Case #2

Si Shannika naman ay may fear din pero sa clowns

naman ito. She’s working na. Everytime na aattend
siya sa mga birthday parties, umiiwas siya sa
presence ng clowns. Na-associate na niya sa certain
CHAPTER I. ABNORMAL BEHAVIOR IN balloon shop yung clowns kaya umiiwas siya doon. If
HISTORICAL CONTEXT may time na maka-encounter siya ng clown sa
elevator, hindi siya nakilos or parang iniisip niya na
UNDERSTANDING PSYCHOPATHOLOGY hindi nage-exist ang clown sa tabi niya.
PSYCHOLOGICAL DISORDER / ABNORMAL QUESTION: WHO HAS DIAGNOSABLE PROBLEM?
BEHAVIOR
MARY’s case
- Psychological dysfunction within an individual that is  DYSFUNCTION Hindi na siya nakakapagwork
associated with distress or impairment in functioning ng maayos and hindi na
and a response that is not typical or culturally bearable ang mga
expected. consequences ng kaniyang
fear.
CRITERIA IN ASSESSING PSYCHOPATHOLOGY:  DISTRESS May fear, embarrassment
1. PSYCHOLOGICAL DYSFUNCTION  DEVIANCE Hindi normal at her age na
takot siya sa elevators
- refers to breakdown in cognitive, emotional or
 DANGER Exhaustion sa araw-araw na
behavioral functioning pag-akyat; potential asthma;
2. DISTRESS OR IMPAIRMENT pag natisod.
- sometimes part of life;
- Distress – criterion is satisfied if the individual is
extremely upset. The most accepted definition used in
- Impairment – weaker or worst. Diagnostic and Statistical Manual of Mental disorders
3. ATYPICAL OR NOT CULTURALLY EXPECTED (DSM 5) describes“behavioral, psychological or
- important but also insufficient to determine if a biological dysfunctions that are unexpected in
disorder is present by itself. their cultural context and associated with present
- many people are far from average in their distress and impairment in functioning or
behavior but few would be considered disorder, increased risk of suffering, death, pain or
we might call them talented or eccentric. EX: impairment.”
LADY GAGA
THE SCIENCE OF PSYCHOPATHOLOGY
4. DANGER
- kapag nakakasakit ka na sa ibang tao or Psychopathology is a scientific study of
nasasaktan mo na ang sarili mo, possible ay may psychological disorders. Within this field are specially
occurring disorder ka. trained professionals, including: clinical and
counseling psychologists, psychiatrist, psychiatric
Case Analysis
social worker and psychiatric nurses, marriage and
Case #1 family therapists and mental health counselors. In
studying psychopathology, psychologists must not
Si Mary ay takot sa elevator. Iniiwasan niya na be alone.
sumakay sa elevators regardless sa taas ng kaniyang
apartment at workplace, araw-araw niya itong CLINICAL JUDGEMENTS deals with how clinicians
inaakyat. May times pa na nagdadahilan na si Mary gives impression to the case of their client.
sa work niya para hindi siya makapasok.

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 Clinical Psychologists  Marriage and Family Therapists; Mental
- receives Ph.D., doctor of Philosophy degree Health Counselors
or Psy. D., doctor of Psychology. It prepares - spend 1 to 2 years earning a master’s degree
them to conduct research into the causes and and are employed to provide clinical services
treatment of psychological disorders and to by hospitals or clinics, usually under a
diagnose, assess and treat these disorders. supervision of a doctoral-level clinicians.
- usually concentrate on more severe
psychological disorders.
The Scientist-Practitioner
 Counseling Psychologists * The most important development in recent history of
- tend to study and treat adjustments and psychopathology is the adoption of scientific methods
vocational issues encountered by relatively to learn more about nature of psychological disorders,
healthy individuals. their causes and their treatments.

 Psychiatrists * Mental health practitioners must function as

- first earn an M.D degree (general medicine for scientist-practitioner in one or more of three ways:
physicians) in medical school and then
specialize in psychiatry during residency
training that lasts 3 to 4 years.
- investigates the nature and causes of
psychological disorders, often from a
biological point of view; make diagnoses and
offer treatments.
- emphasize drugs or other biological
treatments, although most use psychological
treatments as well.

 Psychiatric Social Worker

- earns a master’s degree in social work as they
develop expertise in collecting information o First, they may keep up with the latest
relevant to the social and family situation of the scientific developments in their field and
individual with a psychological disorders. therefore use the most current diagnostic
- Social workers also treat disorders, often and treatment procedures. In this sense,
concentrating on family problems associated they are consumers of science of
with them. psychopathology to the advantage of their
patients/clients.
 Psychiatric Nurses o Second, scientist-practitioners evaluate their
- have advanced degrees such as masters or own assessments or treatments
even a Ph.D., and specialize in the care and procedures to see whether they work.
treatment of patients with psychological o Third, scientist-practitioners might conduct
disorders, usually in hospital as part of research, often in clinics or hospitals, that
treatment team. produces new information about disorders
or their treatment; thus becoming immune
to the fads that plague our field, often at
the expense of patients and their families.

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 c. Time-limited means the disorder will
improve without treatment in relatively short
period with little or no risk of recurrence.
Onset of Disorder (kalian nagsimula ang disorder)
a. Acute onset means the disorder begin
suddenly. (walang pinagmulan at biglaang
CLINICAL DESCRIPTIONS nangyari)
In hospitals and clinics, we often say that a patient b. Insidious onset means develop gradually
“presents” with a specific problem or set of problems over an extended period.
or we discuss the presenting problems. The anticipated course of disorder is called the
Presents is a traditional shorthand way of prognosis.
indicating why the person came to the clinic. Prognosis
Presenting problems is the first step in determining
her clinical description, which represents the unique - Futuristic in nature.
combination of behaviors, thoughts, and feelings - Educated guess; it can be based on signs and
that make up a specific disorders. symptoms of disorders.
- Should be good; more or less accurate.
Note: The word “clinical” refers both to the types of - Kung ano ang tingin ng clinician na possible
problems or disorders that you would find in clinic or mangyari sa client/patient.
hospitals and to activities connected with - (e.g. good prognosis – possible gumaling or
assessments and treatments. may treatment na posibleng makapagpagaling;
One important function of clinical description bad prognosis – severe or critical na ang
is to specify what makes the disorder different from patient or kahit anong treatment pwedeng hindi
normal behavior or from other disorders. Statistical na ito gumaling.
data may also be relevant. NOTE:
PREVALENCE means “how many people in the - Patient’s age may be an important part of
population as a whole have the disorder?” Ex: COVID clinical description.
70% of the population. - We call the study of changes in behavior over
INCIDENCE means “how many new cases occur time is developmental psychology and we
during given period , such as year. It has time refer to the study of changes in abnormal
element. behavior as developmental psychopathology.
- The study of abnormal behavior across the
SEX RATIO means “percentage of males and entire age span is referred to life-span
females have the disorder-and the typical age of developmental psychopathology.
onset, which often differs from one disorder to another.
Ex: Anong disorder ang mas prevalent sa babae?
CAUSATION AND TREATMENT
Pattern or Cause of Disorder
Etiology
a. Chronic means that they tend to last a long
time, sometimes a life time. - study of origins.
b. Episodic means that the individual is likely - Has to do with why a disorder begins.
to recover within a few months only to suffer - “WHAT CAUSES IT?”
a recurrence of the disorder at at later time. - Includes biological, psychological, and social
dimensions.

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 We value integrative approach (we try to In addition, since the era of ancient Greece,
integrate diff. aspects to derive to psychological the mind has often been called the soul or psyche
disorder. We look at 360 to evaluate and assess the and considered separate from the body.
disorder).
This split gave rise to two traditions of
Treatment thoughts about abnormal behavior, summarizes as
the biological model and psychological model. These
- Often important to the study of psychological three models – supernatural, biological and
disorders. psychological model – are very old but continue to be
- If a new drug or psychosocial treatment is used today.
successful in treating a disorder, it may give us
some hints about the nature of its disorders and THE SUPERNATURAL TRADITION
its causes.
Deviant behavior has been considered a
- Considered interventions
reflection of the battle between good and evil. In fact,
- In psychology, we use psychosocial or
the Great Persian Empire from 900 to 600 B.C., all
psychotherapy.
physical and mental disorders were considered the
- In psychiatrists, they use drug and medication
work of devil. (parusa)
to cure patients.
- The treatments must be inclined to the trend in Non-scientific; kapag may psychological
modern perspective. disorder ka, isa kang masamang tao o makasalanan.
- CBT (cognitive behavioral therapy) is one of the
best treatment to MDD (Major Depressive Demons and Witches
Disorder). - During the last quarter of the 14th century,
NOTE: religious and lay authorities supported these
popular superstitions, and society as a whole
Seasoned psychologists – mga psychologists na began to believe more strongly in the existence
nasanay sa outdated treatments. and power of demons and witches.
- In reaction to this schism, the Roman Church
fought back against the evil in the world that it
believed must have been behind this heresy.
- People increasingly turned to magic and
sorcery to solve their problems.
- It followed that individuals possessed by evil
spirits were probably responsible for any
misfortune experienced by people in the local
community, which inspired drastic action
HISTORICAL CONCEPTIONS OF ABNORMAL against the possessed.
BEHAVIOR - Treatments included exorcism (negates the
possessions), in which various religious rituals
The purpose of these models is to explain were performed in an effort to rid the victim of
why someone is “acting like that.” evil spirits.
Humans have always supposed that agents - Other approaches included shaving the pattern
outside our bodies and environment influence our of a cross in the hair of the victim's head and
behavior, thinking and emotions. These agents – securing sufferers to a wall near the front of a
which might be divinities, demons, spirits and other church so that they might benefit from hearing
phenomena such as magnetic fields or moon or the Mass.
stars – are driving forces behind supernatural model.

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 - Extremely believe and patronize the work of - Possession, however is not always connected
witches. with sin but may be seen as involuntary and
- Sort responsible to psychological disorders. possessed individual as blameless.
- Somewhere along the way, a creative
Stress and Melancholy
“therapist” decided that hanging people in
- MELANCHOLIA at this time is DEPRESSION. bottom pit of snakes.
- insanity was a natural phenomenon, caused by
Mass Hysteria
mental or emotional stress, and that it was
curable. - Simply demonstrate the phenomenon of
- Mental depression and anxiety were recognized emotional contagion in which the experience of
as illnesses, although symptoms such as an emotion seems to spread to those around
despair and lethargy were often identified by them.
the church with the sin of acedia, or sloth. - If one person identifies a “cause” of problem,
(walang paki-alam; 7 major sin-katamaran) others will probably assume that their own
- Usually babae ang nagsa-suffer. reactions have the same source. In popular
- They believe that women who did not care or language this shared response is sometimes
do their duties and responsibilities as a woman referred to mob psychology.
suffer insanity or you are not doing your duties - in Europe, whole groups of people were
to God. simultaneously compelled to run out in the
- Common treatments were rest, sleep, and a streets, dance, shout, rave and jump around in
healthy and happy environment. Other patterns as if they were in particularly wild party
treatments included baths, ointments, and late at night (still called a rave today but with
various potions. music).
- Indeed, during the 14th and 15th centuries, - This behavior was known by several names,
people with insanity, along with those with including Saint Vitus’s Dance and Tarantism.
physical deformities or disabilities, were often - In an attempt to explain the inexplicable,
moved from house to house in medieval several reasons were offered in addition to
villages as neighbors took turns caring for them. possession. One reasonable guess was
- In the 14th century, one of the chief advisers to reaction to insect bites. Another possibility was
the king of France, a bishop and philosopher what we now call mass hysteria.
named Nicholas Oresme, also suggested that
Additional Notes:
the disease of melancholy (depression) was the
source of some bizarre behavior, rather than - MOB PSYCHOLOGY: a branch of social
demons. Oresme pointed out that much of the psychology that deals with the ways in which
evidence for the existence of sorcery and the psychology of a crowd is different from the
witchcraft, particularly among those considered psychology of the individual persons who are
insane, was obtained from people who were the crowd.
tortured and who, quite understandably,
confessed to anything. Moon and The Stars
- E.g. The Mad King- King Charles VI became - Paracelsus, a Swiss physician who lived from
the eye opener; since king siya hindi 1493 to 1541, rejected notions of possession by
acceptable na kaya ito nawala sa sarili ay dahil the devil, suggesting instead that the
sa demons or any type of witchcraft. movements of the moon and stars had
Additional Notes: profound effects on people's psychological
functioning.

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 - He speculated that the gravitational effects of humors: blood, black bile, yellow bile, and
the moon on bodily fluids might be a possible phlegm. Blood came from the heart, black bile
cause of mental this disorders. from the spleen (apdo), phlegm (cerebral spinal
- This influential theory inspired able, the word fluid) from the brain, and choler or yellow bile
lunatic, which is derived from the Latin word from the liver.
luna, meaning "moon." - The humoral theory was, perhaps, the first
- The belief that heavenly bodies affect human example of associating psychological disorders
behavior still exists, although there is no with a "chemical imbalance," an approach that
scientific evidence to support it. is widespread today.
- In Filipino context, “BINUBUWAN” - In addition to rest, good nutrition, and exercise,
two treatments were developed. In one,
THE BIOLOGICAL TRADITION
bleeding or bloodletting, a carefully measured
Physical causes of mental disorders have amount of blood was removed from the body,
been sought since early in history. Important to the often with leeches.
biological tradition are a man, Hippocrates; a disease, - The other was to induce vomiting, indeed, in a
syphilis; and the early consequences of believing that well-known treatise on depression published in
psychological disorders are biologically caused. 1621, Anatomy of Melancholy, Robert Burton
recommended eating tobacco and a half-boiled
Hippocrates and Galen cabbage to induce vomiting.
- The Greek physician Hippocrates is considered - In ancient China and throughout Asia, a similar
to be the father of modern Western medicine: idea existed. But rather than "humors," the
He and his associates left a body of work called Chinese focused on the movement of air or
the Hippocratic Corpus, written between 450 "wind" throughout the body. Unexplained
and 350 B.C. in which they suggested that mental disorders were caused by blockages of
psychological disorders could be treated like wind or the presence of cold, dark wind (yin) as
any other disease. opposed to warm, life- sustaining wind (yang).
- They did not limit their search for the causes of - Treatment involved restoring proper flow of
psychopathology to the general area of wind through various methods, including
"disease," because they believed that acupuncture.
psychological disorders might also be caused - Hippocrates also coined the word hysteria to
by brain pathology or head trauma and could describe a concept he learned about from the
be influenced by heredity (genetics). Egyptians, who had identified what we now call
- Hippocrates considered the brain to be the seat the somatic symptom disorders.
of wisdom, consciousness, intelligence, and - In these disorders, the physical symptoms
emotion. Therefore, disorders involving these appear to be the result of a medical problem for
functions would logically be located in the brain. which no physical cause can be found, such as
- The Roman physician Galen (approximately paralysis and some kinds of blindness.
A.D. 129-198) later adopted the ideas of Because these disorders occurred primarily in
Hippocrates and his associates and developed women, the Egyptians. (and Hippocrates)
them further, creating a powerful and influential mistakenly assumed that they were restricted to
school of thought within the biological tradition women. They also presumed a cause: The
that extended well into the 19th century. empty uterus wandered to various parts of the
- One of the more interesting and influential body in search of conception (the Greek word
legacies of the Hippocratic-Galenic approach is for "uterus" is hysteron). The prescribed cure
the humoral theory of disorders. might be marriage or, occasionally, fumigation
- Hippocrates assumed that normal brain of the vagina to lure the uterus back to its
functioning was related to four bodily fluids or natural location. Ang idea ni Hippocrates ay

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 gumagala raw ang uterus sa katawan ng babae patients convulsed and became temporarily
finding conception, pinapausukan ito para comatose. (Sakel, 1958).
bumalik ang uterus to its place. - The procedure became known as insulin shock
therapy, but it was abandoned because it was too
The 19th Century
dangerous, often resulting in prolonged coma or
Two factors: the discovery of the nature and cause of even death.
syphilis and strong support from the well-respected - During the 1950s, the first effective drugs for severe
American Psychiatrist John P. Grey psychotic disorders were developed in a systematic
way. Before that time, a number of medicinal
Syphilis substances, including opium (derived from poppies),
Behavioral and cognitive symptoms of what had been used as sedatives, along with countless
we now know as advanced syphilis, a sexually herbs and folk remedies.
transmitted disease caused by a bacterial Moral Therapy
microorganism entering the brain, include believing
that everyone is plotting against you (delusion of - During the first half of the 19th century, a strong
persecution) or that you are God (delusion of psychosocial approach to mental disorders called
grandeur), as well as other bizarre behaviors. moral therapy became influential. The term moral
actually referred more to emotional or psychological
In 1825, the condition was designated a factors rather than to a code of conduct. Its basic
disease, general paresis, because it had consistent included treating institutionalized patients as
symptoms (presentation) and a consistent course that normally as possible in a setting that encouraged
resulted in death. and reinforced normal social interaction (Bockoven,
John P. Grey 1963), thus providing them with many opportunities
for appropriate social and interpersonal contact.
The champion of the biological tradition in - When Pinel arrived in 1791, Pussin had already
the United State was the most influential American instituted remark able reforms by removing all
psychiatrist of the time, John P. Grey (Bockoven, chains used to restrain patients and instituting
1963). humane and positive psychological interventions.
Grey's position was that the causes of Psychoanalytic Theory
insanity were always physical. Therefore, the mentally
ill patient should be treated as physically ill. - Franz Anton Mesmer (1734-1815) and with
millions of people since his time who have been
Under Grey's leadership, the conditions in hypnotized Mesmer suggested to his patients
hospitals greatly improved and they became more that their problem was caused by an
humane, livable institutions. But in subsequent years undetectable fluid found in all living organisms
they also became so large and impersonal that called "animal magnetism," which could become
individual attention was not possible. blocked.
- Mesmer is widely regarded as the father of
The Development of Biological Treatments
hypnosis, a state in which extremely suggestible
- In the 1930s, the physical interventions of electric subjects sometimes appear to be in a trance.
shock and brain surgery were often used. Their - Freud teamed up with Josef d Breuer (1842-
effects, and the effects of new drugs, were 1925), who had experimented with a some what
discovered b quite by accident. different hypnotic procedure.
- In 1927, a Viennese physician, Manfred Sakel, began - Breuer and Freud had "discovered" the
using increasingly higher dosages until, finally, unconscious mind and its apparent influence on
the production of psychological disorders.

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- A close second was their discovery that it is - SYNCOPE: sinking feeling or swoon caused by
therapeutic to recall and relive emotional trauma low blood pressure in the head.
that has been made unconscious and to release - people with little or no syncope reaction might
the accompanying tension. This release of develop or not the phobia.
emotional material became known as catharsis
Behavioral Model
- Is also known as the cognitive-behavioral model
EMOTIONAL INFLUENCES
or social learning model brought the systematic
development of a more scientific approach to - emotions can affect physiological responses such
psychological aspects of psychopathology. as blood pressure, heart rate, and respiration,
particularly if we know rationally there is nothing
CHAPTER II. AN INTEGRATIVE APPROACH TO
to fear (more of anxiety).
PSYCHOPATHOLOGY
- emotions also play a substantial role in the
development of many disorders.
ONE DIMENSIONAL MULTIDIMENSIONAL
SOCIAL INFLUENCES
-we try to figure out -we use different lenses.
- our social and cultural factors make direct
the cause of disorder Ex: you’ll look not only in
contributions to biology and behavior.
in one lens. Ex: biological but also in
- being supportive only when somebody is
biological only, psychological, social,
experiencing symptoms is not always helpful
psychological only. mental and emotional.
because the strong effects of social attention may
actually increase the frequency and intensity of
the reaction.

EXAMPLE OF MULTIDIMENSIONAL APPROACH GENETIC CONTRIBUTIONS TO

PSYCHOPATHOLOGY
- Genes are long molecules of deoxyribonucleic
acid (DNA) at various locations on chromosomes,
within the cell nucleus. Ever since Gregor
Mendel's pioneering work in the 19th century, we
have known that physical characteristics such as
hair color and eye color and, to a certain extent,
height and weight are determined-or at least
strongly influenced by our genetic endowment.
THE NATURE OF GENES
- We have known for a long time that each normal
BIOLOGICAL INFLUENCES human cell has 46 chromosomes arranged in 23
pairs.
- VASOVAGAL SYNCOPE: common cause of - 1-22 pair provide programs or directions for the
fainting and it is an overreaction of a mechanism development of the body and brain (physical
called the sinoaortic baroreflex arc, which characteristics/ diseases inherited by parents)
compensates for sudden increases in blood - 23rd pair are the sex chromosomes.
pressure by lowering it.

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- The DNA molecules contain genes have a certain - Epigenetic – value more the environment than
structure, a double helix that was discovered only vulnerability.
a few decades ago.
NEUROSCIENCE AND ITS CONTRIBUTIONS TO
- A dominant gene is one of a pair of genes that
PSYCHOPATHOLOGY
strongly influence a particular trait and we only
need one of them to determine. It includes the central nervous system,
- A recessive gene, must be paired with another consisting of the brain and spinal cord, and the
(recessive) gene to determine a trait. peripheral nervous system, consisting of the somatic
nervous system and the autonomic nervous system.
THE DIATHESIS-STRESS MODEL The Central Nervous System
- The diathesis-stress model, individuals inherit - CNS processes all information received from our
tendencies to express certain traits or behaviors, sense organs and reacts as necessary.
which may then be activated under conditions of - It consist of brain and spinal cord.
stress. - The brain uses an average of 140 billion nerve
- DIATHESIS: each inherited tendency, it is a cells, called neurons, to control our thoughts and
condition that makes someone susceptible to actions. Neurons transmit information throughout
develop a disorder. the nervous system.
- : when the right kind of life event, such as a - One kind of branch is called a dendrite. Dendrites
certain type of stressor comes along, the disorder have numerous receptors that receive messages
develops. Example: Judy inherited a tendency to in the form of chemical impulses from other nerve
faint at the sight of blood. This tendency is the cells, which are converted into electrical impulses.
diathesis or vulnerability.
: SPINAL CORD: part of CNS, but the primary
function is to facilitate the sending of messages to
and from the brain, which is the other major
component of the CNS and it is the most complex
organ in the body.
: NEURONS: the brain uses an average of 140
billion nerve cells to control every thought and action.
The GENE-ENVIRONMENT CORRELATION Model Neurons transmit information throughout the nervous
system.
- Increase the probability that an individual will
experience stressful life events. : the typical neuron contains a central cell body with
two kinds of branches. One of these is the (1)
DENDRITES: have numerous receptors that receive
messages in the form of chemical impulses from
other nerve cells, which are converted into electrical
impulses. The other kind of branch is the
(2) AXON: which transmits these impulses to other
neurons. Any one nerve cell may have multiple
connections to other neurons.
Epigenetics and the nongenomic “inheritance” of : neurons are not actually connected to each other.
behavior There is a small space through which the impulse
must pass to get to the next neuron.
- Genetic influences are often a lot less powerful
than is commonly believed. The environment : SYNAPTIC CLEFT: it is the space between the

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axon of one neuron and the dendrite of another NOREPINEPHRINE
: NEUROTRANSMITTERS: biochemicals that are : acts in a more general way to regulate or
released from the axon of one neuron and transmit modulate certain behavioral tendencies.
the impulse to the dendrite receptors of another
neuron.
DOPAMINE
: is a major neurotransmitter in the monoamine
class also termed a catecholamine because of the
similarity of its chemical structure to epinephrine
and norepinephrine.
: deficiencies in dopamine have been associated
with disorders such as Parkinson’s disease.
THE STRUCTURE OF THE BRAIN
○ BRAIN STEM: is the lower and more ancient part
of the brain. Handles most of the essential
automatic functions (breathing, sleeping, moving
around in a coordinated way, digestion).
: major neurotransmitters to psychopathology are :
: HINDBRAIN: the lowest part of the brain stem
GLUTAMATE AND GABA “chemical brothers”
which contains medulla, pons, and cerebellum.
: GLUTAMATE: an excitatory transmitter that turns
: CEREBELLUM: it controls motor coordination,
on many different neurons leading to action.
and research suggests that abnormalities here may
: GABA: an inhibitory transmitter. It regulates be associated with autism.
transmission of information & action potential.
: MIDBRAIN: which coordinates movement with
: reduces postsynaptic activity, which, in turn, sensory input and contains parts of the reticular
inhibits a variety of behaviors and emotions. activating system, which contributes to processes
of arousal and tension (awake or asleep).
: reduce levels of anger, hostility, aggression, and
: THALAMUS & HYPOTHALAMUS: top of the
perhaps even positive emotional states such as
eager anticipation and pleasure. brain stem which are involved with regulating
behavior and emotion.
SEROTONIN OR 5HT
: these structures function primarily as a relay
: influence great deal of our behavior, moods, and
between forebrain and lower areas of brain stem.
thought processes.
○ FOREBRAIN: part of the brain that is
: an extremely low activity levels of serotonin are
more advanced and evolved more recently.
associated with less inhibition and instability,
impulsivity & tendency to overreact to situations. : LIMBIC SYSTEM: base of the forebrain, which
helps regulate our emotional experiences and
: a low serotonin activity has been associated with
expressions and our ability to learn and to control
aggression, suicide, impulsive overeating, and
our impulses. It is also involved with the basic
excessive sexual behavior.
drives of sex, aggression, hunger, and thirst.
: a high level of serotonin may interact with GABA
: BASAL GANGLIA: also base of the forebrain.
to counteract glutamate.

