Assessment & Anxiety Disorders 

Factors in Mental Disorders

Causes of abnormal behavior;

    Medical model - mental disorders involve genetic or neurological factors that can be fixed. 
    
    Cognitive-behavioral - mental disorders result from deficits in cognitive processes such as thoughts & beliefs, 
    & from behavioral problems, such as deficits in skills & abilities.
 
    Environmental - being in or seeing a traumatic event can contribute to developing a mental disorder such as PTSD. 

    Psychodynamic - mental disorders are caused by unconscious or repressed conflicts. 
  
Three approaches to defining abnormal (deviant) behavior;

    Statistical frequency approach - Behavior may be considered abnormal if it occurs infrequently in 
the general population.

    Social norms approach - Behavior may be considered abnormal if it deviates greatly from accepted 
social standards, values or norms.

    Maladaptive behavior approach - Behavior may be considered abnormal if it interferes with the 
individuals ability to function in personal life or in society. This is the most useful of the three definitions.

Assessing Mental Disorders

   A Clinical Assessment; involves a systematic evaluation of an individual's various psychological, 
biological, & social factors, as well as identifying past & present problems, stressors, & other cognitive 
or behavioral problems.

Note Three methods of clinical assessment:
 
    1. Neurological tests - MRI & fMRI
        2. Clinical interview - can be structured or unstructured
            3. Psychological Tests - includes personality tests - two types; Objective e.g. (MMPI)
                                                         & Projective e.g (Rorschach), as well as IQ tests etc. 

Diagnosing Mental Disorders

            DSM-IV    Diagnostic & Statistical Manual of Mental Disorders-IV
 
    (Technically, the name now includes TR (for Test Revision), so it is DSM-IV-TR. But it is enough 
for you to learn DSM-IV, as most people call it.)
 
The DSM has five major dimensions called axes,They follow
 
    Axis I, Nine major syndromes:
 
    1. Disorders usually first diagnosed in infancy, childhood, or adolescence
     2. Organic mental disorders
      3. Substance-related disorders - Most common!
       4. Schizophrenia (2% of population) & other psychotic disorders
        5. Mood disorders
         6. Anxiety disorders
          7. Somatoform disorders
           8. Dissociative disorders
            9. Sexual and gender-identity disorders
 
    Axis II: Personality Disorders
 
    Axis III: General Medical Conditions
 
    Axis IV: Psychosocial and Environmental Problems
 
    Axis V: Global Assessment of Functioning Scale
 
    Note All five Axes may be used at once in the diagnosis of one person.
 
Three advantages of using the DSM-IV classification system;
 
   • communication of diagnoses
       • to explain & study mental disorders
           • to design treatment programs
 
Potential problems using DSM-IV
 
   • Labeling of mental disorders
       • Social or political implications
           • Frequency of mental disorders 

Anxiety

    Generalized Anxiety Disorder (GAD) is characterized by excessive or unrealistic worry 
about almost everything or feeling that something bad is about to happen. ( 5% of adults have this. )
 
 • physical symptoms: restlessness, insomnia, headaches, etc.
 
 • psychological symptoms: being irritable, having difficulty concentrating, & being unable to 
control one’s worry, which is out of proportion to the actual event.
 
 Treatment: Tranquilizers, such as alprazolam & benzodiazepines
 
    Panic Disorder is characterized by recurrent and unexpected panic attacks.
 
 Symptoms: Panic Attack a period of intense fear or discomfort in which four or more of the following 
symptoms are present:
 
 • pounding heart, sweating
   • trembling
     • shortness of breath
       • feelings of choking
          • chest pain
            • nausea
               • feeling dizzy
                 • fear of losing control or dying
 
  Treatment: benzodiazepines, antidepressants, & or psychotherapy
 
    Phobias are anxiety disorders characterized by an intense and irrational fear that is out of all 
proportion to the possible danger of the object or situation.
 
  Social phobias are characterized by irrational, marked, and continuous fear of performing in 
social situations.
 
 Specific phobias ( formerly called simple phobias ) are characterized by marked & persistent fears 
that are unreasonable and triggered by anticipation of, or exposure to, a specific object or situation.
 
 Agoraphobia is characterized by anxiety about being in places or situations from which escape 
might be difficult or embarrassing.
 
 Obsessive-Compulsive Disorders (OCD) are OBSESSIONS, persistent, recurring irrational thoughts, 
impulses, or images, that a person is unable to control and that interfere with normal functioning 
and COMPULSIONS which are irresistible impulses to perform over & over some senseless 
behavior or ritual.

Somatoform disorders

    Somatoform disorders are marked by a pattern of recurring, multiple, and significant bodily (somatic) 
symptoms that extend over several years. Somatization disorder begins before age 30, lasts several years, 
and is characterized by multiple symptoms.
 
   Conversion disorder refers to changing anxiety or emotional distress into real physical, motor, sensory, 
or neurological symptoms for which no physical or organic cause can be identified.
 
   Mass hysteria is a condition experienced by a group of people who, through suggestion, observation, 
or other psychological processes, develop similar fears, delusions, abnormal behaviors, 
or physical symptoms. 

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                 Topics in Psychology
                      Robert C. Gates