ABNORMAL PSYCHOLOGY

Jade Gomez | Prelims to Finals

● Science-practitioners are mental health

professionals who take a scientific approach to their
Topic Outline:
● Abnormal Psychology in Historical Context clinical work.
● Historical Conceptions of Abnormal Behavior
● An Integrative Approach to Psychopathology Prevalence
● Clinical Assessment and Diagnosis It is a figure that describes how many people in the
● Research Methods population as a whole have this disorder.
● Anxiety Disorders
● Trauma- and Stress-Related Disorders
Incidence
● Obsessive-Compulsive and Related Disorders
● Somatic Symptom and Related Disorders It represents the statistics on how many new cases
● Dissociative Disorders occur during a given period.
● Mood Disorders and Suicide
● Eating and Sleep-Wake Disorders Course
● Sexual Dysfunctions, Paraphilic Disorders, and The individual pattern that disorders follow.
Gender Dysphoria
● Substance-Related, Addictive, and Impulse-Control
● Chronic course tend to last a long time.
Disorders
● Personality Disorders ● Episodic course means that the individual is likely to
● Schizophrenia Spectrum and Other Psychotic recover within a few months only to suffer a
Disorders recurrence of the disorder at a later time.
● Neurodevelopmental Disorders ● Time-limited course means that the disorder will
● Neurocognitive Disorders improve without treatment in a relatively short period.

ABNORMAL BEHAVIOR IN HISTORICAL CONTEXT Prognosis

It refers to the anticipated course of a disorder.
Psychological Disorder
Ir is a psychological dysfunction within an individual ● The prognosis is good. The individual will likely
associated with distress, or impairment in functioning and a recover.
response that is not typical or culturally expected. ● The prognosis is guarded. The probable outcome
does not look good.
● Psychological Function
It refers to a breakdown in cognitive, emotional, or Etiology
behavioral functioning. It is the study of origins.
The behavior must be associated with distress, the It has something to do with why a disorder begins
criterion is satisfied if the individual is extremely upset. (what causes it) and includes biological, psychological, and
social dimensions.
● Impairment
It is a concept that is useful, but not entirely HISTORICAL CONCEPTIONS OF ABNORMAL BEHAVIOR
satisfactory.
Humans have always supposed that agents outside
● Atypical or not culturally expected our bodies and environment influence our behavior.
In the DSM-V, it describes behavioral, psychological, - May be divinities, demons, spirits, magnetic fields,
or biological dysfunctions that are unexpected in their cultural or the moon or the stars. (the supernatural
contct and associated with present distress and impairment in tradition)
functioning, or increased risk of suffering, death, pain, or
impairment. Most philosophers looked for the causes of abnormal
behavior in one or the other. This split gave rise to two
Psychopathology traditions of thought about abnormal behavior.
It is the scientific study of psychological - Summarized as the biological model and the
disorders. psychological model.

● Counseling psychologists study and treat THE SUPERNATURAL TRADITION

adjustment and vocational issues
● Clinical psychologists concentrate on more sever During the last quarter of the 14th century, religious
psychological disorders and lay authorities supported popular superstitions.
● Psychiatrists investigate the nature and causes of - Society as a whole began to believe more strongly
psychological disorders, often from a biological point in the existence and power of demons and
of view, make diagnosis, and offer treatments witches.
● Psychiatric social workers develop expertise in
collecting information relevant to the social and family The bizarre behavior of people afflicted with
situation of the individual with a psychological psychological disorders was seen as the work of the devil
disorder. and witches.
● Social workers treat disorders, concentrating on - Treatments included exorcism, in which various
family problems associated with them. religious rituals were performed in an effort to rid
● Psychiatric nurses speicalize in the care and the victim of evil spirits
treatment of patients with psychological disorders in - Other approaches included shaving a pattern of a
hospitals as part of a treatment team. cross in the hair of the victim’s head and securing
● Marriage and family therapists and mental health sufferers to a wall near the front of a church so
counselors provide clinical services by hospitals or that they might benefit from hearing Mass
clinics under the supervision of a doctoral-level
clinician.

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 Mental depression and anxiety were seen as ● Bloodletting - a carefully measured amount of blood
illnesses, but symptoms (such as despair and lethargy) were was removed from the body, often with leeches
identified by the church as the sin of acedia (sloth) ● Induce vomiting - well-known treatise on depression
- Common treatments: rest, sleep, and a happy and (1621); Robert Burton (Anatomy of Melancholy);
healthy environment eating tobacco and a half-boiled cabbage to induce
- Other treatments: baths, ointments, and various vomiting
potions
Hippocrates also coined the word hysteria to describe a
In the 14th century, Nicholas Oresme suggested concept he learned about from the Egyptians.
that the disease of melancholy (depression) was the source - Now called somatic symptom disorder (physical
of some bizarre behavior, rather than demons. symptoms for which no physical cause can be found)
- Oresme was one of the chief advisers of the king
of France, a bishop, and a philosopher Advanced Syphilis
It is a secually transmitted disease caused by a
In the Middle Ages, if exorcism failed, people were bacterial microorganism entering the brain.
subjected to confinement, beatings, and other forms of Its behavioral and cognitive symptoms include
torture. delusion of persecution and delusion of grandeur.
- Because some authorities thought that steps were
necessary to make the body inhabitable by evil spirits. Louis Pasteur’s Germ Theory of Disease
- Developed in about 1870
- Facilitated the identification of the specific baterial
Mass hysteria microorganism that caused syphilis
It may have simply demonstrated the phenomenon of
emotion contagion (the experience of an emotion that seems John P. Grey
to spread to those around us). He posited that the causes of insanity were always
physical.
Paracelsus Therefore, a mentally ill patient should be trated as
He was a Swiss physician who lived from 1493 to physically ill.
1521. Under his leadership, hospital conditions greatly
He rejected the notions of possession by the devil. improved and became more human, livable institutions.
He suggested that the movements of the moon and
stars had profound effects on people’s psychological Benjamin Franklin
functioning. He accidentally discovered and confirmed
experimentally in the 1750s, that a mild and modest eclectic
Roman Catholic Church shock to the head produced a brief convulsion and
They required that all healthcare resources be amnesia but otherwise did little harm.
exhausted first before spiritual solutions can be considered. Because of this, physical interventions of electric
shock and brain surgery in 1930s were often used.
THE BIOLOGICAL TRADITION
Emil Kraeplin
Hippocrates He was a dominant figure during this period.
He was considered to be the Father of Modern He was one of the founding father of modern
Western Medicine. psychiatry.
He and his associates left a body of work called the He was extremely influential in advocating the major
Hippocratic Corpus (written between 450 and 350 BC). ideas of the biological tradition, but was little involved in
- They suggested that psychological disorders could treatment.
be treated like any other disease. His lasting contribution was in the area of diagnosis
He considered the brain to be the seat of wisdom, and classification.
consciousness, intelligence, and emotion.
- Therefore, disorders involving these functions would THE PSYCHOLOGICAL TRADITION
logically be located in the brain.
He also recognized the importance of psychological Moral Therapy
and interpersonal contributions to psychopathology. It was a strong psychosocial approach to mental
- He removed patients from their familites on some disorders in the first hald of the 19th century.
occasions in response to the negative effects of family Its basic tenets includedtreaing institutionalized
stress. patients as normally as possible in a setting that
encouraged and reinforced normal social interaction.
Galen It originated with Philippe Pinel (a well-known french
He adopted the ideas of Hippocrates and his psychiatrist) and his close associated Jean-Baptiste Pussin
associates.
He developed them further, creating a powerful and Jean-Baptiste Pussin
influential school of thought within the biological tradition that He had already instituted remarkable reform by
extended well into the 19th century. removing all chains used to restrain patients and
instituting human and positive psychological
The Humoral Theory of Disorders interventions.
It is one fo the more interesting and influential When Pinel arrived in 1791, Pussin persuaded Pinel
legacies of the Hippocratic-Galenic Approach. to go along with the changes.

● Blood (heart): sanguine: cheerful and optimistic; ruddy ● William Turke followed Pinel’s lead in England
in complexion; insomnia and delirium ● Benjamin Rush (founder of U.S. psychiatry)
● Black Bile (spleen); melancholic; depression introduced moral therapy in his early work at
● Phlegm (brain); phlegmatic; apathy and sluggishness; Pennsylvania Hospital.
calm under stress
● Choler/Yellow Bile (liver); choleric; hot tempered Asylums appeared in the 16th century, but they were
more like prisons than hospitals. It was the rise of moral
Two treatments developed:

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therapy in Europe and the U.S. that made asylums habitable Neurotransmitters are biochemicals that are released from
and even therapeutic. the amazon of one neuron and transmit the impulse to the
dendrite receptors of another neuron.
After the mid-19th century, humane treatment
declined because of convergence factors. Brain Stem is the lower and more ancient part of the brain. It
is responsible for essential automatic functions like breathing,
Dorothea Dix campaigned endlessly for reform in the sleeping and moving around in a coordinated way.
treatment of insanity.
- Her work became known as the mental hygiene The forebrain is more advanced and evolved more recently.
movement
- She was rightly acknowledged as a hero fo the 19th The hindbrain is the lowest part of the brainstem. It contains
century the medulla, pons, and the cerebellum. It regulates many
autonomic activities like breathing, heartbeat, and digestion.
Franz Mesmer ● The cerebellum controls motor action. Recent
He was widely regarded as the father of hypnosis (a research suggests that abnormalities in is may be
state in which extremely suggestible subjects sometimes associated with autism, although its connection to
appear to be in a trance) motor coordination is not clear.
He suggested the concept of animal magnetism ● The midbrain coordinates with sensory input and
(problems were caused by an undetectable fluid found in all contains parts of the reticular activating system
living organisms which could become blocked) (arousal and tension)

Jean-Martin Charcot At the top of the brainstem are the thalamus and
He demonstrated that some techniques of hypothalamus which are involved with regulating behavior
mesmerism were effective with a number of psychological and emotion. They serve as relays between the forebrain and
disorders. the remaining lower areas of the brain stem.
He did much to legitimize the fledgling practic of
hypnosis. At the base of the forebrain is the limbic system. It regulates
He discovered that it is therapeutic to recall and our emotional experiences and expressions, our ability to learn
relieve emotional trauma that has been made unconscious and and control our impulses, and is involved with the basic drives
to release the accompanying tension (catharsis). of sex, aggression, hunger, and thirst.