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 Damage to these structures may make us change gonadal glands) and also aids digestion and
our posture, twitch, shake and control in motor regulates body temperature.
activity.
: ENDOCRINE SYSTEM: each endocrine gland
: CEREBRAL CORTEX: the largest part of the produces its own chemical messenger called the
forebrain which contains more than 80% of all hormone that release directly to the bloodstream.
neurons in the CNS.
: ADRENAL GLANDS: produce
: this part provides us with our distinctly human epinephrine (adrenaline) in response to
qualities, allowing us to look to the future and plan, stress, as well as salt regulating hormones.
reason, and create.
: THYROID GLAND: produces thyroxine
: the (1) LEFT HEMISPHERE of cerebral cortex is
responsible for verbal and other cognitive which facilitates energy metabolism and growth;
processes while the (2) RIGHT HEMISPHERE : PITUITARY: is a master gland that produces a
seems to be better at perceiving the world around variety of regulatory hormones.
us and creating images.
: GONADAL GLANDS: produce sex hormones
4 SEPARATE AREAS OF THE such as estrogen and testosterone.
HEMISPHERES 2 MAJOR COMPONENTS
1. TEMPORAL LOBE Recognizing various Responsible for
sights and sounds mobilizing the body
during times of stress
and with long-term memory storage or danger by rapidly
activating the organs
2. PARIETAL LOBE Sensations of touch and and glands under its
monitoring body positioning control.
when goes on alert, the
3. OCCIPITAL LOBE Integrating and making
sense of various visual inputs. heart beats faster,
SYMPATHETIC
thereby increasing the
NERVOUS
4. FRONTAL LOBE Responsible for higher flow of blood to the
SYSTEM
cognitive functions such as thinking, reasoning, muscles, respiration
and planning for the future, as well as long-term increases, allowing
memory. more oxygen to get
Synthesizes all information received from other into the blood and
parts of the brain and decides how to respond. brain All these changes
help mobilize us for
action.
Peripheral Nervous System: Emergency/alarm
coordinates with the brain stem to make sure the body balance the
sympathetic system.
is working properly.
normalizing our arousal
: SOMATIC NERVOUS SYSTEM: controls the PARASYMPATHETIC
and facilitating the
muscles, so damage in this area might make it NERVOUS SYSTEM
storage of energy by
difficult for us to engage in any voluntary movement, helping the digestive
including talking. process.

: AUTONOMIC NERVOUS SYSTEM: regulate the : AGONISTS: effectively increase the activity of a
cardiovascular system (heart/ blood vessels) and neurotransmitter by mimicking its effects.
endocrine system (pituitary, adrenal, thyroid, and
: ANTAGONISTS: decrease/ block neurotrans.

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: INVERSE AGONISTS: it produces effects that is
opposite to what neurotransmitter produces.
: SSRIs: used to treat a number of psychological
disorders (anxiety, mood, and eating disorders).
: ST. JOHN’S WORT: it also affects serotonin
levels which is an herbal medication available in
health food stores.

2 MAJOR DOPAMINE PATHWAYS

MESOLIMBIC SYSTEM - Implicated in
schizophrenia
BASAL GANGLIA - Contributes to problems in
the locomotor system, such as tardive dyskinesia,
which sometimes results from use of neuroleptic
drugs.

Division of the nervous system.

Behavioral and Cognitive Sciences

Cognitive Sciences
- is concerned with how we acquire and process
information and how we store and ultimately
retrieve it (one of the processes involved in
memory.
Conditioning and Cognitive Processes
Under this is the Classical Conditioning by Ivan
Pavlov and Operant Conditioning.
Learned Helplessness
- People become depressed if they “decide” or
“think” they can do little about the stress in their
lives, even if it seems to others that there is
something they could do.
- People make an attribution that they have no
control and they become depressed.
- Martin Seligman – first described the concept of
learned helplessness.

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Social Learning - Suppressing almost any kind of emotional
response, such as an anger or fear, increases
- Concept of Albert Bandura in which ‘they can sympathetic nervous system activity, which may
learn just as much by observing what happens to contribute to psychopathology.
someone else in a given situation.’
Cultural, Social and Interpersonal Factors
Prepared Learning
Voodoo, the Evil Eye and other Fears.
- In this concept, we have become highly prepared
for learning about certain types of objects or - Latin American susto, which describes various
situations over the course of evolution because anxiety-based symptoms, including insomnia,
this knowledge contributes to the survival of irritability, phobias, and marked somatic
species. symptoms of sweating and increase heart rate
(tachycardia). But susto has only one cause:
Cognitive Science and the Unconscious individual believes that he or she has become the
- We are not aware of much of what goes on inside object of black magic, or witchcraft, and is
our heads, but our unconscious is not necessarily suddenly badly frightened.
the seething caldron of primitive emotional Gender
conflicts envisioned by Freud.
- Gender roles have a strong and sometimes
Emotions puzzling effect on psychopathology.
- It plays an enormous role in our day-to-day lives - Our gender doesn’t cause psychopathology. but
and can contribute in major ways to the because gender role is social and cultural factor
development of psychopathology. that influences the form and content of a disorder.
- The alarm reactions that activates during
potentially life-threatening emergencies is called
the fight or flight response.
- Usually short-lived, temporary states lasting from
several minutes to several hours, occurring in Social Effects on Health and Behavior
response to an external event. - Many studies have demonstrated that the greater
Emotional Phenomena the number and frequency of social relationships
and contacts, the longer you are likely to live.
- The emotion of fear is a subjective feeling of
terror, a strong motivation for behavior (escaping Social Stigma
or fighting), and a complex physiological or - Psychological disorders continue to carry a
arousal response. substantial stigma in our society.
- A tendency to behave in a certain way (e.g.
escape), elicited by an external event (a threat) Global Incidence of Psychological Disorder
and a feeling state (terror) and accompanied by a - Most societies have not yet developed the social
(possibly) characteristic physiological response. context for alleviating and ultimately preventing
- Mood is a more persistent period of affect or them. Changing societal attitudes is just one of
emotionality. the challenges facing us as the century unfolds.
- Affect often refers to the valence dimension (e.g.
pleasant/positive vs. unpleasant/negative) of an Life-Span Development
emotion.
- We must appreciate how experiences during
Emotions and Psychopathology different periods of development may influence
our vulnerability to other types of stress or
differing psychological disorders.

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The Principle of Equifinality
- This principle is used in developmental
psychopathology to indicate that we must
consider a number of paths to a given outcome.

CHAPTER III. CLINICAL ASSESSMENT AND

DIAGNOSIS
Clinical Assessment
- Clinical assessment is the systematic evaluation
and measurement of psychological, biological,
and social factors in an individual presenting with
a possible psychological disorder.
- Diagnosis is the process of determining whether
The Clinical Interview
the particular problem afflicting the individual
meets all criteria for a psychological disorder, as - The clinical interview, the core of most clinical
set forth in the fifth edition of the Diagnostic and work.
Statistical Manual of Mental Disorders, or DSM-5 - Could be semi-structured (may guidelines na
(American Psychiatric Association, 2013). tanong but can do follow up)
- Evaluation that arrive in certain decision; always - The interview gathers information on current and
integrative approach. past behavior, attitudes, and emotions, as well as
a detailed history of the individual's life in general
KEY concepts in assessment
and of the presenting problem.
oReliability – is the degree to which a - To organize information obtained during an
measurement is consistent. interview, many clinicians use a mental status
oValidity – whether something measures exam.
what it is designed to measure.
Mental Status Exam
oStandardization – process by which a
certain set of standards or norms is - Involves the systematic observation of an
determined for a technique to make its individual’s behavior.
use consistent across different - The trick for clinician is to organize their
measurements; uniformity to procedure of observation of other people in a way that gives
administration, scoring and interpretation. them sufficient information to determine whether
a psychological disorder might be present.
- The exam covers 5 categories:
oAppearance and behavior – clinician notes
overt physical behaviors, as well as the
individual’s dress, general appearance,
posture and facial expressions.
oThought processes – based on how client
answers. Clinician listens to a patient talk,
they’re getting a good idea of that
person’s thought processes.
oMood and Affect – mood is predominant
feeling of state (matagal) while affect is a

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 feeling state accompanied what we say at The ABCs of Observation
a given point.
oIntellectual functioning – clinicians makes - Usually focused on the here and now.
rough estimate or other’s intellectual - This antecedent-behavior-consequences might
functioning just by talking to them. suggest that the boy was being reinforced for his
oSensorium – the term sensorium refers to violent outburst by not having to clean up his
general awareness of our surrounding. mess.
SENSES. It is oriented to three spheres: - Informal observation – is that it relies on the
 Person observer’s recollection, as well as interpretation,
 Place of the events.
 Time - Formal observation – involves identifying
specific behaviors that are observable and
“anything that you think is relevant MUST BE measurable.
ASKED.”
Self-Monitoring
Semistructured Clinical Interviews
- People can also observe their own behavior to
- Are made up of questions that have been find patterns, also known as self-observation.
carefully phrased and tested to elicit useful info in - A phenomenon known as reactivity can distort
a consistent manner so that the clinicians can be any observational data. Any time you observe
sure that they have inquired about most how people behave, the mere fact of your
important aspects of particular disorders. presence may cause them to change their
- Clinicians may also depart from set questions to behavior.
follow up on specific issues – thus the label
“semistructured”. Psychological Testing

Physical Examination - Tests must be reliable.

- It includes specific tools to determine cognitive,
- With particular attention to medical conditions emotional or behavioral responses that might be
sometimes associated with the specific associated with a specific disorder and more
psychological problem. Many problems general tools that assess longstanding
presenting as disorders of behavior, cognition or personality features, such as tendency to be
mood may, on careful physical examination, have suspicious.
a clear relationship to a temporary toxic state.
- Can be caused by bad food, the wrong amount or Projective Testing
type of medicine or onset of a medical condition. - Psychoanalytic workers developed several
assessment measures known as projective
Behavioral Assessment testing
- include a variety of methods in which ambiguous
- Process one step further by using direct stimuli, such as pictures of people or things, are
observation to formally assess an individual’s presented to people who are asked to describe
thoughts, feelings and behavior in specific what they see. The theory here is that people
situation or contexts. project their own personality and unconscious
- Target behaviors are identified and observed with fear onto other people and things- in this case,
the goal of determining the factors that seem to the ambiguous stimuli – and without realizing it,
influence them. reveal their unconscious thoughts to their
- Most clinicians assume that a complete picture of therapist.
a persons problem requires direct observation in - Rorshach Inkblot Test and Thematic
naturalistic environments. Apperception Test

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Personality Inventories Images of Brain Structure
- Self-report questionnaires that assess personal CT Scan
traits
- Meehl pointed out that what is necessary from - Computerized axial tomography
these types of tests is not whether the questions - A form of X-raying that involves a large x-ray
necessarily make sense on the surface but rather, machine
what the answers to these questions predict. - Typically used for
- Minnesota Multiphasic Personality Inventory. In oBone fractures
stark contrast to projective tests, which rely oTumors
heavily on theory for an interpretation, the MMPI oCancer monitoring
and similar inventories are based on an empirical oPossible internal bleeding
approach, that is, the collection and evaluation of MRI
data.
- Magnetic resonance imaging
Intelligence Testing - Used radio waves and magnets
- The test provided a score known as an - Frequently used to diagnose issues like:
intelligence quotient or IQ. oJoints
- Confuse IQ with intelligence. An IQ score oBrain
significantly higher than average means the oWrists
person has a significantly greater than average oAnkles
chance of doing well in our educational system. oHeart
oBlood vessels
Neuropsychological Testing
PET Scan
- measure abilities in areas such as receptive and
expressive language, attention and concentration, - Positron emission tomography
memory, motor skills, perceptual abilities, and - Uses traces to help your doctor to see how well
learning and abstraction in such a way that the your organs and tissues are working
clinician can make educated guesses about the - Scan can measure blood flow, oxygen use, how
person's performance and the possible existence your body uses sugar and much more
of brain impairment. SPECT
- In other words, this method of testing assesses
brain dysfunction by observing the effects of the - Single photon emission computed
dysfunction on the person's ability to perform tomography
certain tasks. - Produce images that show how organs are
- A fairly simple neuropsychological test often used functioning
with children is the Bender Visual-Motor Gestalt - Can show how well blood is flowing to you heart;
Test. what areas of the brain are active or less active;
- Two of the most popular advanced test of organic or what part of your bone are affected by cancer.
(brain) damage that allow more precise Psychophysiological Assessment
determinations of the location of the problem are
Luria-Nebraska Neuropsychological Battery and - Method use in assessing brain structure and
the Halstead-Reitan Neuropsychological Battery. function specifically and nervous system activity
generally
Neuroimaging: Pictures of the Brain - Of other bodily responses may also play a role in
- Partially controlled by specific areas of the brain. assessment. These responses include heart rate,
respiration and electrodermal responding,

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 formerly referred to as galvanic skin 1. Stigma.
response(GSR), which is a measure of sweat 2. Controversial.
gland activity controlled by peripheral nervous
system. Definitions of “normal” and “abnormal” are
questioned, and is the assumption that a behavior or
Diagnosing Psychological Disorder cognition is part of one disorder and not another.
Some would prefer to talk about behavior and feelings
Idiographic Strategy – uniqueness on a continuum from happy to sad or fearful to non
Nomothetic Strategy – similarities fearful rather than to create such categories as mania,
depression and phobia.
Classification
Categorical and Dimensional Approaches
- Simply to any effort to construct groups or
categories and to assign objects or people to Classical (or pure) categorical approach
these categories on the basis of their shared - Originates in the work of Emil Kraepelin and the
attributes or relations. biological tradition in the study of
Taxonomy psychopathology.
- Every diagnosis has a clear underlying
- Classification of entities for scientific purposes, pathophysiological cause and that the disorder is
such as insects, rocks, or – if the subject is unique.
psychology – behaviors. - Cause could be psychological or cultural instead
Nosology (general disorder) of pathophysiological, but there is still only one
set of causative factors per disorder, which does
- All diagnostic system used in health-care settings, not overlap with those of other disorder.
such as those for infectious diseases, are - Quite useful in medicine
nosological systems. - “but if someone is depressed or anxious, is there
a similar type of underlying cause?”
Nomenclature (under nosology)
- Clearly inappropriate to the complexity of
- The names or labels of the disorder that make up psychological disorders
the nosology.
Dimensional approach
Most mental health professionals in North
- Which we note the variety of cognitions, moods
America use the classification system contained in
and behaviors with which the patient presents
DSM. This is the official system in US, and is used
and quantify them on a scale.
widely throughout the world along with closely related
- How many dimensions are required?
International Classification of Diseases,10th edition
- Categorical approach with a twist that is basically
(ICD-10 WHO). A clinician refers to DSM5 to identify
combines some features of each of the former
specific psychological disorder in process if making a
approaches.
diagnosis.
Prototypical approach
Bawal i-diagnose ang client using nosology and
nomenclature. - Identifies certain essentials characteristics of an
entity so that you can classify it, but it also allows
Classification Issues
certain nonessential variations that do not
If we could not order and label objects or necessarily change the classification.
experiences, scientists could not communicate with
Reliability
one another and our knowledge would not advance.
Everyone would have to develop a personal system
that would mean nothing to anyone else.

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- Any system of classification should describe DSM III and DSM III-R
specific subgroups or symptoms that are clearly
evident and can be readily identified by - 1980 brought a landmark in history of nosology:
experienced clinicians. the 3rd edition of DSM. DSM III was departed
- one of the most unreliable categories in current radically from its predecessors.
classification is the area of personality disorders- - Two changes stood out:
chronic, trait-like sets of inappropriate behaviors oDSM III attempted to take an atheoretical
and emotional reactions that characterize a approach to diagnosis, relying on precise
person’s way of interacting with the world. descriptions of disorder, as they
presented to clinicians rather than on
Validity psychoanalytic or biological theories of
etiology.
- Construct validity – the signs and symptoms oWas the specificity and detail with which the
chosen as criteria for the diagnostic category are criteria for identifying a disorder were
consistently associated or “go together” and what listed made it possible to study their
they identify differs from other categories. reliability and validity.
- Predictive validity – a valid diagnosis tells the - The multiaxial format, emphasized broad
clinicians what is likely to happen with consideration of whole individual rather than a
prototypical patient; it may predict the course of narrow focus on disorder alone, was also thought
disorder and likely effect of one treatment or to be useful. More clinicians around the world
another. used DSM III-R at the beginning of 1990s than
- Criterion validity – when the outcome is the ICD system designed to be applicable
criterion by which we judge the usefulness of internationally.
diagnostic category.
- Content validity – means if you create criteria DSM IV and DSM-IV TR
for a diagnosis of, say social phobia, it should
reflect the way most experts in the field think of - The 10th edition of ICD would be published in
social phobia, as opposed to, say depression. In 1992
other words, you need to get the label right. - To make ICD-10 and DSM as compatible as
possible, work proceeded more or less
Diagnosis before 1980 simultaneously on both ICD-10 and 4th edition of
DSM published in 1994.
Kraepelin first identified what we now - 12 independent studies or field trials examined
know as the disorder schizophrenia. His term of the reliability and validity of alternative sets of
the disorder at the time was dementia praecox – definitions or criteria and in some cases,
deterioration of the brain that sometime occurs with possibility of creating new diagnosis.
advancing age (dementia) and develops earlier than - In 2000, committee upload the text that describes
is supposed to or “prematurely” (praecox). Kraepelin research literature accompanying DSM-IV
landmark – describes not only dementia praecox but diagnostic category and made minor changes to
also bipolar disorder then called manic depressive some of the criteria themselves to improve
psychosis. consistency.
In 1948, World Health Organization added a DSM V
section classifying mental disorders to 6th edition of
International Classification of Diseases, ICD. Nor did - DSM 5 was published in the spring of 2013.
the first Diagnostic and Statistical Manual published in - DSM-5 is largely unchanged from DSM-IV
1952 by American Psychiatric Association. In 1968, although some new disorders are introduced and
APA published DSM II and in 1969, WHO published other disorders have been reclassified. Also,
the 8th ed of ICD which was all but identical to DSM II. there have been some organizational and

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 structural changes in the diagnostic manual itself explain the causes of that abnormality. Rarely
For example, the manual is divided into three can a single study accomplish so much.
main sections. The first section introduces the Instead, we usually are left with partial
manual and describes how best to use it. The answers to the question of what causes a
second section presents the disorders certain disorder or symptom, and we must
themselves, and the third section includes piece together the partial answers from
descriptions of disorders or conditions that need several studies to get a complete picture.
further research before they can qualify as official
diagnoses. For abnormal psychology, the focus of researches
- The use of dimensional axes for rating severity, will be the nature of the problem, the etiology of
intensity, frequency, or duration of specific abnormal behavior and evaluation of treatments for a
disorders in a relatively uniform manner across specific disorder.
all disorders is also a feature of DSM-5. The Basic Components of a Research Study
DSM V-TR Various research strategies have the same
- March 2022 basic element or component. The basic research
- Many diagnostic criteria was unchanged process is simple. It would always start with an
- Changes include in the new DSM: educated guess called hypothesis. When a
oProlonged grief disorder researcher decided how to test their hypothesis,
oUnspecified mood disorder formulation of research design is needed which
oStimulant-induced mild neurocognitive includes the variables of study independent and
disorder. dependent variable) Finally, a research study should
be valid both internally and externally

CHAPTER IV. RESEARCH METHODOLOGIES IN Hypothesis

ABNORMAL PSYCHOLOGY hypothesis is an educated guess about what
Examining Abnormal Behavior you expect to find in the research you are doing.
Human beings look for order and purpose. We want
While research in abnormal psychology in to know why the world works as it does, and why
many ways resembles research in other fields, the people behave the way they do. Robert Kegan
study of psychopathology presents some special describes us as "meaning-making" organisms,
challenges. constantly striving to make sense of what is going on
around us. The familiar search for meaning and order
o One challenge is accurately measuring also characterizes the field of abnormal behavior.
abnormal behaviors and feelings. We cannot Almost by definition, abnormal behavior defies the
see, hear, or feel other people's emotions and regularity and predictability we desire. It is this
thoughts. Researchers often must rely on departure from the norm that makes the study of
people's own accounts, or self-reports, of abnormal behavior so intriguing. In an attempt to
their internal states and experiences. make sense of these phenomena, behavioral
o A second challenge is the difficulty of scientists construct hypotheses and then test them.
obtaining the participation of populations of
interest, such as people who are paranoid Dependent and Independent Variable
and hearing voices.
o The third challenge is that most forms of When researchers develop hypotheses, they
abnormality probably have multiple causes. also specify the dependent and independent variable.
Unless a single study can capture all the A dependent variable is what is measured, and it
biological, psychological, and social causes of may be influenced directly by the study.
the psychopathology of interest, it cannot fully Psychologists studying abnormal behavior typically

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measure an aspect of the disorder in question, such Researchers who study human behavior use
as overt behaviors, self-reported thoughts and several forms of research when studying the causes
feelings, or biological symptoms. On the other hand, of behavior.
independent variables are those factors thought
to affect the dependent variables and may be
directly manipulated by the researchers Case Study Method
Internal and External Validity One of the best way to begin exploring a
Internal validity is the extent to which you can be relatively unknown disorder. In this method, the
confident that the independent variable is causing the researcher is investigating intensively one or more
dependent variable to change. External validity refers individuals who display the behavioral and physical
to how well the results relate to things outside your patterns. The case study method relies on a
study-in other words, how well your findings describe clinician's observations of differences among one
similar individuals who were not among the study person or one group with a disorder, people with other
participants. Scientists use many strategies to ensure disorders, and people with no psychological disorders.
internal validity in their studies three of them were usually collects as much information as possible to
control groups, randomization, and analogue models obtain a detailed description of the persons.
Historically, interviewing the person under study
o Control Group. In a control group, people yields a great deal of information on personal
are similar to the experimental group in background, education, health, and work history, as
every way except that members of the well as the person's opinions about the nature and
experimental group are exposed to the causes of the problems being studied.
independent variable and those in the control
group are not. Because researchers can't One difficulty with depending heavily on
prevent people from being exposed to many individual cases is that sometimes coincidences occur
things around them that could affect the that are irrelevant to the condition under study.
outcomes of the study, they try to compare Because a case study does not have the controls of
people who receive the treatment with an experimental study, the results may be unique to a
people who go through similar experiences particular person without the researcher realizing it or
except for the treatment (control group). may derive from a special combination of factors that
o Randomization. It is the process of are not obvious.
assigning people to different research Correlational Research.
groups in such a way that each person has
an equal chance of being placed in any It answers the fundamental question of
group. Placing people in groups by flipping a scientists whether two variables have significant
coin or using a random number table helps relationship. Unlike experimental designs, which
improve internal validity by eliminating any involve manipulating or changing conditions,
systematic bias in assignment. If random correlational designs are used to study phenomena
assignment is not used, people sometimes just as they occur. The result of a correlational study-
"put themselves in groups," and this self- whether variables occur together-is important to the
selection can affect study results. ongoing search for knowledge about abnormal
o Analogue models. Created in the controlled behavior. One of the clichés of science is that
conditions of the laboratory aspects that are correlation does not imply causation. In other words,
comparable (analogous) to the phenomenon two things occurring together does not necessarily
under study. mean that one caused the other.

