Classification of Mental Disorders
When the clinician wants to indicate the reason why the client's symptoms do not meet the criteria.
What is Other specified disorder
A suicidal client has passive thoughts but denies intent, plan, or means. The next best step is:
What is conduct a comprehensive suicide risk assessment and collaboratively develop a safety plan?
1. Temperament of behavioral inhibition (social avoidance, fear of unfamiliar people and situations)
2. Biased information processing - attending only to socially threatening information, overestimating likelihood of negative outcomes
What is Social Anxiety Disorder?
Behavioral techniques: (Lovaas)
1. Shaping
2. Discrimination Training
What is ASD treatment?
A 4-year-old has excellent rote memory and can read at a second-grade level but avoids eye contact, has repetitive behaviors, and struggles with reciprocal conversation.
What is Autism Spectrum Disorder?
Clinician does not want to indicate the reason why the client's symptoms do not meet criteria for a specific disorder.
What is Unspecified disorder
A client reports hearing God's voice but has no impairment and belongs to a religion where this experience is culturally normative.
What is avoiding a diagnosis until cultural context is evaluated?
Structural brain differences
1. Enlarged ventricles
2. Smaller hippocampus, amygdala, globus pallidus
3. Less active prefrontal cortex --> negative symptoms of schizophrenia
Neurotransmitters
1. Dopamine hypothesis - elevated levels
2. Serotonin, glutamate, GABA
Environment
1. Being born in the late winter or early spring (maybe because of increased risk of infection)
What is Schizophrenia?
1. antipsychotics - haloperidol, pimozide
2. alternative: clonidine (usually for hypertension)
3. habit reversal training, relaxation, psychoed
What is Tourette's Disorder treatment?
Social inhibition and fear of rejection despite desire for relationships.
What is Avoidant Personality Disorder?
To help clinicians consider and understand the impact of a client's cultural background on diagnosis and treatment, the DSM-5 TR includes an Outline for ______ that provides guidelines for assessing a client's cultural identity, cultural conceptualization of distress, psychosocial stressors and cultural factors that impact risk or protective factors and cultural factors relevant to relationship with therapist.
What is Cultural Formulation
1. lack of knowledge
2. parent-child conflict
3. developmental issues - especially hard during adolescence
1. Brain - loss of neurons, plaques, tangles, especially in the medial temporal lobe (hippocampus, amygdala)
2. Neurotransmitters - low acetylcholine
3. Environment - low education level, type II diabetes, depression, TBI, Down syndrome
What is Alzheimer's?
1. Traditional first generation antipsychotics: haloperidol, fluphenazine
2. Psychoed
3. Family-based interventions that reduce the levels of expressed emotion, like criticism and hostility, overprotectiveness, and enmeshment
What is Schizophrenia treatment?
A client has experienced depressed mood for three years with no symptom-free period lasting longer than two months.
What is Persistent Depressive Disorder?
1. cultural syndromes - SYMPTOMS recognized by the culture as coherent patterns of experience
2. cultural idioms of distress - used by members of cultures to COMMUNICATE distress, concerns
3. cultural explanations - models that members of a culture used to EXPLAIN meaning and causes of illness
What is the 3 cultural concepts of distress
The strongest predictor of future suicide attempts is:
What is a previous suicide attempt?
↑ dopamine + supersensitive dopamine receptors in the caudate nucleus
What is Tourette's Disorder?
Identifying triggers and developing coping strategies
What is relapse prevention therapy?
Hallucinations and delusions for 4 months without mood symptoms. Impairment may occur but is not required.
What is Schizophreniform Disorder?
The DSM-5 divides disorders into types, each defined by a set of criteria. Most disorders require a client to present with only a subset of characteristics from a larger list, so 2 clients can have the same disorder but different diagnoses.
What is DSM-5 Categorical Approach/Polythetic Criteria Set
1. Age - 45-54 years old
2. Gender - males 4x more likely than females; because they use more lethal means
3. Race/ethnicity - American Indians/Alaska Natives are highest, then White
4. Marital status - divorced, separated, widowed highest, then single
Previous SI - 80% have given warning sign, maybe a previous attempt
5. Early warning signs - talking about death, planning for their death (e.g. giving away possessions)
6. Life stress - rejection, interpersonal conflict, aloneness
What are suicide risk factors?
1. Neurotransmitters - ↑ serotonin (leading to restlessness, anxiety, obsessiveness)
2. Psychology - perfectionistic tendencies, female
3. Environment - possibly family conflict, overprotective families, overly rigid parents, mothers who are depressed, mothers who are domineering, fathers who are absent
What is Anorexia?
Therapy is usually only sought because others encourage the client OR because it is court-ordered. No specific treatments are recommended. Generally agreed that need:
1. a good therapeutic relationship
2. supportive therapy
3. consistent care
What is Factitious Disorder treatment?
A client has psychotic symptoms for one month, and overall functioning is not markedly impaired.
What is Delusional Disorder?