Mental disorders

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 Outline
This topic is about mental health. We will explore what mental health is and some mental
health disorders

Lecture: Mental health

Workshop 1: The psychology of narcissism
Workshop 2: Academic writing
Coursework: Essay

GC: Oral communication → ----

SC1: Written outputs → 10%
SC2: Read texts → ----
SC3: Communicate → ----

Mental disorders
 What is mental health?
What is a mental health disorder?
Can you name some mental disorders?
Psychopathology
Normal and abnormality
What is the DSM-5?

Digital canvas

Mental disorders
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Mental health
A person who is considered
'mentally healthy' is someone
who (WHO, 2018):
• can realise his or her own
abilities
• can cope with the normal
stresses of life
• can work productively
• is able to make a
contribution to his or her Esta foto de Autor desconocido está bajo licencia CC BY-NC-ND

community

HOWEVER, YOUR MENTAL HEALTH OR SENSE OF 'WELLBEING' DOESN'T ALWAYS STAY THE
SAME AND CAN CHANGE IN RESPONSE TO CIRCUMSTANCES AND STAGES OF LIFE

Mental disorders
Definition of a Mental Disorder (APA, 2013; p. 20)
A mental disorder is a syndrome characterized by clinically significant
disturbance in an individual’s cognition, emotion regulation, or behaviour
that reflects a dysfunction in the psychological, biological, or developmental
processes underlying mental functioning.
Mental disorders are usually associated with significant distress or disability
in social, occupational, or other important activities.
An expectable or culturally approved response to a common stressor or loss,
such as the death of a loved one, is not mental disorder.
Socially deviant behavior (e.g., political, religious, or sexual) and conflicts
that are primarily between the individual and society are not mental
disorders unless the deviance or conflict results from a dysfunction in the
individual, as described above.
Mental disorders
 A mental disorder is a significant impairment in
psychological functioning
Schizophrenia spectrum and other psychotic disorders
Bipolar and related disorders
Depressive disorders
Anxiety disorders
Obsessive-compulsive and related disorders
Trauma- and stressor-related disorders
Dissociative disorders
Paraphilic disorders
Substance-related and addictive disorders
Personality disorders
Other Conditions That May Be a Focus of Clinical Attention: Esta foto de Autor desconocido está bajo licencia CC BY-NC-ND

Relational Problems, Abuse and Neglect, Problems Related

to Crime or Interaction With the Legal System
Mental disorders
 sad, empty, or
exposure to
Mental health disorders irritable mood,
with somatic and
traumatic or
stressful event is
cognitive changes
listed explicitly as a
Schizophrenia spectrum and other psychotic disorders diagnostic criterion
Bipolar and related disorders preoccupations and
Depressive disorders repetitive behaviors intense and persistent
Anxiety disorders or mental acts in sexual interest
Obsessive-compulsive and related disorders response to them involving anomalous
activity preferences or
Trauma- and stressor-related disorders
anomalous target
Dissociative disorders disturbances
preferences
Paraphilic disorders related to drug
abuse or
Substance-related and addictive disorders dependence
Personality disorders excessive fear and disruption in the normal
anxiety and integration of
unhealthy related behavioral consciousness, memory,
loss of identity, emotion,
personality disturbances
contact with perception, body
patterns
reality representation, motor
mania or control, and behavior
depression Mental disorders
 Psychopathology
Scientific study of mental, emotional and
behavioural disorders
Abnormality:
Subjective discomfort: feelings of pain,
unhappiness or emotional distress
BUT psychopathology doesn’t always
cause personal anguish
Mania: on top of the world
ALSO lack of discomfort might reveal a
problem
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Mental disorders
 What is normal? Social nonconformity
Failure to conform to societal norms or the
Statistical abnormality usual minimum standards for social conduct
Abnormality based based on an extreme
score on some dimension

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Mental disorders
 What is normal? Cultural relativity
Judgements are made relative to the values
Situational context of one’s culture
A young woman ties a thick rubber cord ALL cultures classify people as abnormal if:
around her ankles, screams hysterically, (a) they fail to communicate with others or
and jumps headfirst off a bridge (b) are consistently unpredictable in their
actions

Cultural syndrome
Cultural idiom of distress
Cultural explanation or perceived cause

