to Epilepsy-prominent hallucinations
or delusions that are judged to be due to the direct
physiological effects of a general medical condition.
Depression caused by Diabetes-persistent sadness & feeling
helpless due to sickness & commonly found in diabetic
person.
AIDS Related Psychosis- it occurs due to brain damages
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Personality changes due to Brain Damage hematoma & brain
damages depends to what extent may affect the memory &
personality.
7. Neurocognitive Disorders
those that involve cognitive abilities such as memory, problem
patient experiences extremes of mood,
solving and perception. Some anxiety disorder, mood disorders
and psychotic disorders are classified as cognitive disorders.
Alzheimer's Disease -still no cure loss of memory.
Delirium-
severe confusion and disorientation least a two week period.
Dementia- is a serious loss of global cognitive ability in a
previously unimpaired person.
Amnesia-loss of memory due to brain damage
>retrograde -retention of new memory but old is lost
> anterograde-retention of old memory but new is lost or both
9. Neurodevelopmental Disorders
also referred to as childhood disorders, are those that are
typically diagnosed during infancy, childhood, or adolescence.
Mental Retardation-impaired cognitive functioning
Learning Disability-
neurobehavioral disorder where in there is childhood behavior. Children suffering from this disorder may
difficulty in learning.
Communication Disorder- speech & language disorder related to
oral motor functions. Simple to complex sound substitution
problem.
Autism- disorder of neural development characterized by
impaired social interaction and verbal and non-verbal
communication.
Conduct Disorders-behavioral & emotional disorders that usually
occurs in children & teens. Disruptive violent behavior.
Delusional Disorder- psychotic mental disorder is diagnosed
when prominent non-bizarre delusionsare present for at least one
month and the symptom criteria for Schizophrenia
11. Personality Disorders
create a maladaptive pattern of thoughts, feelings, and behaviors
that can cause serious detriments to relationships and other life
areas.
Antisocial Personality Disorder- disregarding others, lack of
concern to others right, aggressive and irritable, lacks empathy.
Avoidant Personality Disorder- extreme shyness, sensitive to
criticism and rejection, low self esteem and feeling of inadequacy.
Dependent Personality Disorder - needy behavior, seek out
excessive advice, approval, and encouragement. Low in self
esteem and confidence. Inability to make decisions without others.
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8. Mood Disorders
are all characterized by changes in mood.
Bipolar Disorder-
ranging from mania or hypomania - the upper end of mood
swings - to depression, the lower end.
Major Depressive Disorder-depressed mood or a loss of
interest or pleasure in daily activities consistently for at
Cyclothymic Disorder- common mood swing of mild to
moderate but not like bipolar disorder.
ADHD/Attention Deficit Hyperactivity Disorder - problems with
attention, impulse control, and hyperactivity.
ODD/Oppositional Defiant Disorder-on going pattern of anger-
guided disobedience, hostility, and defiant behavior toward
authority figures which goes beyond the bounds of normal
appear very stubborn and often angry.
10. Psychotic Disorders
involve a loss of contact with reality. People experiencing
psychotic disorders may experience hallucinations and often
display disorganized thinking. Delusional beliefs are another
common characteristic of this class of psychological disorders.
Schizophrenia-perception of the distorted experience of reality,
thought disorder, auditory hallucinations.
Borderline Personality Disorder- usually have poor self identity
that lead to overly intense relationship with others, intense
episode of anxiety, depression and irritability that may last from
few hours to several days. May also engage into self destructive
behavior such as drug abuse, eating disorder or suicide.
Histrionic Personality Disorder- shallow emotions, need others to
witness their emotional displays in order to gain validation or
attention. Often display exaggerated symptoms of weakness or
illnessand may use threats of suicide to manipulate others.
Narcissistic Personality Disorder- common to men than women,
those who seemed more concerned with themselves than with
others, exaggeration of self confidence, arrogance and self
centeredness.
Obsessive-Compulsive Personality Disorder- significant
preoccupation with perfection, control, and order, resistance to
change, rigid and stubborn.
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Paranoid Personality Disorder- feelings that they are being lied
to, deceived, or exploited by other people. Family or loved ones
treated as dishonest, unfaithful and not worth for a trust.
Schizoid Personality Disorder- detachment from other people,
little or no desire to form close relationships with others, often
described as cold, uninterested, withdrawn, and aloof.
Schizotypal Personality Disorder- eccentric perceptions,
thoughts, and behaviors. Magical thinking including saying they