Types of Research Methods o Positive Correlation. This means that great

strength or quantity in one variable is

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 associated with great strength or quantity in the instead of only once before you change the
other variable. At the same time, lower strength independent variable and once afterward. The
or quantity in one variable is associated with researcher takes the same measurements
lower strength or quantity in the other. repeatedly to learn how variable the behavior is
o Negative Correlation. This means that great and whether it shows any obvious trends.
strength or quantity in one variable is Repeated measurement is part of each single-
associated with lower strength or quantity in the subject experimental design. It helps identify
other variable. how a person is doing before and after
intervention and whether the treatment
accounted for any changes
o Withdrawal Designs. One of the more
common strategies used in single-subject
research is a withdrawal design, in which a
researcher tries to determine whether the
Epidemiological Research. independent variable is responsible for changes
in behavior. A simple withdrawal design has
One type of correlational research that is three parts. First, a person's condition is
much like the efforts of detectives. It studies the evaluated before treatment, to establish a
incidence, distribution, and consequences of a baseline. Then comes the change in the
particular problem or set of problems in one or more independent variable, the beginning of
populations. Epidemiologists expect that by tracking a treatment. Last, treatment is withdrawn ("return
disorder among many people they will find important to baseline") and the researcher assesses
clues as to why the disorder exists. whether level changes again as a function of
this last step. Although case studies often
Experimental Research
involve treatment, they don't include any effort
An experiment involves the manipulation of to learn whether the person would have
an independent variable and the observation of its improved without the treatment. A withdrawal
effects. We manipulate the independent variable to design gives researchers a better sense of
answer the question of causality. whether or not the treatment itself caused
behavior change.
Single-Case Experimental Designs o Multiple Baseline. In comparison to withdrawal
Skinner formalized the concept of single- designs that the treatment is withdrawn, in
case experimental designs. This method involves the multiple baseline, rather than stopping the
systematic study of individuals under a variety of intervention to see whether it is effective, the
experimental conditions. Skinner thought it was much researcher starts treatment at different times
better to know a lot about the behavior of one across settings, behaviors, or people.
individual than to make only a few observations of a Genetic Studies
large group for the sake of presenting the "average"
response. Single-case experimental designs differ the interaction between our genetic makeup
from case studies in their use of various strategies to and our experiences is what determines how we will
improve internal validity, thereby reducing the number develop. The goal of behavioral geneticists is to tease
of confounding variables. out the role of genetics in these interactions. Genetic
researchers examine phenotypes, the observable
o Repeated Measurement. One of the more characteristics or behavior of the individual, and
important strategies used in single-case genotypes, the unique genetic makeup of individual
experiment design is repeated measurement, in people. With the rapid advance of science, a third
which a behavior is measured several times concept is now the focus of intense study-

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endophenotypes. Endophenotypes are the genetic Signs
mechanisms that ultimately contribute to the
underlying problems causing the symptoms and - are objective findings observed by the clinician
difficulties experienced by people with psychological - observed by the clinicians
disorders. Here are specific research techniques used - visible ang signs; nakikita visually
by researchers in Genetic Studies Symptoms
o Family Studies. In family studies, scientists - are subjective experiences described by the
simply examine a behavioral pattern or emotional patient.
trait in the context of the family. The family - Pwede hindi makita sa client; info ay galling sa
member with the trait singled out for study is client mismo.
called the proband. If there is a genetic influence, - Ex: “madalas po kasi akong gutom” hindi
presumably the trait should occur more often in makikita ng clinician ang gutom ng client but the
first- degree relatives (parents, siblings, or info ay galling sa client na possible ay symptom.
offspring) than in second-degree or more distant
relatives. The problem with family studies is that Syndrome
family members tend to live together and there - is a group of signs and symptoms that occur
might be something in their shared environment together as a recognizable condition that may be
that causes the high familial aggregation. less than specific than a clear-cut disorder or
o Adoption Studies. In adoption studies, disease.
researchers try to separate environmental from - Kapag hindi name-meet ang criteria pero may
genetic influences in families. Scientists identify symptoms na ito ay syndrome
adoptees who have a particular behavioral - Pino-propose pa lang ang sakit, hindi pa kilala.
pattern or psychological disorder and attempt to
locate first-degree relatives who were raised in
different family settings. If the siblings raised with
I. Consciousness: state of awareness
different families have the disorder more often
than would be expected by chance, the Apperception- perception modified by one's own
researchers can infer that genetic endowment is emotions and thoughts
contributor.
o Twin Studies. Nature presents an elegant Sensorium- state of cognitive functioning of the
experiment that gives behavioral geneticists their special senses (something used as a synonym for
closest possible look at the role of genes in consciousness)
development: identical (monozygotic twins. A. Disturbances of consciousness
These twins not only look a lot alike but also have
identical genes. Some changes do occur in 1. Disorientation- disturbance of orientation in
chemical markers (called epigenetic markers) in time, place, or person.
the womb, which explains the subtle differences 2. Clouding of consciousness- incomplete
even in identical twins. Fraternal (dizygotic) twins, clear-mindedness with disturbances in
on the other hand, come from different eggs and perception and attitudes (PERSON BECOMES
have only about 50% of their genes in common, UNAWARE OF HIS SURROUNDINGS)
as do all first-degree relatives. 3. Stupor- lack of reaction to and unawareness of
surroundings
4. Delirium- bewildered, restless, confused,
disoriented reaction associated with fear and
hallucinations
SIGNS AND SYMPTOMS 5. Coma- profound degree of unconsciousness

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 6. Coma vigil- coma in which the patient appears A. Affect- observed expression of emotion; may be
to be asleep but ready to be aroused inconsistent with patient's description of emotion
7. -also known as akinetic mutism (momentary emotion)
8. Twilight State - disturbed consciousness with
hallucinations. (A CONDITION OF 1. Appropriate affect- condition in which the
DISORDERED CONSCIOUSNESS DURING emotional tone is in harmony with the
WHICH ACTIONS MAY BE PERFORMED accompanying idea, thought, or speech; also
WITHOUT CONSCIOUS VOLITION AND further described as broad or full affect, in which
WITHOUT ANY REMEMBRANCE a full range of emotion is appropriately expressed.
AFTERWARD) 2. Inappropriate affect - disharmony between the
9. Dreamlike state - often used as synonym for emotional feeling tone and the idea, thought or
complex partial seizure or psychomotor speech accompanying it
epilepsy 3. Blunted affect - a disturbance in affect
10. Somnolence- abnormal drowsiness manifested by a severe reduction in the
intensity of externalized feeling tone
B. Disturbance of attention: attention is the amount (unemotional).
of effort exerted in focusing on certain portions of an - nagpatawa ka tapos tumango lang si client.
experience; ability to sustain a focus on one activity; 4. Restricted or constricted affect- reduction in
ability to concentrate intensity of feeling tone less severe than blunted
affect but clearly reduced (tipid emotional
1. Distractibility- inability to concentrate expression)
attention; attention drawn to unimportant or - nagpatawa ka tapos ngumisi lang si client.
irrelevant external stimuli 5. Flat affect- absence or near absence of any
2. Selective inattention- blocking out only signs of affective expression, voice monotonous,
those things that generate anxiety face immobile (no emotion)
3. Hypervigilance- excessive attention and - regardless kung pinapatawa mo si client o
focus on all internal and external stimuli, pinapaiyak ay wala siyang emotion na
usually secondary to delusional or paranoid napapakita.
states 6. Labile affect- rapid and abrupt changes in
4. Trance- focused attention and altered emotional feeling tone, unrelated to external
consciousness, usually seen in hypnosis, stimuli
dissociative disorders, and ecstatic religious
experiences B. Mood- a pervasive and sustained emotion,
subjectively experienced and reported by the patient
C. Disturbances in suggestibility: complaint and and observed by others
uncritical response to an idea or influence
1. Dysphoric mood- an unpleasant mood (you feel
1. Folie a deux (or folie a trois)- bad, down, you're irritated)
communicated emotional illness between 2. Euthymic mood- normal range of mood,
two (or three) persons (a madness shared by implying absence of depressed or elevated mood
two; usually paranoid or delusional belief) 3. Expansive mood- expression of one's feelings
2. Hypnosis- artificially induced modification of without restraint, frequently with an
consciousness characterized by a overestimation of one's significance or
heightened suggestibility importance (elevated mood)
4. Irritable mood-easily annoyed and provoked to
anger
II. Emotion- a complex feeling state with psychic, 5. Mood swings (labile mood)- oscillations
somatic and behavioral components that is related to between euphoria and depression or anxiety
affect and mood

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6. Elevated mood- air of confidence and enjoyment; dysfunction of the person, most often associated with
a mood more cheerful than usual depression (also called vegetative signs)
7. Euphoria- intense elation with feelings of
grandeur. 1. Anorexia- loss of or decrease in appetite
8. Ecstasy- feeling of intense rapture (a trance or 2. Hyperphagia- increase in appetite and
trance-like state in which an individual transcends intake of food
normal consciousness). 3. Insomnia- lack of or diminished ability to
9. Depression-psychopathological feeling of sleep
sadness a. Initial-difficulty in falling asleep
10. Anhedonia- loss of interest in and withdrawal b. Middle--difficulty in sleeping through the
from all regular and pleasurable activities, often night without waking up and difficulty in
associated with depression. going back to sleep
- common sa MDD, withdrawal sa pleasurable c. Terminal- early morning awakening
activities 4. Hypersomnia- excessive sleeping.
11. Grief or mourning- sadness appropriate to real 5. Diurnal variation- mood is regularly worst in
loss the morning. immediately after awakening,
12. Alexithymia- inability or difficulty in describing or and improves as the day progresses
being aware of one's emotions or moods 6. Diminished libido- decreased sexual
(WITHOUT WORDS FOR EMOTIONS) interest, drive, and performance (increased
libido is often associated with manic states)
C. Other Emotions 7. Constipation- inability or difficulty in
defecating
1. Anxiety- feeling of apprehension caused by
anticipation of danger, which may be internal or
external
2. Free-floating anxiety- pervasive, unfocused fear III. Motor Behavior (conation): the aspect of the
not attached to any idea psyche that includes impulses, motivations, wishes,
3. Fear- anxiety caused by consciously reorganized drives, instincts and cravings as expressed by a
and realistic danger person's behavior or motor activity
4. Agitation- severe anxiety associated with motor 1. Echopraxia: pathological imitation of
restlessness movements of one person by another.
5. Tension- increased motor and psychological - kung ano ginagawa ng iba, gagawin din
activity that is unpleasant nito.
6. Panic- acute, episodic, intense attack of anxiety - common sa children (normal), abnormal sa
associated with overwhelming feelings of dread adult.
and autonomic discharge 2. Catatonia: motor anomalies in nor-organic
7. Apathy- dulled emotional tone associated with disorders (as opposed to disturbances of
detachment or indifference. consciousness and motor activity secondary
8. Ambivalence- coexistence of two opposing to organic pathology)
impulses toward the same thing in the same a. Catalepsy: general term of an immobile
person at the same time position that is constantly maintained ;
9. Abreaction- emotional release or discharge after hindi gumagalaw (immovable peron)
recalling a painful experience e.g. pumunta siya sa clinic tapos umupo
10. Shame- failure to live up to self-expectations siya kung ano pwesto niya from the start
11. Guilt - emotional secondary to doing what is after an hour yun pa rin pwesto niya.
perceiver as wrong b. Catatonic excitement: agitated,
D. Physiological disturbances associated with purposeless motor activity, uninfluenced
mood: signs of somatic (usually autonomic) by external stimuli

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 c. Catatonic stupor: markedly slowed e. Akathisis: subjective feeling of
motor activity, often to a point of muscular tension secondary to
immobility and seeming unawareness of antipsychotic or other medication which
surroundings can cause restlessness, pacing,
d. Catatonic rigidity: voluntary repeated sitting and standing; can be
assumption of a rigid posture, held mistaken for psychotic agitation (inability
against all efforts to be moved to sit still)
e. Catatonic posturing: voluntary f. Compulsion: uncontrollable impulse to
assumption of an inappropriate or perform an act repetitively
bizarre posture, generally maintained for i. Dipsomania: compulsion to drink
long periods of time alcohol
f. Cerea Felexibilitas (waxy flexibility): ii. Kleptomania: compulsion to steal
the person can be molded into a position iii. Nymphomania: excessive and
that is then maintained; when the compulsive need for coitus in a
examiner moves the person's limb, the man
limb feels as if it were made of wax. iv. Satyriasis: excessive and
3. Negativism: motiveless resistance to all compulsive need for coitus in a
attempts to be moved or to all instructions man
4. Cataplexy: temporary less of muscle tone v. Trichotillomania: compulsive to
and weak less precipitated by a variety of pull out one's hair
emotional states vi. Ritual: automatic activity,
5. Stereotype: repetitive fixed pattern of compulsive in nature. anxiety-
physical action or speech reducing in origin
6. Mannerism: ingrained, habitual involuntary g. Ataxia: failure of muscle coordination,
movement irregularity of muscle action
7. Automatism: automatic performance of an h. Polyphagia: pathological overeating
act or acts generally representative of 11. Hypoactivity (hypokinesis): decreased
unconscious symbolic activity motor and cognitive activity, as in
8. Command automatism: automatic following psychomotor retardation; visible slowing of
of suggestions (also called automatic thought, speech and movements
obedience) 12. Mimicry: simple, imitative motor activity of
9. Mutism: voicelessness without structural childhood
abnormalities 13. Aggression: forceful goal-directed action
10. Overactivity that may be verbal or physical, the motor
a. Psychomotor agitation: excessive counterpart of the affect or rage, anger or
motor and cognitive overactivity, usually hostility.
non-productive and in response to inner 14. Acting out: direct expression of an
tension unconscious wish or impulse in action;
b. Hyperactivity (hyperkinesis): restless, unconscious fantasy is lived out impulsively
aggressive, destructive activity, often in behavior
associated with some underlying brain 15. Abulia: reduced impulse to act and think,
pathology associated with indifference about
c. Tic: involuntary, spasmodic motor consequences of action; association with
movement neurological deficit (lack of initiative; non will)
d. Sleepwalking (somnambulism): motor
activity during sleep

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IV. Thinking: goal directed flow of ideas, symbols normally found in dreams abnormally in
and associations initiated by a problem or a task and psychosis.
leading toward a reality-oriented conclusion; when a
logical sequence occurs, thinking is normal, B. Specific disturbance in form of thought
parapraxis (unconsciously motivated lapse from logic 1. Neologism: new word created by the patient,
is also called Freudian slip) considered part of normal often by combining syllables of other words,
thinking. for idiosyncratic psychological reasons.
A. General disturbances in form or process of - kaya niya gumawa ng new terminologies
thinking. na siya lamang ang may alam
1. Mental disorder: Clinically significant behavioral 2. Word salad. Incoherent mixture of words
or psychological syndrome, associated with and phrases. Common sa bata
distress or disability. not just an expected 3. Circumstantiality: indirect speech that is
response to a particular event or limited to delayed in reaching the point but eventually
relations between the person and society. gets from original point to desired goal;
2. Psychosis: Inability to distinguish reality from characterized by an over inclusion of details
fantasy impaired testing, with the creation of a and parenthetical remarks.
new reality (as opposed to neurosis: mental - marami siyang pasikot-sikot sa
disorder in which reality testing is intact, behavior pagkukwento.
may not violate gross social norms, relatively 4. Tangentialtiy: inability to have goal-directed
enduring or recurrent without treatment. association of thought; patient never gets
3. Reality testing: the objective evaluation and from desired point to desired goal.
judgment of the world outside the self. - nagtanong ka tapos walang ayos na sagot
4. Formal thought disorder: disturbances in the ang nakuha mo.
form of thought, instead of the contend of thought; 5. Incoherence: thought that generally, is not
thinking characterized by loosened associations, understandable: running together of thoughts
neologisms and illogical constructs, thought or words with no logical or grammatical
process is disordered, and the person is defined connection, resulting in disorganizations.
as psychotic. 6. Perseveration: persisting response to a
5. Illogical thinking: containing erroneous prior stimulus after a new stimulus has been
conclusion or internal contradictions; it is presented often associated with cognitive
psychopathological only when it is marked and disorders.
when not caused by cultural values or intellectual - e.g. what is your name? JUAN. How old
deficit. are you? JUAN. Sino papa mo? JUAN.
6. Dereism: mental activity not concordant with 7. Verbigeration: meaningless repetition of
logic or experience. (mental activity that is specific words or phrases.
absorbed by fantasy) 8. Echolalia: psychological repeating of words
7. Autistic thinking: Preoccupation with inner, or phrases of one person by another; tends
private world; term used somewhat to be repetition and persistent. may be
synonymously with deresism. spoken with mocking or staccato intonation.
8. Magical thinking: a form of dereistic thought, 9. Condensation: fusion of various concepts
thinking that is similar to tat of the preoperational into one.
phase in children (jean Piaget), in which thoughts, 10. Irrelevant answer: answer that is not a
words or actions; assume power (for example, harmony with question asked (patient
they can cause or prevent events) appears to ignore or not attend to question)
9. Primary process thinking: general term for 11. Loosening of association: flow of thought
thinking that is dereistic, illogical, magical; in which ideas shift from one subject to
another in a completely unrelated way, when

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 severe speech may be incoherent (severe example, invaders from space have
thought disorder characterized by the lack of implanted electrodes in the patients brain)
an obvious connection between one thought b.Systematized delusion: false belief or
or phrase and the next.) belief united by a single event of theme
12. Derailment: gradual or sudden deviation in (for example, patient is being persecuted
rain of thought without blocking, sometimes by the CIA, the FBI, the Mafia, or the boss)
used synonymously with loosening of c.Mood-congruent delusion: delusion with
associations. mood- appropriate content (for example, a
13. Flight of ideas: rapid, continuous depressed patient believes that he or she
verbalization or plays on words produce is responsible for the destruction of the
constant shifting from one idea to another; world)
the ideas tend to be connected and in the d.Mood incongruent delusion: delusion with
less severe form a listener may be able to content that has no association to moods
follow them. or is mooed-neutral (for example, a
14. Clang association: association of words depressed patient has delusion of thought
similar in sound but not in meaning; words control or thought broadcasting)
have no logical connection, may include e.Nihilistic delusion: false feeling that self,
rhyming and punning. others or the world is nonexistent or
- dapat may rhyming ang sinasabi niya. ending.
15. Blocking: abrupt interruption in train of f. Delusion of poverty: false feeling that one
thinking before a thought or idea is finished, is bereft or will be deprived of all material
after a brief pause, the person indicates no possessions.
recall of what was being said or was going to g.Somatic delusion: false belief involving
be said (also known as thought deprivation) functioning of one's body (for example.
16. Glossolalia: the expression of a revelatory Belief that one's brain in rotting or melting)
message though unintelligible words (also h.Paranoid delusions: includes persecutor
known as speaking in tongues); not delusions and delusions of reference,
considered a disturbance in thought if control and grandeur (distinguished from
associated with practices of specific paranoid ideation, which suspiciousness
Pentecostal religions of less that delusional proportion)
i. Delusion of persecution: false
C. Specific disturbance in content of thought. belief that one is being harassed,
1. Poverty of content: thought that gives little cheated or persecuted, often found in
information because of vagueness, empty litigious patients who have a
repetitions, or obscure phrases. pathological tendency to take legal
- walang laman ang sinasabi. action because of imagined
2. Overvalued idea: unreasonable, sustained mistreatment.
false belief maintained less firmly than a ii. Delusion of grandeur: exaggerated
delusion. conception of one's importance,
3. Delusion: false belief, based on incorrect power or identity.
inference about external reality, not consistent iii. Delusion of reference: false belief
with patient's intelligence and cultural that the behavior of other refers to
background, that cannot be corrected by oneself; that events objects or other
reasoning. people have a particular and unusual
a.Bizarre delusion: An absurd, totally significance, usually of a negative
implausible. strange false belief (for nature, derived from idea of
references, in which one falsely feels

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 that one is being talked about by eliminated from consciousness by logical
other (for example, belief that on effort, which is associated with anxiety (also
television or radio to or about the termed rumination)
patient) 9. Compulsion: pathological need to act on an
i. Delusion of accusation: false feeling of impulse that, if resisted, produces anxiety,
remorse and guilt repetitive behavior in response to an
j. Delusion of control: external forces are obsession or performed according to certain
controlling false feeling that one's will rules, with no true end in itself other than to
thoughts or feeling. prevent something from occurring in the
i. Thought withdrawal: delusion that future.
other people or forces are removing 10. Copralalia: compulsive utterance of obscene
one's thoughts from one's mind. words.
ii. Thought Insertion: delusion that 11. Phobia: persistent, irrational, exaggerated,
other people or foces is implanting and invariably pathological dread of some
thoughts in one's mind. specific type of stimulus or situation; results in
iii. Though control: delusion that other a compelling desire to avoid the feared
people or forces though are stimulus.
controlling one's a.Specific phobia: circumscribed dread of a
k.Delusion of infidelity (delusional discrete object or situation (for example,
jealously): false belief derived from dread of spiders or snakes)
pathological jealously that one's love is b.Social phobia: dread of public humiliation,
unfaithful. as in fear of public speaking, performing,
l. Erotomania: delusional belief, more or eating in public.
common in women that in men, that c.Acrophobia: dread of high places
someone in deeply in love with them (also d.Agoraphobia: dread of open places.
known as Clerambault-Kandinsky e.Algophobia: dread of pain
complex) f. Ailurophobia: dread of cats.
m. Pseudologia phantastica: a type of lying g.Erythrophobia: dread of red (refers to fear
to belief in the reality of his or her of blushing)
fantasies and acts on them associated h.Panphobia: dread of everything
with Munchuasen syndrome; repeated i. Claustrophobia: dread of closed places.
feigning of illness. j. Xenophobia: dread of strangers
4. Trend or preoccupation of thought: k.Zoophobia: dread of animals.
centering of thought content on a particular 12. Noesis: a revelation in which immense
idea, associated with a strong affective tone, illumination occurs in association with a sense
such as paranoid trend or a suicidal or that one has been chosen to lead and
homicidal preoccupation> command,
5. Egomania: pathological self-preoccupation. 13. Unio mystica: an oceanic feeling, one of
6. Monomania: preoccupation with a single mystic unity with an infinite power, not
object. considered a disturbances in thought content
7. Hypochondria: exaggerated concern about it congruent with patient's religious or cultural
one's health that based not on real organic milieu.
pathology but rather on unrealistic
interpretations of physical signs or sensations
as abnormal. V. Speech: idea, thoughts, feelings as expresses
8. Obsession: pathological persistence of an through language, communication through the use of
irresistible thought or feeling that cannot be words and language.

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 A. Disturbances in speech 4. Syntactical aphasia: inability to arrange
words in proper sequence
1. Pressure of speech: rapid speech that is 5. Jargon aphasia: words produced are totally
increased in amount and difficult to interrupt neologisctic, non-sense words repeated with
2. Volubility (logorrhea): copious, coherent, various intonations and inflections.
logical speech. 6. Global aphasia: combination of a grossly
3. Poverty of speech: restriction in the amount non-fluent aphasia and severe fluent aphasia.
of speech used; Replies may be
monosyllabic
4. Non-spontaneous speech: verbal
responses given only when asked or spoken VI. Perception: process of transferring physical
to directly, no self-initiation of speech. simulation into psychological information; mental
5. Poverty of content of speech: speech that process by which sensory simul are brought to
is adequate in amount but conveys little awareness.
information because of vagueness, A. Disturbances of perception
emptiness or stereotyped phrases.
allucination: false sensory perception notloss
6. Dysprosody: associated
of normal with real external
speech melody stimuli; there may or may not be a delusional interpretation of
e hallucinatory experience. (called prosody)
Hypnagogic hallucination: false perception
7. Dysarthria: occurring
difficulty while fallingnot
in articulation, asleep;
in generally considered non-pathological phenomenon.
Hypnopompic hallucination: false perception
word finding or in grammar. occurring while awakening from sleep; generally considered non- pathological.
Auditory hallucination: 8. Excessively loud or soft speech: loss of other noises, such as music: most common hallucination in
false perception of sound, usually voices but also
psychiatric disorders. modulation of normal speech volume, may
Visual hallucination: falsereflect
perception
a varietyinvolving sight consisting
of pathological of both formed images (for example, people) and unformed images
conditions
(for example, flashes of light);
ranging from psychosis to depression todisorders.
most common in medically determined
Olfactory hallucination: false perception of smell, most common in medical disorders.
deadness.
Gustatory hallucination: false
9. Stuttering:perception frequent
of taste, suchrepetition
as unpleasant or taste caused by an uncinate seizure; most common in medical
disorders. prolongation of a sound or syllable, leading
Tactile (haptic) hallucination: false perception
to markedly impaired speechof touch or surface sensation, as from an amputated limb (phantom limb), crawling
fluency.
sensation on or under10.theClustering:
skin (formication) erratic and dysrhythmic speech,
Somatic hallucination: false sensation
consisting of things
of rapid occurring
and jerky spurts.in or to the body, most often visceral in origin (also known as cenesthesic
hallucination).
B. Aphasic
Lilliputian hallucination: falsedisturbances:
perception in which disturbances
objects arein language
seen as reduced in size (also termed micropsia).
output
Mood-congruent hallucination: hallucination in which the content is consistent with either a depressed or a manic mood (for example,
a depressed patient 1.hearsMotor
voicesaphasia:
saying thatdisturbances
the patient isofa bad person; a manic patient hears voices saying that the patient is of
speech
inflated worth, power, andcaused
knowledge).by a cognitive disorder in which
Mood-incongruent hallucination:
understanding hallucination
remains inbutwhich
abilitythe contentis is not consistent with either depressed or manic mood (for
to speak
example, in depression.grosslyHallucinations not involving such
impaired; speech in halting, laborious themes as guilt, deserved punishment, or inadequacy: in mania,
hallucinations involving such
andthemes
inaccurate as inflated worth as
(also known or power).
Broca's, non-
Hallucinosis: hallucinations, fluent and expressive aphasia) are associated with chronic alcohol abuse and that occur within a clear
most often auditory, that
sensorium, as opposed 2. toSensory
delirium tremens
aphasia:(DTS), organichallucinations
loss of ability thattooccur in the context of a clouded sensorium.
Synesthesia: sensation ofcomprehend
hallucinationthecaused meaning by another
of words;sensation
speech (for example, an auditory sensation is accompanied by or
triggers a visual sensation;is afluid
soundand spontaneous but incoherent or
is experienced as being seen, anda visual experience is heard)
Trailing phenomenon: perceptual abnormality associated
nonsensical (also known as Wernicke's with hallucinogenic drugs in which moving objects are seen as the series of
discrete and discontinuousfluent
images.and receptive aphasia)
3. Nominal aphasia: difficulty in finding correct
usion: misperception or misinterpretation of real
name for an object external
(also termedsensory
anomiastimuli.
and
amnestic aphasia)

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B. Disturbances associated with cognitive disorder: of Diagnostic and Statistical Manual Disorders
agnosia- an inability to recognize and interpret the DSM- IV)
significance of sensory compressions.
1. Anosognosia (ignorance of illness): inability to
recognize a neurological deficit as occurring to VII. Memory: function by which information stored in
oneself (there is nothing wrong with me!) the brain is later recalled to consciousness.
2. Somatopagnosia (ignorance of the body): A. Disturbances of Memory
inability recognize a body part as one's own.
3. Visual Agnosia: inability to recognize objects or 1. Amnesia: partial or total inability to recall past
person. experiences may be organic (brain mismo ang
4. Astereognosis: inability to recognize objects by may problem) or emotional in origin.
touch. Prosopagnosia: inability to recognize a. Anterograde: amnesia from events
faces. occurring after a point in time.
5. Apraxia: inability to carry out specific tasks. b. Retrograde: amnesia prior to a point in
Simultagnosis: inability to comprehend more lime. Past experiences
than one element of a visual scene at a time or to 2. Paramnesia: falsification of memory by
integrate the parts into a whole. distortion of recall.
6. Adiadochokinesia: inability to perform rapid a. Fausse reconnaissance: false
alternating events recognition.
b. Retrospective falsification: memory
C. Disturbances associated with conversion and becomes unintentionally (unconsciously)
dissociative phenomena: somatization of repressed distorted by being filtered though
material or the development of physical symptoms patient's present emotional cognitive,
and distortions involving the involuntary muscles or and experiential state.
special sense organs, not under the voluntary control c. Confabulation: unconscious filling of
and not explained by any physical disorder. gaps in memory by imagined or untrue
1. Hysterical anesthesia: loss of sensory experiences that patient believes but
modalities resulting from emotional conflicts. that have no basis in fact, most often
2. Macropsia: state in which objects seen smaller associated with organic pathology
than they are. d. Déjà vu: illusion of visual recognition in
3. Micropsia: state in which objects seem smaller which a new situation is incorrectly
than they are (both macropsia and micropsia can regarded as a repetition of a previous
also be associated with clear organic conditions, memory.
such as complex partial seizures) e. Déjà entendu: illusion of auditory
4. Depersonalization: a subjective sense of being recognition
unreal, strange or unfamiliar to oneself. 5. f. Dejà pensé: illusion that a new thought
5. Derealization: a subjective sense that the previously fell or expressed.
environment is strange or unreal feelings of g. Jamais vu: false feeling of unfamiliarity
changed reality. with a real situation one has
6. Fugue: taking on a new identity with amnesia for experienced
the old identity, often involves travel or wandering 3. Hypermnesia: exaggerated degree of retention
to new environments. and recall.
7. Multiple personality: one person who appears 4. Eidetic image: visual memory of almost
at different times to be more or more entirely hallucinatory vividness
different personalities and characters (called 5. Screen memory: a consciously tolerable
dissociative identity disorder in the fourth edition memory covering of a painful memory

