Assessment & Anxiety Disorders 

Factors in Mental Disorders

Causes of abnormal behavior;

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

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

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

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

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

Assessing Mental Disorders

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

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

 Classifying Mental Disorders
Ψ  Classifying Disorders 
          •  IC10 - International Statistical Classification of Diseases & Related Health Problems, 
             10th Revision, Chapter V Mental and behavioural disorders 

           •  DSM-V    Diagnostic & Statistical Manual of Mental Disorders-V 

   "The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is the 2013 
update to the American Psychiatric Association's (APA) classification and diagnostic tool. In the 
United States the DSM serves as a universal authority for psychiatric diagnosis. Treatment 
recommendations, as well as payment by health care providers, are often determined by DSM 
classifications, so the appearance of a new version has significant practical importance. 
    The DSM-5 was published on May 18, 2013, superseding the DSM-IV-TR, which was published 
in 2000. The development of the new edition began with a conference in 1999, and proceeded with 
the formation of a Task Force in 2007, which developed and field-tested a variety of new 
classifications. In most respects DSM-5 is not greatly changed from DSM-IV-TR. Notable changes
include dropping Asperger syndrome as a distinct classification; loss of subtype classifications for 
variant forms of schizophrenia; dropping the "bereavement exclusion" for depressive disorders; a 
revised treatment and naming of gender identity disorder to gender dysphoria, and removing the 
A2 criterion for posttraumatic stress disorder (PTSD) because its requirement for specific emotional 
reactions to trauma did not apply to combat veterans and first responders with PTSD. 
    Various authorities criticized the fifth edition both before and after it was formally published. Critics 
assert, for example, that many DSM-5 revisions or additions lack empirical support; inter-rater reliability 
is low for many disorders; several sections contain poorly written, confusing, or contradictory information; 
and the psychiatric drug industry unduly influenced the manual's content. Various scientists have argued
that the DSM-5 forces clinicians to make distinctions that are not supported by solid evidence, distinctions 
that have major treatment implications, including drug prescriptions and the availability of health insurance
 coverage. General criticism of the DSM-5 ultimately resulted in a petition, signed by many mental health 
 organizations, which called for outside review of DSM-5." 
•  From Wikipedia, the free encyclopedia, 9 November 2015 

			Classification is all about labeling. 
    Labels can be time saving,  even life saving and are necessary for billing BUT they can also bias us, 
 affect our judgment, stigmatize the patient and give us false preconcived notions. 


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

Somatoform disorders

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

                 Topics in Psychology
                      Robert C. Gates