emotional disabilities psychiatric diagnosis and practical applications linda zimmerman professor,...

Emotional Disabilities

Psychiatric DiagnosisAnd

Practical Applications

Linda ZimmermanProfessor, Psychology and Student

DevelopmentOakton Community College

What is Mental Illness?

Mental illness is a term that describes a broad range of mental and emotional conditions.

What is Mental Illness?

Mental illness also refers to one portion of the broader ADA term mental impairment, and is different from other covered mental impairments such as mental retardation, organic brain damage, and learning disabilities.

Psychiatric Disability The term ‘psychiatric

disability’ is used when mental illness significantly interferes with the performance of major life activities, for example:

Learning Thinking Communicating Sleeping others

Mental Illness

can experience a mental illness over many years.

type, intensity and duration of symptoms vary from person to person.

symptoms come and go and do not always follow a regular pattern

difficult to predict when symptoms will worsen, even if treatment recommendations are followed

Mental Illness

Although the symptoms of mental illness often can be controlled effectively through medication and/or psychotherapy, or may even go into remission, for some people the illness continues to cause periodic episodes that require treatment.

Support needed varies widely: 1. none2. occasional 3. Substantial4. ongoing support to maintain their

productivity

Most Common Forms of Mental Illness

Anxiety Disorders Depressive

Disorders Schizophrenia

Anxiety Disorders

the most common group of mental illnesses

characterized by severe fear or anxiety associated with particular objects and situations.

most people with anxiety disorders try to avoid exposure to the situation that causes anxiety

Panic Disorder

the sudden onset of paralyzing terror or impending doom with symptoms that closely resemble a heart attack

Phobias

Simple Phobias: excessive fear of particular objects

Social Phobias: situations that expose a person to the possible judgment of others

Agoraphobia: situations where escape might be difficult

Phobias – Fear of…

Acrophobia: Heights

Ophidiophobia: Snakes

Aerophobia: Flying Arachnophobia:

Spiders Ornithophobia:

Birds Agoraphobia: Open

spaces

Astraphobia: Lightning

Mikrophobia: Germs

Phonophobia: Speaking aloud

Brontophobia: Thunder

Trichophobia: Hair Anthropophobia:

People

Phobias – Fear of…

Gephyrophobia: Bridges

Herpetophobia: Reptiles

Ailurophobia: Cats Murophobia: Mice Pyrophobia: Fire Claustrophobia: Closed

spaces

Numerophobia: Numbers Thanatophobia: Death Anthophobia: Flowers Cynophobia: Dogs Nyctophobia: Darkness Aquaphobia: Water

Obsessive-Compulsive Disorder

1. Obsessions - persistent distressing thoughts

2. Compulsions - a person attempts to alleviate the distress of certain thoughts by performing repetitive, intentional actions such as hand washing

Obsessive-Compulsive Disorder

OCD – As Good as it Gets: Jack Nicholson

http://www.youtube.com/watch?v=5wM_W8OcExo&NR=1

http://www.vh1.com/video/misc/503670/the-ocd-project-supertrailer.jhtml

Post-Traumatic Stress Disorder (PTSD)

a psychological syndrome characterized by specific symptoms that result from exposure to terrifying, life-threatening trauma such as an act of violence, war, or a natural disaster

Anxiety Therapy Exercise Meditation Sleep Reduce caffeine Psychotherapy

– Behavioral therapy (extinction)– Cognitive therapy (change thinking)– Tranquilizers

New drug, D-cycloserine – increase learning receptors– Virtual reality sessions

Depressive Disorders Mood Disorders or Affective

DisordersSymptoms• changes in mood• Mania• Depression

Treatments• Medication• Psychotherapy• Electroconvulsive

Therapy (ECT)• Phototherapy

Depressive Disorders

Major depression - an extreme or prolonged episode of sadness in which a person loses interest or pleasure in previously enjoyed activities

Depressive Disordershttp://www.facetheissue.com/depressionmovie.html

Major depression – characteristicsDepressed moodHopeless, helplessLoss of interest, pleasureAppetite, weight changesSleeping problemsAgitationDecreased energyGuilt, worthless feelingsSuicidal thoughtsDelusions, hallucinationsPhysical aches and pains

Depressive Disorders

Bipolar Disorder alternating episodes of mania ("highs") and depression ("lows")

Depressive Disorders

Dysthymia - continuous low-grade symptoms of major depression and anxiety

Depressive Disorders

Seasonal affective disorder (SAD) - a form of major depression that occurs in the fall or winter and may be related to shortened periods of daylight

Dissociative Disorders

Dissociative Disorders conscious awareness

becomes separated (dissociated) from previous memories, thoughts, and feelings

Dissociative Disorders

Dissociative Identity Disorder rare dissociative disorder in which a

person exhibits two or more distinct and alternating personalities

formerly called multiple personality disorder

SchizophreniaHighly complex illnessDifficult to generalizeUndetermined if it is a single

disorder or a group of related illnesses

Symptoms generally develop between the ages of 15 and 25.

Characterized by thoughts that seem fragmented and difficulty processing information.

Schizophrenia Symptoms are categorized

as either "negative" or "positive."

-Negative symptoms include:

social isolation or withdrawal,

loss of motivationa flat or

inappropriate affect (mood or disposition).

