Psy 410 Week 2 and 3 Matrix of Disorders Essay.

Anxiety, Mood, and Dissociative Disorder Matrix Abnormal Psychology Disorders| DSM-IV-TR Criteria| Examination of Classifications and Symptoms| A. Anxiety Disorders:| | | 1. Generalized Anxiety Disorder (GAD)| A. Excessive anxiety and worry (apprehensive expectation) about two (or more) domains of activities or events (for example, domains like family, health, finances, and school/work difficulties)B. The excessive anxiety and worry occur on more days than not for three months or more (APA, 2000) Examination of Classifications and SymptomsC. The anxiety and worry are associated with one or more of the following symptoms: 1.Psy 410 Week 2 and 3 Matrix of Disorders Essay.

Restlessness or feeling keyed up or on edge2. Being easily fatigued3. Difficulty concentrating or mind going blank4. Irritability5. Muscle tension6. Sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)D. The anxiety and worry are associated with one or more of the following behaviors:a. Marked avoidance of situations in which a negative outcome could occurb. Marked time and effort preparing for situations in which a negative outcome could occurc. Marked procrastination in behavior or decision-making due to worriesd. Repeatedly seeking reassurance due to worries E.Psy 410 Week 2 and 3 Matrix of Disorders Essay.

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The focus of the anxiety and worry are not restricted to symptoms of another disorder, such as Panic Disorder (e. g. , anxiety about having a panic attack), Social Anxiety Disorder (e. g. , being embarrassed in public), Obsessive-Compulsive Disorder (e. g, anxiety about being contaminated), Separation Anxiety Disorder (e. g. , anxiety about being away from home or close relatives), Anorexia Nervosa (e. g. , fear of gaining weight), Somatization Disorder (e. g. , anxiety about multiple physical complaints), Body Dysmorphic Disorder (e. g. , worry about perceived appearance flaws), Hypchondriasis (e. . , belief about having a serious illness), and the anxiety and worry do not occur exclusively during Posttraumatic Stress Disorder. F. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. G. The disturbance is not due to the direct physiological effects of a substance (e. g. , a drug of abuse, a medication) or a general medical condition (e. g. , hyperthyroidism) and does not occur exclusively during a Mood Disorder, a Psychotic Disorder, or an Autism Spectrum Disorder. APA, 2000)| Lifetime Estimated Prevalence of Anxiety disorders in the populationGAD = 5% populationPD = 1-2% populationPhobias = 9-24% populationOCD = 1-2. 5% populationPTSD = over 8% population(Hansell & Damour, 2008). | 2. Panic Disorder| A. Both (1) and (2):1. Recurrent unexpected Panic attacks. 2. At least one of the attacks has been followed by 1 month (or more) of one (or more) of the following:a. Persistent concern about having additional attacksb. Worry about the implications of the attack or its consequences(e. g. , losing control, having a heart attack, “going crazy”)c.Psy 410 Week 2 and 3 Matrix of Disorders Essay.

A significant change in behavior related to the attacksB. The presence (or absence) of AgoraphobiaC. The Panic Attacks are not due to the direct physiological effects of a substance (e. g. , a drug of abuse, a medication) or a general medical condition (e. g. , hyperthyroidism). D. The Panic Attacks are not better accounted for by another mental disorder, such as Social Phobia (e. g. , occurring on exposure to feared social situations), Specific Phobia (e. g. , on exposure to a specific phobic situation), Obsessive-Compulsive Disorder (e. g. on exposure to dirt in someone with an obsession about contamination), Posttraumatic Stress Disorder (e. g. , in response to stimuli associated with a severe stressor), or Separation Anxiety Disorder (e. g. , in response to being away from home or close relatives). (APA, 2000)| Lifetime Estimated Prevalence of Anxiety disorders in the population:PD = 1-2% population (Hansell & Damour, 2008)| 3. Phobias| A. Both (1) and (2):1. Recurrent unexpected Panic Attacks 2. At least one of the attacks has been followed by 1 month (or more) of one (or more) of the following:a. Persistent concern about having additional attacksb.Psy 410 Week 2 and 3 Matrix of Disorders Essay.