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 6. Repression - a defense mechanism E. Abstract thinking: ability to appreciate nuances
characterized by unconscious forgetting of of meaning multidimensional thinking with ability
unacceptable ideas or impulses to use metaphors and hypothesis appropriately.
7. Lethologica - temporary inability to remember
a name or a proper noun
B. Levels of Memory IX. Insight: ability of the patient to understand the
1. Immediate: reproductive or recall of true cause and meaning of a situation (such as a set
perceived material seconds to minutes. of symptoms).
2. Recent: recall of events over past few days.
3. Recent past: recall of events over past few A. Intellectual insight: understanding of the
months. objective reality of a set of circumstances without
4. Remote: recall of events in distant past. the ability to apply the understanding in any
useful way to master the situation
B. True insight: understanding of the objective
VIII. Intelligence: The ability to understand, recall, reality of a situation, coupled with the motivation
mobilizes, and constrictively integrates previous and the emotional impetus to master the situation
learning in meeting new situation. C. Impaired insight: diminished ability to
understand the objective reality of the situation
A. Mental retardation: lack of intelligence to a
degree in which there is interference with social
and vocational performance: mild (1.Q. of 50 or X. Judgment: ability to assess a situation correctly
55 to approximately 70), moderate (1.Q. of 35 or and to objective reality of the situation.
40 to 55), severe (1.Q. of 20 or 25 to 35 or 40), or
profound (1.Q. below 20 or 25), obsolete terms A. Critical judgment: ability to assess,
are idiot (mental age less than 3 years), imbecile discerns, and chooses among various
(mental age of 3 to 7 years), and moron (mental options in a situation
age of about ) B. Automatic judgment: reflex performance of
B. Dementia: organic and global deterioration of an action
intellectual functioning without clouding of C. Impaired of judgment: diminished ability to
consciousness. understand a situation correctly and to act
1. Dyscalculia (acalculia): loss of ability to do appropriately.
calculations not caused by anxiety or
impairment in concentration
2. Dysgraphia (agraphia): loss of ability to CHAPTER V. ANXIETY DISORDER
write in cursive style, loss of word structure. - Different disorder under this nomenclature shares
3. Alexia: loss of a previously possessed the presence of “anxiety”
reading facility, not explained by defective - Anxiety is normal. Worry stems out from:
visual acuity ANXIETY; FEAR; PANIC
C. Pseudodemetia: clinical features resembling a
dementia not caused by an organic condition; WHAT GROWN UPS WORRY ABOUT?
most often caused by depression (dementia
syndrome of depression). 1. SCHOOL WORKS
D. Concrete thinking: literal thinking; limited use of 2. FRIENDSHIPS
metaphor without understanding of nuances of 3. PARENTS AND FAMILY
meaning multidimensional thought. 4. THINGS AT HOME; GETTING INTO
TROUBLE; BEILNG ILL; DARKNESS
5. APPEARANCES

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 Feel overwhelming tension, apprehension or
fear there is no actual danger; many take extreme
Anxiety actions to avoid the source of anxiety.
- Future-oriented state characterized by negative Causes of Anxiety Disorder
affect in which a person focuses in the possibility
of uncontrollable danger or misfortune. 1. BIOLOGICAL influences
- Negative mood state characterized by bodily A. inherited vulnerability to experience anxiety
symptoms of physical tension and by and/or panic attacks.
apprehension about the future.  Contributions from collection of genes in several
- Also called as “shadow of intelligence” -Howard areas on chromosomes that make us vulnerable
Liddell; black side na humaharang sa pag-iisip. to anxiety.
B. Activation of specific brain circuits,
Fear
neurotransmitters and neuro hormonal system.
- Immediate emotional reaction to current danger  High level of gamma-ammo (GABA)
characterized by strong escapist action 2. PSYCHOLOGICAL influences
tendencies. - Freud thought anxiety as a psychic reaction to
- Subjective sense of terror which motivate as to danger surrounding the reactivation of an infantile
escape (flee),or, possibly, to attack (flight) often fearful situation
called “flight or fight response” (sympathetic) - Behavioral theorist thought anxiety was the
- False alarm is when we experience the alarm product of early classical conditioning or other
response of fear when there is nothing to be forms of learning.
afraid of. - A general “sense of uncontrollably” may develop
- False alarm can lead to abnormalities. early as a function of upbringing and other
disruptive or traumatic environment factors.
Panic Attack - Parents who provide a “secure home” but allow
- Abrupt experience of intense fear or acute their children to explore their world and develop
discomfort accompanied by physical symptoms the necessary skills to cope with unexpected
that usually include heart palpitations, chest pain, occurrences enable their children to develop a
shortness of breath and possibly dizziness. healthy sense control.
- Three types of Panic Attack: - Parents who are overprotective and over
 Situationally bound intrusive and who “clear the way” for their
- if you are afraid of something and you children, never letting them experience any
might have panic attack in these situation adversity, create a situation in which children
but not anywhere else. never learn how to cope with adversity when it
 Unexpected comes along.
- if you m “doubting yourself, if intensifies, can lead to
 Situationally predisposed anxiety and fear.”
- attacks may or may not occur in specific
situation 3. SOCIAL influences
- Stressful life events trigger our biological and
When does ANXIETY becomes a disorder? physiological vulnerabilities to anxiety. Most are
social and interpersonal in nature – marriage,
When anxiety occurs in appropriate time
divorce, difficulties at works, death of a love one
occurs frequently so intense and long lasting that
etc.
interferes with a person’s normal activities.
People with Anxiety Disorder

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 ANXIETY DISORDERS

SEPARATION ANXIETY DISORDER (SAD)

- EXCESSIVE FEAR or anxiety concerning
SEPARATION from home or attachment figure.
- May exhibit social withdrawal, apathy, sadness or
Figure. The three vulnerabilities that contribute to the development of anxiety difficulty concentrating on work or play.
disorders. If individual possess all three, there is a 100% chance that if you
encounter a stressful event you’ll develop a anxiety disorder. - SAD in children may lead to school refusal, which
in turn may lead to academic difficulties and
Comorbidity social isolation.
- Co-occurrence of two or more disorder in an - Disorder may be described as demanding,
individual. intrusive and in need of constant attention
and as adults may appear dependent and
Comorbidity of anxiety and related disorder overprotective.
- Separation anxiety from attachment figures are
Anxiety and Mood disorder
part of normal early development and may
- Results indicate that 55% of the patient who indicate the development of secure attachment
received principal diagnosis of anxiety of relationships.
depressive disorder at the time of assessment. RISK FACTORS: Environmental & Genetic &
Physiological
Comorbidity of anxiety disorder with physical PREVALENCE: younger than 12 years old.
disorder
- An important study indicated that the presence of DIAGNOSTIC CRITERIA 309.21
any anxiety disorder was uniquely and (F93.0)
significantly associated with thyroid disease,
respiratory disease, gastrointestinal disease, A. Developmentally inappropriate and
arthritis, migraine headaches and allergies. excessive fear or anxiety concerning
- Other studies also found the same relationship separation from those to whom the individual
between anxiety disorders, particularly panic is attached, as evidenced by at least three of
disorders, and cardiovascular (heart) disease. the following:
1. Recurrent excessive distress when
Suicide anticipating or experiencing
separation from home or from major
- (Weismann study) having any anxiety or related attachment figures.
disorder, not just panic disorder, uniquely 2. Persistent and excessive worry
increases the chances of having thought about about losing major attachment
suicide (suicidal ideation) or making suicidal figures or about possible harm to
attempts. them, such as illness, injury,
- a later epidemiological study reported that all disasters or death.
anxiety disorders are associated with an 3. Persistent and excessive worry
increased risk for suicide attempts and suicidal about experiencing an untoward
ideations, even after accounting for mood event (e.g.Getting lost, being
disorders, such as dysthymia, major depressive kidnapped, having an accident,
disorder, and bipolar disorder, as well as becoming ill) that causes
separation from a major attachment
substance use disorder.
figure.
4. Persistent reluctance or refusal to

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 go out, be away from home, go to - Disturbance is often marked by high social
school, go to work, or elsewhere anxiety
because of fear of separation. - Hindi nagsasalita unless trusted ang kausap.
5. Persistent and excessive fear or - Lack of speech interfere social communication.
reluctance about being alone or - They couldn’t spoke what’s on their mind.
without major attachment figures at - Associated features of selective mutism include
home or in other settings. excessive shyness, fear of social embarrassment,
6. Persistent reluctance or refusal to social isolation and withdrawal, clinging,
sleep away from home or to go to
compulsive traits, negativism, temper tantrums or
sleep without being near a major
attachment figure. mild oppositional behavior.
7. Repeated nightmares involving the - rare disorder
theme of separation. - manifest in young children than in adolescents
8. Repeated complaints of physical and adults.
symptoms (e.g.headaches,
RISK FACTORS: temperamental, environmental,
stomach aches, nausea, vomiting)
genetic and physiological factors.
when separation from major
attachment figures occurs or is PREVALENCE: 0.03% and 1% of the whole
anticipated. population.
B. The fear, anxiety, or avoidance is persistent,
lasting at least 4 weeks in children and ONSET: before age 5 years, but the disturbance may
adolescents and typically 6 months or more not come to clinical attention until entry to school,
in adults. where there is an increase in social interaction and
C. The disturbance causes clinically significant performance tasks, such as reading aloud.
distress or impairment in social, academic,
occupational, or other important areas of NOTE: if hindi nagsasalita totally possible speech
functioning. disability na ito; dapat nagsasalita siya before.
D. The disturbance is not better explained by
another mental disorder, such as refusing to DIAGNOSTIC CRITERIA
leave home because of excessive resistance 312.23(F94.0)
to change in autism spectrum disorder;
delusions or hallucinations concerning A. Consistent failure to speak in specific social
separation in psychotic disorders; refusal to situations in which there is an expectation for
go outside without a trusted companion in speaking (e.g., at school) despite speaking in
agoraphobia; worries about ill health or other other situations.
harm befalling significant others in B. The disturbance interferes with educational or
generalized anxiety disorder; or concerns
occupational achievement or with social
about having an illness in illness anxiety
communication.
disorder.
C. The duration of the disturbance is at least one
month (not limited to the first month of school).
D. The failure to speak is not attributable to a lack
SELECTIVE MUTISM (SM) of knowledge of, or comfort with, the spoken
- Children with SM do not initiate speech or language required in the social situation.
reciprocally respond when spoken to by others. E. The disturbance is not better explained by a
- Children w/ SM will speak in their home in communication disorder (e.g., stuttering) and
presence of immediate family members but often does not occur exclusively during the course
not even in front of close friends or second- of autism spectrum disorder, schizophrenia, or
degree relatives, such as grandparents or another psychotic disorder.
cousins.

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SPECIFIC PHOBIA clinically significant distress or impairment in
social, occupational, or other important areas
- IRRATIONAL FEAR of a specific object or
of functioning.
situation that markedly interferes with individuals’
F. The fear, anxiety, or avoidance is persistent,
ability to function.
typically lasting for 6 months or more.
- Four major subtypes of SP
G. The disturbance is not better explained by the
 Blood-Injection-Injury type symptoms of another mental disorder,
 Situational type including fear, anxiety, and avoidance of
 Natural Environment type situations associated with panic-like symptoms
 Animal type or other incapacitating symptoms; objects or
Blood-Injection-Injury type situations related to obsessions; reminders of
traumatic events; separation from home or
- Always differ in their physiological reaction from attachment figures; or social situations.
people with other types of phobia.
- May kinalaman sa MEDICAL SUPPLIES and Specify if:
SUGAT. Code based on the phobic stimulus:
Situational type (man-made places) 300.29 (F40.218) Animal
- Phobias characterized by fear of public 300.29 (F40.228) Natural Environment
transportations or enclosed places.
300.29 (F40.23x) Blood-Injection-Injury
Natural Environment type
Coding note: select specific ICD-10 code as
- Young people developed fears of situation of follows:
events occurring in nature
- Major examples are heights, storms and water.  F40.232 – fear of blood;
 F40.231 – fear of injections and
Animal type transfusions;
- Fear to all types of animals and insects.  F40.232 – fear of other medical care; or
 F40.233 – fear of injury.
Treatment
309.29 (F40.248) Situational
- Systematic desensitization – require structured
and consistent exposure-based exercises. 309.29 (F40.298) Other (situations that may
- Fairly straightforward lead to choking, vomiting; in
children. e.g., loud sounds or
DIAGNOSTIC CRITERIA costumed characters.

A. Marked fear or anxiety about a specific object Coding note: when more than one phobic
or situation. stimulus is present code all ICD-10-CM codes that
B. The phobic object or situation almost always apply (e.g., for fear of snakes an flying.F40.218
provokes immediate fear or anxiety. specific phobia, animal and F40.248 specific
C. The fear or anxiety is out of proportion to the phobia, situational)
actual danger posed by the specific object or
situation and to the sociocultural context.
D. The phobic object or situation is actively SOCIAL ANXIETY DISORDER (SOCIAL PHOBIA)
avoided or endured with intense fear or
- SAD is more than exaggerated shyness
anxiety.
E. The fear, anxiety, or avoidance causes

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- Common if individual is very anxious only while context.
others are present and maybe watching and, to
some extent, evaluating their behavior. The fear, anxiety, or avoidance is persistent,
- People have no difficulty eating, writing or typically lasting for 6 months or more.
urinating in private only when others are watching The fear, anxiety or avoidance causes clinically
does the behavior deteriorate. significant distress or impairment in social,
- Inadequately assertive or excessively submissive occupational or other important areas of
or, less commonly highly controlling of functioning.
conversation
- Blushing is the hallmark. The fear, anxiety or avoidance is not attributable to
physiological effects of a substance (e.g., a drug of
Prevalence: abuse, medication) or another medication.
- 12% of general population suffer from SAD at The fear, anxiety or avoidance is not better
some point of their lives (western); Sex ratio – explained by the symptoms of another mental
50:50. HINDI ITO COMMON SA PILIPINAS. disorder, such as panic disorder, body dysmorphic
- SAD secondly only to specific phobia as most disorder, or autism spectrum disorder.
prevalent anxiety disorder, afflicting more than 35
million people. If another medical condition (e.g., Parkinson’s
- Prevalent in people who are young (18-29 yrs), disease, obesity, disfigurement from burns or
undereducated, single and low economic status. injury) is present, the fear, anxiety or avoidance is
clearly unrelated or is excessive.
NOTE: if sa public speaking lamang nakakaranas ng
SAD. SPECIFY: PUBLIC SPEAKING. Specify if:
Performance only: if the fear is restricted to
DIAGNOSTIC CRITERIA speaking or performing in public.
300.23(F40.10)
Marked fear of anxiety about one or more social
situations in which the individual is exposed to PANIC DISORDER
possible scrutiny by others. Examples include - Had one or more panic attacks and are anxious
social interactions (e.g., having a conversation, and fearful about having future attacks.
meeting unfamiliar people), being observed (e.g., - A person having panic attack feels.
eating or drinking), and performing in front of  Apprehension leading to intense fear
others (e.g., giving a speech).
 Sensation of “going crazy” or losing of control
Note: In children, anxiety must occur in peer  Physical signs of distress, racing heartbeat, rapid
settings and not just during interactions with adults. breathing, dizziness, nausea or sensation of
heart attack or imminent death.
The individual fears that he/she will act in a way or
show anxiety symptoms that will be negatively Nocturnal Panic
evaluated. (i.e., will be humiliating or
- People are afraid to go to sleep at night. Panic
embarrassing; will lead to rejection or offend
attack may occur between 1:30 a.m. to 3:30 a.m.
others)
than any other time.
The social situations are avoided or endured with
Agoraphobia
intense fear or anxiety.
- Before (kind of phobia); irrational fear of
The fear or anxiety is our of proportion to the actual
avoidance of situations, people or place where it
threat posed by social situation and to sociocultural
would be unsafe to have panic attack: malls,

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 grocery stores, etc. In extreme, inability to leave heart rate.
their houses or even specific room. 2. Sweating.
- Begins after panic attack but can continue for 3. Trembling or shaking.
years even if no other attacks occur 4. Sensations of shortness of breath or
- “marketplace phobia” smothering.
- Nangyayari ang panic attack sa agoraphobia 5. Feelings of choking.
kapag nakakaharap nila yung irrational fear nila. 6. Chest pain or discomfort.
- Two types: 7. Nausea or abdominal distress.
 Panic Disorder with Agoraphobia (PDA) 8. Feeling dizzy, unsteady, light-headed, or faint.
o Individuals experience severe, unexpected 9. Chills or heat sensations.
panic attacks, they may think they’re dying or 10. Paresthesias (numbness or tingling
otherwise losing control. sensations).
o They have fear and avoidance of situation in 11. Derealization (feelings of unreality) or
which they would feel unsafe in event of panic depersonalization (being detached from one-
attack or symptoms. self).
 Panic Disorder without Agoraphobia 12. Fear of losing control or "going crazy."
o People who has panic attacks but not 13. Fear of dying.
necessarily develop panic disorder.
NOTE: Note: Culture-specific symptoms (e.g., tinnitus,
neck soreness, headache, uncontrollable
Approximately 2.7% of the population meet screaming or crying) may be seen. Such
criteria for PD or PDA during a given 1 year period symptoms should not count as one of the four
and two-thirds of them are women. required symptoms.

PD PDA B. At least one of the attacks has been followed by

1 month (or more) of one or both of the following:
Unexpected. Situationally Bound
1. Persistent concern or worry about
Hindi natutukoy kung Alam kung kalian additional panic attacks or their
kalian susunod mangyayari mangyayari ang susunod consequences (e.g., losing control, having
ang panic attack na panic attack. a heart attack, "going crazy").
2. A significant maladaptive change in
behavior related to the attacks (e.g.,
behaviors designed to avoid having panic
PANIC DISORDER attacks, such as avoidance of exercise or
DIAGNOSTIC CRITERIA 300.01 unfamiliar situations).
(F41.0) C. The disturbance is not attributable to the
physiological effects of a substance (e.g., a drug of
A. Recurrent unexpected panic attacks. A panic
abuse, a medication) or another medical condition
attack is an abrupt surge of intense fear or intense
(e.g., hyperthyroidism, cardiopulmonary disorders).
discomfort that reaches a peak within minutes, and
during which time four (or more) of the following D. The disturbance is not better explained by
symptoms occur. another mental disorder (e.g., the panic at- tacks
do not occur only in response to feared social
Note: The abrupt surge can occur from a calm
situations, as in social anxiety dis- order; in
state or an anxious state.
response to circumscribed phobic objects or
1. Palpitations, pounding heart, or accelerated situations, as in specific phobia; in response to

CARISSA MAE D. MAGTIBAY | BSP 

obsessions, as in obsessive-compulsive disorder;
H. If another medical condition (e.g., inflammatory
in response to re- minders of traumatic events, as
bowel disease, Parkinson's disease) is present, the
in posttraumatic stress disorder; or in response to
fear, anxiety, or avoidance is clearly excessive.
separation from attachment figures, as in
separation anxiety disorder). I. The fear, anxiety, or avoidance is not better
explained by the symptoms of another mental
disorder-for example, the symptoms are not
confined to specific phobia, situational type; do not
AGORAPHOBIA involve only social situations (as in social anxiety
DIAGNOSTIC CRITERIA 300.22 disorder); and are not related exclusively to
(F40.00) obsessions (as in obsessive-compulsive disorder),
perceived defects or flaws in physical appearance
A. Marked fear or anxiety about two (or more) of (as in body dysmorphic disorder), reminders of
the following five situations: traumatic events (as in posttraumatic stress
disorder), or fear of separation (as in separation
1. Using public transportation (e.g.,
anxiety disorder).
automobiles, buses, trains, ships, planes).
2. Being in open spaces (e.g., parking lots,
marketplaces, bridges).
3. Being in enclosed places (e.g., shops, Note: Agoraphobia is diagnosed irrespective of the
theaters, cinemas). presence of panic disorder. If an individual's
4. Standing in line or being in a crowd. presentation meets criteria for panic disorder and
5. Being outside of the home alone. agoraphobia, both diagnoses should be assigned.

B. The individual fears or avoids these situations TREATMENT

because of thoughts that escape might be difficult - Medication: various drugs on panic anxiety.
or help might not be available in the event of - Psychological Intervention – treatments
developing panic-like symptoms or other concentrated on reducing agoraphobic avoidance
incapacitating or embarrassing symptoms (e.g., using strategies based on exposure to feared
fear of falling in the elderly, fear of incontinence). situation.
C. The agoraphobic situations almost always - Combined Psychological and Drug Treatment
provoke fear or anxiety. D. The agoraphobic – patients referred for psychological treatment
situations are actively avoided, require the but are often already taking medication.
presence of a companion,or are endured with
intense fear or anxiety.
GENERALIZED ANXIETY DISORDER
- Lahat pinoproblema
E. The fear or anxiety is out of proportion to the - They find it hard to focus to everyday life.
actual danger posed by the agoraphobic situations
and to the sociocultural context.
DIAGNOSTIC CRITERIA 300.02
F. The fear, anxiety, or avoidance is persistent, (F41.1)
typically lasting for 6 months or more.
A. Excessive anxiety and worry (apprehensive
G. The fear, anxiety, or avoidance causes clinically expectation), occurring more days than not for at
significant distress or impairment in social, least 6 months, about a number of events or
occupational, or other important areas of activities (such as work or school performance).
functioning.
B. The individual finds it difficult to control the

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worry. C. The anxiety and worry are associated - Highlight: nightmares of flashbacks (of
with three (or more) of the following six symptoms traumatic event); re-experience the trauma
(with at least some symptoms having been present (what you feel during the traumatic event, you
for more days than not for the past 6 months): may feel it again and again in the time of your
life).
Note: Only one item is required in children. - Avoidance of intense feeling of events thru
1. Restlessness or feeling keyed up or on emotional numbing (pamamanhid/ pakiramdam
edge. na wala ka ng nararamdaman sa sobrang sakit.
2. Being easily fatigued. Statistics
3. Difficulty concentrating or mind going blank.
4. Irritability. - Surveys indicate that among population as a
5. Muscle Tension whole, 6.8% have experienced PTSD at some
6. Sleep disturbance (difficulty falling or staying point of their lives.
asleep, or restless, unsatisfying sleep).
D. The anxiety, worry, or physical symptoms cause DIAGNOSTIC CRITERIA 309.81
clinically significant distress or impairment in (F43.10)
social, occupational, or other important areas of Note: The following criteria apply to adults,
functioning. adolescents, and children older than 6 years. For
E. The disturbance is not attributable to the children 6 years and younger, see corresponding
physiological effects of a substance (e.g., a drug of criteria below.
abuse, a medication) or another medical condition A. Exposure to actual or threatened death, serious
(e.g., hyperthyroidism). injury, or sexual violence in one (or more) of the
F. The disturbance is not better explained by following ways:
another mental disorder (e.g., anxiety or worry 1. Directly experiencing the traumatic event(s).
about having panic attacks in panic disorder, 2. Witnessing, in person, the event(s) as it
negative evaluation in social anxiety disorder occurred to others.
[social phobia), contamination or other obsessions 3. Leaming that the traumatic event(s) occurred
in obsessive-compulsive disorder, separation from to a close family member or close friend. In
attachment figures in separation anxiety disorder, cases of actual or threatened death of a family
reminders of traumatic events in posttraumatic member or friend, the event(s) must have
stress disorder, gaining weight in anorexia been violent or accidental.
nervosa, physical complaints in somatic symptom 4. Experiencing repeated or extreme exposure to
disorder, perceived appearance flaws in body aversive details of the traumatic event(s) (e.g.,
dysmorphic disorder, having a serious illness in first responders collecting human remains;
illness anxiety disorder, or the content of delusional police officers repeatedly exposed to details of
beliefs in schizophrenia or delusional disorder). child abuse).
Note: Criterion A4 does not apply to exposure
through electronic media, television, movies,
POSTTRAUMATIC STRESS DISORDER or pictures, unless this exposure is work
related.
- Fear of re-experiencing a traumatic event, such
as rape, war, life-threatening situations, etc.
- Subjective (p’wedeng hindi life-threatening sa’yo
ang experience ng iba pero life-threatening ito sa B. Presence of one (or more) of the following
kanila.) intrusion symptoms associated with the traumatic
event(s), beginning after the traumatic event(s)