AN INTEGRATIVE APPROACH TO PSYCHOPATHOLOGY The basal ganglia control motor activity.

No influence operates in isolation. The cerebral cortex contains more than 80% of all neurons,
Each dimension (biological or psychological) is and allows us to plan, reason, and create.
strongly influenced by the others and by developments. They ● The left hemisphere is for verbal and other cognitive
weave together in various complex and intricate ways to create processes.
a psychological disorder. ● The right hemisphere is for perceiving the world
around us and creating images.
● Huntington’s disease has been traced to a genetic ● The temporal lobe is for auditory recognition.
defect that causes deterioration in the basal ganglia. It ● The parietal lobe is for touch and body positioning.
causes broad changes in personality, cognitive ● The occipital lobe is for visual inputs.
functioning, and motor behavior (particularly). ● The frontal lobe is for thinking and reasoning,
● Phenylketonuria (PKU) can results in intellectual planning for the future, and long term memory.
disability. It is present at birth and is caused by the
inability of the body to metabolize phenylalanine. THE PERIPHERAL NERVOUS SYSTEM

Linkage Studies It coordinates with the brain stem to make sure the
In this, scientists study individuals who have the body is working properly.
same disorder, also share other features.
This allows scientists to attempt to link known gene The Somatic Nervous System controls muscles (voluntray)
locations with the possible location of a gene contributing to The Autonomic Nervous System includes the sympathetic
the disorder. nervous system and parasympathetic nervous system.
● Sympathetic - mobilizes the body in times of stress
Diathesis-Stress Model or danger
Individuals inherit tendencies to express certain traits ● Parasympathetic - balances sympathetic system
or behavior, which then may be activated under conditions of
stress. THE ENDOCRINE SYSTEM

● Diathesis - inherited tendency; vulnerability Hormones are produced by each endocrine gland as a
● Stressor - life event; the disorder develops chemical messenger.
● Adrenal glands - epinephrine (adrenaline); in
THE CENTRAL NERVOUS SYSTEM response to stress
● Thyroid glands - thyroxine; energy metabolism and
The CNS consists of the brain and spinal cord. The PNS growth
consists of the somatic nervous system and the autonomic ● Pituitary gland - master gland; regulatory hormones
nervous system. ● Gonadal glands - sex hormones; estrogen and
testosterone
Dendrites receive messages, while axons transmit impulses to
other neurons. Hypothalamic-pituitary-adrenocortical axis (HPA Axis)
It is the cortical part of the adrenal glands that
Synaptic Cleft produce the stress hormone cortisol.
It is a small space between the axon of one neuron
and the dendrite of another. NEUROTRANSMITTERS
It is through which the impulse must pass to get to the
next neuron. Agonists increase the activity of neurotransmitters.

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Antagonists decrease or block a transmitter. 4. Amount of psychosocial stress reported
Inverse agonists produce effects opposite to those produced 5. Level of adaptive functioning
by the neurotransmitter.
DSM-IV
Amino-acid neurotransmitters: - 1994
● Glutamate - excitatory transmitter - Personality disorders and intellectual ability disorders
● Gamma-aminobutyric acid (GABA) - inhibitory were now coded on the Axis II
transmitter for information and action potentials - Axes:
1. Pervasive developmental disorders, learning
Monoamine neurotransmitters disorders, motor skills disorders,
● Serotonin - behavior, mood, and thought process communication disorders
● Norepinephrine - states of panic 2. Personality disorders and intellectual
● Dopamine - catecholamine; schizophrenia; pleasure disability
3. Physical disorders and conditions
Other neurotransmitters: 4. Reporting psychosocial and environmental
● Acetylcholine - learning problems
● Endorphine - euphoria 5. Level of adaptive functioning
● Adrenaline - concentration
DSM-IV-TR
CLINICAL ASSESSMENT AND DIAGNOSIS - 2000
- Minor changes to some of the criteria to improve
Clinical Assessment consistency
It is the systemic evaluation and measurement of - Helped clarify many issues related to the diagnosis of
psychological, biological, and social factors in an individual psychological disorders
presenting with a possible psychological disorder.
DSM-V
Diagnosis - 2012
It is the process of determining whether the particular - Divided into 3 main sections:
problem afflicting the individual meets all criteria for a 1. Introduces the manual and describes how to
psychological disorder. best use it
2. Disorders themselves
Affect 3. Descriptions of disorders or conditions that
It is the feeling state that accompanies what we say at need further research
a given point. - Removal of multiaxial system
- “Mental retardation” was idropped in favor of
Computer axial tomography scan gives an image of the “intellectual disability”
brain structure. - Comorbidity

Magnetic resonance imagine gives greater resolution than ANXIETY DISORDERS

CT scan without the inherent risks of x-ray tests.
Definition of Abnormality
Positron emission tomography subjects are injected with a
tracer substance attached to radioactive isotopes. Abnormality in people’s behavior can best be understood by
keeping the 4Ds in mind:
Single photon emission computed tomography works like ● Dysfunction - interferes daily functioning; a
a PET scan but is less accurate and less expensive. breakdown in cognitive, emotional, or behavioral
functioning
Functional Magneric Resonance Imaging allow researchers ● Distress - either to self or others; an individual is
to see the immediate response of the brain to a brief event, extremely upset and cannot function properly
such as seeing a new face. ● Deviance - deviates from the average or the norm of
the culture; atypical or not culturally expected, not just
Electroencephalogram is where electrodes are placed to the society but deviation from the person’s usual
directly on various places on the scalp to record the different behavior
low-voltage currents. ● Dangerousness - creates potential harm to self
(suicidal gestures) and others (excessive aggression)
DIAGNOSTIC AND STATISTICAL MANUTAL
Anxiety
DSM-1 It is negative mood state characterized by bodily
- 1952 symptoms of physical tension and by apprehension about the
- American Psychiatric Association future
It differs from fear as fear is an emotional response to
DSM-II an immediate threat and is more associated with a fight or
- 1968 flight reaction, while anxiety refers to anticipation of a future
- American Psychiatric Asscosiaction concern and is more associated with muscle tension and
avoidance behavior.
DSM-III
- 1980 Different Types of Anxiety Disorders
- Robert Spitzer’s leadership
- Changes: Panic Attack
1. Atheoretical approach to diagnosis
2. Specificity and detail Description: an abrupt surge or intense fear or intense
3. Five dimensions or axes (multiaxial system) discomfort that reaches peak within minutes
- Axes:
1. Disorder itself Symptoms: (four or more must occur)
2. Enduring (chronic) disorders of personality ● Palpitations
3. Physical disorders and conditions ● Sweating

