2. The balance between all aspects of life.
 Physical
 Social
 Spiritual
 Emotional

3. Far more than the absence of mental illness and has
to do with many aspects of our
lives including:
• How we feel about our selves
• How we feel about others
• How we are able to meet
the demands of life

4. MAINTAINING MENTAL HEALTH INVOLVES:
• Attention to lifestyle
• Social contact
• Reviewing lifestyle from time to
time
• Awareness of reaction of mind
and body
• Having people in our lives to trust
• Awareness on what can go wrong
• Taking steps to resolve problem

5. Mental Disorders
5

6. Definition
 Mental disorders – disturbances of an individual’s
behavioral or psychological functioning that are not
culturally accepted and that lead to psychological
distress, behavioral disability, and/or impaired overall
functioning (Baron, 2005).
6

7. Definition
 Leventhal et al (2009) use 5 criteria in defining mental illness:
 Statistical rarity- many mental disorders are uncommon.
 Subjective distress- most although not all mental illness causes
emotional pain.
 Impairment- most mental disorders interfere with individuals
daily functioning.
 Societal disapproval- we often stereotype and discriminate
against individuals with mental disorders.
 Biological dysfunction- failures in biological systems.
7

8. Mental disorders
THEN AND NOW
CAUSES
 1400’s- moon influenced brain and induced madness
 Supernatural forces
 Possession of evil spirits
 Physical factors- brain damage, hereditary
TREATMENT
 Asylums
 Exorcism
 Beaten
 Starved
 Rest, good food and drink and solitude
 Trephening, bloodletting, snake pits
8

9. MODERN MODELS OF MENTAL DISORDER
 BIOLOGICAL MODEL
 PSYCHOLOGICAL MODEL
 SOCIOLOGICAL MODEL
 DIATHESIS- STRESS MODEL
9

10.  Biological model- role of the nervous system in mental disorders.
Seeks to understand such disorders in terms of malfunctions in
portions of the brain, imbalance in various neurotransmitters and
genetic factors
 Psychological model emphasizes psychological factors in the
development of mental disorders; for instance many psychologists
believe that learning play a key role in many mental disorders .e.g.
learning phobias
 Sociocultural factors – emphasizes external factors such as
negative environments – poverty, homelessness, unemployment,
inferior education, prejudice as potential causes of some mental
disorders.
 Diathesis-stress model – mental disorders result from a
predisposition for a given disorder (diathesis) and stressors in an
individual’s environment that tend to activate or stimulate the
predisposition.
10

11. Psychiatric Diagnosis across cultures
Ataque de nervios
Symptoms commonly include uncontrollable shouting,
(Latin America, Latin
attacks of crying, trembling, heat in the chest rising into
Mediterranean,
the head, and verbal and physical aggression.
Caribbean)
Symptoms may include watering or dry eyes, dizziness,
Brain fag or brain fog
blurring of vision, difficulty concentrating or remembering,
(West Africa)
pain or feelings of pressure in the head or neck, fatigue and
difficulty sleeping, shaking hands, rapid heartbeat, crawling
Studiation Madness
sensations under the skin, feelings of weakness and
(Trinidad)
depression.
Mal de ojo "evil eye". A common term to describe the cause of disease,
(Mediterranean) misfortune, and social disruption.
Windigo Psychosis occurs when a person becomes filled
Windigo Psychosis
with anxiety that they are becoming a cannibal, and may
(Native American)
increasingly view those around them as edible.
Latah is an exaggerated startle response, typically found
Latah (Malaysia) among women. Being surprised may result in screaming,
cursing, dancing and hysterical laughter that might last a
half hour or more.
11

