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Abnormal Behaviour Definition Norm Violation Norms are culturally influenced Lives in a certain culture, violates culture norms

Statistical Infrequency Statistically rarity Deviates from what is considered average Lies outside range of majority Personal Discomfort Experience distress over own thought, behaviour (eg. severe depression) Maladaptive Behaviour Cannot perform normal daily duties (eg. going to work, paying their bills) Normality Medical & Psychiatry Absence of Disease Statistical Frequency Asymptomatic Standard bell-shaped non-disabled person curve

Cultural Criteria Idealized beliefs, asymptomatic by societies, subcultures

Abnormality Psychiatry (3 Major Types) Psychoses (major psychiatric disorders) Neuroses (minor psychiatric illness) Organicity (organic mental disorders) Other categories Personality disorders Psychiatric Abnormality Psychoses (Major Psychiatric Disorders) Disoriented thinking Unable to distinguish reality from fantasy Impaired ability to test reality Reality testing Processes of testing one s thoughts, hypothesis Against cues identified in external world Characteristics Severe Involves total personality Accompanied by impaired reality testing Bizarre behaviour Disturbance of affect Speech disturbances Perceptual disturbances Thought disturbances Cognitive impairment less likely Judgement, insight are poor Examples (4 main illness) Schizophrenic disorders Affective disorders Delusional disorders Psychoses not elsewhere classified

Neuroses (Minor Psychiatric Illness)

Organicity (Organic Mental Disorders) 3 Sections y Delirium, Dementia, Amnesia, Other cognitive disorders y Mental disorders (due to a general medical condition) y Substance-related disorders

Characteristics Mild Do not involve total personality Manifested by anxiety (or its derivatives) Not accompanied by impaired reality testing Similar to certain medical illness Appropriate affect Understandable

Cognitive impairment more likely impaired Judgement, insight are intact Examples (3 main illness) Anxiety disorders Somatoform disorders Dissociative disorders

Causes of Psychiatric Disorders (Chronological Classification) Predisposing factors Precipitating factors Perpetuating factors Mental Status Examination Behaviour, Appearance Social manner, Movement, Dress Mood Affect Type, Range, Congruence (appropriateness), Lability Speech Amount, Speed, Volume, Tone Thinking Flow (stream), Formed (connection), Abstraction, Content, Possession (control) Perception Sensory distortions, Sensory deceptions, Illusion, Pseudohallucination, Other mental images Cognitions Orientation (time, place, person), Attention and concentration, Memory (immediate, recent, remote), Intelligence (general knowledge, calculation, vocabulary) Judgement Impaired (poor insight), Intellectual (partial insight), True (good insight)

Physical Examination Vital signs Basic systemic examination Neurological examination Relevant system Investigation Laboratory investigations Radiological investigations EEG Neuropsychologic assessment Intelligence test Personality assessment

Standard Classification DSM-IV Diagnostic & Statistical Manual of th Mental Disorder (4 edition)

ICD-10 International Classification of th Diseases (10 edition)

Definition of Mental Disorder (DSM) Clinically significant behaviour Psychological syndrome, pattern Typically associated with either a y Painful symptom (distress) y Impairment in 1 important areas of functioning (disability) Sign An objective manifestation of a pathologic condition (catatonia) State General term for current status of a patients signs, symptoms (atypical psychosis) Disorder Similar to syndrome Implying more certainly regarding as possibility that may represent single disease (bipolar affective disorder) Symptom A subjective manifestation of a pathologic condition (phobia) Trait General term for an enduring characteristics of an individual (paranoid personality disorder) Disease A syndrome with a known cause, pathophysiologic process (Alcoholic hallucinosis) Dysfunction General term for difficult, abnormal function (functional vaginismus) Syndrome A group of signs, symptoms that occur together in a recognized pattern (dementia, organic brain syndrome)

Causes of Abnormal Behaviour Popular Models Biologic (biomedical) Psychodynamic Behavioural Phenomenologic (humanistic) Social/ interpersonal

Multidimensional Biopsychosocial Biology y Normal biology y Disease process y Genetic influences Psychological (factors affecting) y Thoughts y Feelings y Emotions Social y Environment y Social y Culture

Interaction Model Diathesis condition making one susceptible to develop a disorder (genetic, early learning) Interaction between y Genetic predisposing factor (nurture) y Environmental factor (nature) Models Diathesis-Stress Reciprocal-Gene Environmental

Reliable, Valid categories, Criteria (DSM) Reliability Validity Different users of a classifications Instrument, classification system system can agree on diagnoses in a Accurateness of the measurement series of cases Consistency of the measurement

Heritability Schizophrenia Asthma Cleft lip, palate CHD Hypertension Neural tube defect Peptic ulcer

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