Characteristics Of Disorders - A01 Flashcards
What do mental disorders lack?
They lack biomarkers for mental disorders but there are biomarkers for cancer.
What are the 2 diagnostic manuals most commonly used in psychiatry?
The DSM and the ICD, which are books that are used by professionals to categorise/ diagnose mental disorders.
What is DSM?
Diagnostic Statistical Manual, which is currently in its fifth version, DSM5.
It was published by the American Psychiatric Association (APA).
What is ICD
International Statical Classification of Diseases which is currently in its eleventh version (ICD11). It was published by the World Health Organisation (WHO).
What are the 3 categories of symptoms that you need to be aware of?
Emotional – feelings.
Behavioural – actions.
Cognitive – thoughts.
What is the definition of a phobia?
- A persistent irrational fear that’s disruptive to daily life.
- Which is either purposefully avoided or endured with marks of distress.
Common phobias?
Arachnophobia - fear of spiders. Up to 18% of men and 55% of women have symptoms of arachnophobia.
Ophidiophobia - fear of snakes. Approximately 1/3 of adults are ophidiophobic.
Acrophobia – fear of heights. Around 5 % of the general population suffers from this but it varies.
Agoraphobia – an extreme fear of entering crowded or open spaces where it is difficult to escape. This affects approximately 1.7% of adult; women are twice as likely to be affected.
Cynophobia – Fear of dogs; the figures vary.
What are the 3 categories of phobias recognised by DSM-5?
Agoraphobia
Social phobia/ social anxiety
Specific phobia
What is agoraphobia?
Having a phobia or being outside or in a public place.
What is a social phobia/social anxiety?
Having a phobia of social situations. E.g using a public toilet or public speaking.
What is a specific phobia?
Having a phobia of an object. E.g. a body part, animal, or situation like injections or flying.
What are the diagnostic criteria for phobias for DSM-5?
The presence of emotional, behavioural and cognitive responses is typically triggered in response to the phobic stimulus for a period of 6 or more months.
Describe the emotional symptoms (feelings) associated with phobias.
Fear
Anxiety
Unreasonable
Definition of fear
An immediate and unpleasant response when we think about or encounter a phobic stimulus.
Definition of anxiety
Phobias involve the emotional response of anxiety: high arousal, by definition.
Definition of unreasonable
Disproportionate to any threat posed.
Describe the behavioural symptoms (actions) associated with phobias.
Avoidance
Endurance
Panic
What is avoidance
Showing the effort to avoid the phobic stimulus, which can affect their everyday life.
E.g. reducing the amount of sleep you have.
What is endurance
This occurs when a person chooses to remain in the presence of the phobic stimulus.
An example of this is a person with arachnophobia staying in a room with a spider in order to keep your eye on it rather than leaving.
What is panic
Phobic people experience panic, which causes shaking, high heart rates, and shortness of breath.
Describe the cognitive symptoms (thoughts) associated with phobias.
Cognitive distortions
Selective attention
Irrational beliefs
What are cognitive distortions
Phobic stimulus thoughts are distorted.
E.g. someone with arachnophobia sees a spider as bigger than it actually is.
What is selective attention
A person finds is difficult to look away from the phobic stimulus.
What are irrational beliefs
The person with a phobia doesn’t respond to evidence.
E.g. someone finds out that it is safer to fly than to drive doesn’t reduce the phobia.
What is the definition of a depression?
A persistent sadness and lack of interest in pleasure.
In addition, it can disturb sleep and appetite with common factors of tiredness and poor concentration.
What are the 4 categories of depression recognised by DSM-5?
Premenstrual dysphoric
Persistent depressive disorder
Major depressive disorder
Disruptive mood dysregulation disorder
What is premenstrual dysphoric
A disruption to mood before and/or during menstruation.
What is persistent depressive disorder
Recurring or long-term depression, which includes sustained major depression (it used to be called dysthymia).
What is major depressive disorder
It’s severe but it’s often short-term depression.
What is disruptive mood dysregulation disorder
Temper tantrum in childhood.
What are the diagnostic criteria for depression for DSM-5?
Having a depressed mood for most of the day, almost everyday, anhedonia, and for at least 2 weeks, 5 of the listed symptoms should occur.
Describe the emotional symptoms associated with depression.
Anger
Low self esteem
Low mood (a required symptom)
Anhedonia
What is anger
Can be directed towards others or yourself – this comes form the general feeling of being emotionally hurt.
What is low self esteem
Having a low perception of self which can lead to self loathing.
What is low mood (a required symptom)
This includes feeling ‘worthless’, ‘hopeless’, or ‘empty’.