12. Assessment and Diagnosis of
Mental Disorders
DSM-IV
Diagnostic and Statistical Manual of Mental Disorder – IV
12

13.  It is the official diagnostic tool used by psychologist.This
manual help psychologist to describe and classify mental
disorders. Major Diagnostic Categories – page 539.
 The book describes diagnostic features- symptoms that must
be present. It looks at variations in age, gender, culturally
related features, some things that are normal in one culture are
not abnormal in others (eg. incest – African tribes).
 Disorders are classified along five axes – Axis I – clinical
disorder, Axis II – personality disorder/mental retardation, Axis
III – medical conditions, Axis IV- psychosocial or environmental
conditions, and Axis V- GAF – global assessment functioning.
13

14. Limitation of the DSM-IV
 The manual is mainly descriptive – doesn’t attempt to explain.
 The manual also attaches labels to people and the person may
then be perceived in terms of that label – certain stigma
associated.
14

15. CATEGORIES OF MENTAL
DISORDERS
15

16. CLASSIFICATION OF MENTAL
DISORDERS
16

17. 1. Disruptive Disorder
Divided into two categories:
1. Oppositional defiant disorder
2. Conduct disorder.
 The essential feature of ODD-
a recurrent pattern of
negativistic, defiant,
disobedient, and hostile
behavior toward authority
figures that persists for at least
6 months.
 Usually start when children are
young (ages 3 to 7) and can
lead to more serious disorder –
conduct disorder which begins
17 somewhat later – puberty.

18. Conduct disorder
 Involves more serious antisocial behaviors that go
beyond throwing tantrums or disobeying rules.
 Here the child impedes on the basic rights of others
and violates major age-appropriate societal norms or
rules.
 Children are seen as being aggressive towards
people and animals, destroying property, being
deceitful and engaging in theft, violations of rules –
i.e. running away, staying out at night, truant from
school.
18

19. Attention-Deficit/Hyperactivity Disorder (ADHD)
 ADHD – persistent pattern of inattention and/or
hyperactivity that is more frequent and severe
than is typically observed in individuals at a
comparable level of development.
 Causes are both biological and
psychological. Low birth weight, oxygen
deprivation at birth, and alcohol or drug
consumption. Psychological factors include
parental intrusiveness or over stimulation –
parents who just can’t seem to leave their
infants alone.
 Treated with drugs – Ritalin
19

20. 2. Feeding and Eating Disorders
 Disturbances in eating behavior
that involve maladaptive and
unhealthy efforts to control body
weight.
a. Anorexia Nervosa
 Excessive and intense fear of
gaining weight coupled with
refusal to maintain a normal body
weight.
 More common in women than in
men. Why? Sociological factors –
women feel pressure to live up to
the images of beauty shown in the
media. Psychological control –
family pressures
20

21. b. Bulimia
 Persons engage in recurrent episodes of binge eating
– eating huge amounts of food within short periods of
time and then engage in some activity that will
prevent them from gaining weight.
 Usually women, and unlike anorexics, bulimics are of
normal weight – so it is harder to detect that
something is wrong with them.
 Seem to have same sociological causes – wanting to
be thin as defined by society.
21

22. Autism: Pervasive Developmental Disorder
 Involve lifelong impairment in mental or physical
functioning.
The essential features of autism are the presence of
 abnormal or impaired development in social interaction
– don’t use nonverbal behaviors such as eye contact
and communication and
 a restricted repertoire of activity or interest – repetitive
pattern of behaviors.
 Children with this disorder seem to be preoccupied with
themselves and to live in a private world.
22

23. 3. Mood Disorders
 Demonstration of swings in mood –
from very elated to very dejected.
Although we have all felt some level of
sadness or happiness – persons
suffering from a mood disorder have
swings that are extreme, prolonged
and impair daily functioning.
23

24. What constitute the diagnosis of depression?
 Major Depressive Episode
 Persons suffering from depression should have five or
more symptoms for at least 2 consecutive weeks.
 Symptoms include profound unhappiness most of the
day, nearly every day; diminished interest or pleasure in
all, or almost all activities – eating, sports, sex; significant
weight loss when not dieting or weight gain; insomnia or
hypersomnia; fatigue or loss of energy; psychomotor
agitation or retardation (feeling of restlessness or being
slowed down); recurrent thoughts of death, diminished
ability to think or concentrate.
24