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 ● Trembling/shaking Description: fear of experiencing additional recurrent
● Sensations of shortness of breath unexpected panic attacks
● Feeling of choking Duration: 1 month or more
● Chest pain or discomfort Symptoms: (1 or both of the following)
● nausea/abdominal distress ● Persistent concern or worry about additional panic
● Feeling dizzy/lightheaded attacks or their consequences
● Chill or heat sensations ● Significant maladaptive change in behavior related to
● Paresthesias (numbness/tingling) the attacks (e.g. avoidance of exercise)
● Derealization or depersonalization Criteria:
● Fear of losing control or going crazy ● Description
● Fear of dying ● Duration and symptoms
● Not attributed to physiological effects of a substance
Neurotransmitters involved: serotonin, norepinephrine, and ● Not explained by another mental disorder
gamma-aminobutyric acid (GABA)
Agoraphobia
Therapies for Panic Attack:
● Cognitive behavioral therapy (CBT) - gold standard; Description: markbed fear or anxiety about public
helping clients identify and challenge worried thoughts situations/settings
and reduce avoidance of triggers Duration: 6 months or more
● Exposure therapy - a specific CBT technique to help Criteria:
desensitize people to anxiety triggers and reduce ● Mentioned description
avoidance behaviors ● Individual avoids these situations due to thoughts that
● Applied relaxation for panic disorder - helps escape might be difficult or help might not be
people identify triggers and early anxiety cues while available in the event of developing panic-like
teaching relaxation techniques symptoms
● Panic-focused psychodynamic psychotherapy ● Agoraphobic situations almost always provoke fear or
(PPFP) - earliest forms of psychotherapy; 24 sessions anxiety
over a 12-14 week period; focuses on helping people ● Agoraphobic situations are actively avoided, require
build awareness and resolve inner conflicts believed the presence of a companion, or are endured with
to cause anxiety intense fear or anxiety
● Online self-guided CBT and relaxation programs - ● The fear or anxiety is our of proportion to the actual
visual therapy and online self-help programs danger present
● Duration mentioned
Medications: ● The fear, anxiety or avoidance causes clinically
● Antidepressants - like SSRIs; work on some of the significant distress or dysfunction
same chemicals involved in anxiety and can also help ● If another medical condition is present (e.g.
to treat co-occurring symptoms of depression or mood parkinson’s disease, inflammatory bowel disease, the
disorders fear, anxiety, or avoidance is clearly excessive
● Beta blockers - off-label medications typically used to ● Not better explained by the symptoms of another
treat high BP but may also be prescribed to people mental disorder and are not related to obsessions,
who struggle with panic attacks; lower risk for serious traumatic events, or fear of separation
side effects
● Benzodiazepines - prescribed short-term or Specific Phobia
as-needed; deactivates nervous system responses
that case physical symptoms of anxiety; very Duration: 6 months or more
addictive and has adverse side effects (black box Criteria:
warning) like risk of suicidal thoughts and behaviors ● Marked fear or anxiety about a specific object or
situation
Generalized Anxiety Disorder (GAD) ● Phobic object almost always provokes immediate fear
or anxiety
Description: excessive anxiety or worry about a number of ● Phobic object or situations are actively avoided with
events or activities; trigger cannot be pinpointed intense fear or anxiety
Duration: at least 6 months, occurring more days than not ● Fear or anxiety is out of proportion to the actual
Symptoms: (3 or more, only 1 is needed for children) danger posed and to the sociocultural context
● Restlessness ● Mentioned duration
● Easily fatigued ● Causes clinically significant distress or dysfunction
● Difficulty concentrating/mind going blank ● Not better explained by the symptoms of another
● Irritability disorder
● Muscle tension Specifers: (specific type)
● Sleep disturbance ● Animal
Criteria: ● National environment
● The mentioned description and duration ● Blood-injection-injury
● Individual finds it difficult to control the worry ● Situational (e.g. planes, elevators, enclosed spaces)
● Experience of symptoms mentioned ● Other (e.g. clowns, avoidance of situations that may
● The anxiety, worry, or physical symptoms cause lead to choking, vomiting, or contracting an illness)
dysfunction
● Not due to direct physiological effects of a substance
● Not better explained by another mental disorder Social Anxiety Disorder (Social Phobia)
Comorbidities: Description: marked fear or anxiety about one or more social
● Major Depressive Disorder (MDD) situations in which the person is exposed to possible scrutiny
● Specific phobia by others
● Social anxiety disorder Duration: 6 month or more
● Panic disorder Criteria:
● Description mentioned
Panic Disorder ● Individual fears that they will act in a way, or show
anxiety symptoms, that will be negatively evaluated

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 ● Social situations almost always provoke fear or d. Repeated or extreme exposure to aversive
anxiety detailed of events (does not include
● Social situations are avoided or endured with intense exposure through electronic media)
fear or anxiety B. Presence of one (or more) intrusion symptoms
● Out of proportion to the actual threat posed by the associated with the traumatic event/s after it occurred
social situation and to the sociocultural context a. Recurrent, involuntary, and intrusive
● Duration mentioned distressing memories of the traumatic
● Causes clinically significant distress or dysfunction event/s
● Not attributed to the effects of a substance b. Recurrent distressing dreams in which the
● Not better explained by the symptoms of another content/affect of the dream are related to the
mental disorder traumatic event/s
● If another medical condition is present, the fear, c. Dissociative reactions in which the
anxiety, or avoidance is excessive individuals feels/acts as if the traumatic
Specifier/s: (specify if) event/s were recurring. (in young children,
● Performance only: if fear is restricted to speaking or reenactment may occur in play)
performing in public d. Intense or prolong psychological distress at
exposure to internal or external cues that
Selective Mutism symbolize or represent an aspect of the
Now grouped with the anxiety disorders in DSM-5 event
Description: A rare childhood disorder characterized by lack e. Marked physiological reactions to internal or
of speech in one more setting in which speaking is socially external cues
expected (commonly occurs in some settings but not others) C. Persistent avoidance of stimuli associated with the
Duration: more than one month, not counting the first month of traumatic event after it happened (1 or both)
school a. Avoidance of or efforts to avoid distressing
memories, thoughts, feelings, or
Separation Anxiety conversations about or closely associated
Description: a childhood disorder characterized by anxiety with the traumatic event/s
that excessive for the child’s developmental level and related to b. Avoidance of or efforts to avoid external
separation from parents or others who have parental roles reminders that arouse distressing
memories/thoughts/feelings or closely
Factors that Trigger Anxiety; (biopsychosocial model) associated with the event
● Environment - people develop anxiety disorder when c. Inability to recall an important aspect of the
they posses both biological and psychological trauma
vulnerabilities, coupled with a social environment that d. Markedly diminished interest or participation
set-off or trigger these vulnerabilities in significant activities
● Biology/Biological Aspect - refers tot he body’s e. Feeling of detachment or estrangement from
physiological, adaptive responses to fear; also refers others
to genetic trains and the brain functioning that we f. Restricted range of affect (e.g. unable to
inherit have loving feelings)
● Psychological Factors - our thoughts, beliefs, and g. Sense of a foreshortened future (e.g. does
perceptions about or experiences, our environment, not expect to have a career, marriage,
and ourselves; cognitive patterns that affect our children, or a normal life span)
perceived sense of control over our environment; D. Negative alterations in cognitions and mood
cognitive patterns influence how we assess and associated with the traumatic event/s beginning or
interpret events in our environment as either worsening after it occurred (2 or more)
threatening or nonthreatening a. Inability to remember an important aspect of
the traumatic event due to dissociative
Living with Anxiety: (RASH) amnesia not due to physiological factors
● Regular exercise b. Persistent and exaggerated negative beliefs
● Adequate sleep aor expectations about oneself, other, or the
● Healthy diet world
● Stress reduction techniques c. Persistent distorted cognitions about the
cause or consequences that lead the
Trauma- and Stress-Related Disorders individual to blame themselves or others
d. Persistent negative emotional state
DSM-5 consolidates a group of formerly disparate e. Markedly diminished interest or participation
disorders that all develop after a relatively stressful life event, in significant activities
often an extremely stressful or traumatic life event. f. Feelings of detachment or estrangement
This set of trauma and stressor-related disorders from others
include attachment disorders in childhood following inadequate g. Persistent inability to experience positive
or abusive child-rearing practices, adjustment disorders emotions
characterized by persistent anxiety and depression following a E. Duration of disturbance: more than 1 month
stressful life event, and reactions to trauma such as PTSD and F. Causes significant distress or dysfunction
acute stress disorder. Specifiers: (specify if)
● With delayed expression - if the diagnostic threshold
Post Traumatic Stress Disorder (PTSD) is not exceeded until at least 6 months after the event
Criteria: ● With dissociative symptoms: in response to the
A. Exposure to actual or threatened death, serious injury, stressor, the individual experiences persistent or
or sexual violence recurrent symptoms of depersonalization or
a. Direct experience derealization
b. Witnessing in person that occurred to others Causes:
c. Learning that the event/ occurred to a close ● Family history of anxiety (generalized biological
relative or friend. Must be violent or vulnerability for PTSD)
accidental. ● Serotonin transporter gene involving 2 short alleles
(SS) (increasing probability of becoming depressed)

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 ● Family instability (may instill a sense that a world is an nonthreatening interactions with adult
uncontrollable, potentially dangerous place) caregivers
Treatment:
● Psychoanalytic therapy = catharsis Disinhibited Social Engagement Disorder
● Cognitive therapy = correct negative assumptions
Description: might engage in inappropriately intimate behavior
Adjustment Disorder by showing a willingness to immediately accompany an
unfamiliar adult figure somewhere without first checking back
Describe anxious or depressive reactions to life stress with a caregiver
that are generally milder than one would see in acute stress Criteria:(at least 2)
disorder or PTSD A. a pattern of behavior in which a child actively
Nevertheless impairing in terms of interfering with approaches and interacts with unfamiliar adults
work or school performance, personal relationship or other a. Reduced or absent reticence in approaching
areas of living and interacting with unfamiliar adults
Criteria: b. Overly familiar verbal or physical behavior
A. Development of emotional or behavioral symptoms in that is not consistent with culturally
response to an identifiable stressor/s occurring within sanctioned and age-appropriate social
3 months of the onset of the stressor/s boundaries
a. Symptoms or behaviors are clinically c. Diminished or absent checking back with
significant as evidenced by one of both of adult caregiver after venturing away, even in
the following unfamiliar settings
b. Marked distress that is out of proportion to d. Willingness to go off with an unfamiliar adults
the severity or intensity of the stressor with minimal or no hesitations
(taking into account the external context and B. Behaviors in criterion a are not limited to impulsivity
cultural factors) (e.g. ADHD) but include socially inhibited behavior
B. Significant impairment in social, occupational, or other C. (1 or more) experienced a pattern of extremes of
areas of functioning insufficient care
C. Stress-related disturbance does not meet the criteria a. Social neglect or deprivation in the form of
for another mental disorder and is not merely an persistent lack of having basic emotional
exacerbation of a preexisting mental disorder needs met by caregiving adults
D. Symptoms do not represent normal bereavement b. Repeated changes of primary caregivers that
E. Once the stressor or its consequences hce limit opportunities to form stable attachments
terminated, the symptoms do not persist for mote than c. Rearing in unusual setting that severely limit
an additional 6 months opportunities to form selective attachments
Specifiers: (specify whether) D. Care in criterion c presumed to be responsible for
● F43.21: with depressed mood - predominant low disturbed behavior in criterion a
mood, tearfulness, or feelings or hopelessness E. Child has a developmental age of at least 9 months.
● F43.22: with anxiety - predominant nervousness, Specifier:
worry, jitteriness, or separation anxiety ● Persistent - more than 12 months
● F43.23: with mixed anxiety and depressed mood: ● Current severity - mild,/severe
predominant combination of depression and anxiety
● F43.24: with disturbance of conduct Obsessive-Compulsive and Related Disorders
● F43.25: with mixed disturbance of emotions and
conduct Obsessive Compulsive Disorder
● F43.20: unspecified - maladaptive reactions that are
not classifiable as one of the specific subtypes of Criteria:
adjustment disorder ● Presence of obsession, compulsions, or both:
● Obsessions are defined by:
Attachment Disorders ○ Recurrent and persistent thoughts, urges, or
images; intrusive and unwanted; marked
Refers to disturbed and developmentally anxiety or distress
inappropriate behaviors in children ○ Attempts to ignore or suppress such
Emerging before 5 years of age thoughts/urges/mage or to neutralize them
Child is unable or unwilling to form normal attachment with some other thought or action
relationships with caregiving adults ● Compulsions are denied by:
○ Repetitive behavior or mental acts; individual
Reactive Attachment Disorder feels driven to perform; obsession or
according to rules
Description: very seldomly seek out a caregiver for protection, ○ Behaviors or acts are aimed at preventing or
support, ad nurturance and will seldom respond to offers from reducing anxiety/distress or preventing some
caregivers to provide this kind of care dreaded event or situation
Criteria:
A. Consistent pattern of inhibited, emotionally withdrawn Four major types:
behavior toward adult caregivers, manifested by both
of the following; Symmetry obsession - 26.7%
a. Rarely or minimally seeks comfort when Forbidden thoughts or actions - 21%
distressed Cleaning and contamination - 15.9%
b. Rarely or minimally responded to comfort Hoarding - 15.4%
when distressed
B. A persistent social and emotional disturbance Tic Disorder
characterized by at leat 2 of the following: Characterized by: involuntary movement (ex.sudden
a. Minimal social and emotional jerking of limbs)
responsiveness to others Co-occurs in: patients with OCD (particularly
b. Limited positive affect children) or in their families
c. Episodes of unexplained irritability, sadness, More complex: Tourette;s disorder, with involuntary
or fearfulness that are evident even during vocalizations