Worry about the implications of the attack or its consequences(e. g. , losing control, having a heart attack, “going crazy”)c. A significant change in behavior related to the attacksB. The presence (or absence) of Agoraphobia. C. The Panic Attacks are not due to the direct physiological effects of a substance (e. g. , a drug of abuse, a medication) or a general medical condition (e. g. , hyperthyroidism). D. The Panic Attacks are not better accounted for by another mental disorder, such as Social Phobia (e. g. , occurring on exposure to feared social situations), Specific Phobia (e. g. on exposure to a specific phobic situation), Obsessive-Compulsive Disorder (e. g. , on exposure to dirt in someone with an obsession about contamination), Posttraumatic Stress Disorder (e. g. , in response to stimuli associated with a severe stressor), or Separation Anxiety Disorder (e. g. , in response to being away from home or close relatives). (APA, 2000)| Lifetime Estimated Prevalence of Anxiety disorders in the population Phobias = 9-24% Population(Hansell & Damour, 2008)| 4. Obsessive-compulsive Disorder| A. Either obsessions or compulsions:Obsessions as defined by (1), (2), (3), and (4):1.

Recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress2. The thoughts, impulses, or images are not simply excessive worries about real-life problems3. The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action4. The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion)Compulsions as defined by (1) and (2):1.

Repetitive behaviors (e. g. , hand washing, ordering, checking) or mental acts (e. g. , praying, counting, repeating words silently) that the person counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly2. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessiveB.

At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable. Note: This does not apply to children. C. The obsessions or compulsions cause marked distress, are time consuming (take more than 1 hour a day), or significantly interfere with the person’s normal routine, occupational (or academic) functioning, or usual social activities or relationships. D. If another Axis I disorder is present, the content of the obsessions or compulsions is not restricted to it (e. g. preoccupation with food in the presence of an Eating Disorder; hair pulling in the presence of Trichotillomania; concern with appearance in the presence of Body Dysmorphic Disorder; preoccupation with drugs in the presence of a Substance Use Disorder; preoccupation with having a serious illness in the presence of Hypochondriasis; preoccupation with sexual urges or fantasies in the presence of a Paraphilia; or guilty ruminations in the presence of Major Depressive Disorder). E. The disturbance is not due to the direct physiological effects of a substance (e. . , a drug of abuse, a medication) or a general medical condition. (APA,2000)| Lifetime Estimated Prevalence of Anxiety disorders in the population OCD = 1-2. 5% population(Hansell ; Damour, 2008)| 5. Post-traumatic Stress Disorder| A. The person has been exposed to a traumatic event in which both of the following were present:1. The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others2.

The person’s response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behaviorB. The traumatic event is persistently re-experienced in one (or more) of the following ways:1. Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed. 2. Recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content. . Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur. 4. Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event5. Physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic eventC.Psy 410 Week 2 and 3 Matrix of Disorders Essay.

Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:1. Efforts to avoid thoughts, feelings, or conversations associated with the trauma2. Efforts to avoid activities, places, or people that arouse recollections of the trauma3. Inability to recall an important aspect of the trauma4. Markedly diminished interest or participation in significant activities5. Feeling of detachment or estrangement from others6.

Restricted range of affect (e. g. , unable to have loving feelings)7. Sense of a foreshortened future (e. g. , does not expect to have a career, marriage, children, or a normal life span)D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:1. Difficulty falling or staying asleep2. Irritability or outbursts of anger3. Difficulty concentrating4. Hypervigilance5. Exaggerated startle responseE. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than 1 month. F.

The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Specify if:Acute: if duration of symptoms is less than 3 monthsChronic: if duration of symptoms is 3 months or moreWith Delayed Onset: if onset of symptoms is at least 6 months after the stressor(APA, 2000)| Lifetime Estimated Prevalence of Anxiety disorders in the population PTSD = over 8% pop(Hansell & Damour, 2008)| Acute stress disorder (ASD)| A. The person has been exposed to a traumatic event in which both of the following were present:1.Psy 410 Week 2 and 3 Matrix of Disorders Essay.