25. Bipolar Disorder
 Characterized by wide swings in mood between deep depression
and mania.
 Causes – biological and psychological. Depression runs in family
– this support the argument for biological causes.
 Research also shows that there seem to be some abnormality in
brain biochemistry. It is found that levels of norepinephrine and
serotonin are lower in the brains of those suffering from depression.
 They also found that these two neurotransmitters were higher in
those suffering from mania
25

26.  Psychological factors – learned helplessness – beliefs that
outcomes of events are out of the control of the individual. One
result in feelings of learned helplessness is depression.
 Negative views about oneself also lead to feelings of
depression. These persons possess negative self-schemas –
that is negative conceptions of their own traits, abilities, and
behavior.
26

27. 4. Anxiety Disorders
27

28. a. Phobias– excessive fear that causes intense
emotional distress and impairs daily functioning.
 Most common phobia is social phobia – persistent fear
of social or performance situations in which
embarrassment may occur.
 Exposure to the social or performance situation almost
invariably provokes an immediate anxiety response,
such as panic attack.
 Causes –Psychological factors – learning – classical
conditioning.
28

29. b. Panic Disorder and Agoraphobia
 Panic attacks are what lead to a person being diagnosed
with a panic disorder. Panic attacks are characterized by
periodic, unexpected attacks of intense, terrifying anxiety.
Some panic attacks occur due to specific situation.
 One such case is panic disorder that is associated with
agoraphobia, or fear of situations from which escape
might be difficult or in which help may not be available.
Take the form of intense fear of open spaces, fear of
being in public, fear of traveling or fear of having a panic
attack while away from home.
 Claustrophobia – fear of enclosed spaces
29

30. c. Obsessive-Compulsive Disorder
 Recurrent obsessions (thoughts) and compulsions (actions) that
are severe enough to be time consuming or causes marked
distress or significant impairment.
 Most common fear is those of dirt, germs, or touching infected
people or objects, disgust over body waste or secretions. The
compulsive actions include repetitive hand washing, checking
doors, windows, water, and gas; counting objects a precise
number of times or repeating an action a specific number of
times, and hoarding old mail, newspaper and other useless
objects.
30

31. d. Posttraumatic Stress Disorder (PTSD)
 Disorder in which people persistently re-experience a
traumatic event in their thoughts or dreams.
 Feel as if they are reliving the event from time to time.
 Persistently avoid stimuli associated with the traumatic
event.
 Persistently experience 2 or more of the following
symptoms of increased arousal such as difficulty falling
or staying asleep/ irritability or outbursts of anger,
difficulty concentrating; hypervigilance; exaggerated
startle response.
31

32. 6. Dissociative Disorders
 They involve profound losses of identity or memory,
intense feelings of unreality, a sense of being
depersonalized (i.e. separate from oneself), and
uncertainty about one’s own identity
32

33. a. Dissociative amnesia
 Individuals suddenly experience a loss of memory that does not
stem from medical conditions or other mental disorders.
 Such losses can be localized, involving only a specific period of
time, or generalized, involving memory for the person’s entire
life
b. Dissociative Fugue
 An individual suddenly leaves home and travels to a new
location where he or she has no memory of his or her previous
life.
33

34. b. Dissociative Identity Disorder
 Also known as Multiple Personality Disorder in the past
 Involves a shattering of personal identity into two- and often
more- separate but coexisting personalities, each possessing
different traits, behaviors, memories, and emotions
 Usually there is one host personality- the primary identity that is
present most of the time, and one or more alters- alternative
personalities that appear from time to time
34

35. 7. Somatoform Disorders
Involves experiencing
physical symptoms for
which there is no
apparent physical cause.
35

36. a. Hypochondriasis
 Fear of having or the idea that one has a serious disease based
on a misinterpretation of one or more bodily signs or symptoms.
 Even after assurance from their doctors they continue to worry.
Many hypochondriacs are not faking; they feel the pain and
discomfort they report.
36