7
 Causes of OCD: Trichotillomania (Hair Pulling Disorder)
● Thought-action fusion - clients with OCD equate
thoughts with the specific actions or activity Description: the urge to pull out one’s own hair from anywhere
represented on the body, including the scalp, eyebrows, and arms
● This may be because of attitudes of excessive Results in; noticeable hair loss, distress, and significant social
responsibility and resulting guilt developed during impairments
childhood, when een a bad thought is associated with Prevalence: more common thant once believed; observed
evil intent between 1% and 5% of college students, with females
reporting the problem more than male
Treatment for OCD:
● Inhibiting the reuptake of serotonin - most effective Excoriation (Skin Picking Disorder)
(up to 60% of patients with OCD)
● Exposure and ritual prevention (ERP) - most effective Description: characterized by repetitive and compulsive
approach; rituals are actively prevented and the picking of the skin, leading to tissue damage
patient is systematically and gradually exposed to the Results in: significant embarrassment, distress, and
feared thoughts or situations impairment in terms of social and work functioning
Prevalence; largely a female disorder
Body Dysmorphic Disorder Prior DSM-5: both trichotillomania and excoriation were
classified under impulse control disorders, but it has been
Criteria: established that these disorders often co-occur with OCD and
A. Preoccupation with one or more defects or flaws in BDD as well as with each other
physical appearance that are NOT OBSERVABLE or
APPEAR SLIGHT to others Somatic Symptom and Related Disorders
B. At some point during the course of the disorder, the
individual has performed repetitive behaviors (e.g. Somatic Symptom Disorder
mirror checking, excessive grooming, skin picking) in
response to appearance concerns It used to be called Briquet’s Syndrome.
C. The preoccupation causes clinically significant Description: Excessive thoughts, feelings, and behaviors,
distress or dysfunction related to the somatic symptoms
D. The appearance preoccupation is not better explained Duration: State of being symptomatic is persistent (typically
by concerns with body fat or weight (does not meet more than 6 months)
the diagnostic criteria for an eating disorder) Specify if:
Specifiers: (specify if) ● With predominant pain (previously pain disorder)
● With food or fair insight - BDD beliefs are definitely Specify current severity:
/probably/may/may not be true ● Mild
● With poor insight - BDD beliefs are probably true ● Moderate
● With absent insight/delusional beliefs - completely ● Severe
convinced that BDD beliefs are true
● With muscle dysmorphia - his or her body build is too Illness Anxiety Disorder
small or insufficiently muscular
It was formerly known as hypochondriasis.
In Men vs. Women Disease conviction is a core conviction.
Description: It is severe anxiety that is focused on the
● Equally seen in both sexes possibility of having or developing a serious disease.
● Men tend to focus on body build, genitals, and Specify whether:
thinning hair and tend to have more sever BDD ● Care-seeking type - medical care is frequently used
● Women focus more on varied body areas and are ● Care-avoidant type - medical care is rarely used
more likely to also have an eating disorder Statistics:
● Onset ranges from early adolescence through the ● 1-5% prevalence
20s, peaking at the age of 16-16 ● Culture specific: koro (severe anxiety that the genitals
are retracting into the abdomen), dhat (anxiety about
Hoarding Disorder losing semen)
Causes:
Description: excessive acquisition of things, difficulty ● Faulty interpretation of physical signs and symptoms
discarding anything, and living with excessive clutter under ● “Benefits” of being sick
conditions best characterized as gross disorganization Treatment:
Criteria: ● Reassurance and education
A. Persistent difficulty discarding items, regardless of ● Explanatory therapy
actual value ● CBT
B. Due to perceived need to save the items and distress
associated with discarding them Conversion Disorder
C. Resulting in accumulation of possessions that clutter
living areas thus substantially interfering with function It is a disorder characterized by altered motor or
and activities sensory function, which cannot be explained by a medical
D. Causes clinically significant distress or dysfunction disorder or condition
E. Not attributed to a medical condition (e.g. brain injury,
stroke, etc.) Factitious Disorder
F. Not better explained by the symptoms of another
mental disorder (e.g. dementia, MDD, schizophrenia, It is the falsification of physical or physiological
autism, OCD) ailments for “benefits” of having it.
Specifiers: (specify if) Statistics:
● With excessive acquisition ● Relatively rare in mental health settings
● With good/poor/no insight ● Primarily found in women and typically develop during
adolescence or slightly thereafter
Causes:

8
 ● Indifference to conversion symptoms They become hyperactive, require little sleep and may
● Occur in less educated, lower socioeconomic groups develop grandiose plans.
● Freud: primary gain (to reduce anxiety about a Duration: at least 1 week and present most of the day
traumatic event), secondary fain (to receive attention
and/or to avoid a difficult task/situation) Hypomanic episodes are less severe and do not
Treatment: cause marked impairment in social or occupational functioning
● reexperiencing/reliving the event (catharsis) and need only last for 4 days rather than a full week.
● Reduce any reinforcing or supporting consequences
Major Depressive Disorder
Dissociative Disorders
It is the most easily recognized mood disorder,
Depersonalization-Derealization Disorder defined by the absence of mani or hypomanic episodes before
or during the disorder.
During an episode of depersonalization, you If two or more MDE occurred and were separated by
temporarily lose the send of your own reality, as if you were in at least 2 mos in which the individual was not depressed, the
a dream and you were watching yourself. MDD is noted as being recurrent.
During an episode of derealization, your sense of the
reality of the reality of the external world is lost. Persistent Depressive Disorder (Dysthimia)
Mean age of onset is 16 and the course tends to be
chronic. It is defined as a depressed mood that continues for
at leat 2 years, during which the patient cannot be symptom
Dissociative Amnesia free for more than 2mos at a time even though they may not
experience all of the symptoms of MDE.
In most cases of dissociative amnesia, the forgetting Differs from MDD as it is considered more severe.
is selective for traumatic events or memories rather than
generalized. Premenstrual Dysphoric Disorder (PMDD)
A subtype is dissociative fugue, wherein a person
takes trips and are unable to remember why or how they got It is described as severe and sometimes
there. incapacitating emotional reactions during the premestrual
period.
Dissociative Identity Disorder It is a combination of physical symptoms, sever mood
swings, and anxiety, which are associated with incapacitation
It is the disruption of identity characterized by two or during this period of time.
more distinctive personality states, which may be described in It must occur in most menstrual cycles in the
some cultures as an experience of possession. preceding year.
Statistics:
● The average number of alters is closer to 15. Disruptive Mood Dysregulation Disorder
● The onset is almost always in childhood, as young as
4 years of age. Criteria:
● The ratio of females is as high as 9:1. A. This refers to severe recurrent temper outburst
● Often misdiagnosed as a psychotic disorder because manifested verbally and/or behaviorally that are
auditory hallucinations are common. grossly out of proportion in intensity or duration
Causes: to the situation or provocation.
● Abused as a child B. The temper outburst are inconsistent with
● Sexual or physical abuse developmental level.
● Chaotic, unsupportive family environment C. The temper outbursts occur 3 or more times per
● Suggestibility week.
● Self-hypnosis D. The mood between temper outbursts is persistently
Treatment: irritable or angry most of the day, nearly every
● Therapeutic resolution of the distressing situation and day, and is observable by others.
personal coping mechanism E. Present for 12 or more months, not had a period
● Recalling what happened during the amnesic or fugue lasting 3 or more consecutive months without all
states of the symptoms
● Hypnosis or benzodiazepines F. Present in at least ⅔ settings and are severe in at
least one of those
Mood Disorders and Suicide G. Diagnosis should not be made for the first time
before age 6 years or after age 18 years
They are called mood disorders because they are H. Age of onset of Criteria A-E is before 10 years
characterized by gross deviations in mood. I. No distinct period lasting more than 1 day during
which full symptom criteria for a mani or hypomanic
Major Depressive Episode episode have been met
J. Not better explained by another mental disorder
Anhedonia is the loss of energy and inability to K. Not attributed to the physiological effects of a
engage in pleasurable activities or have any “fun” substance

Description: It is an extremely depressed mood that includes Bipolar Disorders

cognitive symptoms (e.g. feelings of worthlessness and
indecisiveness) and disturbed physical functions (e.g. altered The key identifying feature is the tendency of mani
sleeping patterns, significant changes in appetite and weight, episodes to alternate with major depressive episodes in
notable loos of energy) an unending roller-coaster ride from the peaks of elation to
Duration: at least 2 weeks, 4-9 months if left untreated the depths of despair.