The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others2. The person’s response involved intense fear, helplessness, or horrorB. Either while experiencing or after experiencing the distressing event, the individual has three (or more) of the following dissociative symptoms:1. Subjective sense of numbing, detachment, or absence of emotional responsiveness2. A reduction in awareness of his or her surroundings (e. . , “being in a daze”)3. De-realization4. Depersonalization5. Dissociative amnesia (i. e. , inability to recall an important aspect of the trauma)C. The traumatic event is persistently re-experienced in at least one of the following ways: recurrent images, thoughts, dreams, illusions, flashback episodes, or a sense of reliving the experience; or distress on exposure to reminders of the traumatic event. D. Marked avoidance of stimuli that arouse recollections of the trauma (e. g. , thoughts, feelings, conversations, activities, places, people).

E. Marked symptoms of anxiety or increased arousal (e. g. , difficulty sleeping, irritability, poor concentration, hypervigilance, exaggerated startle response, motor restlessness). F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning or impairs the individual’s ability to pursue some necessary task, such as obtaining necessary assistance or mobilizing personal resources by telling family members about the traumatic experience. G.

The disturbance lasts for a minimum of 2 days and a maximum of 4 weeks and occurs within 4 weeks of the traumatic event. H. The disturbance is not due to the direct physiological effects of a substance (e. g. , a drug of abuse, a medication) or a general medical condition, is not better accounted for by Brief Psychotic Disorder, and is not merely an exacerbation of a preexisting Axis I or Axis II disorder. (APA, 2000)| | Mood Disorders| DSM-IV-TR Criteria| Examination of Classifications and Symptoms| Major depressive episode| Note: This is not a codeable disorder. A.

Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations. 1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e. g. , feels sad or empty) or observation made by others (e. g. , appears tearful). Note: In children and adolescents, can be irritable mood. 2.

Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)3. Significant weight loss when not dieting or weight gain (e. g. , a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains. 4. Insomnia or hypersomnia nearly every day5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)6.

Fatigue or loss of energy nearly every day7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicideB. The symptoms do not meet criteria for a Mixed Episode. C.

The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. D. The symptoms are not due to the direct physiological effects of a substance (e. g. , a drug of abuse, a medication) or a general medical condition (e. g. , hypothyroidism). E. The symptoms are not better accounted for by Bereavement, i. e. , after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation. APA, 2000)| Major depressive disorder The lifetime estimated prevalence in the most common combination of major depressive episodes is approximately 17% of the U. S. population. Dysthymic disorder is depression that is less severe than depression but more chronic than a major depressive episode, lasting at least two years in adults or one year in children and adolescents and has an estimated lifetime prevalence of approximately 6%. Bipolar I disorder is a combination of manic and major depressive episodes and has a an estimated lifetime prevalence of approximately 1%.Psy 410 Week 2 and 3 Matrix of Disorders Essay.

Bipolar II disorder is a combination of hypomanic and major depressive episodes with a lifetime prevalence of approximately 0. 5%. Cyclothymic disorder is a combination of hypomanic and depressive mood swings that are less severe than in Bipolar I and II disorders but occur chronically for at least two years with an estimated lifetime prevalence of up to 1%. (Hansell ; Damour, 2008)| Manic Episode| Note: This is not a codeable disorder. A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary). B.

During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:1. Inflated self-esteem or grandiosity2. Decreased need for sleep (e. g. , feels rested after only 3 hours of sleep)3. More talkative than usual or pressure to keep talking4. Flight of ideas or subjective experience that thoughts are racing5. Distractibility (i. e. , attention too easily drawn to unimportant or irrelevant external stimuli)6. Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation7.

Excessive involvement in pleasurable activities that have a high potential for painful consequences (e. g. , engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)C. The symptoms do not meet criteria for a Mixed Episode. D. The mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others, or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features. E. The symptoms are not due to the direct physiological effects of a substance (e. . , a drug of abuse, a medication, or other treatment) or a general medical condition (e. g. , hyperthyroidism). Note: Manic-like episodes that are clearly caused by somatic antidepressant treatment (e. g. , medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder. (APA, 2000)| | Hypomanic Disorder| A. A distinct period of persistently elevated, expansive, or irritable mood, lasting throughout at least 4 days, that is clearly different from the usual non-depressed mood.