37. b. Munchausen’s syndrome
Parent-child/Self-mutilation
 Disorder where patients pretend to have illness and
therefore are subject to many medical tests and surgical
procedures
 These persons are usually faking. Devote their lives to
seeking – and often obtaining – costly and painful medical
procedures they know they don’t need.
 Why? Maybe to get attention.
37

38. c. Conversion disorder
 Persons actually experience physical problems such as
motor deficits (paralysis) or sensory deficits (blindness).
No medical conditions to account for deficits.
 Causes – Psychological factors – focus on inner
sensations – they tend to perceive normal bodily
sensations as being more intense and disturbing than
most people. Tend to be highly negativistic – low self-
esteem.
 Sociological factors – persons learn that they will get
more attention and better treatment – patients are
reinforced.
38

39. 8. Sexual Disorders
 Sexual dysfunction is
characterized by a disturbance in the
process that characterize the sexual
response cycle (attain orgasm,
erections) or by pain associated with
sexual intercourse.
 Sexual desire disorder involves
a lack of interest in sex or active
aversion to sexual activity. Persons
report that they rarely have sexual
fantasies and that they avoid almost all
sexual activity and this causes them
39 distress.

40.  Sexual arousal disorder involves the inability
to attain or maintain an erection (male erectile
disorder) or the absence of vaginal swelling and
lubrication (female sexual arousal disorder).
 Orgasm disorder includes the delay or absence
of orgasms in both sexes (female/male orgasmic
disorder) and premature ejaculation (reaching
orgasm too quickly) in males.
40

41. Sexual pain disorders
 Dyspareunia – genital pain that is associated with
sexual intercourse in either males or females. Causes marked
distress.
 Vaginismus – recurrent or persistent involuntary spasm
of the musculature of the outer third of the vagina that
interferes with sexual intercourse. Causes marked distress.
41

42. Paraphilias
 Recurrent and intense sexually arousing fantasies, sexual urges
or behaviors generally involving
 nonhuman objects,
 the suffering or humiliation of oneself or one’s partner, or
 children or other non-consenting persons that occurs over a period
of at least 6 months. These things are necessary for sexual
arousal.
42

43. 9. Gender Identity Disorders
 These persons feel that they were born with the wrong sexual
identity.
 Identify with the opposite sex and show preference in cross-
dressing. Many of these people undergo sex-change
operations – sexual organs are altered to resemble the other
gender.
 People usually undergo years of hormonal therapy and
counseling before the actual therapy.
43

44. 10. Schizophrenia
44

45.  Described as the most devastating mental disorder.
 Fragmentation of basic psychological functions (attention,
perception, thought, emotions, and behavior).
 Problems with adjusting to the demands of reality.
Misperceive what is happening around them, often hearing
and seeing things that aren’t there (hallucinations).
 Trouble paying attention to what is going on around them,
thinking is often confused and disorganized that they cannot
communicate w/others.
 Bizarre behavior and blunting emotions.
45

46.  Characterized as having psychotic
symptoms. The essential features of
schizophrenia are a mixture of both
positive and negative symptoms.
 Positive symptoms – adding
something that is not normally there.
Include delusions, hallucinations,
disordered thought processes, and
disordered behavior.
 Delusions are misinterpretations of
normal events and experiences. 1)
Delusion of persecution 2) Delusion of
grandeur 3) Delusion of control. These
are phasic – meaning they come and
go – just like most of the positive
symptoms.
46

47.  Hallucinations – seeing and hearing things that
aren’t really there. Usually voices telling them
what to do.
 Disorganized speech – word salad (jumbled
words), frequent derailment (start with one
thought and go off into another) or incoherence,
create their own words. All this seems to stem
from the fact the schizophrenics are easily
distracted – lack capacity for selective attention.
 Disorganized behaviors – odd movements or
strange gestures or no movement at all for long
periods of time – catatonia.
47