Manic Episode Hypomanic episodes criteria:

● minimum duration is 4 days
It is when individuals find extreme pleasure in every ● Although the episode represents a definitie change in
activity, some patients compare their daily experience of mania functioning, it is not severe enough to cause
with a continuous sexual orgasm.
9
 marked social or occupational impairment or - Side effects: physical agitation, sexual
hospitalization dysfunction, low sexual desire, insomnia,
● There are no psychotic features. and GI upset
2. Mixed reuptake inhibitors
The specifier unique to bipolar disorders is 3. Tricyclic antidepressants, like Effexor (venlafaxine),
rapid-cycling specifier.It is when an individual experiences at Tofranil (imipramine), and Elavil (amitriptyline)
least 4 manic or depressive episodes within a year. It is a 4. Monoamine oxidase (MAO) inhibitors
severe variety that does not respond well to treatments.
St. John’s Wort (hypericum)
Bipolar II - major depressive episode alternate with hypomanic - Natural herb with antidepressant properties
episodes - Few side effects
Average onset: 19-22 yo - Relatively easy to produce
- National Institutes of Health in the US found that no
Bipolar I - major depressive episodes alternate with full manic benefits were found when compared with a placebo
episodes
Average onset: 15-18 yo Lithium carbonate
- A common salt widely available in the natural
Cyclothymic Disorder environment
- Side effects are potentially more serious compared to
This is a milder but more chronic version of bipolar other antidepressants
disorder. It is similar in many ways to persistent depressive - Dosage is carefully regulated to prevent poisoning
disorder. and lowered thyroid functioning
- Common side effect is substantial weight gain
It is a chronic alternation of mood elevation and - Major advantage: often effective in preventing and
depression that does not reach the severity of manic or major treating mani episodes
depressive episodes. - Often referred to as mood stabilizing drug

Such individuals are just considered moody. Valproate

- Recently overtaken lithium as the most commonly
Mood Disorders Statistics: prescribed mood stabilizer for bipolar disorder
- Equally effective
● Both bipolar disorders can begin in childhood. - Less effective than lithium in preventing suicice
● Rates of completed suicide are 4 times higher in
people with bipolar disorder. Suicide
● MDD in adolescents is largely a female disorder.
● Women are twice as likely to have mood disorders as It is the 11th leading cause of death in the US.
men. It is an overwhelmingly white phenomenon.
● Bipolar disorders are distributed approximately equal It is the 5th leading cause of death from ages 5-14.
across genders Males are 4 times more likely to commit suicide than females.
Male generally choose far more violent methods, while females
Causes of Mood Disorders tend to rely on less violent options.
In China, suicide is an honorable solution if the family
● In family studies, we look at the prevalence of a given collapses and is seen as a reasonable solution to problems.
disorder in the first-degree relatives.
● Mood disorders are heritable. Indices of Suicide
● If one identical twin is unipolar, there is an 80%
chance that the other twin is unipolar as opposed to Indices = indicator, sign, measure
bipolar.
● Evidence supports the assumption of a close Suicide ideation
relationship among depression, anxiety, and panic - Thinkinf seriously about suicide
disorders.
● Low levels of serotonin. Suicidal plans
● Biological Test for Depression: dexametjasone - The formulation of a specific method for killing oneself
suppression test (DST)
○ Dexamethasone is a glutocorticoid that Suicidal attempts
suppresses cortisol secretion in normal - The person survives
participants.
○ Much less suppression was notices in Attempters
patients who were depressed. - Self-injurers with the intent to die
○ Later, individuals with other disorders also
demonstrated nonsuppression, elminiating Gesturers
its usefulness as a test to diagnose - Self-injurers who intend not to die but to influence or
depression. manipulate somebody or communicate a cry for help
● Shrinkage of the hippocampus was seen in
heightened levels of stress hormones over a long Causes of Suicide
period.
Emile Durkheim’s suidice types:
Treatment of Mood Disorders ● Formalized suicide - approved of (ex. Hara-kiri of
Japan); Altruistic suicide
Four basic antidepressant medications to treat depressive ● Egoistic suicide - loss of social supports
disorders: ● Anomic suicide - sudden loss of a high-prestige job
1. Selective-serotonin reuptake inhibitors (SSRIs), such ● Fatalistic suicides - loss of control over one’s destiny
as Prozac (fluoxetine) (mass suicide of 39 Heaven’s Gate cult members in
- Temporarily increases levels of serotonin at 1997)
the receptor site
- Block presynaptic reuptake of serotonin Sigmund Freud

10
 - believed that suicide intication unconscious hostility ● Binge-eating/purging type: during the last 3 months,
directed inward to the self rather than outward to the the individual has engaged in recurrent episodes of
person or situation causing the anger. binge-eating or purging behavior

Risk Factors of Suicide Treatment:

1. Inpatient treatment
● A family member committed suicide - Severe medical complication, particularly
● Low levels of serotonin acute cardiac failure, could occur if weight is
○ Associated with impulsivity, instability, and not restored immediately
the tendency to overreact to situations
● A sever, stressful event experiences as shameful or Bulimia Nervosa
humiliating
○ Succh as physical or sexual abuse The hallmark of bulimia nervosa is eating a lerger
● Effects of media amount of food – typically junk foods, more than fruits and
○ Suicide is romanticized in the media vegetables – than most people would under similar
○ Media often describes in detail the methods circumstances.
used in the suicide People with bulimia are ashamed of both their eating
issues and their lack of control.
Treatment Amenorrhea (cessation of menstruation) used to be a
criterion but was dropped because it does not occur in all
The clinician myst assess for: cases.
1. Suicidal desire (ideation, hopelessness,
burdensomeness, feeling trapped) Criteria:
2. Suicidal capability (past attempts, high anxiety/rage, a. Recurrent episodes of binge-eating:
available means) i. Eating in any 2-hour period an amount of
3. Suicidal intent (available plan, expressed intent to food that is definitely larger than most people
die, preparatory behavior) would eat during a similar period of time and
under similar circumstances.
Get the individual to agree or to even sign a no-suicide ii. A sense of lack of control over eating during
contract the episode.
Immediate hospitalization b. Recurrent inappropriate compensatory behvaior in
Limiting access to lethal weapons order to prevent weight-gain, such as self-induced
Telephone hotlines and other crisis intervention services vomiting, misuse of laxatives, diuretics or other
Cognitive-behavioral intervention medications, fasting, or excessive exercise
- 30 sessions cuts the risk of additional attempts by c. The binge eating and inappropriate compensatory
50% over the next 18 months behavior both occur on average at least once a week
for 3 months
Eating and Sleep-Wake Disorders d. Self-evaluation is unduly influenced by body shape
and weight.
Eating Disorders e. The disturbance does not occur exclusively under
episodes of anorexia nervosa.
The chief characteristic of these disorders is an
overwhelming, all-encompassing drive to be thin. Treatment:
1. CBT-E
It is not found in developing countries where access - Teaching the patient the physical
to sufficient food is so often a daily struggle. But evidence consequences of binge-eating and purging,
suggests that eating disorders are going global. and the inaffectiveness of vomiting and
laxative abuse for weight control
Obesity is not considered an official disorder in the - Altering dysfunctional thoughts and attitudes
DSM but it is thought to be one of the most dangerous about body shape, weight, and eating
epidemics. - Coping strategies for resisting the impulse to
binge and/or purge
Anorexia Nervosa 2. IPT
3. Family Therapy
It has the highest mortality rate of any psychological - Directed at the painful conflicts present in
disorder, including depression. families with an adolexcent who has an ED
People with anorexia are proud of their diets and their can be helpful
extraordinary control.
Binge-Eating Disorder
Criteria:
A. Restriction of energy reuptake relative to Criteria:
requirements, leading to a significantly low body a. Recurrent episodes of binge-eating:
weight in the context of age, sex, developmental i. Eating within any 2-hour period an amount of
trajectories, and physical health. food that is definitely larger than most people
B. Intense fear of gaining weight or of becoming fat, or would in a similar period of time and under
persistent behavior that interferes with weight gain, the same circumstances.
even though at a significantly low weight. ii. A sense of lack of control over eating during
C. Disturbance in the way in which one’s body weight or the episode.
shape is experienced, undue influence of body weight b. The binge-eating episodes are associated with 3 or
or shape on self-evaluation, or persistent lack of more of the following:
recognition of the seriousness of current body weight. i. Eating musch more rapidly than normal
ii. Eating until feeling uncomfortably full
Specify if: iii. Eating large amounts of food when not
● Restricting type: during the last 3 months, the feeling physically hungry
individual has not engaged in recurrent episodes of iv. Eating alone because of feeling
binge eating or purging behavior. embarrassed by how much one is eating

