Back To CourseUExcel Abnormal Psychology: Study Guide & Test Prep
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Natalie is a teacher and holds an MA in English Education and is in progress on her PhD in psychology.
Imagine that you are a psychologist, and Pat comes to your office. He says he feels like he's going crazy. He sometimes feels like he's having heart attacks, but the doctor says there's nothing wrong with his heart. During these attacks, he sweats a lot, his heart pounds, and he feels like he his choking. Sometimes, he feels dizzy and thinks he might be dying. How do you decide what's wrong with Pat, and how do you treat him?
The Diagnostic and Statistical Manual of Mental Disorders, or DSM for short, is a text that provides the requirements to diagnose a mental disorder, along with statistics and suggested course of treatment for different psychological disorders. The DSM has gone through many revisions, and the most current version is the DSM-5.
Think of it like a cookbook, except instead of looking for a recipe, you are eating something and trying to figure out what it is. In this case, you are going to look through the cookbook to match up the ingredients with the name of the recipe. Maybe you are eating something with macaroni pasta, and it tastes pretty cheesy. It's creamy, too - maybe it has milk or cream in it? When you look through the cookbook, you notice that mac and cheese has all of those ingredients, and you decide that's what you're eating.
That's kind of what psychologists do with the DSM. The book acts as a guide to help them find the diagnosis, or name, of a mental disorder, such as schizophrenia, bipolar disorder, or autism. Each diagnosis is also given a number to help separate it and speed up referencing another professional's work. For example, 315.1 is dyscalculia, or mathematics disorder, which is a type of neurodevelopmental disorder in which a person has trouble with math and numbers.
As we mentioned, the text also has informative statistics, or the mathematical description of a disorder's cultural, familial, and gender prevalence. For example, about 1% of the population has schizophrenia, but if your twin sibling has it, your chances go up to about 50%.
Let's look a little closer at how psychologists use the DSM to make diagnoses.
Think back to Pat. He's got symptoms, like ingredients, and you've got to put the symptoms together to diagnose what's wrong with him, like choosing the recipe from the cookbook. Mental disorders and their symptoms are found in the DSM, but as the psychologist, it is your job to determine which diagnosis is correct.
You start by looking at all of Pat's symptoms: feeling like he is going crazy, feeling like he is having heart attacks, sweating, heart pounding, sensation of choking, dizziness, feeling like he is dying, and no medical issues with his heart. Together, these symptoms make up a constellation, or group of symptoms. It's called a constellation because it's as if each symptom is a star, and you, as the psychologist, need to identify the correct constellation (or disorder) the star (or symptom) belongs to.
Pat's constellation of symptoms has a lot to do with anxiety, such as the feeling of going crazy or dying and the physical sensation of a pounding heart. Luckily, the DSM divides disorders into groups. Some of these include: neurodevelopmental, depressive, personality, anxiety, and sleep-wake disorders. They are all very broad categories and in each section are the individual disorders and how to diagnose someone with them.
You open your copy and find the anxiety section. It opens with a short paragraph of the many anxiety conditions. You find that a brief description of panic attacks is very similar to your client's symptoms, so you go to the full text to learn more. The section for panic attacks says that you need four symptoms that begin abruptly and end within 10 minutes. Your client has seven physical symptoms, and they are not caused by a medical condition with their heart. Your client is having panic attacks, but as you continue to read the criteria, you see that panic attacks themselves aren't actually a disorder. They are a symptom of a different anxiety disorder.
But which one? When you look closely, you notice that Pat has some of the symptoms of an anxiety disorder called panic disorder, which involves regularly and suddenly feeling terror. You flip to the page that describes panic disorder to see if Pat meets the criteria.
To be diagnosed with panic disorder, a patient must have panic attacks (expected or unexpected), followed by at least 1 month of:
We know that Pat has had panic attacks, so he fits the first part of the description. But, what about the second part, at least one month of worrying or changing his behavior for the worse? Well, as you talk to Pat, you realize that he has changed his life all around because he's scared that he might get another panic attack. He goes out much less often in case he has a panic attack in public, and even at home, he refuses to watch the news or certain television shows in case they trigger an attack.
Clearly, Pat is worried about his panic attacks. But, he's also engaging in 'significant maladaptive behavior,' by withdrawing from his friends and family and avoiding the news and other television programs. Thus, you diagnose Pat as having panic disorder. You write this in his patient chart and have successfully used the DSM to make a diagnosis.