CARISSA MAE D. MAGTIBAY | BSP 

occurred: associated with the traumatic event(s). beginning
or worsening after the traumatic event(s) occurred,
1. Recurrent, involuntary, and intrusive
as evidenced by two (or more) of the following:
distressing memories of the traumatic
event(s). 1. Inability to remember an important aspect of
Note: In children older than 6 years, repetitive the traumatic event(s) (typically due to dis-
play may occur in which themes or aspects of sociative amnesia and not to other factors
the traumatic event(s) are expressed. such as head injury, alcohol, or drugs).
2. Persistent and exaggerated negative beliefs or
expectations about oneself, others, or the
2. Recurrent distressing dreams in which the world (e.g., "I am bad," "No one can be
content and/or affect of the dream are related trusted," "The world is completely dangerous,"
to the traumatic event(s). "My whole nervous system is permanently
Note: In children, there may be frightening ruined").
dreams without recognizable content. 3. Persistent, distorted cognitions about the
3. Dissociative reactions (e.g., flashbacks) in cause or consequences of the traumatic
which the individual feels or acts as if the event(s) that lead the individual to blame
traumatic event(s) were recurring. (Such himself/herself or others.
reactions may occur on a continuum, with the 4. Persistent negative emotional state (e.g., fear,
most extreme expression being a complete horror, anger, guilt, or shame).
loss of awareness of present surroundings.) 5. Markedly diminished interest or participation in
Note: In children, trauma-specific reenactment significant activities.
may occur in play. 6. Feelings of detachment or estrangement from
4. Intense or prolonged psychological distress at others.
exposure to internal or external cues that 7. Persistent inability to experience positive
symbolize or resemble an aspect of the emotions (e.g., inability to experience
traumatic event(s). happiness, satisfaction, or loving feelings).
5. Marked physiological reactions to internal or
E. Marked alterations in arousal and reactivity
external cues that symbolize or resemble an
associated with the traumatic event(s), be- ginning
aspect of the traumatic event(s).
or worsening after the traumatic event(s) occurred,
as evidenced by two (or more) of the following:

C. Persistent avoidance of stimuli associated with 1. Irritable behavior and angry outbursts (with
the traumatic event(s), beginning after the little or no provocation) typically ex- pressed
traumatic event(s) occurred, as evidenced by one as verbal or physical aggression toward
or both of the following: people or objects.
2. Reckless or self-destructive behavior.
1. Avoidance of or efforts to avoid distressing 3. Hypervigilance.
memories, thoughts, or feelings about or 4. Exaggerated startle response.
closely associated with the traumatic event(s). 5. Problems with concentration.
2. Avoidance of or efforts to avoid external 6. Sleep disturbance (e.g, difficulty falling or
reminders (people, places, conversations, staying asleep or restless sleep).
activities, objects, situations) that arouse
distressing memories, thoughts, or feelings F. Duration of the disturbance (Criteria B, C, D,
about or closely associated with the traumatic and E) is more than 1 month.
event(s).
G. The disturbance causes clinically significant
D. Negative alterations in cognitions and mood distress or impairment in social, occupattional, or

CARISSA MAE D. MAGTIBAY | BSP 

other important areas of functioning. actual or threatened death, serious injury. or
sexual violence in one (or more) of the following
H. The disturbance is not attributable to the
ways:
physiological effects of a substance (e.g.
medication, alcohol) or another medical condition. 1. Directly experiencing the traumatic event(s).
2. Witnessing, in person, the event(s) as it
occurred to others, especially primary care-
Specify whether: givers.
Note: Witnessing does not include events that
With dissociative symptoms: The individual's are witnessed only in electronic me dia,
symptoms meet the criteria for post- traumatic television, movies, or pictures.
stress disorder, and in addition, in response to the 3. Learning that the traumatic event(s) occurred
stressor, the individual experiences persistent or to a parent or caregiving figure.
recurrent symptoms of either of the following:
1. Depersonalization: Persistent or recurrent
experiences of feeling detached from, and as if one B. Presence of one (or more) of the following
were an outside observer of, one's mental intrusion symptoms associated with the traumatic
processes or body (e.g.. feeling as though one event(s), beginning after the traumatic event(s)
were in a dream; feeling a sense of unreality of self occurred:
or body or of time moving slowly). 1. Recurrent, involuntary, and intrusive
2. Derealization: Persistent or recurrent distressing memories of the traumatic
experiences of unreality of surroundings (e.g., the event(s).
world around the individual is experienced as Note: Spontaneous and intrusive memories
unreal, dreamlike, distant, or distorted). may not necessarily appear distress- ing and
may be expressed as play reenactment.
2. Recurrent distressing dreams in which the
Note: To use this subtype, the dissociative content and/or affect of the dream are related
symptoms must not be attributable to the to the traumatic event(s).
physiological effects of a substance (e.g., Note: It may not be possible to ascertain that
blackouts, behavior during alcohol intoxication) or the frightening content is related to the
another medical condition (e.g., complex partial traumatic event.
seizures). 3. Dissociative reactions (e.g., flashbacks) in
which the child feels or acts as if the traumatic
event(s) were recurring. (Such reactions may
occur on a continuum, with the most extreme
Specify it:
expression being a complete loss of
With delayed expression: If the full diagnostic awareness of present surroundings.) Such
criteria are not met until at least 6 months after the trauma-specific reenactment may occur in
event (although the onset and expression of some play.
symptoms may be immediate). 4. Intense or prolonged psychological distress at
exposure to internal or external cues that
symbolize or resemble an aspect of the
Posttraumatic Stress Disorder for Children 6 traumatic event(s).
Years and Younger 5. Marked physiological reactions to reminders of
the traumatic event(s).
C. One (or more) of the following symptoms,
A. In children 6 years and younger, exposure to

CARISSA MAE D. MAGTIBAY | BSP 

representing either persistent avoidance of stimuli school behavior.
associated with the traumatic event(s) or negative
G. The disturbance is not attributable to the
alterations in cognitions and mood associated with
physiological effects of a substance (e.g..
the traumatic event(s), must be present, beginning
medication or alcohol) or another medical
after the event(s) or worsening after the event(s):
condition.
Persistent Avoidance of Stimuli
1. Avoidance of or efforts to avoid activities,
places, or physical reminders that arouse Specify whether:
recollections of the traumatic event(s). With dissociative symptoms: The individual's
2. Avoidance of or efforts to avoid people, symptoms meet the criteria for post- traumatic
conversations, or interpersonal situations that stress disorder, and the individual experiences
arouse recollections of the traumatic event(s). persistent or recurrent symptoms of either of the
following:
Negative Alterations in Cognitions
1. Depersonalization: Persistent or recurrent
3. Substantially increased frequency of negative
experiences of feeling detached from, and as if one
emotional states (e.g., fear, guilt, sadness,
were an outside observer of, one's mental
shame, confusion).
4. Markedly diminished interest or participation in processes or body (e.g... feeling as though one
significant activities, including constriction of were in a dream; feeling a sense of unreality of self
play. or body or of time moving slowly).
5. Socially withdrawn behavior. 2. Derealization: Persistent or recurrent
6. Persistent reduction in expression of positive experiences of unreality of surroundings (e.g., the
emotions. world around the individual is experienced as
unreal, dreamlike, distant, or distorted).
Note: To use this subtype, the dissociative
D. Alterations in arousal and reactivity associated
symptoms must not be attributable to the
with the traumatic event(s), beginning or worsening
physiological effects of a substance (eg, blackouts)
after the traumatic event(s) occurred, as evidenced
or another medical condition (e.g., complex partial
by two (or more) of the following:
seizures).
1. Irritable behavior and angry outbursts
(with little or no provocation) typically ex-
pressed as verbal or physical aggression Specify if:
toward people or objects (including
extreme temper tantrums). With delayed expression: If the full diagnostic
2. Hypervigilance. criteria are not met until at least 6 months after the
3. Exaggerated startle response. event (although the onset and expression of some
4. Problems with concentration. symptoms may be immediate).
5. Sleep disturbance (e.g., difficulty falling or Treatment
staying asleep or restless sleep).
- From psychological point of view, most clinician
E. The duration of the disturbance is more than 1 agree that victims of PTSD should face the
month. original trauma, process the intense emotions,
F. The disturbance causes clinically significant and develop effective coping procedures in order
distress or impairment in relationships with to overcome the debilitating effects of disorder.
parents, siblings, peers, or other caregivers or with - Cognitive Behavioral Therapy.

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 (F42)
OBSESSIVE-COMPULSIVE DISORDER A. Presence of obsessions, compulsions, or both
OBSESSIONS are recurrent and persistent thoughts, Obsessions are defined by (1) and (2):
urges, images that are experienced as intrusive and
unwanted. WHAT YOU THINK 1. Recurrent and persistent thoughts, urges, or
images that are experienced, at some time
COMPULSIONS are repetitive behaviors or mental during the disturbance, as intrusive and
acts that an individual feels driven to perform in unwanted, and that in most individuals cause
response to an obsession or according to rules that marked anxiety or distress.
must be applied rigidly. WHAT YOU DO TO FULFILL 2. The individual attempts to ignore or suppress
THE IDEA OF OBSESSION. such thoughts, urges, or images, or to
neutralize them with some other thought or
Statistics
action (Le., by performing a compulsion)
Prevalence of OCD range from 1.6% - 2.3%.
Compulsions are defined by (1) and (2):
Once OCD develop, it tend to become chronic
(lifetime) 1. Repetitive behaviors (e.g., hand washing,
ordering, checking) or mental acts (e.g
Causes
praying, counting, repeating words silently)
Brain circuit from specific areas of frontal that the individual feels driven to per- form in
cortex to areas of basal ganglia called the striatum, response to an obsession or according to
then thru basal ganglia to thalamus then loop it back rules that must be applied rigidly.
to frontal cortex. 2. The behaviors or mental acts are aimed at
preventing or reducing anxiety or dis tress, or
Thought-action-fusion equate thoughts with preventing some dreaded event or situation;
specific actions or activity represented by the however, these behaviors or mental acts are
thoughts (obligado silang gawin ang isang bagay na not connected in a realistic way with what they
iniisip nila) are designed to neutralize or prevent, or are
clearly excessive.
Note: Young children may not be able to articulate
the aims of these behaviors or mental acts.
B. The obsessions or compulsions are time-
consuming (e.g., take more than 1 hour per day) or
cause clinically significant distress or impairment in
social, occupational, or other important areas of
functioning.
C. The obsessive-compulsive symptoms are not
attributable to the physiological effects of a
substance (eg, a drug of abuse, a medication) or
another medical condition.
D. The disturbance is not better explained by the
symptoms of another mental disorder (e.g,
excessive worries, as in generalized anxiety
disorder; preoccupation with appearance, as in
DIAGNOSTIC CRITERIA 300.3 body dysmorphic disorder; difficulty discarding or

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parting with possessions, as in hoarding disorder; - People with BDD complains of persistent,
hair pulling, as in trichotillomania [hair-pulling intrusive and horrible thoughts about their
disorder]: skin picking, as in excoriation (skin- appearance, and they engage in such
picking] disorder; stereotypies, as in stereotypic compulsive behaviors as repeatedly looking in
movement disorder; ritualized eating behavior, as mirrors to check their physical features.
in eating disorders; preoccupation with substances
or gambling, as in substance related and addictive DIAGNOSTIC CRITERIA 300.7
disorders; preoccupation with having an illness, as (F45.22)
in illness anxiety disorder; sexual urges or
fantasies, as in paraphilic disorders; impulses, as A. Preoccupation with one or more perceived
in disruptive, impulse control, and conduct defects or flaws in physical appearance that are
disorders; guilty ruminations, as in major not observable or appear slight to others.
depressive disorder, thought insertion or delusional B. At some point during the course of the disorder,
preoccupations, as in schizophrenia spectrum and the individual has performed repetitive behaviors
other psychotic disorders; or repetitive patterns of (e.g., mirror checking, excessive grooming, skin
behavior, as in autism spectrum disorder). picking, reassurance seeking) or mental acts (e.g.,
Specify if: comparing his or her appearance with that of
others) in response to the appearance concerns.
With good or fair Insight: The individual
recognizes that obsessive-compulsive disorder C. The preoccupation causes clinically significant
beliefs are definitely or probably not true or that distress or impairment in social, occupational, or
they may or may not be true. other important areas of functioning.

With poor Insight: The individual thinks

obsessive-compulsive disorder beliefs are probably D. The appearance preoccupation is not better
true. explained by concerns with body fat or weight in an
With absent insight/delusional beliefs: The individual whose symptoms meet diagnostic
individual is completely convinced that obsessive- criteria for an eating disorder.
compulsive disorder beliefs are true. Specify it:
Specify if: With muscle dysmorphia: The individual is
Tic-related: The individual has a current or past preoccupied with the idea that his or her body build
history of a tic disorder. is too small or insufficiently muscular. This specifier
is used even if the individual is preoccupied with
Treatment other body areas, which is often the case.
- Selective serotonin reuptake inhibitor (SSRI) or Specify it:
clomipramine
- Exposure and Ritual Prevention Therapy (ERP) Indicate degree of insight regarding body
- Psychotherapy (open brain surgery) winrate dysmorphic disorder beliefs (e.g., "I look ugly" or "I
70/30 look deformed").
With good or fair Insight: The individual
recognizes that the body dysmorphic disorder
BODY DYSMORPHIC DISORDER beliefs are definitely or probably not true or that
they may or may not be true.
- Preoccupation with some imagined defect in
appearance by someone who actually looks With poor insight: The individual thinks that the
reasonably normal. body dysmorphic beliefs are probably true.

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 compromises their intended use. If living areas are
With absent insight/delusional beliefs: individual
uncluttered, it is only because of the interventions
is completely convinced that the body dysmorphic
of third parties (e.g., family members, cleaners,
disorder beliefs are true.
authorities).
Statistics D. The hoarding causes clinically significant
Prevalence of BDD is hard to estimate distress or impairment in social, occupational, or
because it very nature tend to kept secret. other important areas of functioning (including
maintaining a safe environment for self and
BDD seen equally in men and women but others).
they exhibit different concern.
E. The hoarding is not attributable to another
Causes medical condition (e.g., brain injury,
cerebrovascular disease, Prader-Willi syndrome).
- Social and cultural determinants of beauty and
body image largely define what is deformed. F. The hoarding is not better explained by the
- Psychoanalytic speculations are numerous but symptoms of another mental disorder (e.g..
most often centered on defensive mechanism of obsessions in obsessive-compulsive disorder,
displacement. decreased energy in major depressive disorder,
delusions in schizophrenia or another psychotic
Treatment
disorder, cognitive deficits in major neurocognitive
- SSRI- Clomipramine (Anafranil) and Fluvoxamine disorder, restricted interests in autism spectrum
(Lurox) disorder).
- Exposure and response prevention, type of CBT
Specify if:
effective in OCD has also successful with BDD.
With excessive acquisition: If difficulty discarding
possessions is accompanied by excessive
HOARDING DISORDER acquisition of items that are not needed or for
which there is no available space.
- Excessive acquisition of things
- Difficulty in disregarding anything.
- Living with excessive clutter under conditions
Specify if:
best characterized as gross disorganization
- Estimate prevalence range between 2% to 5% of With good or fair Insight: The individual
the population w/ equal no. of men and women recognizes that hoarding-related beliefs and
- Generation after Japanese war (most probably) behaviors (pertaining to difficulty discarding items,
clutter, or excessive acquisition) are problematic.
DIAGNOSTIC CRITERIA 300.3
With poor Insight: The individual is mostly
(F42)
convinced that hoarding-related beliefs and
A. Persistent difficulty discarding or parting with behaviors (pertaining to difficulty discarding items,
possessions, regardless of their actual value. clutter, or excessive acquisition) are not
problematic despite evidence to the contrary.
B. This difficulty is due to a perceived need to save
the items and to distress associated with With absent Insight/delusional beliefs: The
discarding them. individual is completely convinced that hoarding-
related beliefs and behaviors (pertaining to
C. The difficulty discarding possessions results in difficulty discarding items, clutter. or excessive
the accumulation of possessions that congest and acquisition) are not problematic despite evidence
clutter active living areas and substantially

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to the contrary.
D. The skin picking is not attributable to the
physiological effects of a substance (e.g., cocaine)
or another medical condition (e.g., scabies).
TRICHOTILLOMANIA (HAIR PICKING DISORDER)
E. The skin picking is not better explained by
- Hair pulling disorder symptoms of another mental disorder (e.g..
- Observed in between 1% to 5% of college delusions or tactile hallucinations in a psychotic
students and most common to woman. disorder, attempts to improve a perceived defect or
- Some study said that it is genetically inherited flaw in appearance in body dysmorphic disorder,
stereotypies in stereotypic movement disorder, or
DIAGNOSTIC CRITERIA 312.39 intention to harm oneself in non-suicidal self-
(F63.2) injury).
A. Recurrent pulling out of one's hair, resulting in
hair loss.
SOMATIC SYMPTOMS AND RELATED
B. Repeated attempts to decrease or stop hair DISORDERS
pulling.
- Soma= body
C. The hair pulling causes clinically significant - Somatic symptoms – bodily/physical symptoms.
distress or impairment in social, occupational, or - No organic basis- usual problem (hindi alam ng
other important areas of functioning. doctor kung ano ang sakit)
- DSM IV – Somatoform disorder
D. The hair pulling or hair loss is not attributable to
another medical condition (e.g., a dermatological
condition).
SOMATIC SYMPTOM DISORDER
E. The hair pulling is not better explained by the
symptoms of another mental disorder perceived - Briquet syndrome.
defect or flaw in appearance in body dysmorphic - DSM IV - Somatization disorder (pain disorder)
(e.g., attempts to improve a disorder). - People with SDD do not always feel the urgency
to take action but continually feel week and ill and
they avoid exercising, thinking it will make them
worse.
EXCORIATION (SKIN PICKING DISORDER)
- Physical complaints that can involve discomfort in
- Characterized by repetitive and compulsive different parts of the body.
picking of skin leading to tissue damage  Gastrointestinal symptoms
- Prevalence: 1%-5%; female disorder’  Sexual symptoms
 Pseudoneurological symptoms
DIAGNOSTIC CRITERIA 698.4
(L98.1) DIAGNOSTIC CRITERIA 300.82
(F45.1)
A. Recurrent skin picking resulting in skin lesions.
A. One or more somatic symptoms that are
B. Repeated attempts to decrease or stop skin
distressing or result in significant disruption of daily
picking.
life.
C. The skin picking causes clinically significant
B. Excessive thoughts, feelings, or behaviors
distress or impairment in social, occupational, or
related to the somatic symptoms or associated
other important areas of functioning.
health concerns as manifested by at least one of

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the following: - Many of these individual mistakenly believe they
have disease, a difficult-to-shake belief
1. Disproportionate and persistent thoughts sometimes referred to “disorder conviction”
about the seriousness of one's symptoms.
2. Persistently high level of anxiety about health
or symptoms. DIAGNOSTIC DISORDER 300.7
3. Excessive time and energy devoted to these (F45.21)
symptoms or health concerns. A. Preoccupation with having or acquiring a
C. Although any one somatic symptom may not be serious illness.
continuously present, the state of being B. Somatic symptoms are not present or, if
symptomatic is persistent (typically more than 6 present, are only mild in intensity. If another
months). medical condition is present or there is a high risk
Specify if: for developing a medical condition (e.g., strong
family history is present), the preoccupation is
With predominant pain (previously pain disorder): clearly excessive or disproportionate.
This specifier is for individuals whose somatic
symptoms predominantly involve pain. C. There is a high level of anxiety about health,
and the individual is easily alarmed about
Specify it:
D. The individual excessive health-related
Persistent: persistent course is characterized by behaviors (e.g., repeatedly checks personal health
severe symptoms, marked impairment, and long status. his or her body for signs of illness) or
duration (more than 6 months). exhibits maladaptive avoidance (e.g., avoids doctor
appointments and hospitals).
Specify current severity:
E. Illness preoccupation has been present for at
Mild: Only one of the symptoms specified in
least 6 months, but the specific Illness that is
Criterion B is fulfilled.
feared may change over that period of time.
Moderate: Two or more of the symptoms specified
F. The illness-related preoccupation is not better
in Criterion B are fulfilled.
explained by another mental disorder, such as
Severe: Two or more of the symptoms specified in somatic symptom disorder, panic disorder,
Criterion B are fulfilled, plus there are multiple generalized anxiety disorder, body dysmorphic
somatic complaints (or one very severe somatic disorder, obsessive-compulsive disorder, or
symptom). delusional disorder, somatic type.
Specify whether:

ILLNESS ANXIETY DISORDER Care-seeking type: Medical care, including

(HYPOCONDRIASIS) physician visits or undergoing tests and
procedures, is frequently used.
- Physical symptoms are either not experienced at
present time or are very mild but severe anxiety Care-avoidant type: Medical care is rarely used.
is focused on the possibility of having or
- Those with IAD have some tendency to :
developing serious disease.
 Catastrophic: overgeneralize
- Doctor hopping – they’ll find doctor that can
 Display all or nothing thinking
explain their disorder.
- Focused on being sick  Show selective attention
Statistics

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- 6% to 17% symptoms or necessitating medical attention.
Causes of SSD and IAP C. The psychological and behavioral factors in
Criterion B are not better explained by an- other
- Evidence shows that SSD run in families
disorder (e.g., panic disorder, major depressive
 Disorders seem to develop in context of stressful disorder, posttraumatic stress disorder).
life events
 They carry strong memories of illness that could Specify current severity:
easily become focus of anxiety.
Mild: Increases medical risk (e.g., inconsistent
 That an ill person often gets a lot of attention
adherence with antihypertension treatment).
Treatment
Moderate: Aggravates underlying medical
- CBT condition (e.g., anxiety aggravating asthma).
- Reassurance and education Severe: Results in medical hospitalization or
emergency room visit.

PSYCHOLOGICAL FACTORS AFFECTING OTHER Extreme: Results in severe, life-threatening risk

MEDICAL CONDITIONS (e.g., ignoring heart attack symptoms).

- Essential feature of this disorder is the presence

of diagnosed medical condition such as asthma,
CONVERSION DISORDER (FUNCTIONAL
diabetes or severe pain clearly caused by a
NEUROLOGICAL SYMPTOM DISORDER)
known medical condition such as cancer that is
adversely affected (increase the frequency or - Wala dapat sakit but due to stress nagkasakit.
severity) by one or more psychological or
behavioral factors. DIAGNOSTIC CRITERIA

DIAGNOSTIC CRITERIA 316 A. One or more symptoms of altered voluntary

(F54) motor or sensory function.

A. A medical symptom or condition (other than a B. Clinical findings provide evidence of

mental disorder) is present. incompatibility between the symptom recognized
neurological or medical conditions.
B. Psychological or behavioral factors adversely
affect the medical condition in one of the following C. The symptom or deficit is not better explained
ways: by another medical or mental disorder.

1. The factors have influenced the course of the D. The symptom or deficit causes clinically
medical condition as shown by a close significant distress or impairment in social,
temporal association between the occupational, or other important areas of
psychological factors and the development or functioning or warrants medical evaluation.
exacerbation of, or delayed recovery from, the Coding note: The ICD-9-CM code for conversion
medical condition. disorder is 300.11, which is assigned regardless of
2. The factors interfere with the treatment of the the symptom type. The ICD-10-CM code depends
medical condition (e.g., poor adherence). on the symptom type (see below).
3. The factors constitute additional well
established health risks for the individual. Specify symptom type:
4. The factors influence the underlying (F44.4) With or paralysis
pathophysiology, precipitating or exacerbating

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 FACTITIOUS DISORDER
(F44.4) With abnormal movement (e.g., tremor,
dystonic movement, myoclonus, gait disorder) - Munchausen syndrome by proxy – purposely
making others sick to gain pity and attention
(F44.4) With swallowing symptoms
(F44.4) With speech symptom (e.g., dysphonia, DIAGNOSTIC CRITERIA 300.19
slurred speech) (F68.10)
(F44.5) With attacks or seizures Factitious Disorder Imposed on Self
(F44.6) With anesthesia or sensory loss A. Falsification of physical or psychological signs
or symptoms, or induction of injury or disease,
(F44.6) With special sensory symptom (e.g., visual,
associated with identified deception.
olfactory, or hearing disturbance)
B. The Individual presents himself or herself to
(F44.7) With mixed symptoms
others as ill, impaired, or injured.
Specify if:
C. The deceptive behavior is evident even in the
Acute episode: Symptoms present for less than 6 absence of obvious external rewards.
months.
D. The behavior is not better explained by another
Persistent: Symptoms occurring for 6 months or mental disorder, such as delusional disorder or
more. another psychotic disorder.

Specify if: Specify

With psychological stressor (specify stressor) Single episode

Without psychological stressor Recurrent episodes (two or more events of

falsification of illness and/or induction of Injury)
Prevalence estimate in neurological setting is high
averaging 30%
Women disorder; onset: adolescent and after
adolescence.
Causes
- Experiences a traumatic event
- Confict and the resulting anxiety are
unacceptable, the person represses the conflict, DISSOCIATIVE DISORDERS
making it unconscious.
- Anxiety continue to increases and threatens to
emerge into consciousness, and the person DEPERSONALIZATION-DEREALIZATION
“converts” it into physical symptoms thereby DISORDER
relieving the pressure of having to deal directly
with the conflict. DEPERSONALIZATION means your perception
- Individual receives greatly increased attention alters so that you temporary lose the sense of the
and sympathy from loved ones and may also be reality, as if you were in a dream and watching
allowed to avoid difficult situation or task. yourself.