11
 v. Feeling disgusted with oneself, depressed,
Central Sleep Complete cessation Polysomnograph
or very giolty afterward Apnea of respiratory activity y of at least 5
c. Marked distress regarding binge-eating is present for brief period obstructive
d. This bing-eating occurs on average at leat one a Often associated with apneas or
week for 3 months CNS disorders hypopneas per
e. This binge-eating is not associated with the recurrent Wake up frequently at hour of sleep
use of inappropriate compensatory behavior as in night but not aware of
having a serious
bulimia nervosa
breathing problem

Treatment: Sleep-Related Decrease in airflow Elevated CO2

1. IPT Hypoventilatio without a complete levels
2. Self-help procedures n pause in breathing

Statistics of Eating Disorders Circadian Brought on by the Jet lag type

Rhythm brain’s inability to Shift work type
Sleep-Wake synchronize sleep Delayed sleep
● 90-95% of individuals with bulimia are women
Disorder patterns with the phase type
● Male with bulimia have a slightly later age of onset, current patterns of Advanced sleep
and a large minority are predominantly gay males or day and night phase type
bisexual Irregular
● Male athletes are another large groups of males with sleep-wake type
eating disorders Non-24 hour
● Adolescent girls are most at risk. sleep-wake type
● The median onset occurred in a narrow range of
PARASOMNIAS (abnormal behavior or physiological events
18-21 years. during sleep)

Causes of ED Disorder of Occur during NREM: Sleepwalking is

arousal Incomplete also called
● Cultural imperative awakening somnambulism
● Glorification of slenderness (Levine and Smolak) Sleep walking
● Exposure to media images depicting thin-ideal body Sleep terrors (abrupt Nocturnal eating
awakening from sleep syndrome
(Grabe, Ward, 7 Hyde) that begins with a (sleep-eating)
● Reverse anorexia nervosa in males (Olivardia, Pope, panicky scream)
& Hudson) Sexsomnia
● Perfectionistic attitudes (sexual behaviors
○ May reflect attempts to exert control over while sleeping)
important events in their lives
Nightmare Frequently being Occurs during
Disorder awakened by rem
Sleep-Wake Disorders
extended and Nightmares
extremely frightening awaken the
dreams that cause sleeper, bad
significant distress dreams do not
DYSSOMNIAS (amount, timing, or quality of sleep)
and impaired
functioning It must be so
Insomnia Difficulty falling stressful that they
asleep, impair a person’s
problems staying ability to carry on
asleep throughout the normal activities
night,
sleep does not result
REM Sleep Frequently being
in the person feeling
Behavior awakened by
rested even after
3 nights per week Disorder extended and
normal amounts of
for 3 months extremely frightened
sleep
dreams that cause
significant distress
Hypersomnole Excessive sleepiness and impaired
nce Disorder that is displayed as functioning
either sleeping longer
than is typical ro
Restless Legs Irresistible urges to
frequently falling
Syndrome move the legs as a
asleep during the day
results of unpleasant
sensations in the
Narcolepsy Episodes of 3 times per week limbs
irresistible attacks of over the past 3
refreshing sleep months
Substance-ind Results of substance
occurring daily,
uced Sleep intoxicatioin or
accompanied by
Disorder wtihdrawal
episodes of brief loss
of muscletone
Sexual Dysfunctions, Paraphilic Disorders, and Gender
Obstructive Nocturnal breathing Polysomnograph Dysphoria
Sleep Apnea disrubances y of at least 5
Hypopnea (snoring/gasping/brea obstructive
Gender Differences
Syndrome thing pauses) apneas or
Daytime sleepiness, hypopneas per ● Higher percentage of men than women report that
fatigue or hour of sleep they masturbate.
unrefreshing sleep (with symptoms) ● There is no difference in attitudes about
homosexuality, experience of sexual satisfaction, or
15 or more, attitudes toward masturbation.
regardless of ● Men show more sexual desire and arousal.
symptoms
● Women emphasize committed relationships as a
context for sex more than men.
12
 ● Men’s sexual self-concept is characterized partly by
process of disrobing, or engaging in sexual
power, independence,and aggression.
activity
● Women’s sexual beliefs are more plastic, in that they
are more easily shaped by culture, social, and
Exhibitionistic Sexual arousal from the exposure of one’s
situational factors.
genitals to an unsuspecting person

Sexual Response Cycle

Transvestic Seuxal arousal from cross-dressing
1. Desire - sexual urges occur in response to sexual
cues or fantasies
2. Arousal - a subjective sense of sexual pleasure and Sexual Sexual arousal from the psychological or
physiological signs of sexual arousal Sadism physical suffering of another person
a. Penile tumescience
b. Vasocongestion (blood pools in pelvic area) Sexual Sexual arousal from the act of being
leading to vaginal lubrication and breast masochism humiliated, beaten, bound, or otherwise
tumescience made to suffer
3. Plateau - brief period before orgams
4. Orgasm Pedophilic Sexual attraction with children aged 13
a. Feelings of inevitability of ejaculation, then years or younger, at least 16, at least 5
ejaculation years older than the child
b. Contactions of the lower third of the vagina
5. Resolution - decrease in arousal after orgasm incest Victims tend to be girls beginning to mature
physically
Sexual Dysfunctions
Causes of Paraphilic Disorders
All must have a minimum duration of 6 months.
● Inability to develop adequate social relations
Type Men Women ● Disordered relationships during childhood and
adolescence
● Early experience
Desire Male hypoactive Female sexual ● Nature of the person’s early sexual fantasies
sexual desire interest/arousal disorder ● Operant-conditioning paradigm
disorder ● Frequency of masturbation

Arousal Erectile disorder Female sexual Treatment of Paraphilic Disorders

interest/arousal disorder
● Covert sensitization
Orgasm Delayed/premature Female orgasmic disorder ○ Patients associate sexually arousing images
ejaculation in their imagination with some reasons why
the behavior is harmful or dangerous
Pain genito-pelvic
● Orgasmic conditioning
pain/penetration disorder
○ Patients are instructed to masterbate to their
(pain/anxiety/tension)
usual fantasies but to substitute more
desirable ones just before ejaculation
Vaginismus (muscle
● Chemical Castration
spasms that interfere with
○ An antiandrogen called cyproterone
penetration)
acetate
■ Eliminates sexual desire and
Paraphilic Disorders fantasy by reducing testosterone
levels dramatically
These disorders of sexual arousal if they cause ○ Medroxyprogesterone
distress or impairment to the individual, or cause personal ■ Is the injectable form that reduces
harm, or the risk of harm to others. testosterone
DSM-5 does not consider paraphilia a disorder unless ○ Triptorelin
it is associated with distress or impairment or harm or the ■ Inhibits gonadotropin secretion in
threat of others. men
It is unusual for an individual to have just one ■ Appears to be somewhat more
paraphilic pattern of sexual arousal. effective than the other drugs
It is not uncommon for individuals with this to also mentioned, with fewer side effects
suffer from comorbid mood, anxiety, and substance-abuse
disorders. Gender Dysphoria
Minimum duration is 6 months.
In children:
A. A marked incongruence between one’s
experienced/expressed gender and assigned gender,
Frotteuristic Sexual arousal from touching or rubbing
of at least 6 months’ duration, as manifested by at
against a non-consenting person
least 6 of the following, one of which must be
Criterion A1:
Fetishistic Sexual arousal from:
a. Strong desire to be of the other gender
1. Inanimate object
b. In boys, a strong preference for cross
2. Source of specific tactile
dressing; in girls, a strong preference for
stimulation
wearing only typical masculine clothing
3. partialism
c. A strong preference for cross-gender roles in
make-believe play
Voyeuristic Sexual arousal from observing an
d. A strong preference for the toys, games, or
unsuspecting person who is naked, in the
activities stereotypically used or engaged in
by the other gender

13
 e. In boys, a strong rejection of typically
masculine toys, games, and activities and Six General Categories of Substances:
avoidance of rough-and-tumble play; the
same with girls Depressants
f. A strong dislike of one’s sexual anatomy - Induce relaxation
g. A strong desire for the primary/secondary - Include alcohol, barbiturates (sedatives), and
sex characteristics that match one’s benzodiazepines (hypnotic drugs)
experienced gender
B. The condition is associated with clinically significant Stimulants
distress/impairment in social, school, or other areas of - Makes us active and alert
functioning - Elevates mood
- Include amphetamines, cocaine, nicotine, and
In Adolescents and Adults: caffeine
A. A marked incongruence between one’s
experienced/expressed gender and assigned gender, Opiates
of at least 6 months’ duration, as manifested by at - Produces analgesia temporarily and euphoria
least 2 of the following: - painkillers
a. A marked incongruence between one’s - Include heroin, opium, codeine, and morphine
experienced/expressed gener and
primary/secondary sex characterstics Hallucinogens
b. A strong desire to be rid of one’s - Alter sensory perception
primary/secondary sex characteristics - Produce delusions, paranoia, and hallucinations
because of marked incongruence with one’s - Include cannabis and LSD
experienced/expressed gender
c. A strong desire for the primary/secondary Other Drugs of Abuse
sex characteristic of the other gender ● Inhalants (e.g. airplane glue)
d. A strong desire to be of the other gender ● Anabolic steroid
e. A strong desire to be treated as of the other ● OTC and prescription medications (e.g. nitrous oxide)
gender
f. A strong conviction that one has the typical Gambling Disorder
feelings and reactions of the other gender - Unable to resist the urge to gamble which results in
B. This condition is associated with clinically significant negative personal consequences (e.g. divorce, loss of
distress/impairment in social, school, or other employment)
important areas of functioning
Biological Treatment
Substance-Related, Addictive, and Impulse-Control
Disorders Agonist Substitution
- Providing the person with a sage drug that has a
Any substance abuse should be occurring within a chemical makeup similar to the addictive drug
12-month period to be diagnosed as such. - Methadone is an opiate agonist that is often given as
a heroin substitute.
Substance - It is combined with counseling.
- Chemical compounds that are ingested to alter mood - Nicotine patches, gums, inhalers, or nasal sprays
or behavior are provided to smokers.
- It lacks the carcinogens in cigarette smokes.
Psychoactive substances - The dose is later tapered off to lessen
- Alter mood, behavior, or both withdrawal from the drug.