Ok, Pat has panic disorder. But, what about your other patients? As we mentioned before, Pat's panic disorder is grouped with several other disorders under the heading of 'anxiety disorders.' There are several different groupings like this one in the DSM-5. They include:
1. Neurodevelopmental disorders: These are disorders that are often diagnosed in childhood and have to do with the way children develop. They include things like intellectual disabilities, ADHD, and autism spectrum disorders.
2. Schizophrenia spectrum and other psychotic disorders: Besides schizophrenia, this group also includes delusional disorder and catatonic disorder, among others.
3. Bipolar and related disorders: The different types of bipolar disorder (which involve intense mood swings) are the main focus of this group of disorders.
4. Depressive disorders: Unsurprisingly, these disorders have to do with depression, such as major depressive disorder and persistent depressive disorder, and other disorders that disrupt a person's mood, such as premenstrual dysphoric disorder, among others.
5. Anxiety disorders: In addition to panic disorder, anxiety disorders include things like social anxiety disorder, generalized anxiety disorder, specific phobias, and others.
6. Obsessive-compulsive and related disorders: These are disorders that have to do with having obsessions and/or compulsions. Besides OCD, other examples of disorders in this group are things like body dysmorphic disorder and hoarding disorder.
7. Trauma- and stressor-related disorders: These disorders have to do with a person's response to trauma. PTSD, acute stress disorder, and adjustment disorders are a few examples.
8. Dissociative disorders: Sometimes, a person feels like he or she is disconnected from their psyche. Disorders like dissociative identity disorder, dissociative amnesia, and depersonalization disorder are included in this group.
9. Somatic symptom and related disorders: Somatic disorders, like somatic symptom disorder, conversion disorders, and others, are about the way a person reacts to physical ailments - real or imagined.
10. Feeding and eating disorders: Besides the commonly known anorexia nervosa and bulimia nervosa, psychological disorders in this group include things like pica, binge-eating disorder, and others.
11. Elimination disorders: Psychological disorders that involve the physical elimination of waste (that is, going to the bathroom) fall under this heading.
12. Sleep-wake disorders: Many people are familiar with insomnia and narcolepsy. Other disorders related to sleep and wakefulness include disorders that involve breathing during sleep (such as central sleep apnea), and those that deal with unusual behavior during sleep (such as sleepwalking or sleep terrors).
13. Sexual dysfunctions: As the name suggests, disorders in this group have to do with sexual functioning, such as erectile disorder, female orgasmic disorder, and others.
14. Gender dysphoria: The disorders in this group apply to people who struggle with having a psychological gender that is different from their biological sex.
15. Disruptive, impulse-control, and conduct disorders: These disorders are about disregarding the needs of others, including antisocial personality disorder, pyromania, and conduct disorder, among others.
16. Substance-related and addictive disorders: These disorders focus on addiction, including substance abuse and dependence on alcohol, caffeine, cannabis, and others.
17. Neurocognitive disorders: This group of disorders is about the issues in thinking, communication, and movement that occur due to neurological diseases, such as Parkinson's, Alzheimer's, and Huntington's disease.
18. Personality disorders: This group includes disorders in which the patient has a personality that is maladaptive, such as borderline personality disorder, avoidant personality disorder, and narcissistic personality disorder. Note that in addition to being part of the disruptive, impulse-control, and conduct disorders group, antisocial personality disorder is also part of this group.
19. Paraphilic disorders: These disorders are those that involve sexual excitement outside of what is considered normal, such as exhibitionistic disorder, fetishistic disorder, and pedophilic disorder.
In addition to these 19 categories, the DSM-5 also covers issues that might arise due to side effects of medication and other mental disorders that do not fall into a traditional mold.
The Diagnostic and Statistical Manual of Mental Disorders, or DSM, contains information on what a disorder is, what is needed to diagnose it, and how common it is. Psychologists use the DSM to help them diagnose patients. They do this by looking up a patient's constellation of symptoms and finding the disorder that contains those symptoms. The DSM-5 groups psychological disorders into clusters.
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Back To CourseUExcel Abnormal Psychology: Study Guide & Test Prep
27 chapters | 184 lessons | 18 flashcard sets