B. During the period of mood disturbance, three (or more) of the following symptoms have persisted (four if the mood is only irritable) and have been present to a significant degree:1. Inflated self-esteem or grandiosity2. Decreased need for sleep (e. g. , feels rested after only 3 hours of sleep)3. More talkative than usual or pressure to keep talking4. Flight of ideas or subjective experience that thoughts are racing5. Distractibility (i. e. , attention too easily drawn to unimportant or irrelevant external stimuli)6.

Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation7. Excessive involvement in pleasurable activities that have a high potential for painful consequences (e. g. , the person engages in unrestrained buying sprees, sexual indiscretions, or foolish business investments)C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the person when not symptomatic. D. The disturbance in mood and the change in functioning are observable by others.

E. The episode is not severe enough to cause marked impairment in social or occupational functioning, or to necessitate hospitalization, and there are no psychotic features. F. The symptoms are not due to the direct physiological effects of a substance (e. g. , a drug of abuse, a medication, or other treatment) or a general medical condition (e. g. , hyperthyroidism). Note: Hypomanic-like episodes that are clearly caused by somatic antidepressant treatment (e. g. , medication, electroconvulsive therapy, light therapy) should not count oward a diagnosis of Bipolar II Disorder. (APA, 2000)| | Dissociative Disorders| DSM IV TR Criteria| Examination of Classifications and Symptoms| Depersonalization disorder| A. Persistent or recurrent experiences of feeling detached from, and as if one is an outside observer of, one’s mental processes or body (e. g. , feeling like one is in a dream). B. During the depersonalization experience, reality testing remains intact. C. The depersonalization causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The depersonalization experience does not occur exclusively during the course of another mental disorder, such as Schizophrenia, Panic Disorder, Acute Stress Disorder, or another Dissociative Disorder, and is not due to the direct physiological effects of a substance (e. g. , a drug of abuse, a medication) or a general medical condition (e. g. , temporal lobe epilepsy). (APA, 2000)| Lifetime Estimated Prevalence of distressing feelings of being detached from one’s body can be up to 2. 8% of U. S. population. (Hansell & Damour, 2008)| Dissociative amnesia| A.Psy 410 Week 2 and 3 Matrix of Disorders Essay.

The predominant disturbance is one or more episodes of inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness. B. The disturbance does not occur exclusively during the course of Dissociative Identity Disorder, Dissociative Fugue, Posttraumatic Stress Disorder, Acute Stress Disorder, or Somatization Disorder and is not due to the direct physiological effects of a substance (e. g. , a drug of abuse, a medication) or a neurological or other general medical condition (e. g. Amnestic Disorder Due to Head Trauma). C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. (APA, 2000)| Lifetime Estimated Prevalence of the inability to remember important personal data as a result of a highly traumatic experience can be up to as much as 6% of a population experiencing a lot of tragedy or trauma. (Hansell & Damour, 2008)| Dissociative fugue| A. The predominant disturbance is sudden, unexpected travel away from home or one’s customary place of work, with inability to recall one’s past. B.

Confusion about personal identity or assumption of a new identity (partial or complete). C. The disturbance does not occur exclusively during the course of Dissociative Identity Disorder and is not due to the direct physiological effects of a substance (e. g. , a drug of abuse, a medication) or a general medical condition (e. g. , temporal lobe epilepsy). D. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. (APA, 2000)| Lifetime Estimated Prevalence of spur of the moment escape from home accompanied by amnesia symptoms can be up to 0. % and is very uncommon. (Hansell & Damour, 2008)| Dissociative Identity Disorder (DID)(formally multiple personality disorder)| A. The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self). B. At least two of these identities or personality states recurrently take control of the person’s behavior. C. Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness. D. The disturbance is not due to the direct physiological effects of a substance (e. . , blackouts or chaotic behavior during Alcohol Intoxication) or a general medical condition (e. g. , complex partial seizures). Note: In children, the symptoms are not attributable to imaginary playmates or other fantasy play. (APA, 2000)| Lifetime Estimated Prevalence of of two or more distinct personalities or identities that claims control of an individual’s mind or behavior can be a touchy subject, butis believed to occur in less than 1% of the U. S. population. | Abnormal Psychology Disorders| DSM-IV-TR Criteria| Examination of Classifications and Symptoms| Anorexia Nervosa| A.