Substance use Antagonist Treatments

- Ingestion of psychoactive substances in moderate - Block or counter the effects of psychoactive drugs
amounts that does not significantly interfere with - Naltrexone produces immediate withdrawal
social, educational, or occupational functioning symptoms. (removes euphoria)
- The user must be highly motivated to
Substance intoxication continue treatment.
- Experienced as impaired judgment, mood changes, - Acamprosate decreases cravings in people
and lowered motor ability dependent on alcohol.
- Our physiological reaction to ingested substances - Works best with highly motivated people

Substance abuse Aversive Treatment

- If a substance disrupts your education, job, - Drugs that make ingesting the abused substances
relationship with others, and puts you in a physically extremely unpleasant
dangerous situation, you would be considered a drug - Disuldiram (Antabuse0 prevents the break down of
abuser acetalhyde in alcohol dependents
- Silver nitrate in gums or lozenges combines with the
Drug dependence saliva of the smoker to produce a bad taste in the
- Usually described as addiction mouth
- The person is physiologically dependent on the drug/s
- Involves tolerance and withdrawal Impulse-Control Disorders
● Tolerance = requiring increasingly greater
amounts of the drug to experience the same It starts with an irresistible impulse.
effect The person experiences increasing tension leadin gup
● Withdrawal = responding physically in a to the act, and sometimes, pleasurable anticipation of acting on
negative way when the substance is no the impulse.
longer ingested
- Uses drug seeking behaviors Intermittent Explosive Disorder

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 People having episodes in which they act out on - Excessively mistrustful and suspicious of others
aggressive impulses that result in serious assaults or without any justification
destruction of property. - Assume people are out to trick or harm them
It is not often diagnosed. - Tend to not confide in others
This diagnosis is controversial and has been debated
throughout the development of the DSM. Schizoid Personality Disorder
- Neither desire nor enjoy closeness with others
Kleptomania - Appear cold and detached
- Do not seem to be affected by praise or criticism
It is the recurrent failure to resist urges to steal things - Consider themselves to be observers rather than
that are not needed for personal use nor their monetary value. participants in the world around them (Beck &
The person begins to feel a sense of tension just Freeman)
before stealing, which is then followed by feelings of pleasure
or relief while the theft is committed. Schizotypal Personality Disorder
Have no memory about the act. - Have psychotic-like symptoms (such as believing
Naltrexone is somewhat effective in reducing the urge everything relates to them personally)
to steal. - Have social deficits and sometimes cognitive
impairments or paranoia
Pyromania - Often considered odd or bizarre because of:
● How they relate ot other people
It involves having an irresistible urge to set fires. ● How they think and behave
The person feels tension before setting a fire, and a ● how they dress
sense of gratification or relief while the fire burns. - Have odd beliefs or engage in “magical thinking”
Treatment is generally CBT, helping the person
identify signals that initiate urges and teaching coping
Cluster B - Dramatic, Emotional, or Erratic
strategies to resist the temptation.

Personality Disorders Antisocial A pervasive pattern of I am entitled

disregard for and violation to break
It refers to a persistent pattern of emotions, of the rights of others rules.
cognitions, and behavior that results in enduring emotional
distress for the person affected and/or for others and may Borderline A pervasive pattern of I deserve to
cause difficulties with work and relationships. instability of interpersonal be punished.
These disorders present in early adulthood. relationships, self-image,
affects, and control over
DSM IV-TR: most of the disorders were in Axis I. impulses.
Whereas personality disorders were in Axis II.
Histrionic A pervasive pattern of People are
Gender Differences excessive emotion and there to serve
● Men diagnosed with PD tend to display traits attention seeking. or admire me.
characterized by aggressive, structured,
self-assertive, and detached. Narcissistic A pervasive pattern of Since I am
● Women tend to present with characteristics that are grandiosity, need for special, I
more submissive, emotional, and insecure. admiration, and lack of deserve
● ASPD presents more in males. empathy special rules.
● DPD presents more in females.
● HPD and BPD present in equal numbers of males and Antisocial Personality Disorder
females. - Have a history of failing to comply with social norms
- Tend to be irresponsible, impulsive, and deceitful
- Completely lacking in conscience and empathy
Cluster A - Odd or Eccentric - Lying and cheating are second nature
- Show no remorse nor concern over the sometimes
devastating effects of their actions
Paranoid Pervasive distrust and I cannot trust - Substance abuse is common
suspiciousness of others people. Defining Criteria:
that their motives are ● Glibness (superficial charm)
interpreted as malevolent. ● Grandiose sense of self-worth
● Pathological lying
Schizoid A pervasive pattern of Relationships
● conning/manipulative
detachment from social are messy.
● Lack of remorse or guilt
relationships, and a
● callous/lack of empathy
restricted range of
expression of emotions in
Conduct Disorder
interpersonal settings.
- Childhood-onset type: at least 1 criterion prior 10
years
Schizotypal A pervasive pattern of social It’s better to
- Adolescent-onset type: absence of any criteria prior
and interpersonal deficits be isolated
10 years
marked by acute discomfort from others.
Criteria:
with reduced capacity for
A. A repetitive and persistent pattern of behavior in
close relationships, as well
which the basic rights of others or major
as by cognitive and
age-appropriate societal norms/rules are violated
perceptual distortions and
with at least 3 criteria in the past 12 months from
eccentricities of behavior.
any of the categories, with atleast one criterion
present in the past 6 months:
Paranoid Personality Disorder ● Aggression to People and Animals
a. Often bullies, threatens, or intimidates others
15
 b. Often initiates physical fights
Dependent A pervasive and excessive I need people
c. Has used a weapon that can cause serious
need to be taken care of, to survive, to
physical harm to others
which leads to submissive be happy.
d. Has been physically cruel to people
and clinging behavior and
e. Has been physically cruel to animals
fears of separation.
f. Has stolen while confronting a victim
g. Has forced someone into sexual activity
Obsessive- A pervasive pattern of People
● Destruction of Property
Compulsive preoccupation with should do
a. Has deliberately engaged in fire setting with
orderliness, perfectionism, better, try
the intention of causing serious damage
and mental and harder.
b. Has deliberately destroyed others’ property
interpersonal control, at the
● Deceitfulness or Theft
expense of flexibility,
a. Has broken into someone else’s house,
openness, and efficiency.
building, or car
b. Often lies to obtain goods or favors or to
avoid obligations Avoidant Personality Disorder
c. Has stolen items of nontrivial value without - Asocial because they are apathetic, affectively flat,
confronting a victim and uninterested in interpersonal relationships
● Serious Vioaltions of Rules - Feel chronically rejected by other and are pessimistic
1. Often stays out at night despite parental about their future
prohibitions, beginning before age 13 years
2. Has run away from home overnight at least Dependent Personality Disorder
twice while living in parental or parental - Sometimes agree with other people when their own
surrogate home, or once without returning opinion differs so as to not be rejected
for a lengthy period of time - Similar to avoidant personality as they have feelings
3. Is often truant from school, beginning before of inadequacy, sensitivity to criticism, and need for
age 13 years reassurance
B. This disturbance causes clinically significant impairment in - But people with APD respond to these
social, academic, or occupational functioning feelings by avoiding relationship, wheras
C. if the individual is 18 years or older, criteria are not met for people with DPD respond by clinging to
ASPD. relationships

Borderline Personality Disorder Obsessive-Compulsive Personality Disorder

- Have turbulent relationships, fearing abandonment, - Fixation on things being done “the right way”
but lacking control over their emotions - Preoccupation with details prevents them from
- Engage in behaviors that are suicidal, self-mutilative, completing musch of anything
or both - Their rigidity makes them have poor interpersonal
- Are often intense, going from anger to deep relationships
depression in a short time
- Core features: instability in emotions, interpersonal Schizophrenia Spectrum and Other Psychotic Disorders
relationships, self-concept, and behavior, and
dysfunction in the area of emotion Schizophrenia
- Are more likely to seek treatment than people with
anxiety and mood disorders Criteria:
- DBT (dialectical behavior therapy) is the CBT
- Helping people cope with the stressors that A.2 or more of the following, significant portion during a
seem to trigger suicidal behaviors 1-month period, must be 1,2, or 3:
1. Delusions
Histrionic Personality Disorder 2. Hallucinations
- Express their emotions in an exaggerated fashion 3. Disorganized speech (frequent derailment or
- Tend to be vain, self-centered, and uncomfortable incoherence)
when they are not in the limelight 4. Grossly disorganized or catatonic behavior
- Often seductive in appearance and behavior 5. Negative symptoms (diminished emotional
- Typically concerned about their looks expression or avolition)
- Constantly seek reassurance and approval
- Speech is often vague, lacking in detail, and B. For a significant portion of the time since the onset of
characterized by exaggeration disturbance, level of functioning in 1 or more major areas is
markedly achieved prior the onset.
Narcissistic Personality Disorder
- Unreasonable sense of self-importance C. Continuous signs of disturbance persists for at least 6
- Grandiosity months.
- Exploit others for their own interests and show little - Must include at least 1 month of symptoms that meet
empathy Criterion A
- Extremely envious and arrogant when confronted with - May include period of prodromal or residual
other successful people symptoms

D. Other disorders with psychotic features have been ruled out

Cluster C - Anxious or Fearful
E. The disturbance is not attributed to the physiological effects
Avoidant A pervasive pattern of social If people of a substance or another medical conditions.
inhibition, feelings of knew the
inadequacy, and “real” me, F. If there is a history of autism spectrum disorder, or a
hypersensitivity to negative they will reject communication disorder of childhood onset, the additional
evaluation me. diagnosis of schizophrenia is made only if prominent delusions
or hallucinations are also present for at least 1 month (or less if
successfully treated).