can read minds or can foretell the future. May talk to themselves,
ignore others, or react inappropriately.
12. Sexual and Gender Identity Disorders
are those that impact sexual functioning, while gender identity
disorders are those that involve a discontentment with the
biological sex a person was born with.
Sleep apnea- characterized by pauses in breathing or instances
of shallow or infrequent breathing during sleep. Each pause in
breathing, called anapnea, can last from at least ten seconds to
minutes, and may occur 5 to 30 times or more an hour.
Insomnia- or sleeplessness, is a sleep disorder in which there is
an inability to fall asleep or to stay asleep as long as desired.
14. Somatoform Disorders
is a class of psychological disorder that involves physical
symptoms that do not have a physical cause. These symptoms
usually mimic real diseases or injuries. It is important to note
somatoform disorders differ from factitious disorders; people
suffering from somatoform disorders are not faking their
symptoms.
Body Dysmorphic Disorder-alsoknown as body dysmorphia, the
affected person is concerned with body image, manifested as
excessive concern about and preoccupation with a perceived
defect of their physical features.The person thinks they have a
defect in either one feature or several features of their body,
which causes psychological distress that causes clinically
significant distress or impairs occupational or social functioning.
Often BDD co-occurs with depression and anxiety, social
withdrawal or social isolation.
Pain Disorder-ischronic pain experienced by a patient in
one or more areas, and is thought to be caused bypsychological
stress. The pain is often so severe that it disables the patient
from proper functioning. Duration may be as short as a few days
or as long as many years which begins at any age and frequently
occurs in girls than boys.
themselves once they start.
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13. Sleep Disorder
involve an interruption in sleep patterns. These disorders can have
a negative impact on both physical and mental health.
Narcolepsy-sleepiness can be profound and may lead to falling
asleep in inappropriate situations like the following:
Excessive Daytime Sleepiness
Cataplexy is a loss of muscle tone in response to an emotional
stimulus, such as surprise or laughter.
Sleep Paralysis is an inability to move one's body while being
awake, usually while falling asleep or awakening.
Hypnagogic Hallucinations are vivid dream-like auditory, visual, or
tactile sensations that occur while falling asleep.
Somnambulism- also known as noctambulism, talking or even
walking while sleeping.
Conversion Disorder-causes patients to suffer from neurological
symptoms, such as numbness, blindness or paralysis. Without a
definable organic cause. It is thought that symptoms arise in
response to stressful situations affecting a patient's mental health.
Conversion disorder is considered apsychiatric disorder.
Hypochondriasis or hypochondria- health phobia or
anxiety,refers to excessive preoccupancy or worry about having a
serious illness. This debilitating condition is the result of an
inaccurate perception of the bodys condition despite the absence
of an actual medical condition. An individual suffering from
hypochondriasis is known as ahypochondriac.
Somatization disorder- characterized by recurring, multiple,
clinically significant complaints about pain, gastrointestinal,
sexual and pseudo neurological symptoms. Those complaints
must begin before the individual turns 30 years of age.
15.Substance Related Disorders
those that involve the use and abuse of different substance, such
as cocaine, methamphetamine, opiates and alcohol. These
disorders can include dependence, abuse, psychosis, anxiety,
intoxication, delirium and withdrawal that results from the use of
various substances. Examples of substance-related psychological
disorders include:
Alcohol Abuse-is a psychiatric diagnosis describing the recurring
use ofalcoholic beverages despite its negative consequences.
There are two types of alcoholics:
#those who have anti social and pleasure-seeking tendencies, and
#those who are anxiety-ridden- people who are able to go without
drinking for long periods of time but are unable to control
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Now its time for you to think!

Caffeine induced disorders- Too much consumption of products
containing caffeine can cause abnormal heart rhythms,
headaches, and make you- anxious and restless. High
consumption of caffeine can cause caffeine induced disorders.
Do I have a
Cocaine Withdrawal- acts in the deep areas of the brain, These psychological
are the areas that reward us for "good behavior" -- those disorder?
activities that lead to food, sex, and healthy pleasure. Stimulating Did I obtain one of
this brain area with cocaine feels good. And it can create a those possible
powerful craving to use more cocaine. Repeated cocaine use symptoms?
leads to tolerance, dependence, and addiction.

Inhalant Abuse- are a broad range ofintoxicativedrugswhose

volatile vapors are taken in via thenoseandtrachea.

Mislabeling Depression hhps://youtu.be/y-m1ePU0qzs?t=58s

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