What is anhedonia
Having a loss of interest in hobbies and activities that were previously enjoyed.
This may be accompanied by avolition (loss of motivation in order to perform goal-directed activities.
Describe the behavioural symptoms associated with depression.
Disrupted sleep/ insomnia or increased sleep.
Disrupted eating/ appetite changes
Aggression/self harm
Low activity level/ reduction in energy
What is disrupted eating/ appetite changes
Eating more or less.
What is aggression/self harm
Having an increase of irritability, becoming verbally or physically aggressive, could lead to ending a relationship or job.
Self harm can result in suicide attempts or cutting.
What is low activity level/ reduction in energy
Sense of tiredness, having a desire to sleep, lower activity. Could also be the opposite: psychomotor agitation.
Describe the cognitive symptoms associated with depression.
Memory bias
Absolutist thinking
Poor concentration
Attention to the negative
What is memory bias
Suffers show cognitive bias of remembering unhappy events more easily.
What is absolutist thinking
‘Black and white’ way of thinking – can catastrophise situations, they see something unfortunate as a disaster.
What is poor concentration
Sufferers can’t focus on a task as much as the norm do; they find it difficult to make decisions.
What is attention to the negative
These include negative self-beliefs such as a sense of worthlessness and guilt.
What is the definition of OCD?
Obsessive Compulsive Disorder is a mental health condition where a person has obsessive thoughts (internal) and compulsive behaviours (external).
What are the 4 categories of OCD recognised by DSM-5?
Hoarding disorder
Excoriation disorder
OCD
Trichotillomania
What is hoarding disorder
A compulsive gathering of possessions and being unable to get rid of anything, ignoring the value.
What is excoriation disorder
Compulsive skin-picking.
What is OCD
Obsessive, recurring images, thoughts and or compulsion which are repetitive behaviours such as hand washing.
Most patients with OCD experience both symptoms.
What is Trichotillomania
Compulsive hair pulling.
What are the diagnostic criteria for OCD for DSM-5?
A presence of compulsions, obsessions or both that cause significant distress of impacting daily function or which are time consuming. This would be >1 hour per day.
Describe the emotional symptoms associated with OCD
Depression
Anxiety & distress
Guilt/disgust
What is depression in terms of OCD
OCD is typically accompanied by depression.
Compulsive behaviour can bring short-term relief.
What is anxiety & distress
Obsessive thoughts can be frightening and intrusive.
Anxiety can be produced when there is an urge to compulsively repeat behaviour.
What is guilt/disgust
OCD sufferers are typically aware that obsessive thoughts are irrational and that their compulsive behaviours are abnormal.
On the other hand, they can suffer guilt over minor moral issues.
Disgust might be directed towards themselves or externally like dirt.
Describe the behavioural symptoms associated with OCD.
Compulsions reduce anxiety
Repetitive/ritualistic compulsive behaviours
Avoidance
What is compulsions reduce anxiety
Compulsive behaviours are typically performed to reduce anxiety caused by obsessions.
For example: compulsive hand washing as a response to germ fear; compulsive checking such as making sure a door is locked as a response to the obsessive thought that it might have been left unsecured.
What are repetitive/ritualistic compulsive behaviours?
Sufferers may feel that they need to act on their obsessive thoughts with repetitive behaviour acts, called compulsions.
Examples include counting, tidying, praying and hand washing.
These behaviours are unpleasant, repetitive and interfere with everyday life.
What is avoidance in terms of OCD
Sufferers might attempt avoiding situations that trigger obsessions and compulsions.
This could be avoiding obsessive thoughts about germs by not emptying a bin.
Describe the cognitive symptoms associated with OCD.
Sufferer is aware that these obsessive thoughts are irrational
Obsessive thoughts
Cognitive coping strategies
Hypervigilance
What is sufferer is aware that these obsessive thoughts are irrational
People with OCD are typically aware that their cognitions are irrational.
However, they do maintain constant alertness and focus on potential hazards.
What is obsessive thoughts
An obsession is a recurring, unwanted, intrusive thought.
Around 90% of people suffering from OCD experience obsessive thoughts.
Some examples include the idea that dirt in the environment leads to being contaminated, worrying that the front door isn’t locked even if you’ve checked it.
These thoughts are unpleasant, repetitive and interfere with everyday life.
They are present on most days for a period of 2 or more weeks.
What are cognitive coping strategies
An example of this is a religious person being tormented by guilt and might respond to it by meditating or praying.
This helps to manage anxiety, but it can become a distraction.
What is hypervigilance?
Selective attending and increased awareness of a source of obsession in new situations.