48.  Negative symptoms – absence of
functions or reactions that most
persons show.
 Flat affect – no emotion – stare off in
space with a glazed look. When they
do show emotion it is often times
inappropriate – may laugh at funerals
and cry at birthday parties.
 Avolition – lack of motivation or will –
persons may sit down doing nothing
for hours.
 Alogia – lack of speech – may
answer direct questions, but
otherwise tend to remain silent –
w/drawn into private world.
48

49. Onset and Course
• Chronic disorder
• Last for at least 6 months. For most people however it lasts for much
longer and symptoms come and go.
• People with the disorder have period when they appear almost
normal, and long periods when their symptoms are readily apparent
• Generally begins in early 20s. Equal among gender, although males
have earlier onset than females.
49

50. Five types of Schizophrenia
 Catatonic – unusual patterns of motor activity, such as:
catalepsy or stupor; excessive motor activity
(purposeless); extreme negativism; mutism; speech
disturbances such as echolalia (repetition or words) or
echopraxia – automatic imitation of movements.
 Disorganized – disorganized speech, disorganized
behavior, flat or inappropriate affect.
 Paranoid – preoccupation with one or more sets of
delusions, centered around the belief that others are out
to get him
50

51.  Undifferentiated – many symptoms, including delusion,
hallucination, incoherence
 Residual – withdrawal, minimum affect, and absence of motivation;
occurs after prominent delusions and hallucinations are no longer
present
51

52. Causes
 Genetic factors – run in families – twin studies.
 Biological factors – brain dysfunction – larger ventricles
may produce abnormalities in the cerebral cortex.
Reduced activity in the frontal lobes. (page 570).
 Biochemical factors – neurotransmitters disturbance –
high levels of dopamine.
 Psychological factors – families create environments
that place their children at risk. Studies done on relapse
shows - harsh criticism, hostility, and show too much
concern with their problems.
52

53. 10. Personality Disorders
53

54.  Extreme and inflexible patterns of perceiving, relating to,
and thinking about the environment and oneself that are
exhibited in a wide range of social and personal contexts.
 Most personality disorders are said to be ego-syntonic –
that means that they are in sync with the ego and not
distressing to person experiencing the disorder.
 However, there are a few of the disorders that are ego-
dystonic – out-of-sync- with the ego and thus cause the
person problems. These people will usually seek help as
oppose to the former.
54

55. Three clusters of Personality disorders
 Odd and Eccentric PD.
 Dramatic, Emotional, and Erratic PD.
 Anxious and Fearful PD
55

56. Odd and Eccentric PD.
 Paranoid PD – pervasive distrust and suspiciousness of
others
 Schizoid PD – pervasive pattern of detachment from social
relationships and a restricted range of expression of
emotions in interpersonal settings – lack basic social skills.
 Schizotypal – pervasive pattern of social and interpersonal
deficits marked by acute discomfort, cognitive and
perceptual distortions, and eccentric behaviour
56

57. .
Dramatic, Emotional, and Erratic PD
 Histrionic PD –pervasive pattern of excessive emotionality and
attention seeking.
 Narcissistic PD – pervasive pattern of grandiosity in fantasy or
behavior, need for admiration, and lack of empathy.
 Antisocial PD – pervasive pattern of disregard for and violation of
the rights of others. Deceitfulness, impulsivity, irritability, lack of
remorse
g. Borderline PD – pervasive pattern of instability of interpersonal
relationships, self-image and affect.
57

58. Anxious and Fearful PD
 Avoidant PD – pervasive pattern of social inhibition,
feelings of inadequacy, and hypersensitivity to negative
evaluation.
 Obsessive-Compulsive PD –preoccupation with
orderliness, perfectionism, and need for mental and
interpersonal control at the expense of flexibility,
openness and efficiency.
 Dependent PD – pervasive and excessive need to be
taken care of that leads to submissive and clinging
behavior and fears of separation.
58