16
 Positive Symptoms Specifiers:
● Bipolar type - manic episodes as part of the
Delusions presentation
- Misinterpretation of reality ● Depressive type - only if major depressive episodes
- “The basic characteristic of madness” are part of the presentation
Specify if:
● Delusions of Grandeur ● With catatonia
○ Mistaken belief that the person is famous or
powerful Substance/Medication-Related Psychotic Disorder
● Delusions of Persecution
○ Others are “out ot get them” A. Has delusions and/or hallucinations
● Capgras Syndrome B. There is evidence from history that both (1) Criterion
○ Believes someone they know has been A happened during or after substance intoxication and
replaced by a double (2) involved substance/medication is capable of
● Cotard’s Syndrome producing Criterion A.
○ Believes he is dead C. Not explained by another psychotic disorder
● Erotomania D. Not exclusively during the course of a delirium
○ Believes someone is in love with them E. Causes clinically significant distress or impairment
without justifiable cause
Hallucinations Brief Psychotic Disorder
- Experience of sensory events without any input from
the surrounding environment A. Present of 1 or more (must be 1,2, or 2) of (1)
- Broca’s area is the most active part of the brain during delusions, (2) hallucinations, (3) disorganized speech,
hallucinations or (4) grossly disorganized or catatonic behavior).
B. At Least 1 day but less than 1 month
Negative Symptoms C. Not better explained by MDD or BD with psychotic
features
Avolition Specify if:
- Little interest in performing even the most basic ● With marked stressors (brief reactive psychosis)
day-to-day functions ● Without marked stressors
● With postpartum onset (within 4 weeks postpartum or
Alogia during pregnancy)
- Respond to questions with brief replies that have little ● With catatonia
content and may appear uninterested in the
conversation Neurodevelopmental Disorders

Anhedonia Abnormality in the Context of Neurodevelopment

- Indifference to activities that would typically be It is the absence of early and meaningful social
considered pleasurable relationships that has serious consequences

Affective Flattening Biological and psychosocial influences continuously

- Do not opening react to emotional situations interact with each other.
- Little change in facial expression, although
experiencing the appropriate emotions Attention-Deficit/Hyperactivity Disorder

Catatonia Specifier Criteria:

A. Persistent pattern of inattention and/or
A. 3 or more of the following symptoms: hyperactivity-impulsivity with functioning or
a. Stupor (no psychomotor activity) development
b. Cataplexy (passive induction of a posture B. Several inattentive or hyperactive-impulsive
held against gravity) symptoms were present before age 12 years
c. Waxy flexibility C. Several inattentive or hyperactive-impulsive
d. Mutism symptoms are present in 2 or more settings
e. Negativism D. There is clear evidence that the symptoms interfere
f. Postuing with, or reduce the quality of social, academic, or
g. Mannerism occupational functioning
h. Stereotypy (repetitive non-goal-oriented E. Symptoms do not occur exclusively durin the course
movements) of schizophrenia or another psychotic disorder, not
i. Agitation better explained by another mental disorder
j. Grimacing
k. Echolalia (mimicking others’ speech) Specify whether:
l. Echopraxia (mimicking other’s movements) ● Combined presentation: Criterion A1 and A2 are met
for the past 6 months
Other Psychotic Disorders ● Predominantly inattentive presentation
● Predominantly hyperactive-impulsive presentation
Schizophreniform Disorder
Treatment:
Experience the symptoms of schizophrenia for a few 1. Psychosocial Interventions
months only. a. Reinforcement programs
At least 1 month but less than 6 months b. Social skills training
c. Parent education programs
Schizoaffective Disorder 2. Biological Interventions
a. Stimulants - reinforce the brain’s ability to
Has symptoms of schizophrenia but also experiences focus attention
symptoms of mood disorders. b. Nonstimulants - reducing core symptoms
and improving concentration on tasks

17
 3. Combined Approach to Treatment ● Peirnatal (difficulties during labor and delivery)
● Postnatal (infections and head injury)
Specific Learning Disorder
Treatment of ID:
It is characterized by performance that is substantially ● Biological treatment is not a viable option as of today.
below what would be expected given the person’s age, IQ ● Generally are attempts to teach them the skills they
score, and education. need to become more productive and independent.
● Communication training:
Autism Spectrum Disorder ○ Mild = improving articulation
○ Most severe = sign language and/or
It must be present in early developmental period but augmentative communication strategies
may not become fully manifest until social demands exceed ● Supported employment
limited capacities, or may be masked by learned strategies in
later life. Neurocognitive Disorders

Two major characteristics: Most develop much later in life.

1. Impairments in social communication and interaction They were labeled “organic mental disorders” in early
2. Restricted, repetitive patterns of behavior, interests, or editions of the DSM.
activities They were labeled “cognitive disorders” in DSM-IV, as
their predominant feature is the impairment of cognitive
Levels of Severity: abilities such as memory, attention, perception, and thinking.
1. Requiring support
2. Requiring substantial support Delirium
3. Requiring very substantial support
Criteria:
Statistics: A. Disruption in attention and awareness
● 1/50 school-aged children in the US had a diagnosis B. Develops over a short period of time, represents a
under the category of ASD change from baseline attention and awareness, nad
● Male to female estimate being 4.4:1 tends to fluctuate in severity throughout the day.
● 385 of individuals with ASD have intellectual C. An additional disturbance in cognition
disabilities (IQ < 70) D. Not better explained by preexisting, established, or
● IQ measures are used to determine prognosis evolving neurocognitive disorder. Do not occur in the
○ The higher children score on IQ tests, the context of a severely reduced level of arousal
less likely they are to need extensive support E. Disturbance is a direct physiological consequence of
by family members or people in the helping another medical condition, substance intoxication or
professions withdrawal, or exposure to a toxin, or is due to
multiple etiologies.
Causes:
● Psychological/Social Dimensions Treatment:
○ Failed parenting ● Psychosocial intervention is the first line of treatment
○ Lack of self-awareness ○ Reassure the individual to help them with the
○ Savant skills agitation, anxiety, and hallucinations of
○ Social Deficiencies delirium
● BIological Dimensions ● Antipsychotic medications to calm the individual when
○ Genetic influences it is brought on by withdrawal from alcohol or other
○ Increased risk among elder parents drugs.
○ Neurobiological Influences
■ Lower levels of oxytocin Major and Mild Neurocognitive Disorders
■ Mercury in vaccines
MajND is a gradual deterioration of brain functioning
Intellectual Developmental Disorder that affects memory, judgment, language, and other advanced
cognitive processes.
One with mild or moderate impairments can carry out
most of the day to day activities. MinND was created in the DSM-V to focus attention
Ones with more severe impairments experience on the early stages of cognitive decline. The person has
impairmetns in most areas of functioning. modest impairment in cognitive abilities but can continue to
It was previously included on Axis II of DSM-IV-TR. function independently.
Age of onset must be before 18 years.
Due to Alzheimer’s Disease
Four Levels of ID:
1. Mild = between 50-55 and 70 In 1907, the German psychiatrist Alois Alzheimer first
2. Moderate = between 35-40 and 50-55 described the disorder that bears his name.
3. Severe = between 20-25 to 35-40
4. Profound = below 20-25 People with this disease disply one or mroe of the
following:
Levels Accoridng to the American Association on Intellectual ● Aphasia - language difficulties
and Developmental Disorders (AAIDD): ● Apraxia - motor functioning impairment
1. Intermittent support needed ● Agnosia - failure to recognize objects
2. Limiitend support needed ● Difficulties with planning, organizing, sequencing, or
3. Extensive support needed abstracting information
4. Pervasive support needed
It is more prevalent among women because women
Causes: lose estrogen as they grow older. Thus, there exists the
● Environmental (deprivation, abuse, neglect) tentative explanation that estrogen is protective against the
● Prenatal (exposure to disease or drugs while in the disease.
womb)

18
 Due to Vascular Neurocognitive Disorder

Ir is when blood vessels in the brain are blocked or

damaged and no longer carry oxygen and other nutrients to
certain areas of brain tissue.
The risk for men is slightly higher than among women.

Other Medical Conditions that Cause NCD

Frontotemporal NCD Damage to the frontal or temporal

region of the brain

Due to Traumatic Brain Executive dysfunction, problems

Injury with learning and memory

Lewy bodies Microscopic deposits of a protein

that damage brain cells over time

Parkinson’s Motor problems (tremors,

jerkiness, bradykinesia)
Voice (soft monotone)
Reduced dopamine

Human Cognitive slowness, impaired

Immunodeficiency attention, forgetfulness
Virus Type 1 (HIV-1)

Huntington’s Disease Involuntary limb movement

Prion Disease Prions are proteins that can

reproduce themselves and cause
damage to brain cells, leaving to
NC decline

Substance/Medication-I Long term abuse of a number of

nduced NCD drugs
Memory impairment
aphasia/apraxia/agnosia/disturba
nce in executive functioning

19