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DEREALIZATION means your sense of reality of the loss of important personal info or memory of
external world is lost. Things may seem to change specific event.
shape or size; people seem dead or mechanical. - Subtype: DISSOCIATIVE FUGUE – with fugue
literally meaning “flight”. Memory loss revolves
- Rare disorder around a specific incident – an unexpected trip.
- Out of the world disorder - They don’t remember who they are and why
he/she was at certain place.
DIAGNOSTIC CRITERIA 300.6
(F48.1) DIAGNOSTIC CRITERIA 300.12
A. The of persistent or recurrent experiences of (F44.0)
depersonalization, derealization, or both: A. An inability to recall important autobiographical
1. Depersonalization: Experiences of unreality, information, usually of a traumatic or stressful
detachment, or being an outside observer nature, that is inconsistent with ordinary forgetting.
respect to one's thoughts, feelings, Note: Dissociative amnesia most often consists of
sensations, body, or actions (e.g.. perceptual localized or selective amnesia for a specific event
alterations, distorted sense of time, unreal or or events; or generalized amnesia for identity and
absent self, emotional and/ or physical life history.
numbing).
2. Derealization: Experiences of unreality or B. The symptoms cause clinically significant
detachment with respect to surroundings (e.g., distress or impairment in social, occupational, or
individuals or objects are experienced as other important areas of functioning.
unreal, dreamlike, foggy, lifeless, or visually
C. The disturbance is not attributable to the
distorted).
physiological effects of a substance (e.g., alcohol
B. During the depersonalization or derealization or other drug of abuse, a medication) or a
experiences, reality testing remains intact. neurological or other medical condition (e.g., partial
complex seizures, transient global amnesia,
C. The symptoms cause clinically significant sequelae of a closed head injury/traumatic brain
distress or impairment in social, occupational, or injury, other neurological condition).
other important areas of functioning.
D. The disturbance is not better explained by
D. The disturbance is not attributable to the dissociative identity disorder, posttraumatic stress
physiological effects of a substance (e.g., a drug of disorder, acute stress disorder, somatic symptom
abuse, medication) or another medical condition disorder, or major or mild neurocognitive disorder.
(e.g., seizures).
E. The disturbance is not better explained by
another mental disorder, such as schizophrenia, DISSOCIATIVE IDENTITY DISORDER
panic major depressive disorder, acute stress
disorder, posttraumatic stress disorder, or another - Former MULTIPLE PERSONALITY DISORDER
dissociative disorder. - People with DID may adopt 100 new identities, all
simultaneously coexisting, although average
number is to 15
- Identities are complete, each has its own voice,
DISSOCIATIVE AMNESIA
behavior, physical gesture.
- Occur when traumatic event or stressful - The person who become patient and ask for
circumstances result in sudden partial or total treatment is the HOST and other personalities
are the ALTERS

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- Host personalities usually attempt to hold various Two nomenclature:
fragments of identity together but end up being
overwhelmed.  Depressive
- The transition from one personality to another is  Bipolar
called “SWITCH” Structure of Mood Disorder
- In one study, changes in hand-ness occurred
37% of the cases  Unipolar Mood Disorder – iisang polarity ang
continuum ng disorder
DIAGNOSTIC CRITERIA 300.14  Bipolar Mood Disorder – dalawang mood is
(F44.81) existing in one person subsequently.

A. Disruption of identity characterized by two or UNIPOLAR MOOD

more distinct personality states, which may be - Mood remains at one “pole” of the usual
described in some cultures as an experience of depression – mania continuum.
possession. The disruption in identity involves - Individuals who experience either depression or
marked discontinuity in sense of self and sense of mania
agency, accompanied by related alterations in
affect, behavior, consciousness, memory,
perception, cognition, and/or sensory-motor
functioning. These signs and symptoms may be
ob- served by others or reported by the individual.
B. Recurrent gaps in the recall of everyday events,
personal information, and/or traumatic events that
are inconsistent with ordinary forgetting.
C. The symptoms cause clinically significant
distress or impairment in social, occupational, or
other important areas of functioning.
D. The disturbance is not a normal part of a
broadly accepted cultural or religious practice. BIPOLAR MOOD

Note: In children, the symptoms are not better - Someone who alternates between depression
explained by imaginary playmates or other fantasy and mania
play. - Traveling from one pole of depression-elation
continuum to other and back again.
E. The symptoms are not attributable to the
physiological effects of a substance (e.g..blackouts Note:
or chaotic behavior during alcohol intoxication) or In bipolar usually make suicide complete especially in
another medical condition (e.g., complex partial manic stage.
seizures).

Depressive Disorders
MOOD DISORDER
 Major Depressive Disorder
- has something to do with someone’s emotions.  Persistent Depressive Disorder (Dysthymia)
- Emotional tone affect everything.  Premenstrual Dysphoric Disorder

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  Disruptive Mood Dysregulation Disorder more than 5% of body weight in a
month), or decrease or increase in
appetite nearly every day. (Note: in
MAJOR DEPRESSIVE DISORDER children, consider failure to make
expected weight gain.)
- defined by the presence of depression and 4. Insomnia or hypersomnia nearly every
absence of manic or hypomanic episodes, before day
or during the disorder. 5. Psychomotor agitation or retardation
- extremely depressed mood state that lasts at nearly every day (observable by
least 2 weeks and includes cognitive symptoms others, not merely subjective feelings
and disturbed physical functions to the point that of restlessness or being slowed down)
even the slightest activity or movement requires 6. Fatigue or loss of energy nearly every
an overwhelming effort. day
- cognitive symptoms always in the mind; feeling of 7. Feelings of worthlessness or
worthlessness, lahat ng gawin mo ay mali, excessive or inappropriate guilt (which
physical function, ‘di pagkain and ‘di pagtulog. may be delusional) nearly every day
- the best therapy for MDD is cognitive behavioral (not merely self-reproach or guilt about
treatment. being sick).
- severe depression perform suicide attempts 8. Diminished ability to think or
- episodes is typically accompanied by general concentrate, or indecisiveness, nearly
loss of interest in things and an inability to every day (either by subjective account
experience pleasure from life (anhedonia) or as observed by others)
9. Recurrent thoughts of death (not just fear
MAJOR DEPRESSIVE EPISODE of dying), recurrent suicidal ideation
without a specific plan, or a suicide
DIAGNOSTIC CRITERIA attempt or a specific plan for committing
A. Five (or more) of the following symptoms have suicide.
been present during the same 2-week period B. The symptoms cause clinically significant
and represent a change from previous distress or impairment in social,
functioning; at least one of the symptoms is occupational, or other important areas of
either (1) depressed mood or (2) loss of functioning.
interest or pleasure. C. The episode is not attributable to the
Note: Do not include symptoms that are physiological effects of a substance or to
clearly attributable to another medical another medical condition.
condition. Note: The above criteria represent a major
1. Depressed most of the day, nearly depressive episode.
every day as indicated by subjective
report (e.g., feels sad, empty,
hopeless) or observation made by
others (e.g., appears tearful) MAJOR DEPRESSIVE DISORDER
2. Markedly diminished interest or DIAGNOSTIC CRITERIA
pleasure in all, or almost all, activities
most of the day, nearly every day (as A. At least one major depressive disorder (criteria
indicated by subjective account or for major depressive episode)
observation) B. The occurrence of the major depressive
3. Significant weight loss when not episode is not better explained by
dieting or weight gain (e.g., change of schizoaffective disorder, schizophrenia,

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 schizophreniform disorder, delusional
- presence and both severity of accompanying
disorder, or other specified and
anxiety whether in the form of comorbid
unspecified schizophrenia spectrum and
anxiety (anxiety symptoms meeting the full
other psychotic disorders.
criteria for an anxiety disorder) or anxiety
C. There has never been a manic episode or a
hypomanic episode. Note: This exclusion does symptoms that do not meet all criteria for
not apply if all of the manic-like or hypomanic- disorder
like episodes are substance induced or are
attributable to the physiological effects of
another medical condition. Mixed Feature Specifier
- predominantly depressive episodes that have
several (at least three) symptoms of mania as
PERSISTENT DEPRESSIVE DISORDER described above would meet this specifier
which applies to MD Episodes.
- shares many symptoms of MDD but differs in its
course. Melancholic Feature
- defined as depressed mood that continues at
least 2 years, during with patient cannot be - applies only if the full criteria for major
symptom free for more than 2 months at a time depressive episode have been met.
even though they may not experience all of the Catatonic Features Specifier
symptoms of MDD.
- no presence of anhedonia. - serious condition involves an absence of
- low energy and fatigue and low self-esteem movement (a stuporous state) or catalepsy in
- does not require depressive episode but which muscles are waxy and semirigid
depressed mood.
Atypical Feature Specifier

Specifier (both MDD and PDD) - individual with this specifier consistently
oversleep and overeat during depression and
- MILD – few if any symptoms in excess of therefore gain weight, leading to higher
those required to make diagnosis and only incidence of diabetes.
minor impairment in occupational and/or social
functioning. Seasonal Pattern Specifier
- MODERATE – symptoms or functional - it accompanies episode that occur during
impairment between mild and severe. certain season (e.g., winter depression)
- SEVERE – several symptoms in excess of - no DSM-seasonal affective disorder
those necessary to make diagnosis and
marked interference with occupational and/or Peripartum Onset Specifier
social functioning.
- Peri means “surrounding”; in this case the
Psychotic Feature Specifiers (Mood congruent period of time just before and just after the
or incongruent) birth
- Hallucinations (seeing or hearing things that FROM GRIEF TO DEPRESSION
aren’t there) auditory hallucinations are the
most common. - DSM IV-TR and DSM V – never seen grief as
- Delusions (strongly held but inaccurate belief) disorder

Anxious Distress Specifier Normal and Complicated Grief

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 occur
DIAGNOSTIC CRITERIA
Complicated Grief
Common symptoms of acute grief that are within
normal limits within the first 6-12 months after:  Persistent intense symptoms of acute grief
 The presence of thoughts, feelings or
 Recurrent, strong feelings of yearning, wanting
behaviors reflecting excessive or distracting
very much to be reunited with the person who
concerns about the circumstances or
died; possibly even a wish to die in order to be
consequences of the death
with decreased love one.
 Pangs of deep sadness or remorse, episode
of crying or sobbing, typically interspersed with
periods of respite and even positive emotions. PROLONGED GRIEF DISORDER
 Steady stream of thoughts or images of - New diagnosis in DSM 5 – TR
deceased, may be vivid or even entail - It can happen when someone close to the
hallucinatory experiences of seeing or hearing bereaved person has died within at least 6
deceased person. months for children and adolescents or within 12
 Struggle to accept the reality of the death, months for adults.
wishing to protest against it, there may be - Bereaved individual may experience intense
some feelings of bitterness or anger about the longings for deceased or in children and
death. adolescents.
 Somatic distress, e.g., uncontrollable sighing, - These grief reaction occur most of the day, nearly
digestive symptoms, loss of appetite, dry everyday for at least a month
mouth, feelings of hollowness, sleep characteristics/symptoms:
disturbance, fatigue, exhaustion or weakness, o Identity disruption (feeling as some part
restlessness, aimless activity, difficulty of oneself has died)
initiating or maintaining organized activities, o Marked sense of disbelief about the
and altered sensorium. death
 Feeling disconnected from the world or other o Avoidance of reminders that person is
people, indifferent, not interested or irritable died
with others. o Intense emotional pain related to death
o Difficulty moving on with life
Symptoms of integrated grief that are within normal o Emotional numbness
limits: o Feeling that life is meaningless
 Sense of having adjusted to the loss o Intense loneliness (feeling alone or
 Interest and sense of purpose, ability to detached from other)
function and capacity for joy and satisfaction
are restored.
 Feelings of emotional loneliness may persist PREMENSTRUAL DYSPHORIC DISORDER (PMDD)
 Feelings of sadness and longing tend to be in - 2.5% of women (worldwide)
the background but still present - Highlight – intense symptoms within 7months or
 Thoughts and memories of the deceased above
person accessible and bittersweet but no - 100:0 ang sex ration, hindi applicable sa LALAKI.
longer dominate the mind
 Occasional hallucinatory experiences of the
DIAGNOSTIC CRITERIA
deceased may occur
 Surges of grief in response to calendar days A. In the majority of menstrual cycles, at least 5
or other periodic reminders of the loss may symptoms must be present in the final week

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 before the onset of menses, start to improve diagnosis may be made prior to this
within a few days after the onset of menses, confirmation)
and become minimal or absent in the week G. The symptoms are not attributable to the
postmenses physiological effects of a substance (e.g., drug
B. One or more of the following symptoms must abuse, medication or other treatment) or
be present: another medical condition (e.g.,
1. Marked affective lability (e.g., mood hyperthyroidism).
swings, feeling suddenly sad or tearful, or
increased sensitivity to rejection)
2. Marked irritability or anger or DISRUPTIVE MOOD DYSREGULATION DISORDER
increased interpersonal conflicts
3. Markedly depressed mood, feelings of - Core feature of DMDD is chronic, severe
hopelessness, or self-deprecating persistent irritability
thoughts - Frequent temper outbursts
4. Marked anxiety, tension, and/or feelings - Angry mood
of being keyed up or on edge - Could express verbal and behavioral
C. One (or more) of the following symptoms must - Highlight – outburst manifested
additionally be present to reach a total of 5 physically/verbally, temper outbursts – present in
symptoms when combined with symptoms 1 year or more
from criterion B above - Before 6 years old and after 18 years old lang
1. Decreased interest in usual activities pwede idiagnose
2. Subjective difficulty in concentration - Outbursts must not be inconsistent to their
3. Lethargy, easy fatigability, or marked developmental level
lack of energy - 2-3 setting pinapakita ang outbursts
4. Marked change in appetite; overeating
or specific food cravings DIAGNOSTIC CRITERIA
5. Hypersomnia or insomnia
6. A sense of being overwhelmed or out A. Severe recurrent temper outbursts manifested
of control verbally (e.g., verbal rages) and or
7. Physical symptoms such as breast behaviorally (e.g., physical aggression) that
tenderness or swelling; joint or muscle are grossly out of proportion in intensity or
pain, a sensation of “bloating” or weight duration to the situation or provocation.
gain B. The temper outbursts are inconsistent with
D. The symptoms are associated with developmental level.
clinically significant distress or C. The temper outbursts occur, on average,
interference with work, school, usual social three or more times per week.
activities, or relationships with others. D. The mood between temper outbursts is
E. The disturbance is not merely an persistently irritable or angry most of the
exacerbation of the symptoms of another day, nearly every day, and it is observable
disorder, such as major depressive by others
disorder, panic disorder, persistent E. Criteria A–D have been present for 12 or
depressive disorder (dysthymia) or a more months. Throughout that time, the
personality disorder (although it may co- individual has not had a period lasting 3 or
occur with any of these disorders). more consecutive months without all of the
F. Criterion A should be confirmed by symptoms in criteria A–D.
prospective daily ratings during at least 2 F. Criteria A–D are present in at least two of
symptomatic cycles (although a provisional three settings (home/school/peers) and are
severe in at least one setting

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G. The diagnosis should not be made for the
first time before age 6 or after 18
BIPOLAR DISORDERS
H. The age oat onset of criteria A–E is before
10 years - From manic alternately to depressive mode like a
I. There has never been a distinct period roller coaster ride.
lasting more than 1 day during which the
full symptom criteria, except duration, for a
manic or hypomanic episode have been CRITERIA FOR MANIC EPISODE
met.
Note: Developmentally appropriate mood DIAGNOSTIC CRITERIA
elevation, such as occurs in the context of
a highly positive event or its anticipation, A. A distinct period of abnormally and persistently
should not be considered as a symptom of elevated, expansive, or irritable mood and
mania or hypomania. abnormally and persistently goal-directed
J. J. The behaviors do not occur exclusively behavior or energy, lasting at least 1 week and
during an episode of major depressive present most of the day, nearly every day (or
disorder and are not better explained by any duration if hospitalization is necessary).
another mental disorder (e.g., autism B. During the period of mood disturbance and
spectrum disorder, PTSD, separation increased energy or activity, three (or more) of
anxiety disorder). the following symptoms have persisted (four if
Note: This diagnosis cannot coexist with the mood is only irritable) are present to a
oppositional defiant disorder, intermittent significant degree and represent a noticeable
explosive disorder, or bipolar disorder, change from usual behavior:
thought it can coexist with others, 1. Inflated self-esteem or grandiosity
including major depressive disorder, 2. Decreased need for sleep (e.g., feels
ADHD, conduct disorder, and substance rested after only 3 hours of sleep)
use disorders (SUDs). Individuals whose 3. More talkative than usual or pressure
symptoms meet criteria for both DMDD and to keep talking
oppositional defiant disorder (ODD) should 4. Flight of ideas or subjective experience
only be given the diagnosis of DMDD. If an that thoughts are racing
individual has ever experienced a manic or 5. Distractibility (i.e., attention too easily
hypomanic episode, the diagnosis o DMDD drawn to unimportant or irrelevant
should not be assigned. external stimuli)
K. The symptoms are not attributable to the 6. Distractibility (i.e., attention too easily
physiological effects of a substance or to drawn to unimportant or irrelevant
another medical or neurological condition. external stimuli), as reported or
observed.
INSANITY DEFENSE – pag nahuli mo ang asawa mo 7. Increase in goal-directed activity
during intimate acts with his/her affair , napatay mo on (either socially, at work or school, or
the spot, wala kang kaso but kapag nagsalita ka sexually) or psychomotor agitation
muna before mo patayin, murder ang kaso. 8. 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 mood disturbance is sufficiently severe to
cause marked impairment in social or

CARISSA MAE D. MAGTIBAY | BSP 

 occupational functioning or to necessitate
hospitalization to prevent harm to self or
others, or there are psychotic features.
D. The episode is not attributable to the direct
physiological effects of a substance (e.g., a
drug of abuse, a medication, or other
treatment) or another medical condition.
Note: A full manic episode that emerges during
antidepressant treatment (e.g., medication,
electroconvulsive therapy) but persists at fully
syndromal level beyond the physiological effect of
that treatment is sufficient evidence for a manic
episode and therefore a bipolar I diagnosis.
MANIC EPISODE
- Mood is “I can do everything” thinking
- Elevated; expansive; high energy; inflated mood
- If tingin mo nagpapakita ng manic symptoms
ang client, first thing to do is drug testing
- Nakikita rin sa substance influence ang
symptoms ng manic episode

- Different people have different possible time/way

BIPOLAR I and BIPOLAR II of showing episodes.

CYCLOTHYMIC DISORDER
- milder but more chronic version of bipolar
disorder
- a chronic alteration of mood elevation and
depression that does not reach the severity od
manic or major depressive episode
- if their symptoms will be severe, it is vulnerable to
develop bipolar disorder
- less severe depression – hypomania
- 1 year sa bata; 2 years sa adult

DIAGNOSTIC CRITERIA
A. For at least two years (at least one year in
children and adolescents) there have been
numerous periods with hypomanic symptoms
that do not meet criteria for a hypomanic
episode and numerous periods with
depressive symptoms that do not meet criteria

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 for a major depressive episode. - worldwide prevalence of mood disorder suggest
B. During the above two-year period (one year that approximately 16% of the population
in children and adolescents), the - in the Philippines: it has one of highest cases of
hypomanic and depressive periods have depression in Southeast Asia, affecting more
been present for at least half the time and than 3 million Filipinos
the individual has not been without the - about 1 in 10 Filipino young adults experience
symptoms for more than two months at a moderate to severe depression.
time. - 0.2 suffers from Bipolar Disorder
C. Criteria for a major depressive, manic, or
hypomanic episode have never been met.
Causes of Mood Disorder
[If such episodes appear later, the
diagnosis would be changed to bipolar I or BIOLOGICAL DIMENSIONS
bipolar II disorder, as appropriate.]
D. The symptoms aren’t better explained by  Familial and Genetic Influences
another mental disorder. - no direct gene for mood disorder but
E. The symptoms aren’t caused by a vulnerability is 37% can come with genetic
substance (i.e., medication or drug of specifically Bipolar.
abuse) or another medical condition.  Neurotransmitter systems
F. The symptoms cause clinically significant - serotonin level
distress or impairment in social, occupational, - Bipolar – dopamine (L-DOPA (agonist)) –
or other important areas of functioning. produce hypomanic symptoms, chronic
stress reduce dopamine level but increase
depressive like disorder
 The endocrine system
- HPA Axis (hypothalamic-pituitary-adrenal)
SPECIFIERS - stress response system
- Same with MDD & PDD
Specifier unique for Bipolar I & II
 Rapid-cycling specifier – more quickly in and
out depressive manic episodes.
- individuals with bipolar who experience
and manic/depressive episode in a year
can specify as rapid-cycling.
ONSET
- The average age of onset for bipolar I is from 15
to 18 and Bipolar II is from 19 and 22 although - Too much stress- activate HPA, it will release
cases of both disorder begin in childhood. hormone; immune system lowered
- In typical cases, cyclothymia is chronic and - Stress always ready to fight stress but
lifelong. Its most common age of onset to be is imbalances can produce disorder
12 to 14 years old.

PSYCHOLOGICAL DIMENSION
PREVALENCE
 Stressful Life Events

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 o Stress and trauma are among the most nangyari yun, ako na naman ang may
striking unique contributions to the etiology of kasalanan.”
all psychological disorders. Furthermore, o Global – attribution extent to variety of
scientists have confirmed that humiliation, issues. Sa lahat ng aspeto sa buhay
loss, and social rejection are the most potent ang thinking niya ay laging kasalanan
stressful life events likely to lead to niya.
depression while more positive set of stressful
life events seems to trigger mania.  Negative cognitive styles
o Positive stresses more likely it develops to o Proposed by Aaron T. Beck, known for his
possible bipolar. Cognitive Behavior Therapy (CBT), he also
o Positive stressors (e.g. traveling, retirement, give the best explanation for depression.
getting a new job) o Beck suggested that depression may result
o Both positive and negative stresses can from a tendency to interpret everyday events
contribute to development of mood disorder in a negative way
o People with depression tends to
 Learned Helplessness theory of depression overgeneralize and give arbitrary inference.
o Proposed by Dr. Martin Seligman, o They see simple setback as major
proponent/founder of positive psychology, the catastrophe
time when he became the president of APA. o Nasa negative idea ng tao ang development
o Seligman point out that anxiety is the first ng depressive episodes.
response to a stressful situation. Depression o Beck observed that all his depressed client
may follow marked hopelessness about tried to classify different things/situation that
coping with the difficult life events. The they have into different cognitive errors.
depressive attribution is internal, stable and o Cognitive errors – errors in their thinking.
global. Tinitingnan niya ang mga bagay-bagay into
o When someone is facing a certain problem, negative way
the first you would feel is ANXIETY brought o Two most common cognitive error
by stress given by that certain situation. That o People with depression tends to
anxiety needs to be lessen, or to cope. The overgeneralize. The way of thinking
problem if that someone is having difficulty where you apply one experience to all
coping with that stressful life events they experiences even in the future.
would feel that they have no control over that o Give arbitrary inference. They
situation. emphasize negative rather than positive
o If they have that notion, they learned to be aspects of the situation.
helpless. because they thought they have no o Beck stated that our cognition appears in triad
control over the stress in their life and the but the triad is your view of your self, your
depressive attribution: internal, stable and world, and your future.
global
o Internal – attribute the negative event to
their personal failing. They would often
say to themselves na “ako ang may
kasalanan niyan, ako ang mali”
o Stable – after particular negative event
passes the attribution of an individual
with MDD or those who have depressive
state, their thinking is “meron na naman
sigurong kasunod na mangyayari kapag

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 Class Generic Brand Name Usual Prominent
Name Dosage side effects
(mg/day)

Selective Citalopram Celexa 20-60 Nausea,

Serotonin diarrhea,
Reuptake Escitalopram Lexapro 10-20 insomnia,
Inhibitors sexual
(SSRIs) Fluoxetine Prozac 20-60 dysfunctions,
agitation/
Fluvoxamine Luvox 100-300
restlessness,
and daytime
Paroxetine Paxil 20-50
sedation.
Sertraline Zoloft 50-100

Mixed Bupropion Wellbutrin 300-450 Nausea,

Depressive Cognitive Triad Reuptake vomiting,
Inhibitors insomnia,
headaches &
seizures
SOCIAL AND CULTURAL DIMENSIONS
Venlafaxine Effexor 7-225 Nausea,
 Marital Relations diarrhea,
- marital dysfunctions. nervousness
, increased
- some studies said that most women sweating, dry
encounter mood disorder due to divorce. mouth,
muscle jerks,
 Mood Disorders in Women and sexual
- women are expected to be weak than men. dysfunction
- role of sex roles assigned by the society.
Duloxetine Celexa 60-80 Nausea,
women are the disadvantages population of diarrhea,
society. vomiting,
nervousness
 Social Support , increased
sweating, dry
mouth, head-
aches,
An integrative theory insomnia,
daytime
drowsiness,
sexual
dysfunctions,
tremor, and
elevated liver
enzymes.