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Mental disorders
Classification of mental disorders (APA, 2013)
An important note - Medical students' disease!!
Students have a predictable tendency to notice in
themselves the symptoms of each disease they study

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Mental disorders
The dark side of the moon
Schizophrenia spectrum and other
psychotic disorders

Mental disorders
 Schizophrenia spectrum and
other psychotic disorders
• Schizophrenia, other psychotic disorders, and schizotypal
(personality) disorder
• They are defined by abnormalities in one or more of the
following five domains:
• delusions
• hallucinations
• disorganized thinking (speech)
• grossly disorganized or abnormal motor behaviour (including
catatonia)
• negative symptoms (diminished emotional expression & avolition)
• Psychosis is the most dramatic and serious of all mental
problems
• Striking changes in thinking, behaviour and emotion

Mental disorders
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Schizophrenia spectrum and other psychotic disorders
• Hallucinations  imaginary
sensations
• Most common psychotic
hallucination is hearing voices
• Organic psychoses: involving
a clear-cut brain injury or
disease (e.g., poisoning by
lead or mercury: mad hatter)

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Esta foto de Autor desconocido está bajo licencia CC BY-SA-NC Mental disorders
 A tale of mental illness
from the inside
Elyn Saks
mental health law scholar

Identify as many symptoms and

psychotic features as you can from
Elyn Saks’ account

What was helpful for her?

Using a digital canvas, post a

comment about your thoughts on
this personal account of
schizophrenia

Mental disorders
Peaks and Valleys
Mood disorders

Mental disorders
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Bipolar I disorder: Mania: A distinct period of abnormally and persistently elevated, expansive, or
irritable mood and abnormally and persistently increased goal-directed activity
or energy
Manic episodes 1. Inflated self-esteem or grandiosity
(hypomania) and 2. Decreased need for sleep
3. More talkative than usual or pressure to keep talking
Major Depressive 4. Flight of ideas or subjective experience that thoughts are racing
5. Distractibility
Episode 6. Increase in goal-directed activity (either socially, at work or school, or sexually) or
psychomotor agitation (i.e., purposeless non-goal-directed activity)
7. Excessive involvement in activities that have a high potential for painful consequences

Depression: Five (or more) of the following symptoms have been present during
the same 2-week period and represent a change from previous functioning
1. Depressed mood most of the day (e.g., feels sad, empty, or hopeless)
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day
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
4. Insomnia or hypersomnia
5. Psychomotor agitation or retardation
6. Fatigue or loss of energy
7. Feelings of worthlessness or excessive or inappropriate guilt
8. Diminished ability to think or concentrate, or indecisiveness
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 suicide
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The Secret Life Of The Manic Depressive
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Bipolar II disorder
Bipolar II disorder is characterized by a clinical course of
recurring mood episodes consisting of one or more major
depressive episodes and at least one hypomanic episode
The major depressive episode must last at least 2 weeks, and
the hypomanic episode must last at least 4 days
Cyclothymic disorder
Chronic, fluctuating mood disturbance involving numerous
periods of hypomanic symptoms and periods of depressive
symptoms that are distinct from each other (2-year period)
The hypomanic symptoms are of insufficient number, severity,
pervasiveness, or duration to meet full criteria for a hypomanic
episode, and the depressive symptoms are of insufficient
number, severity, pervasiveness, or duration to meet full
criteria for a major depressive episode
Mental disorders
Depressive disorders

Disruptive mood dysregulation disorder

Major depressive disorder
Persistent depressive disorder (dysthymia)
Premenstrual dysphoric disorder
Substance/medication-induced depressive disorder
Depressive disorder due to another medical condition

Mental disorders
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 Major depressive
disorder
Discrete episodes of at least 2 weeks’ duration
involving clear-cut changes in affect, cognition,
and neurovegetative functions and inter-episode
remissions
At least five of the following symptoms have
been present during the same 2-week period
1. Depressed mood most of the day (e.g., feels sad,
empty, or hopeless)
2. Markedly diminished interest or pleasure in all, or
almost all, activities most of the day
3. Significant weight loss when not dieting or weight
gain, or decrease or increase in appetite
4. Insomnia or hypersomnia
5. Psychomotor agitation or retardation
6. Fatigue or loss of energy
7. Feelings of worthlessness or excessive/inappropriate
guilt
8. Diminished ability to think or concentrate
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9. Recurrent thoughts of death, recurrent suicidal
ideation without a specific plan, or a suicide attempt or
a specific plan for committing suicide
Mental disorders
Persistent depressive
disorder (dysthymia)
Depressed mood for most of the
day, for more days than not, for at
least 2 years
Presence, while depressed, of two
(or more) of the following:
1. Poor appetite or overeating
2. Insomnia or hypersomnia
3. Low energy or fatigue
4. Low self-esteem
5. Poor concentration or difficulty
making decisions
6. Feelings of hopelessness

