Module 22 Assessment & Anxiety Disorders

1. Module 22Assessment & Anxiety Disorders

2. Mental Disorder • Prolonged or recurring problem that seriously interferes with an individual’s ability to live a satisfying personal life & function adequately in society

3. Causes of Mental Disorders • Medical Model Approach • Disorders are similar to a physical illness • Drugs are used in treatment • Cognitive-Behavioral Approach • Disorders are due to deficits in cognitive processes & behavioral problems • Psychodynamic Approach • Disorders are due to unconscious conflicts or problems with unconscious conflicts at one of Freud’s psychosexual stages

4. Defining Mental Disorders: 3 Approaches • Statistical Frequency • Abnormal behavior rarely occurs in the general population • Social Norms • Abnormal behavior deviates greatly from accepted social standards, values, or norms • Maladaptive Behavior • Abnormal behavior interferes with the individual’s ability to function in his/her personal life or in society

5. Assessing Mental Disorders • Clinical Assessment • Systematic evaluation of an individual’s various psychological, biological, and social factors • Identifying past & present problems, stressors, or other symptoms

6. 3 Methods of Assessment • Neurological Tests • Check for brain damage • Evaluate reflexes, motor coordination, & brain structures/function • Clinical Interview • Gathering information about a person’s past & current behaviors, beliefs, attitudes, emotions & problems • Structured interviews follow a standard format of questions • Unstructured interviews have no set questions • Psychological Tests • Objective • specific statements or questions (e.g., MMPI) • Projective tests • ambiguous stimuli that a person interprets or makes up a story about

7. 3 Methods of Assessment cont. • (e.g., Rorschach ink blot)

8. Diagnosing Mental Disorders • DSM-IV-TR • Diagnostic & Statistical Manual of Mental Disorders - 4th ed.-Text Revision • Describes a uniform system for assessing symptoms & matching them to different mental disorders • Based on 5 Axes

9. Axis 1 • 9 Major Clinical Syndromes • Disorders usually first diagnosed in infancy, childhood, or adolescence • Organic mental disorders • Substance-related disorders • Schizophrenia & other psychotic disorders • Mood disorders • Anxiety disorders • Somatoform disorders • Dissociative disorders • Sexual & gender identity disorders

10. Axes II thru V • Axis II • Personality Disorders • longstanding, maladaptive, and inflexible traits • impairment of functioning or distress • e.g., antisocial personality disorder, borderline personality disorder • Axis III • General medical conditions • diabetes, arthritis, hemophilia • Axis IV • Psychosocial & environmental problems • experiencing a traumatic event, inadequate social support • Axis V • Global Assessment of Functioning (GAF) Scale

11. Axes II thru V cont. • Scores range from 10 (severe danger of hurting self) to 100 (superior functioning in all activities)

12. 3 Advantages of DSM-IV-TR • Helps professionals communicate • Researchers use the classification system to study & explain mental disorders • Therapists use the classification system to design a treatment program that best fits their client’s needs

13. 3 Potential Problems with the DSM-IV-TR • Labeling • Labels place people into categories • May have positive or negative associations • “Mentally retarded”, “schizo” • Mental health professionals do not always agree as to whether a client fits a particular diagnosis

14. Steps in Making a Clinical Diagnosis

15. Anxiety Disorders • Generalized Anxiety Disorder • Panic Disorder • Phobias • Obsessive-Compulsive Disorders

16. Generalized Anxiety Disorder • Characterized by excessive or unrealistic worry about almost everything or feeling that something bad is about to happen • Anxious feelings occur on most days for at least 6 months • Treatment • Benzodiazepines • Psychotherapy

17. Panic Disorder • Characterized by recurrent and unexpected panic attacks • Symptoms include: pounding heart, sweating, trembling, shortness of breath, feelings of choking, chest pain, nausea, dizziness, fear or losing control/dying • Intense worrying interferes with normal psychological functioning • Treatment • Benzodiazepines • Antidepressants • Psychotherapy

18. Phobias • Characterized by an intense & irrational fear that is out of all proportion to the possible danger of the object or situation • Fear is accompanied by physiological arousal • Person goes to great lengths to avoid the feared event/object

19. Types of Phobias • Social Phobia • Characterized by irrational, marked & continuous fear of performing in social situations • Individuals fear they will humiliate or embarrass themselves • Specific Phobias • Marked & persistent fears that are unreasonable & triggered by anticipation of, or exposure to, a specific object or situation • Agoraphobia • anxiety about being in places or situations from which escape might be difficult or embarrassing

20. Obsessive-Compulsive Disorder (OCD) • Obsessions • Persistent, recurring, irrational thoughts, impulses or images that a person is unable to control • Thoughts interfere with functioning • Compulsions • Irresistible impulses to perform some senseless behavior or ritual over and over • Handwashing, checking things, counting, putting things in order • Treatment • Exposure Therapy • gradually exposing the individual to the real anxiety-producing situations or objects that he/she is attempting to avoid until the anxiety decreases • Antidepressant drugs

21. Somatoform Disorders • A pattern of recurring, multiple, and significant bodily symptoms that extend over several years • Bodily symptoms are NOT under voluntary control • Bodily symptoms are believed to be caused by psychological factors • Examples: • Somatization disorder • multiple symptoms appearing before age 30 that have no physical cause, but are believed to be triggered by psychological problems or distress • Conversion disorder • changing anxiety or emotional distress into real physical, motor, sensory, or neurological symptoms (headaches, dizziness, paralysis)

22. Mass Hysteria • A condition experienced by a group of people, who through suggestion, observation, or other psychological processes, develop similar fears, delusions, abnormal behavior, or physical symptoms

23. TKS (Taijin Kyofusho) • Kind of social phobia characterized by intense fear of offending others through awkward social or physical behavior • Staring, blushing, giving off an offensive odor, having an unpleasant facial expression, having trembling hands • TKS is the 3rd most common psychiatric disorder treated in Japanese college students • The Japanese culture places great emphasis on the appropriate way to conduct oneself in public

24. School Shootings Adolescent Risk Factors • Uncontrolled anger, depression, blaming others for problems & threatening violence • Little parental supervision; troubled family relationships • Isolated & rejected by peers • Easy access to firearms • Warning signs of violent intentions were not taken seriously

25. Treating Phobias • Cognitive-Behavioral Therapy • Changing negative or distorted beliefs by substituting positive, healthy, realistic beliefs • Changing limiting or disruptive behaviors by learning and practicing new skills to improve function • Exposure Therapy • Gradually exposing theperson to real, anxietyproducing situations or objects • Drug Treatment • Benzodiazepines • Antidepressants