- Selective Serotonin Reuptake Inhibitors (SSRIs)

– most common (Prozac and Luvox)
- Mixed Reuptake Inhibitors
- Tricyclic Antidepressants – the best known
variants are probably imipramine (Tofranil) and
amitriptyline (Elavil). Side effects include blurred
Treatment of Mood disorders vision, dry mouth, constipation, difficulty urinating,
drowsiness, weight gain (at least 13 pounds on
 Medications
average) and sometimes sexual dysfunctions.
Because of this kind of medicine as many as

CARISSA MAE D. MAGTIBAY | BSP 

 40% stop taking this drugs thinking that it will - focuses on resolving problems in existing
worsen their depression. relationships and learning to form important new
- Monoamine oxidase inhibitors (MOA interpersonal relationships
inhibitors) – block the enzymes MAO that
breaks down such neurotransmitters as NOTE:
norepinephrine and serotonin. Effective with - For patients with Bipolar Disorders, the principal
depression with atypical feature. objective of psychological intervention was to
Note: for bipolar, lithium carbonate is a common salt increase compliance with medication regimens
widely available in the natural environment. It is found such as lithium. Bipolar patient must be compliant
in our drinking water in amounts too small to have any to their medication regimen.
effect. The mood stabilizing drug. It is effective in
treating manic or mania episodes.
SUICIDE
Electroconvulsive Therapy
- intentional, direct and conscious taking of one’s
- Patients are anesthetized to reduce discomfort own life.
and given muscle-relaxing drugs to prevent bone
breakage from convulsions during seizures. Statistics
Electric shock is administered directly through the - In the Phil, around 3.2% death relating to suicide
brain for less than a second, producing seizure and recorded 100,000 per square capita possible
and a series of brief convulsions that usually lasts affected by the idea of suicide.
for several minutes. In current practice, - Regardless of age, in every country around the
treatments are administered once every other world except China, males are 4x more likely to
day for a total of 6 to 10 treatments. commit suicide than females.
Transcranial Magnetic Stimulation (TMS) - Males usually use violent methods while females
use non-violent and it makes it suicide attempt.
- Placing a magnetic coil over the individual’s head
to generate a precisely localized electromagnetic
pulse. Misconception in suicide
- Hindi lahat ng nagsasabing magpapakamaaty ay
hindi magpapakamatay, hindi palaging totoo na
kapag nagpapaalam ay hindi itutuloy.
PSYCHOLOGICAL TREATMENTS
SUICIDAL IDEATION
 Cognitive-Behavioral Therapy
o Clients are taught to carefully examine their - thinking seriously about suicide
thought processes while they are depressed SUICIDAL PLANS
and to recognize “depressive” errors in
thinking. - the formulation of a specific method for killing
o Client dapat ang maka-realize. oneself
o The therapist purposely takes Socratic
SUICIDAL ATTEMPTS
approach, you teach them the cognitive errors
by asking questions for them to realize. - the person survives
 Interpersonal Psychotherapy
- developed by Dr. Myrna Weissman and Dr. NOTE:
Gerald Klerman if someone told you na magpapakamatay sila, DO
NOT ASK WHY, ask PAANO? For you to categorize

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nasaang state na sila. If may plano na sila nasa Statistics
suicidal plans na sila and kapag naman ang sagot sa
iyo ay “hindi ko alam”, ideation pa lamang ito. Kapag - 50% of people in America know someone who
ang nagsabi saiyo ay may formulated plan na, malapit had the disorder.
na sila to subject themselves in suicide. - 18-20% of young adults having the disorder.
- 2019, most recent survey in Philippines, 1.7%
if ideation pa lang, be there for them, talk to them and yearly are reported with eating disorder.
enlighten them but do not push them na wag gawin. If - Common in adolescent/young adults and some
may plans na, act already, kung kaya mong kunin ang specific population.
materials niya for suicide, kunin mo and you can talk - Equally prevalent sa both gender. 50:50 ratio.
to their parents about it because that’s the only time
you can disregard confidentiality.
 Bulimia Nervosa
- the hallmark of bulimia nervosa is eating a larger
- Nock and Kessler (2006) distinguish two kinds of amount of food – typically more junk foods than
people committing suicide fruits and vegetables – than most people would
o Attempters – mga nagaattempt or may self- eat under similar circumstances.
injury that has intention to die. - Just as important as the amount of food eaten is
o Gesturers – they do self-injury but do not that the eating is experienced as out of control.
have intention to die but to influence or - Another important criterion is that the individual
manipulate somebody or communicate a cry attempts to compensate for the binge eating and
for help. potential weight gain, almost always by purging
techniques.
NON-SUICIDAL SELF-INJURY (NSSI)
- People with bulimia are ashamed of both their
- Some people – often adolescents – repeatedly eating issues and their lack of control.
cut, burn, puncture or otherwise significantly - Kakain sila ng marami then pipiliting mapalabas
injure their skin with no intent to die. ito.
- Some purging techniques are: using of laxatives
(pampurga); self-induce vomiting; diuretics
medicines
Medical Consequences
- Salivary gland enhancement caused by repeated
vomiting, which gives the face a chubby
appearance.
EATING DISORDERS - Electrolyte imbalance – continued vomiting may
upset the chemical balance of bodily fluids
- Characterized by persistent disturbance of eating including sodium and potassium levels.
or eating-related behaviors that result in altered - Cardiac arrhythmia (disrupted heartbeat),
consumption or absorption of food and that seizures, and renal (kidney) failure, all of which
significantly impairs physical health or can be fatal.
psychosocial functioning. - Intestinal problems resulting from laxative abuse
- From DSM I – III there’s no eating disorder, in are also potentially serious; they can include
DSM IV it was added as new nomenclature. severe constipations or permanent colon damage.
- Malaki ang consequences ng eating disorders sa - Marked calluses on their fingers or the back of
physical health. their hands caused by the friction of contact with
the teeth and throat when repeatedly sticking

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 their fingers down their throat to stimulate the gag Extreme – 14-more episodes per week
reflex.
Associated Psychological Disorders
ANOREXIA NERVOSA
- 80.6% of individuals with bulimia had an anxiety
disorder at some point during their lives. - Literally means a “nervous loss of appetite” – but
- Mood disorders, particularly depression, also the term does not suggest the correct definition of
commonly co-occur with bulimia. the disorder.
- They are so successful at losing weight that they
put their lives in considerable danger
DIAGNOSTIC CRITERIA - Characterized by a morbid fear of gaining weight
A. Recurrent episodes of binge eating- an and losing control over eating – are proud of both
episode of binge eating is characterized by their diets and their extraordinary control.
both of the following: - Common among young celebrities and within the
1. Eating, in a discrete period of time modeling world.
(e.g., within any 2-hour period), an - People with anorexia have an intense fear of
amount of food that is definitely larger obesity and relentlessly pursue thinness.
than what most individuals would eat - Anorexia nervosa is less common than bulimia,
in a similar period of time under but there is a great deal of overlap.
similar circumstances. - Many individuals with bulimia have a history of
2. A sense of lack of control over eating anorexia; that is, they once used fasting to
during the episode (e.g., a feeling reduce their body weight below desirable levels.
that one cannot stop eating or control - After seeing numerous doctors, people with
what or how much one is eating). anorexia become good at mouthing what others
B. Recurrent inappropriate compensatory expect to hear. They may agree they are
behaviors in order to prevent weight gain, underweight and need to gain a few pounds - but
such as self-induced vomiting; misuse of they do not really believe it themselves. Question
laxatives, diuretics, or other medications; further and they will tell you the girl in the mirror
fasting; or excessive exercise. is fat. Therefore, individuals with anorexia seldom
C. The binge eating and inappropriate seek treatment of their own.
compensatory behaviors both occur, on - More lenient to women than men.
average, at least once a week for 3 months. Medical Consequences
D. Self-evaluation is unduly influenced by body
shape and weight. - Amenorrhea - cessation of menstruation
E. The disturbance does not occur exclusively - Dry skin, brittle hair or nails and sensitivity to or
during episodes of anorexia nervosa intolerance of cold temperatures
- Cardiovascular problems, such as chronically low
Specifier: blood pressure and heart rate
In partial remission – met all criteria but there are - If vomiting is part of the anorexia, electrolyte
some point of criteria na nawawala. imbalance and resulting cardiac and kidney
problems.
In full remission - met all criteria and they have it
until gumaling sila. Associated Psychological Disorders

Mild – 1-3 episodes per week - Rates of the depression occurring at some point
during their lives as many 71% of cases
Moderate – 4-7 episodes per week
Severe – 8-13 episodes per week

CARISSA MAE D. MAGTIBAY | BSP 

- One anxiety disorder that seems to co-occur - Individuals who experience marked distress
often with anorexia is obsessive-compulsive because of binge eating but do not engage in
disorder extreme compensatory behaviors and therefore
- Substance abuse is also common in individuals cannot be diagnosed with bulimia.
with anorexia nervosa. - Somehow related sa bulimia, lack of control in
eating but walang purging techniques.
DIAGNOSTIC CRITERIA
DIAGNOSTIC CRITERIA
A. Restriction of energy intake relative to
requirements, leading to a A. Recurrent episodes of binge eating. An
significantly low body weight in the episode of binge eating is characterized by
context of age, sex, developmental both of the following:
trajectory, and physical health. 1. Eating, in a discrete period of time
Significantly low weight is defined as (e.g., within any 2-hour period), an
a weight that is less than minimally amount of food that is definitely
normal or, for children and larger than what most people
adolescents, less than that minimally would eat in a similar period of
expected. time under similar circumstances.
B. Intense fear of gaining weight or of 2. A sense of lack of control over
becoming fat, or persistent behavior eating during the episode (e.g., a
that interferes with weight gain, even feeling that one cannot stop eating
though at a significantly low weight. or control what one is eating).
C. Disturbance in the way in which one’s B. The binge-eating episodes are associated
body weight or shape is experienced, with three (or more) of the following:
undue influence of body weight or 1. Eating much more rapidly than
shape on self-evaluation, or persistent normal.
lack of recognition of the seriousness 2. Eating until feeling uncomfortably
of the current low body weight. full.
3. Eating large amounts of food when
Specifier:
not feeling physically hungry.
Restricting type: During the last 3 months, the 4. Eating alone because of feeling
individual has not engaged in recurrent embarrassed by how much one is
episodes of binge eating or purging behavior eating.
(i.e., self-induced vomiting or the misuse of 5. Feeling disgusted with oneself,
laxatives, diuretics, or enemas). This subtype depressed, or very guilty
describes presentations in which weight loss is afterward.
accomplished primarily through dieting, C. Marked distress regarding binge eating is
fasting, and/or excessive exercise. present.
D. The binge eating occurs, on average, at
Binge-eating/purging type: During the last 3 least once a week for 3 months.
months, the individual has engaged in recurrent E. The binge eating is not associated with the
episodes of binge eating or purging behavior (i.e., recurrent use of inappropriate compensatory
self-induced vomiting or the misuse of laxatives, behavior as in bulimia nervosa and does not
diuretics, or enemas) occur exclusively during the course of bulimia
nervosa or anorexia nervosa

Binge-Eating Disorder PICA

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- Persistent eating of nonnutritive food. Biological Dimensions
- Eating disorders run in families and thus seem to
RUMINATION have a genetic component
- Hypothalamus as playing an important role
- Repeated regurgitation
- Kakainin, iluluwa, kakainin, iluluwa… Psychological Dimensions
- Many young women with eating disorders have a
diminished sense of personal control and
AVOIDANT/RESTRICTIVE FOOD INTAKE confidence in their own abilities and talents.
DISORDER - State of relief strongly reinforces the purging, in
- Walang appeal sa pagkain that we tend to repeat behavior that gives us
- Extreme na pagkapihikan pleasure or relief from anxiety.
- Anxiety and mood disorders are also common in
the families of individuals with eating disorders.
Statistics of Eating Disorder - An emphasis in these families on looks and
achievements, and perfectionist tendencies, may
- Majority (90-95%) of individuals with bulimia are help establish strong attitudes about the
women overriding importance of physical appearance to
- Males with bulimia have a slightly later age of popularity and success, attitudes reinforced in
onset and a large minority are predominantly gay peer groups.
males or bisexual
- Athletes in sports that require weight regulation,
such as wrestling, are another large group of Treatments
males with eating disorder.
Drug Treatment
- The drugs generally considered the most
Causes of Feeding and Eating Disorders effective for bulimia are the same antidepressant
Social Dimensions medication proven effective for mood disorders
and anxiety disorders (SSRIs)
- Looking good is more important than being - No drug treatment in anorexia seen effective
healthy - Decreases episodes of binge eating
- For young females in competitive environments,
self-worth, happiness and success are largely Psychological Treatment
determined by body measurements and - Psychological treatments for people with eating
percentage of body fat, factors that have little or disorders were directed at the patient’s low self-
no correlation with personal happiness and esteem and difficulties in developing an individual
success in the long run. identity.
- Strong relationships between exposure to media - Short-term cognitive-behavioral treatments target
images depicting the thin-ideal body and body problem eating behaviors and associated
images concerns in women. attitudes about the overriding importance and
- Dieting is one factor that can contribute to eating significance of body weight and shape, and these
disorder and, along with dissatisfaction with one’s strategies became the treatment of choice for
body, is a primary risk factor for later eating bulimia.
disorders.
- Significance of family interaction patterns in SLEEP-WAKE DISORDER
cases of eating disorders

CARISSA MAE D. MAGTIBAY | BSP 

- Typically present a sleep-wake complaint of - Narcolepsy is relatively rare, occurring in
dissatisfaction regarding the quality timing and 0.03% to 0.16% of the population
amount of sleep, which results to daytime - Cataplexy appears to result from a sudden
distress and impairment onset of REM sleep. Instead of falling asleep
normally and going through the four non-
Sleep-wake disorders are divided into two major rapid eye movement (NREM) stages that
categories: typically precede REM sleep, people with
narcolepsy periodically progress right to this
dream-sleep stage almost directly from the
- Dyssomnias- involve difficulties in getting enough state of being awake.
sleep, problems with sleeping when you want to and - Two other characteristic:
complaints about the quality of sleep, such as not o Sleep paralysis
feeling refreshed even though you have slept the o Hypnagogic Hallucination
whole night
- Parasomnias- characterized by abnormal
behavioral or physiological events that occur during  Breathing-Related Sleep Disorders
sleep, such as nightmares and sleepwalking - People whose breathing is interrupted during
their sleep often experience numerous brief
arousals throughout the night and do not feel
* SLEEP-WAKE DISORDER - Dyssomnias rested even after 8 or 9 hours asleep
- Hypoventilation
 Insomnia Disorder - Sleep apnea
- Insomnia is one of the most common sleep - Other signs that a person has breathing
wake disorders difficulties are heavy sweating during the
- People are considered to have insomnia if night, morning headaches, and episodes of
they have trouble falling asleep at night falling asleep during the day (sleep attacks)
(difficulty initiating sleep), if they wake up with no resulting feeling of being rested
frequently or too early and can't go back to
sleep (difficulty maintaining sleep), or even if
they sleep a reasonable number of hours but  TYPES OF APNEA
are still not rested the next day
(nonrestorative sleep). o Obstructive sleep apnea hypopnea
syndrome
 Hypersomnolence Disorders - occurs when airflow stops despite continued
- Disorders involve sleeping too much (hyper activity by the respiratory system.
means "in great amount" or "abnormal - Occurs commonly in male for 10-20% of the
excess"). Many people who sleep all night population; may kinalaman sa obesity and
find themselves falling asleep several times BMI.
the next day. - Ang client ay walang alam sa symptoms,
commonly relative or bed-partner ang source
of data.
 Narcolepsy - Gumagamit ng machine to check sleep
- Experience of daytime sleepiness and apnea.
cataplexy, a sudden loss of muscle tone.
Cataplexy lasts from several seconds to o Central sleep apnea involves the complete
several minutes; it is usually preceded by cessation of respiratory activity for brief periods
strong emotion such as anger or happiness. and is often associated with certain central

CARISSA MAE D. MAGTIBAY | BSP 

 nervous system disorders, such as cerebral up pawis na pawis ka at takot na takot.
vascular disease, head trauma, and Usually pag sa NON-REM pa lang ang sleep
degenerative disorders. mo dapat hindi ka pa nananaginip.
- Walang kinalaman ang sleep talking dito.
o Sleep-related hypoventilation - Amnestic - di maalala.
- decrease in airflow without a complete pause
in breathing.  Nightmare Disorder
- This tends to cause an increase in carbon - Happening during the sleep literally.
dioxide (CO2) levels, because insufficient air - Well-remembered dreams
is exchanged with the environment. - Bigla kang magigising
- This will need machine to see if an individual
can meet the criteria.  Restless Legs Syndrome
- Sa dugo kukunin ang sample if there is no - Thighs to feet galaw nang ga;aw
machine that can measure oxygen. - Rare disorder
- Usually in European countries.

 Circadian Rhythm Sleep Disorder

- The difficulty has to do with how our Treatment of Sleep Disorders
biological clocks adjust to this change in time.
Convention says to go to sleep at this new Medical Treatments
time while our brains are saying something - most common treatments for insomnia are
different. If the struggle continues for any medical
length of time - medical professional is likely prescribed one
- This disorder is characterized by disturbed of several benzodiazepine or related
sleep (either insomnia or excessive medications
sleepiness during the day) brought on by the - Common drawbacks of medical treatments
brain's inability to synchronize its sleep - benzodiazepine medications can cause
patterns with the current patterns of day and excessive sleepiness
night. - people can easily become dependent on
- Nauso dahil sa rise ng BPO companies them and rather easily misuse them,
- Nililito ang brain sa pagtulog. deliberately or not
- Jet lag type is, as its name implies, caused - Medications are meant for short-term
by rapidly crossing multiple time zones. treatment and are not recommended for use
- Shift work type sleep problems are longer than 4 weeks
associated with work schedules. - The gold standard for the treatment of
Note: hormone “MELATONINE” has something to obstructive sleep apnea involves the use of a
with body clock; it also maintains sleep mechanical device-called the continuous
positive air pressure (CPAP) machine that
improves breathing
SLEEP-WAKE DISORDER- Parasomnias Environmental Treatments
 Non-Rapid Eye Movement Sleep Arousal - One general principle for treating circadian
Disorder rhythm disorders is that phase delays
- People who sleepwalk ay walang alam sa (moving bedtime later) are easier than phase
nangyayari sa kanila advances (moving bedtime earlier)
- Sleep terror – kakatulog mo lang tapos - using bright light (phototherapy) to trick the
nanaginip ka ng masama. When you wake brain into readjusting the biological clock.

CARISSA MAE D. MAGTIBAY | BSP 

Psychological Treatments - find it difficult to function adequately while
having sex.
- Cognitive Therapy
 Paraphilic
- Guided Imagery Relaxation
- relatively new term for sexual deviation,
- Graduated Extinction
sexual arousal occurs primarily in context of
- Paradoxical Intention – uutusan ka na wag
Inappropriate objects or individuals.
matulog pero mas intentional mong gagawin
ang matulog. ++sorogacy sorogate mother/father.
- Progressive Relaxation
Statistics
- In Phil, Filipinas aged 15-24 had engaged in
SEXUAL DYSFUNCTIONS sex before marriage (1:3)
- among the males, three out of four have ever
- Biological need ang sex
watched pornographic videos, while only two
- part of human survival; pleasurable.
out of five females have done the same.

 Gender Difference
 Normal Sexuality - Masturbatory behavior differs - Men engage
- Sa Pinas, it is stigma. Hindi common pag- more frequently with masturbation than
chapan women.
- You may have read magazines or online o mas madali; more obly to do it.
surveys reporting sensational information on Convenient.
sexual practices. o mas acceptable sa lalaki.
- Ex:FHM-women magazine relling woman - reflected in incidince of casual rey, attitudes
body. toward casual premarital sex & porn use with
- they claim to reveal sexual norms, but they men expressing more permisive attitude &
are actually reporting mostly distorted half- behavior than women
truths.
- the fact they present typically are not based
on any scientific methodology that would
 Cultural Diff.
make them reliable, although they do sell
- the sambia in Papua New Guinea believe
magazines.
semen is an essential substance for growth
- normal sexual behavior depends on the
and development in young boys of the tribe.
person.
- Munda of northeast India require
- Current views tend to be quite tolerant of a
adolescents & children to live together.
variety of sexual expressions, even if they
are unusual, unless the behavior is
associated with substantial impairment in
functioning or involves non consenting
Individual such as children.
- People tend to have different sexual
practices
- they have engage in vaginal intercourse, oral
sex, anal sex, multiple partner, homosexual
intercourse & many more

 Sexual Dysfunction Figure: The human sexual response cyche.

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Sexual Intercourse (5 stages)  Sexual Desire Disorder
- Male Hypo active sexual Desire Disorder
1. Desire phase
and Female Sexual Interact/arousal
- Idea of desire; occur in urges in response to - walang interest makipagsex
social cues or fantasy. - one individual might not engage in sex or no
- "gusto mo"; "mind" interest in sex. Parther can be less desirable.
- Reason
o Maraming ginagawa. ++too much an
2. Arousal phase their plate
o little or no interest in any type of
- subjective phare sexual activity
- might happen to different ways by different o Problems of sexual interest or desire
people. used to be considered marital rather
- Physiological signs of arousal: than sexual difficulties.
o lalaki (erection)
o Babae (attained when there is
lubricating/wetting of vagina and  Sexual arousal Disorder
harding of nipples) o Erectile Disorders
3. Plateau phase - Many males with erectile dysfunction have
frequent sexual urges and fantasies and
- brief period before the orgasm. strong desire to have sex, their problem is in
becoming physically aroused.
4. Orgasm phase
- a man typically feels more impaired by his
- lalaki (ejaculate) sperm cell problem than a woman does by hers.
- Babae (contract vaginal wall-egg cell) Inability to achieve and maintain an erection
make intercourse difficult or possible
5. Resolution - highlight: 'di maka-attain ng arousal
- decrease of arousal. NOTE: Medical Vayagra (medicine designed to use to
- lalaki (from hardened penis to softened) arouse penis)

 Orgasm Disorder
When sexual dysfunction happen? - Inability to achieve an orgasm despite
1. Desire phase adequate sexual desire and arousal
o Premature Ejaculation
2. Arousal - early orgasm
3. Orgasm o Delayed Ejaculation
- sobrang tagal ang orgasm
o Female Orgasmic Disorder
- hindi maachieve ang orgasm
 Sexual Dysfunction
o Type of Disorder
 Desire
 Arousal
 Orgasm
 Pain

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Sexual Pain Disorder − Vascular disease is a major cause of sexual
dysfunction, because erection in men and
GENITO-PELVIC PAIN/PENETRATION DISORDER vaginal engorgement in women depend on
− Sexual dysfunction specific to women refers to adequate blood flow.
difficulties w/ penetration during attempted
intercourse or significant pain during intercourse. Psychological Contributions
− They spasm reaction of vaginismus may occur − Most sex researchers and therapist thought the
during any attempted penetration, including a principal cause of sexual dysfunctions was
gynecological exam or insertion of tampon. anxiety - though proved that it was distraction
− There is a drug needed to calm the pelvic floor − Normally functioning individual show increased
− If there is tightening of pelvic, vaginal lock could sexual arousal during performance demand
happen. conditions, experience positive affect, are not
− Highlight - pain during penetration distracted by nonsexual stimuli and have a good
− Women who experienced rape is the most idea of how aroused they are.
vulnerable in this disorder.
Social and Cultural Contributions
ASSESSING SEXUAL BEHAVIOR − Presumably learned early in childhood from
− There are 3 major aspects to assessment families, religious authorities or others, seems to
 Interviews predict sexual difficulties later in life.
- must demonstrate to the patient − Negative events might include sudden failure to
through their actions and interviewing style that become aroused or actual sexual trauma such
they are comfortable talking about those issues. as rape, as well as early sexual abuse.
- clinicians must always be prepared to − Marked deterioration in close interpersonal
use the vernacular (language) of the patient relationships.
realizing also that terms vary from person to − Treatments
person. − EDUCATION
- revolves around the sexual thought, - Ignorance of most basic aspects of sexual
behavior and after that sexual behavior. (how do response cycle and intercourse often leads to long-
they behave in that manner. lasting dysfunctions.
- it is advisable to conduct interview − SEX THERAPY
with his/her spouse − Procedure usually engage by most people in US
 Thorough medical evaluation − BRIEF MARITAL THERAPY
- variety of drugs, including some − Discussion and resolution of problems in
commonly prescribed for hypertension, anxiety marriage.
and depression, often disrupt sexual arousal and − VIAGRA, LEVITRA and CIALIA
functioning − Developed in recent years to treat sexual
- revolving around reproductive organ dysfunctions
 Psychophysiological assessment
- objective measure of an individuals PARAPHILIC DISORDERS
arousal − Recurrent, intense, sexually arousing fantasies,
- equipment - penile plethysmograph is urges or behavior that are distressing or
used to measure blood flow in a penis/ erection. disabling and that involve inanimate objects,
objects or nonconsenting adults.
Causes of Sexual Dysfunctions
Biological Contributions FETISHTIC DISORDER
− 28% of men with diabetes experienced complete − Person is sxually attracted to non living objects.
erectile failure.

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− Many fetishes but women’s undergarments and − Feeling mo “wala ka sa tamang katawan”; may
shoes (high-heeled shoes) are popular. presence ng impairment.
− Nangyayari in sexual context.
− Fetishes enter between dersire and arousal PERSONALITY DISORDER
phase
PERSONALITY
VOYEURISTIC DISORDER − “the dynamic organization within the individual of
− Practice of observing to become aroused, and those psychophysical systems that determine
unsuspecting individual undressing or naked. his characteristic behavior & thought” - G. Allport
− Arousal will happen kapag naninilip siya. − Relatively permanent pattern of behavior
− Ayaw nila gawin pero wala silang magawa − PERSONALITY DISORDER
(uncontrollable) − Persistent pattern of emotions, cognitions and
− If naninilip, wala dapat alam ang sinisilipan. behavior that results in enduring emotional
distress for the person affected and/or for others
EXHIBISTIONISTIC DISORDER and may cause difficulties with work and
− Achieving sexual arousal and gratification by relationships
exposing genitals to unsuspecting strangers. − INCURABLE; usually ginagamit as insanity
− Biglang naghuhubad in the middle of the street. defense.