Mental disorders
When anxiety rules
Anxiety disorders

Mental disorders
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When anxiety rules
Disorders that share features of excessive fear
and anxiety and related behavioural disturbances
Disorders within this category:
Generalised anxiety disorder
Panic disorder
Phobias
Social Anxiety Disorder
Panic disorder
Agoraphobia

Mental disorders
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 Generalised anxiety
disorder (GAD)
Excessive anxiety and worry (apprehensive
expectation), occurring more days than not
for at least 6 months, about a number of
events or activities (such as work or school
performance)
The individual finds it difficult to control
the worry
The anxiety and worry are associated with
at least three of the following symptoms
(present for more days than not for the
past 6 months):
1. Restlessness or feeling on edge
2. Being easily fatigued
3. Difficulty concentrating or mind going blank
4. Irritability
5. Muscle tension
6. Sleep disturbance (difficulty falling or staying
asleep, or restless, unsatisfying sleep) Esta foto de Autor desconocido está bajo licencia CC BY-NC-ND

Mental disorders
 Panic disorder
Recurrent unexpected panic attacks
A panic attack is an abrupt surge of intense fear or
intense discomfort that reaches a peak within minutes
1. Palpitations, pounding heart, or accelerated heart rate
2. Sweating
3. Trembling or shaking
4. Sensations of shortness of breath
5. Feelings of choking
6. Chest pain or discomfort
7. Nausea or abdominal distress
8. Feeling dizzy, unsteady, light-headed, or faint
9. Chills or heat sensations
10. Paresthesias (numbness or tingling sensations)
11. Derealization (feelings of unreality) or depersonalization
(being detached from oneself)
12. Fear of losing control or “going crazy”
13. Fear of dying

Mental disorders
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When anxiety rules
Agoraphobia: Marked fear or anxiety about two (or more) of
the following five situations:
1. Using public transportation (e.g., buses, trains, planes)
2. Being in open spaces (e.g., marketplaces, bridges)
3. Being in enclosed places (e.g., shops, cinemas)
4. Standing in line or being in a crowd
5. Being outside of the home alone
Social anxiety disorder (social phobia): Marked fear or
anxiety about one or more social situations in which the
individual is exposed to possible scrutiny by others. Examples
include social interactions (e.g., having a conversation,
meeting unfamiliar people), being observed (e.g., eating or
drinking), and performing in front of others (e.g., giving a
speech)
Specific phobia: the person’s fear is focused on particular
objects, activities or situations
Mental disorders
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Animal? Natural environment?
Blood-injection-injury?
Situational? Other?

Arachnophobia
Zoophobia
Acrophobia
Astraphobia
Aquaphobia
Aviophobia
Claustrophobia
Xenophobia
Triskaidekaphobia
Coulrophobia
Ophidiophobia
Arachibutyrophobia
Hemophobia Esta foto de Autor desconocido está bajo licencia CC BY-SA

Mental disorders
 Esta foto de Autor desconocido está bajo licencia CC BY

They aren’t real and yet they feel real

Obsessive-compulsive and related disorders
Mental disorders
Obsessive compulsive
and related disorders
The obsessive-compulsive and
related disorders differ from
developmentally normative
preoccupations and rituals by being
excessive or persisting beyond
developmentally appropriate periods
Level of distress and impairment in
functioning
Disorders within this category:
Obsessive-compulsive disorder (OCD)
Body dysmorphic disorder
Hoarding disorder
Trichotillomania (hairpulling disorder)
Excoriation (skin-picking) disorder