Refusal to maintain body weight at or above a minimally normal weight for age and height (e. g. , weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected). B. Intense fear of gaining weight or becoming fat, even though underweight. C. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight. D. In post menarcheal females, amenorrhea, i. . , the absence of at least three consecutive menstrual cycles. (A woman is considered to have amenorrhea if her periods occur only following hormone, e. g. , estrogen administration. )(APA, 2000)| * People who experience more stressful lives are more likely to eat unhealthy and suffer from eating disorders. * Self-Starvation occurs in many cultures, but is not necessarily related to thinness or physical appearance driven behaviors. * Eating disorders are most common in women between the ages of 15 and 25, although there is evidence of increased dieting and weight preoccupation among younger girls. Ninety percent of eating disorders occur in women. However, there is growing awareness of a reverse anorexia syndrome among men. Eating disorders occur at approximately the same rate across different socioeconomic groups, but subclinical eating disorders are more common among members of the upper socioeconomic classes. * While eating disorders have traditionally been thought to be most prevalent among white American women, new research indicates that eating disorders do occur with notable frequency in many minority groups. Specific to certain cultures and carry more historical relevance than anorexia. (Hansell & Damour, 2008)| Bulimia Nervosa| A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:(1) Eating, in a discrete period of time (e. g. , within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances(2) A sense of lack of control over eating during the episode (e. g. a feeling that one cannot stop eating or control what or how much one is eating)B. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise. C. The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months. D. Self-evaluation is unduly influenced by body shape and weight. E. The disturbance does not occur exclusively during episodes of Anorexia Nervosa.Psy 410 Week 2 and 3 Matrix of Disorders Essay.

Specify type:Purging Type: during the current episode of Bulimia Nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas. Nonpurging Type: during the current episode of Bulimia Nervosa, the person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas. (APA, 2000)| * People who experience more stressful lives are more likely to eat unhealthy and suffer from eating disorders. Self-Starvation occurs in many cultures, but is not necessarily related to thinness or physical appearance driven behaviors. * Eating disorders are most common in women between the ages of 15 and 25, although there is evidence of increased dieting and weight preoccupation among younger girls. * Ninety percent of eating disorders occur in women. However, there is growing awareness of a reverse anorexia syndrome among men. * Eating disorders occur at approximately the same rate across different socioeconomic groups, but subclinical eating disorders are more common among members of the upper socioeconomic classes. While eating disorders have traditionally been thought to be most prevalent among white American women, new research indicates that eating disorders do occur with notable frequency in many minority groups. * Specific to certain cultures and carry more historical relevance than anorexia. (Hansell & Damour, 2008)| Abuse| A. A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by one (or more) of the following, occurring within a 12-month period:(1) Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home (e. . , repeated absences or poor work performance related to substance use; substance-related absences, suspensions, or expulsions from school; neglect of children or household) (2) Recurrent substance use in situations in which it is physically hazardous (e. g. , driving an automobile or operating a machine when impaired by substance use)(3) Recurrent substance-related legal problems (e. g. , arrests for substance-related disorderly conduct)(4) Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e. . , arguments with spouse about consequences of intoxication, physical fights)B. The symptoms have never met the criteria for Substance Dependence for this class of substance. (APA, 2000)| * All people are found to misuse and abuse drugs and alcohol (for the exception of very small children). * Men, in general, are more likely to use drugs and alcohol more than women. * Adolescents and young adults abuse drugs to enhance an already existing risk-taking behavior. * Substance abuse in the elderly population is often overlooked, but related to the misuse of prescription drugs. * In the U. S. it is more common for Caucasian, white collar men to use drugs while underemployed men are more likely to abuse alcohol. (Hansell & Damour, 2008)| Dependence| A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:(1) Tolerance, as defined by either of the following:(a) A need for markedly increased amounts of the substance to achieve intoxication or desired effect. (b) Markedly diminished effect with continued use of the same amount of the substance. 2) Withdrawal, as manifested by either of the following:(a) The characteristic withdrawal syndrome for the substance (refer to Criteria A and B of the criteria sets for Withdrawal from the specific substances). (b) The same (or a closely related) substance is taken to relieve or avoid withdrawal symptoms. (3) The substance is often taken in larger amounts or over a longer period than was intended. (4) There is a persistent desire or unsuccessful efforts to cut down or control substance use(5) A great deal of time is spent in activities necessary to obtain the substance (e. g. visiting multiple doctors or driving long distances), use the substance (e. g. , chainsmoking), or recover from its effects. (6) Important social, occupational, or recreational activities are given up or reduced because of substance use. (7) The substance use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance (e. g. , current cocaine use despite recognition of cocaine-induced depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption).