-Positive symptoms include:

hallucinationsdelusionsthought disorder

Schizophrenia

Personality Disorders

Other diagnosis we will explore: Borderline Personality Disorder Narcissistic Personality Disorder Histrionic Personality Disorder

Borderline Personality Disorder (BPD

pervasive instability in mood impaired interpersonal

relationships changing self-image lack of personal boundaries The majority of people diagnosed

with this disorder appear to have been abused or traumatized during childhood

Some researchers believe that BPD is a name given to a particular manifestation of post-traumatic stress disorder

Narcissistic Personality Disorder

extreme self-admiration, self-centeredness and self-regard, superiority, exhibitionism, entitlement, vanity, authority, exploitiveness.

overestimation of personal abilities excessive need for admiration and affirmation

from others disregard for the feelings of others, lack of

empathy erratic behavior well-liked at first meeting, extroverted, perform

well in public mal-adaptive, rigid, persistent

Histrionic Personality Disorder

A pattern of excessive emotional expression and attention-seeking

An excessive need for approval Inappropriate seductiveness Lively, dramatic, enthusiastic, flirtatious Express strong emotions, dramatic Easily influenced by others, easily bored More frequently diagnosed in women May affect social or romantic relationships Great difficulty coping with loss or failure Crave novelty and excitement thus get into risky

situations High risk of developing depression

Autistic Disorder and Asperger’s Syndrome

Autistic Disorder

Autistic Disorder Delays or abnormal functioning

observed prior to 3 years. Cognitive impairment Problems:

social interactionlanguage in social

communicationsymbolic or imaginative

play

Asperger’s Syndrome

Asperger’s Syndrome No clinically significant developmental

delay Eccentric behavior in childhood Impairments in two-sided social interaction Impairments in non-verbal communication Peculiar inflections and repetitions in

speech Gross motor clumsiness Often have a circumscribed area of interest

that leaves little room for more age appropriate, common interests: cars, trains, door knobs, hinges, meteorology, etc.

Asperger’s Syndrome

http://pediatricneurology.com/autism.htm

The speech of a 13 year old girl with Asperger’s

No clinically significant delay in cognitive intelligence

Tourette Syndrome

Inherited neurological disorder Genetic combined with environmental factors

considered causal Onset in childhood Multiple physical (motor) tics and at least

one vocal (phonic) tic Tics wax and wane Coprolalia – exclamation of obscene or

derogatory remarks – only present in a small minority.

Tourette Syndrome

Mild in most cases Often misidentified Incidence may be as high as one in 100

people, up to 530,000 U.S. school-age children may have it.

Exact causes are unknown Most are aware of an urge when they have

a tic No such thing as a typical case Often accompanied by OCD and/or ADHD.

Eating Disorders http://www.youtube.com/watch?v=R

RseSpdGC2s Major Eating disorders:

– Anorexia nervosa characterized by refusal to maintain a healthy body weight and an obsessive fear of gaining weight.

– Bulimia nervosa restraining of food intake for a period of time followed by an over intake or binging period that results in feelings of guilt and low self-esteem.

ADHD

six (or more) of the following symptoms of inattention have persisted for at least six months to a degree that is maladaptive and inconsistent with developmental level: 

Diagnostic criteria for Attention-Deficit/Hyperactivi

ty Disorder

Often: fails to give close attention

to details or makes careless mistakes in schoolwork, work, or other activities

has difficulty sustaining attention in tasks or play activities 

Celebrity ADHD

Diagnostic criteria for Attention-Deficit/Hyperactivity

Disorder does not seem to listen

when spoken to directly  does not follow through

on instructions and fails to finish: school work

chores duties in the workplace

Diagnostic criteria for Attention-Deficit/Hyperactivity

DisorderOften:

has difficulty organizing tasks and activities 

avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework) 

Diagnostic criteria for Attention-Deficit/Hyperactivity

Disorder

loses things necessary for tasks or activities (e.g., school assignments, pencils, books, tools, files, notes, keys, glasses) 

easily distracted by extraneous stimuli 

forgetful in daily activities 

Often:

Diagnostic criteria for Attention-Deficit/Hyperactivity

DisorderAnd/or:hyperactivity-impulsivity: six (or more) of the

following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

Hyperactivity 

Often:

(1) fidgets or squirms  (2) leaves seat in situations in which remaining seated is expected (3) moves excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness) 

Hyperactivity 

(4) has difficulty engaging in leisure activities quietly or alone(5) "on the go" or often acts as if "driven by a motor" (6) talks excessively

Often:

Myths About Mental Illness

People choose to have mental illness.

It reflects moral weakness.A person can “snap out of it.”Nothing will help.The person cannot succeed in

work or school.

Basic Statistics about Mental Illness

Mental illnesses are treatable Lack of treatment can lead to

suicide. 1 in 5 people will experience mental

illness in their lifetime. Depressive disorders occur in 8% of

the population Schizophrenia occurs in 2% of the

population

InternationalPsychological

Disorders

American Psychological Disorders, 2008

Suicide Risk Factors Varies by gender, age, and marital status

– easy accessibility to firearms– mood disorders– substance abuse– feelings of loneliness and hopelessness – previous suicide attempts

under age 30 – interpersonal loss; – poor social adjustment; and – problems surrounding love relationships, dating,

and friends College Undergraduates

– Rejection by a potential partner – loss of a romantic relationship