Mental disorders
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Obsessive compulsive
disorder:
People are preoccupied with certain
distressing thoughts and feel compelled to
perform certain behaviours
https://www.bbc.co.uk/programmes/b037wn0l
Obsessions are defined by:
1. Recurrent and persistent thoughts, urges, or images that are experienced as
intrusive and unwanted, and that cause marked anxiety
2. The individual attempts to ignore or to neutralize them with some other thought or
action (by performing a compulsion)
Compulsions are defined by:
1. Repetitive behaviours (e.g., hand washing) or mental acts (e.g., counting) that the
individual feels driven to perform in response to an obsession or according to rules
that must be applied rigidly
2. The behaviours or mental acts are aimed at preventing or reducing anxiety or
distress, or preventing some dreaded event or situation BUT these behaviours or
mental acts are not connected in a realistic way with what they are designed to
neutralize or prevent, or are clearly excessive
Certain symptom dimensions are common in OCD:
Cleaning (contamination obsessions and cleaning compulsions)
Symmetry (symmetry obsessions and repeating, ordering, and counting compulsions)
Forbidden or taboo thoughts (e.g., aggressive, sexual, and religious obsessions and
related compulsions)
Harm (e.g., fears of harm to oneself or others and related checking compulsions)
OCD is diagnosed when obsessions and compulsions are time-consuming
(e.g., 1+ hour per day) or cause significant distress or impairment in
social, occupational, or other important areas of functioning
Documentary following six British teens and young
adults with obsessive-compulsive disorder as they
embark on an incredible journey to the American
wilderness for treatment

Jack Contamination OCD - germs

Josh Symmetry OCD
Imogen Thoughts that terrible things will happen
Olivia Contamination OCD - smells
Andrew Avoidance of number 13 & Asperger's
Megan Intrusive thoughts

Mental disorders
 Esta foto de Autor desconocido está bajo licencia CC BY-SA

and stressor-related disorders

Mental disorders
 Exposure to actual or threatened death, serious injury, or sexual
Trauma- and violence in one of the following ways:

stressor-related 1. Directly experiencing the traumatic event

2. Witnessing, in person, the event as it occurred to other
disorders 3. Learning that the traumatic event occurred to a close
family member or close friend
4. Experiencing repeated or extreme exposure to aversive
details of the traumatic event

1. Intrusion symptoms associated with the traumatic event:

recurrent, involuntary, and intrusive distressing memories
and dreams related to the traumatic event; dissociative
reactions (e.g., flashbacks) in which the individual feels or
acts as if the traumatic event was recurring; intense
psychological distress and marked physiological reactions at
exposure to cues that symbolize or resemble an aspect of the
traumatic event

Mental disorders
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 2. Persistent avoidance of stimuli associated with the traumatic
Trauma- and event: avoidance of or efforts to avoid distressing memories,
thoughts, or feelings about the traumatic event and
stressor-related avoidance of external reminders

disorders 3. Negative alterations in cognitions and mood associated with

the traumatic event: inability to remember an important
aspect of the traumatic event (to dissociative amnesia);
persistent and exaggerated negative beliefs or expectations
about oneself, others, or the world; persistent, distorted
cognitions about the cause or consequences of the traumatic
event that lead the individual to blame himself/herself or
others; persistent negative emotional state (e.g., fear, horror,
anger, guilt, or shame); persistent inability to experience
positive emotions
4. Marked alterations in arousal and reactivity associated with
the traumatic event: irritable behaviour and angry outbursts;
self-destructive behaviour; hypervigilance; exaggerated
startle response; problems with concentration; and sleep
disturbance

Mental disorders
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 Reflective activity

Write down:
one thing that you did not know
about mental health
the thing that you liked the most
from the lecture on mental
Mental disorders

health
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References
A tale of mental illness – from the inside
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental
disorders (5th ed.). Arlington, VA: Author.
Coon, D & Mitterer, J. O. (2011, 4th ed.). Chapter 12. Psychological disorders.
Psychology: a journey. Wadsworth.
Extreme OCD camp
Extreme OCD (BBC YouTube channel)
*Lilienfeld, S. O., Lynn, S. J., Namy, L. L. & Woolf, N. J. (2011, 2nd ed.). Chapter 15.
Psychological disorders. Psychology: from enquiry to understanding. Pearson.
*Morris, C. G & Maisto, A. A. (2008, 8th ed.). Chapter 12. Psychological disorders.
Understanding psychology. Pearson.
WHO (2018). Mental health: strengthening our response.

Mental disorders