Specify if:With Physiological Dependence: evidence of tolerance or withdrawal (i. e. , either Item 1 or 2 is present)Without Physiological Dependence: no evidence of tolerance or withdrawal (i. e. , neither Item 1 nor 2 is present)Course specifiers (see text for definitions):(APA, 2000)| | Sexual Desire Disorder| A. Persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity. The judgment of deficiency or absence is made by the clinician, taking into account factors that affect sexual functioning, such as age and the context of the person’s life.

B. The disturbance causes marked distress or interpersonal difficulty. C. The sexual dysfunction is not better accounted for by another Axis I disorder (except another Sexual Dysfunction) and is not due exclusively to the direct physiological effects of a substance (e. g. , a drug of abuse, a medication) or a general medical condition. (APA, 2000)| The various disorders can start at different ages. Gender Identity Disorders will occur much younger than some of the other sexual dysfunctions because of the physical maturity of each individual.

The gender classification does not apply to this group because these dysfunctions can occur to both male and female. Some of the dysfunctions have circumstantial reasoning as well. | Sexual Arousal Disorder| A. Persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate lubrication swelling response of sexual excitement. B. The disturbance causes marked distress or interpersonal difficulty. C. The sexual dysfunction is not better accounted for by another Axis I disorder (except another Sexual Dysfunction) and is not due exclusively to the direct physiological effects of a substance (e. . , a drug of abuse, a medication) or a general medical condition. (APA, 2000)| | Orgasmic Disorders (Female)| A. Persistent or recurrent delay in, or absence of, orgasm following a normal sexual excitement phase. Women exhibit wide variability in the type or intensity of stimulation that triggers orgasm. The diagnosis of Female Orgasmic Disorder should be based on the clinician’s judgment that the woman’s orgasmic capacity is less than would be reasonable for her age, sexual experience, and the adequacy of sexual stimulation she receives.

B. The disturbance causes marked distress or interpersonal difficulty. C. The orgasmic dysfunction is not better accounted for by another Axis I disorder (except another Sexual Dysfunction) and is not due exclusively to the direct physiological effects of a substance (e. g. , a drug of abuse, a medication) or a general medical condition. (APA, 2000)| | (Male)| A. Delayed or absent ejaculation occurring on all or almost all sexual encounters for at least 6 months duration. B. The problem causes clinically significant distress or impairment. C.

The sexual dysfunction is not better accounted for by another Axis I disorder (except another Sexual Dysfunction) and is not due to the effects of a substance (e. g. , a drug of abuse, a medication) or a general medical condition. Addition of the following specifiers:1) Lifelong (since the onset of sexual activity) vs. Acquired2) Generalized vs. Situational3) Partner factors (partner’s sexual problems, partner’s health status)4) Relationship factors (e. g. , poor communication, relationship discord, discrepancies in desire for sexual activity)5) Individual vulnerability factors or psychiatric comorbidity (e. . , depression or anxiety, poor body image, history of abuse experience)6) Cultural/religious factors (e. g. , inhibitions related to prohibitions against sexual activity)7) With medical factors relevant to prognosis, course, or treatment(APA, 2000)| | Sexual Pain Disorders| A. Persistent or recurrent difficulties for 6 months or more with at least one of the following:1. Inability to have vaginal intercourse/penetration. 2. Marked vulvo-vaginal or pelvic pain during vaginal intercouse/penetration attempts  3. Marked fear or anxiety either about vulvo-vaginal or pelvic pain or vaginal penetration4.

Marked tensing or tightening of the pelvic floor muscles during attempted vaginal penetrationB. The problem causes clinically significant distress or impairment. C. The sexual dysfunction is not better accounted for by another Axis I disorder (except another sexual dysfunction) and is not due to the effects of a substance (e. g. , a drug of abuse, a medication) or a general medical condition. Addition of the following specifiers:1) Lifelong (since the onset of sexual activity) vs. Acquired2) Generalized vs. Situational3) Partner factors (parter’s sexual problems, partner’s health status)4) Relationship factors (e. . , poor communication, relationship discord, discrepancies in desire for sexual activity)5) Individual vulnerability factors or psychiatric comorbidity (e. g. , depression or anxiety, poor body image, history of abuse experience)6) Cultural/religious factors (e. g. , inhibitions related to prohibitions against sexual activity)7) With medical factors relevant to prognosis, course, or treatment(APA, 2000)| | Gender Identity Disorder| This category is included for coding disorders in gender identity that are not classifiable as a specific Gender Identity Disorder. Examples include:1. Intersex conditions (e. g. partial androgen insensitivity syndrome or congenital adrenal hyperplasia) and accompanying gender dysphoria. 2. Transient, stress-related cross-dressing behavior. 3. Persistent preoccupation with castration or penectomy without a desire to acquire the sex characteristics of the other sex. (APA, 2000)| | Paranoid| A. A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:(1) Suspects, without sufficient basis, that others are exploiting, harming, or deceiving im or her(2) Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates(3) Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her(4)  Reads hidden demeaning or threatening meanings into benign remarks or events(5) Persistently bears grudges, i. e. is unforgiving of insults, injuries, or slights(6) Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack(7) Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner. B. Does not occur exclusively during the course of Schizophrenia, a Mood Disorder With Psychotic Features, or another Psychotic Disorder and is not due to the direct physiological effects of a general medical condition. Note: If criteria are met prior to the onset of Schizophrenia, add “Premorbid,” e. g. , “Paranoid Personality Disorder (Premorbid). (APA, 2000)| * According to the DSM-IV-TR, personality disorders should not be diagnosed inclients under the age of 18 because personality has not yet stabilized. * Some experts contend that there is considerable gender bias in the diagnosis of personality disorders. * Most of the personality disorders appear to occur at the same rates regardless ofsocial class, with the exception of antisocial personality disorder and possibly borderlineand dependent personality disorders, which occur disproportionately amongmembers of lower socioeconomic groups. (Hansell ; Damour, 2008)| Schizoid| A.Psy 410 Week 2 and 3 Matrix of Disorders Essay.

A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:(1) Neither desires nor enjoys close relationships, including being part of a family(2) Almost always chooses solitary activities(3) Has little, if any, interest in having sexual experiences with another person(4) Takes pleasure in few, if any, activities(5) Lacks close friends or confidants other than first-degree relatives(6) Appears indifferent to the praise or criticism of others(7) Shows emotional coldness, detachment, or flattened affectivityB. Does not occur exclusively during the course of Schizophrenia, a Mood Disorder With Psychotic Features, another Psychotic Disorder, or a Pervasive Developmental Disorder and is not due to the direct physiological effects of a general medical condition. Note: If criteria are met prior to the onset of Schizophrenia, add Premorbid,” e. g. , “Schizoid Personality Disorder (Premorbid). ”(APA, 2000)| | Schizotypal| A.

A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:(1) Ideas of reference (excluding delusions of reference)(2) Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e. g. , superstitiousness, belief in clairvoyance, telepathy, or “sixth sense”; in children and adolescents, bizarre fantasies or preoccupations)(3) Unusual perceptual experiences, including bodily illusions(4) Odd thinking and speech (e. g. vague, circumstantial, metaphorical, overelaborate, or stereotyped)(5) Suspiciousness or paranoid ideation(6) Inappropriate or constricted affect(7) Behavior or appearance that is odd, eccentric, or peculiar(8) Lack of close friends or confidants other than first-degree relatives(9) Excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about selfB. Does not occur exclusively during the course of Schizophrenia, a Mood Disorder With Psychotic Features, another Psychotic Disorder, or a Pervasive Developmental Disorder. Note: If criteria are met prior to the onset of Schizophrenia, add “Premorbid,” e. g. , “Schizotypal Personality Disorder (Premorbid). “(APA, 200)| | Antisocial| A.

There is a pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by three (or more) of the following:(1) Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest(2) Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure(3) Impulsivity or failure to plan ahead(4) Irritability and aggressiveness, as indicated by repeated physical fights or assaults(5) Reckless disregard for safety of self or others(6) Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations(7) Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from anotherB. The individual is at least age 18 years. C. There is evidence of Conduct Disorder with onset before age 15 years. D. The occurrence of antisocial behavior is not exclusively during the course of Schizophrenia or a Manic Episode. APA, 2000)| | Borderline Personality| A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:(1) Frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5. (2) A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. (3) Identity disturbance: markedly and persistently unstable self image or sense of self. (4) Impulsivity in at least two areas that are potentially self-damaging (e. g. spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5. (5) Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. (6) Affective instability due to a marked reactivity of mood (e. g. , intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days). (7) Chronic feelings of emptiness. (8) Inappropriate, intense anger or difficulty controlling anger (e. g. , frequent displays of temper, constant anger, recurrent physical fights). (9) Transient, stress-related paranoid ideation or severe dissociative symptoms. APA, 2000)| | Histrionic Personality| A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:(1)    is uncomfortable in situations in which he or she is not the center of attention(2)    interaction with others is often characterized by inappropriate sexually seductive or provocative behavior(3)    displays rapidly shifting and shallow expression of emotions(4)    consistently uses physical appearance to draw attention to self(5)    has a style of speech that is excessively impressionistic and lacking in detail(6)    shows self-dramatization, theatricality, and exaggerated expression of emotion(7)    is suggestible, i. e. , easily influenced by others or circumstances(8)    considers elationships to be more intimate than they actually are (APA, 2000)| | Narcissistic Personality| A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:(1)    has a grandiose sense of self-importance (e. g. , exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)(2)    is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love(3)    believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)(4)    requires excessive admiration(5)    has a sense of entitlement, i. e. , unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations(6)    is interpersonally exploitative, i. e. takes advantage of others to achieve his or her own ends(7)    lacks empathy: is unwilling to recognize or identify with the feelings and needs of others(8)    is often envious of others or believes that others are envious of him or her(9)    shows arrogant, haughty behaviors or attitudes(APA, 2000)| | Avoidant Personality| A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:(1) Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection. (2) Is unwilling to get involved with people unless certain of being liked. (3) Shows restraint within intimate relationships because of the fear of being shamed or ridiculed. (4) Is preoccupied with being criticized or rejected in social situations. (5) Is inhibited in new interpersonal situations because of feelings of inadequacy. (6) Views self as socially inept, personally unappealing, or inferior to others. 7) Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing. (APA, 2000)| | Dependent Personality| A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:(1) Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others. (2) Needs others to assume responsibility for most major areas of his or her life. (3) Has difficulty expressing disagreement with others because of fear of loss of support or approval. Note: Do not include realistic fears of retribution. 4) Has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy). (5) Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant. (6) Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself. (7) Urgently seeks another relationship as a source of care and support when a close relationship ends(8) Is unrealistically preoccupied with fears of being left to take care of himself or herself. | | | | | | (APA, 2000)| |

Obsessive-Compulsive| A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:(1) Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost. (2) Shows perfectionism that interferes with task completion (e. g. , is unable to complete a project because his or her own overly strict standards are not met). (3) Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity). 4) Is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification). (5) Is unable to discard worn-out or worthless objects even when they have no sentimental value. (6) Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things. (7) Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes. (8) Shows rigidity and stubbornness. (APA, 2000)| | Reference: American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th). Washington, DC: Author. Hansell, J. , & Damour, L. (2008). Abnormal psychology (2nd ed. ). Hoboken, NJ: Wiley & Sons.Psy 410 Week 2 and 3 Matrix of Disorders Essay.