TRANSVESTIC DISORDER DSM IV-TR to DSM 5

− Sexual arousal is strongly associated with act of − Axis II, because as a group they were seen as
(or fantasies of) dressing in clothes of the distinct
opposite sex or crossdressing. − Separate axes were eliminated and it can be
− Found arousal in cross dressing during sexual diagnosed solo
intercourse.
Note: Clustered based on resemblance.
SEXUAL SADISM and MASOCHISM
Cluster A. ODD/ECCENTRIC
− Associated with either inflicting pain or
 Paranoid
humiliation (sadism) or suffering pain or  Schizoid
humiliation (masochism)  Schizotypal
− If both partner had the disorder, there will be no
disorder at all. Cluster B. DRAMATIC, EMOTIONAL or ERRATIC
 Anti-Social
PEDOPHILIC DISORDER  Bordeline
− Sexual attraction to children (or young  Histrionic
adolescent generally aged 13 or younger)  Narcissistic

Causes of Paraphilic Disorder Cluster C. ANXIOUS/FEARFUL

− PSYCHOLOGICAL  Avoidant
 Performance demand  Dependent
 Obsessive-Compulsive
GENDER DYSPHORIA
− Present if a person’s physical sex is not CLUSTER A. ODD or ECCENTRIC DISORDER
consistent with the person’s sense of who − Resemble some of the psychotic-like symptoms
he/she really is or with his/her experienced in schizophrenia
gender. − Hindi malala ang interpretation

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PARANOID PERSONALITY DISORDER − Lack of emotional expressiveness and pursued
− They never trust people vague interest.
− “pervasive unjustified distrust” − Do not seem affected by praise or criticism but
− Excessively mistrustful and suspicious of others they are sensitive and unwilling or unable to
w/o any justifications express their emotions
− Assume other people are out to harm or trick − Social isolation may be extremely painful
them
− Tend not to be confide with others CAUSE
− Suspicious are unfounded BIOLOGICAL
− Argumentative − May be associated with lower amount of
− may complain dopamine receptors
− Sensitive to criticism SOCIAL/CULTURAL
− Has excessive need for autonomy − Preference for social isolation
− Has risk for suicide attempts − Lack of social skills
− Have violent behaviors − Lack of interest
− Even events have nothing to do with them are − PSYCHOLOGICAL
interpreted as personal attacks. − Very limited range of emotions
− Apparently cold and unconnected
CAUSES − Unaffected by praise or criticism
BIOLOGICAL − TREATMENT
− Possible but unclear link with schizophrenia − Rare for people to request treatment
− Receive SOCIAL SKILLS TRAINING - taught
SOCIAL/CULTURAL emotions felt by others or learn empathy
− “outsiders” may be susceptible because of − ROLE PLAYING
unique experiences − SCHIZOTYPAL PERSONALITY DISORDER
− Parents early teaching may influence − Socially ISOLATED
− Have psychotic-like symptoms
PSYCHOLOGICAL − Believing that everything relates to personality
− Thoughts that people are malevolent and − Someties have cognitive impairments or
deceptives. paranoia
− Have ideas of references but able to
TREATMENT acknowledge this is unlikely (vs. Schizoprenia
− Difficulty developing the trusting relationship without reality testing)
necessary for successful therapy − Engage in magical thinking
− When they seek therapy, trigger is usually a − Suspicious, have paranoid thoughts, express
crisis in their lives - depression or anxiety not little emotions
necessarily atmosphere − Passive unengaged and hyppersensitive to
− Cognitive therapy criticism
− TREATMENT
SCHIZOID PERSONALITY DISORDER − Combination of approaches - antipsychotic
− Detachment from social relationships medication, community treatment and social
− Limiyted range of emotions in interpersonal skills training
situations − Combination of approaches either reduced their
− Aloof, cold symptoms or postponed the onset of later schizo
− Schizoid (Bleuer, 1924) - has tendency to turn − CBT
inward and way from the outside world. NOTE: all cluster A PD are vulnerable to devloped
schizophrenia

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Grouping schema for Cluster A Disorders − Most common P.D observed
− Fearing abandonment but lacking control over
PSYCHOTIC-LIKE SYMPTOMS
their emotions
− Dysfunction in area of emotions
Cluster A POSITIVE (e.g., NEGATIVE (e.g., − Difficulties with their own identities
Personality Ideas of reference, social isolations, poor
− May have mood disorder and eating disorders.
magical thinking, and rapport, and constricted
Disorder
perceptual distortions) affect) − Takot maiwan so tendency nagiging
manipulative
Paranoid YES YES
TREATMENT
Schizoid NO YES − CBT (dialectical behavioral therapy)
− Symptomatic treatment
Schizotypal YES NO − HISTRIONIC PERSONALITY DISORDER
− Overly dramatic, almost to be acting
− Histrionic -theatrical in manner
− Express their emotions in exaggerated fashion
CLUSTER B. DRAMATIC, EMOTIONAL or
− Uncomfortable and self-centered when they are
ERRATIC DISORDER
not in limelight
− Seek reassurance and approval consistently
ANTISOCIAL PERSONALITY DISORDER
− Became upset
− Fail to comply with social norms
− ATTENTION SEEKER
− Irresponsible, impulsive and deceitful
− Link to antisocial
− Violate the right of others
− Aggressive becayse they take what they want
NARCISSISTIC PERSONALITY DISORDER
− No remorse or concerns over the effects of their
− Think highly of themselves
actions
− Consider themselves different from others and
− Common sa lalaki
deserving special treatment
− Usually comorbid with substance abuse
− Exaggerated self-importance
− Conduct Disorder
 Children who engage in behaviors that
CLUSTER C. ANXIOUS/FEARFUL
vioate to social norms
 Likelihood of an adult having antisocial PD
AVOIDANT PERSONALITY DISORDERS
increases as a child, he has both conduct
− Fear of rejection
disorder & ADHD
− Takot macriticize therefore they avoid people
CAUSE
DEPENDENT PERSONALITY DISORDER
BIOLOGICAL
− Takot sa abandonment
− Genetic vulnerability combined with
− They rely everything to other people
environmental influences
− High hour treshold
OBSESSIVE-COMPULSIVE PERSONALITY
DISORDER
TREATMENT
− They are perfectionist
− CBT
− May sense of perfectionism.
− Parent Training

BORDERLINE PERSONALITY DISORDER

− Moods and relationship are unstable
− Have poor self-image

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Main belief associated with specific PD 1826) schizophrenia.

Personality Disorder Main Beliefs

1852 Benedict Physician at a French institution
Morel (1809- who used the term demence
Cluster Paranoid I cannot trust people.
1873) precoce (in Latin, dementia
A.
praecox), meaning early or
Schizoid Relationships are messy, premature (precoce) loss of
undesirable. mind (demence) to describe
schizophrenia.
Schizotypal It’s better to be isolated from
others.
1898/ Emil A German psychiatrist who
1899 Kraepelin unified the distinct categories of
Cluster Histrionic People are there to serve and (1856-1926) schizophrenia (hebephrenic,
B. admire me. catatonic and paranoid) under
the name dementia praecox.
Narcissistic Since I am special, I deserve
special rules.
1908 Eugen A Swiss psychiatrist who
Bleuler introduced the term
Borderline I deserve to be punished. (1857- 1839) schizophrenia, meaning “splitting
of the mind.”
Antisocial I am entitled to break rules.

IDENTIFYING SYMPTOMS
Cluster Avoidant If people knew the “real” me, − It is not easy to point to one thing that makes a
C. they would reject me.
person “schizophrenic”
− A number of behaviors or symptoms that aren’t
Dependent I need people to survive and
be happy.
necessarily shared by all people who are given
this diagnosis.
Obsessive- People should do better, try
− Individuals who have schixophrenia have
Compulsive harder varying symptoms and causes.
− Proper treatment depends on differentiating
individuals in terms of their varying symptoms
SCHIZOPHRENIA SPECTRUM
− The presence of reality distortion that is evident SCHIZOPHRENIA SPECTRUM DISORDER
from various clients of this spectrum.
GROUP OF DIAGNOSES
Early figues in History of SCHIZOPHRENIA − Schizophreniform
− Schizoaffective
Date Historical Contribution − Delusional
Figure − Brief Psychotic Disorders
− Schizotypal Personality Disorder
1809 John Haslam Superintendent of a British NOTE: Share features of extreme reality distortion
(1764-1844) hospital. In Observations on
Madness and Melancholy, he CLINICAL DESCRIPTION
outlined a description of the (Schizophrenia is a )Psychotic Disorder
symptoms of schizophrenia.
− used to characterize unusual behaviors including
schizophrenia
1801/ Philippe A french physician who − DELUSIONS (irrational beliefs)
1809 Pinel (1745- described cases of

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− HALLUCINATIONS (sensory experience in the prominent delusions or hallucinations, in addition to
absence of external events) the other required symptoms of schizophrenia, are
also present for at least 1 month (or less if
DIAGNOSTIC CRITERIA
successfully treated).

A. Two (or more) of the following, each present for a

Clinical Symptoms
significant portion of time during a 1-month period (or
less if successfully treated). At least one of these Positive Negative Disorganized
must be (1), (2) or (3):
1. Delusions - Delusions - Avolition - Disorganized
2. Hallucinations - Hallucinations
- Alogia speech
3. Disorganized speech (e.g., frequent derailment - Anhedonia - Inappropriate
or incoherence) Most obvious - Affective affecy &
4. Grossly disorganized or catatonic behavior signs of flattening disorganized
5. Negative symptoms (i.e., diminished emotional psychosis 50% behavior
expression or avolition) and 70% Absence of
normal behavior Variety of
B. For a significant portion of time since the onset of 25% erratic
the disturbance, level of functioning in one or more behaviors that
major areas, such as work, interpersonal relations, or affect speech,
selfcare is markedly below the level achieved prior to moptor
the onset (or when the onset is in childhood or behavior and
adolescence, there is a failure to achieve expected emotional
level of interpersonal, academic, or occupational reaction
functioning)
* POSITIVE SYMPTOMS
C. Continuous signs of the disturbance persist for at
least 6 months. This 6-month period must include at
DELUSION
least 1 month of symptoms (or less if successfully
− Disorder of thought content
treated) that meet the above criteria (i.e., active phase
− May false belief
symptoms) and may include periods of prodromal or
− Misrepresentation of reality
residual symptoms. During these prodromal or
− “the basic characteristics of madness”
residual periods, the signs of the disturbance may be
− Delusion of grandeur - believe that you have
manifested only be negative symptoms or by two or
more power than what is happening in the reality;
more symptoms listed in Criterion A present in an
you have more wealth etc.(most common among
attenuated form.
other delusions)
− Delusion of Persecution - when an individual is
D. Schizoaffective disorder and depressive or bipolar
actually convinced that someone is mistreating
disorder with psychotic features have been ruled out.
or conspiring against them. Pakiramdam na may
gustong manakit sa iyo.
E. The disturbance is not attributable to the
− Capgras Syndrome - irrational belief that a
physiological effects of a substance (e.g., a drug of
familiar person/place has been replaced with an
abuse, a medication) or another medical condition.
exact duplicate. Naniniwala sila na ang mga tao
sa paligid niya ay pinalitan ng mga duplicate.
F. If there is a history of autism spectrum disorder or a
− Cotard’s Syndrome - also known as “Walking
communication disorder of childhood onset, the
Corpse Syndrome” or Cotard’s delusion. They
additional diagnosis of schizophrenia is made only if
believe that some parts of their bodies are

CARISSA MAE D. MAGTIBAY | BSP 

 missing or they are dying or technically they do − Although they do not react openly to emotional
not exist. situations, they may be responding from inside
− Motivational View of Delusion - attempt to deal − May represent difficulty expressing emotion, not
with and relieve anxiety and stress (through a lack of feeling.
delusion). thru delusion, narerelieve nila yung
stress na meron sila in real life. * DISORGANIZED SYMPTOMS
− Deficit View of Delusion - from brain DISORGANIZED SPEECH
dysfunction that creates these distorted − Jump from topic to topic
cognitions. Biological POV why delusions exist. − Talk illogically
− Tangentiality - going off on a tangent instead of
HALLUCINATIONS answering the specific question
− Experience of sensory events w/o any input from − Loose association or derailment - change topic
surrounding environment to unrelated areas
− Auditory Hallucination - most common form
− People appear to have intrusive thoughts but INAPPROPRIATE AFFECT & DISORGANIZED
believe they are coming from somewhere or BEHAVIOR
someone else − Inappropriate Affect - laughing or crying at
− People who are hallucinating are not hearing the improper times
voices of others but listening to their own − Catatonia - motor dysfunctions that ranges from
thoughts or their own voices and cannot wild agitation to immobility.
recognize the differences.
− Visual hallucinations - may nakikita ka na wala DSM IV-TR VERSUS DSM V
naman don talaga. − Divisions of Schizophrenia: Paranoid,
Disorganized and Catatonic - were dropped from
* NEGATIVE SYMPTOMS diagnostic criteria in DSM 5
AVOLITION − Not used frequently in clinical work
− Inability to initiate and persist in activities − Nature of individual’s symptoms could move
− Lack of motivation or the ability to do task from one category to another
− Little interest in performing even the most basic − DIMENSIONAL ASSESSMENT OF SEVERITY
day-to-day functions is now used instead of divisions of schizophrenia.
− Apathy
DIMENSIONAL ASSESSMENT
ALOGIA Rate the severity (0-4 scale)
− Relative absence of speech 0 Not present
− Respond to question w/ brief replies that have lil
content and may appear uninterested in 1 Equivocal (not sure)
conversation.
− Trouble finding the right words to formulate their 2 Present but mild
thoughts.
− Takes form of delayed comments or slow 3 Present but moderate
responses to questions.
4 Present and severe
ANHEDONIA
− Lack of pleasure OTHER PSYCHOTIC DISORDER
− AFFECTIVE FLATTENING SCHIZOPHRENIFORM DISORDER
− Do not show emotions − Episode of disorder last at least 1 month but less
than 6 months

CARISSA MAE D. MAGTIBAY | BSP 

− Onset of psychotic symptoms w/in 4 weeks of  Unspecified Type - applies when
first noticeable change in usual behavior dominant delusional belief that cannot be
− Confusion at the height of psychotic episode clearly determined or is not described in
− Good premorbid (before the psychotic episode) specific types.
social and occupational functioning
− Absence of blunted or flat affect BRIEF PSYCHOTIC DISORDER
− Same ng criteria sa schizophrenia ang − Presence of one or more positive symptoms,
differences lang ay time frame. such as delusions, hallucinations or
disorganized speech or behavior
SCHIZOAFFECTIVE DISORDER − Lasting 1 month or less
− Schizophrenia + Mood disorder (depression or − Precipitated by extremely stressful situations
bipolar) − Walang negative symptoms
− Presence of a mood disorder, delusions or
hallucinations for at least 2 weeks in the CAUSES
absence of prominent mood symptoms BIOLOGICAL
− Sa MDD episodic, sa schizoaffective naman ay − Inherited tendency (multiple genes) to develop
prominent mood symptoms. disease. 50% chance if their parents have the
− DELUSIONAL DISORDER disorder
− Persistent belief that is contrary to reality, in − Prenatal/birth complications - viral infection
absence of other characteristics of during pregnancy/ borth injury affect child brain
schizophrenia cells
− Persistent delusion that is not the result of an − Brain chemistry (abnormalities in dopamine and
organic factor such as brain seizures or any glutamate)
severe psychosis − Brain structure (Enlarged ventricles)
− Walang negative symptoms
− Become socially isolated because they are SOCIAL INFLUENCES
suspicious of others − Environment (early family experiences) can
− Onset: Late (35-55 years old) trigger onset
− Afflict more females − Culture influences interpretation of
− Two categories: disease/symptoms (hallucinations, delusions)
 Substance-induced psychotic disorder
 Psychotic disorder associated w/ another EMOTIONAL AND COGNITIVE INFLUENCES
medical condition − Interaction styles that are high in criticism,
− Specifiers hostility and emotional overinvolvement can
 Erotomanic Type - delusion that is trigger relapse.
another person is in love with you
 Grandiose Type - same description w/ BEHAVIORAL INFLUENCES
grandeur − Positive Symptoms
 Jealous Type - delusion that his/her  Active manifestation of abnormal behavior
spouse or lover is unfaithful − Negative Symptoms
 Persecutory Type - belief that he/she is  Flat affect
being conspired against, attack etc.  Avoilition
 Somatic Type - delusion involves bodily  Alogia
functions or sensations
 Mixed Type - no delusional theme TRIGGERS
predominated. − Stressful, traumatic life event
− High expressed emotion

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− Sometimes no obvious trigger interfere with social, education or occupational
functioning
TREATMENT − Could be illegal, legal or prescribed by doctors.
− Individual, Group and Family Therapy − Psychoactive - substances that can alter mood,
 Can help patient and family understand behavior or both.
disease and symptom triggers
 Teaches families communication skills Intoxication
 Provide resources for dealing w/ emotional − Our physiological reaction to ingested
and practical challenges substances - drunkenness or getting high - is
− Social Skills Training substance intoxication
 Can occur in hospital or community − Experince as impaired judgement, mood
settings changes or lowered motor ability
 Teaches the person w/ schizophrenia − May physical manifestation na ang substances
social, self-care and vocational skills − For a person to become intoxicated, many
− Medications variable could interact
 Taking neuroleptic medications may help  Type of drug na naintake.
people w/ schizophrenia to:  Amount of substance ingested
 Clarify thinking and perceptions of − Risk factor
reality − Substance Use Disorder
 Reduce hallucinations and delusions − DSM 5 defines substance use disorders in terms
 Drug treatment mus be consistent to be of how significantly the use interferes with user’s
effective. Inconsistent dosage may life
aggravate existing symptoms or create new − Symptoms for substance use disorder can
ones. include physiological dependence on the drug
NOTE: Schizophrenia can be chronic and lifelong. of druges, meaning the use of increasingly
greater amount of drug to experience the same
SUBSTANCE-RELATED, ADDICTIVE and effect (tolerance) and a negative physical
IMPULSE-CONTROL DISORDERS response when substance is no longer ingested
(withdrawal)
DRUG USE WORLWIDE… − Kaya nagkaka-addiction kasi kapag ikaw ay
− Arouns 275 mil people used drugs worldwide dependent na sa drugs natotolerate na ng
while over 36 mil people suffer from substance katawan mo ang effect ng drug kaya mas
abuse disorder (United Nations-office on drugs tataasan mo ang amount na iintake mo na drug
and crime, 2021) to feel ang effect ng isang drug.
− Between 2010-2019 the number of people using − Ang effect ng withdrawal ay kasing problematic
druges increased by 22% ng physiological dependence
− Current projections suggest an 11% rise in the − If tolerance increases the amount increases that
number of people who use drugs globally 2030 result to addiction.

DRUG USE IN THE PHILIPPINES… TYPES OF SUBSTANCES…

− In 2019, 5227 admissions were recorded
− 97.93% of this were new cases while the rest DEPRESSANTS
were readmission. − Primarily decrease the central nervous system
− Substance Use effect
− Ingestion of psychoactive substances in − Principal effect is to reduce physiological arousal
moderate amounts that does not significantly and help people relax.

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ALCOHOL-RELATED DISORDERS − Extremely high doses = too much relaxation of
− Apparent stimulation is initial effect of alcohol, diaphragm muscles that cause death due to
altho it is a depressant suffocation.
− We generally experience a feeling of well-being, − Overdose of this drug is common means of
our inhibitions are reduced, and we become suicide
more outgoing. This is because the inhibitory − Cause ng suicide is too much relaxation of
centers in the brain are initially depressed-or diaphragm
slowed.
− The inhibitory center of the brain are slowed BENZODIAZEPINES
down in alcohol intake − Muscles relaxants and anticonvulsant
− Alcohol depresses more area of the brain which (antiseizures medicines)
impedes the ability to function properly − People who use them for nonmedical reasons
− Path traveled by alcohol report first feeling a pleasant high and a
 Ingestion reduction of inhibition, similar to the effects of
 Stomach drinking alcohol. With continued use, however,
 Small Intestine tolerance and dependence can develop.
 Heart
 Liver SPECIFIERS (alcohol and sedative disorders):
− Hand tremors - involuntary movement sa kamay  Mild - presence of 2-3 symptoms
(withdrawal symptoms)  Moderate - presence of 4-5 symptoms
− Most extreme withdrawal symptoms - delirium  Severe - presence of 6 or symptoms
tremens the conditions produced hallucinations
and body tremors STIMULANTS
− Most common consumed kind of psychoactive
SEDATIVE-, HYPNOTIC-, or ANXIOLYTIC-, drugs
RELATED DISORDERS − Stimulants are caffeine, nicotine
− General group of depressants also includes
sedative (calming), hypnotic (sleep-inducing), AMPHETAMINES
and anxiolytic (anxiety-reducing) drugs − Illegal drugs
− 12 month period ang symptoms − Low doses = induce feelings of elation and vigor
− Used medically; prescribed medicine, abuse in and can reduce fatigue
this kind of medicine can cause intoxication and − First synthesized in 1887 and later used as a
addicitions. treatment for asthma and as a nasal
 Barbiturates were prescribed to help decongestant
people sleep − Amphetamines are prescribed for people with
 Benzodiazepines used primarily to reduce narcolepsy
anxiety − Low doses could be beneficial for some
 Barbiturates and benzodiazepines are the − If you consumed this there will be period of
common cause of abuse and addictions. elevation and after the effect ay nawala biglang
bagsak ang mood into depressions, tiredness.
BARBITURATES − Examples are truck drivers who used
− Low doses = relax muscle and produce mild amphetamines in long drive
feeling of well being − Kind of amphetamines
− Large doses = slurred speech and problems in  Methylene-dioxymethamphetamine (MDMA)
walking, concentration and working. aka ECSTASY
 Molly (capsulated)

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  Methamphetamine aka crystal meth, shabu − This could lead to jittery and insomnia
or ice. − This drug is relatively long time bago mawala sa
 shabu is ingested thru smoking (foil sistema ng isang tao. Approximately 6 hours ang
method effectivity nito sa katawan.
 most common in Philippines.
− Too much amphetamine mood means too much OPIOID-RELATED DISORDERS
dopamine and more epinephrine leading to − Opiate refers to natural chemicals in opium
delusions and hallucinations poppy that have narcotic effect (they relieve pain
and induce sleep)
COCAINE − Heroin, methadone, hydrocodone, oxycodon
− Derived from the leaves of the coca plant, a − Our brain already has opioid in our endorphins
flowering bush indigenous to South America and enkephalins that could provide narcotic
− Small amounts cocaine increases alertness, effect
produce euphoria, increases blood pressure and − Opioid can be found in anesthesia.
pulse, and causes insomnia and loss of appetite. − High level of this opioid that could be found in
− 1903, people tried to make this cocaine cheaper opium poppy could be fatal and leads to feeling
thru coca-cola that until now being circulated of too much sleep.
around the world but smaller amount na siya − Not common in the Philippines
ngayon.
− same specifier sa Alcohol and Substance, 12 CANNABIS-RELATED DISORDER
month period din 2 symptoms − Cannabis (marijuana) was the drug of choice in
the 1960s and ear;y 1970s. Although it has
TOBACCO-RELATED DISORDERS decreased in popularity, it is still the most
− Nicotine in tobacco is a psychoactive substance routinely used illegal substance, with 5 to 15% of
that produce patterns of dependence, tolerance people in western countries reporting regular
and withdrawal - tobacco-related disorder use.
− DSM 5 does not describe an intoxication pattern − Frequent cannabis users suggests that
for this disorder rather, it lists withdrawal impairments of memory, concentration,
symptoms which include depressed mood, relationships with others, and employment may
insomnia, irritability, anxiety, difficulty be negative outcomes of long-term use.
concentrating, restlessness and increased − In the advent of 21st century, usage of cannabis
appetite and weight gain. became controversial because they legalize the
− Small doses stimulate our nervous system, it use of cannabis as medication.
release stress and regulate our mood
− It causes high blood and increases the chances HALLUCINOGEN-RELATED DISORDER
for heart diseases and cancer. − LSD (d-lysergic acid diethylamide), sometimes
− High doses could cause blur vision, confusions referred to as “acid”, is the most common
and sometimes leads to convulsion that can lead hallucinogenic drug
to death − Perceptual changes such as subjective
− CAFFEINE-RELATED DISORDERS intensification of eprceptions, depersonalization
− Caffeine is the most common of psychoactive and hallucinations. Physical symptoms include
substances; estimates indicate that upwards of pupillary dilation, rapid heartbeat, sweating and
85% of population has at least one caffeinated blurred vision.
beverage per day
− “GENTLE STIMULANTS” INHALANTS
− Least harmful but could lead to same symptoms − Found in volatile solvents - making them
to other disorders available to breathe into the lungs directly

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− Rugby, thinner, nail polish remover, markers,. effects of alcohol
− Diretso ito sa utak dahil sa ilong ito magsisimula.
Reduce alcohol Acamprosate (Campral)
ANABOLIC-ANDROGENIC STEROIDS cravings in abstinent
individuals
− Derived from or are a synthesized form of the
hormone testosterone
Maintenance of Disulfiram (Antabuse)
− Medical uses of these drugs fpcus on people abstinence
with asthma, anemia, breast cancer and males
with inadequate sexual development
CANNABIS No specific medical
− Long-term effects of steroid use seems to interventions
suggest that mood disturbances are common recommended
− Not common sa Pilipinas
COCAINE No specific medical
CAUSES OF SUBSTANCE RELATED DISORDERS interventions
recommended
PSYCHOSOCIAL STRESSORS
OPIOIDS Maintenance of Methadone
abstinence
PSYCHOLOGICAL INFLUENCES
− Positive reinforcement Buprenorphine
(Subutex)
− Negative reinforcement
− Cognitive influences
PSYCHOSOCIAL TREATMENT
EXPOSURE TO DRUG SUPPORTIVE THERAPY
− Media influence − CBT seeks to help patients recognize, avoid and
− Parental drug use cope w/ situations in w/c they’re most likely to
− Peer drug use use drugs
− Lack of parental monitoring − Contingency managements uses positive
reinforcement such as providing rewards or
BIOLOGICAL INFLUENCES privileges for remaining drugfree, for attending
− Sensitivity to drug and participating in counseling sessions or for
− Rate of metabolism functioning.
− Base levels of arousal - e.g., antisocial PD − Motivational enhancement therapy uses
− Disorders of mood or anxiety strategies to make most of people’s readiness to
change their behavior and enter treatment
TREATMENTS − Family therapy helps people (especially young
MEDICAL TREATMENTS people) w/ drug use problems as well as their
− Depends sa drug na naconsume families, address influences on drug use
patterns and improve overall family functioning.
Substance Treatment Goal Treatment Approach − ALCOHOLIC ANONYMOUS (AA) -
organizations founded by former alcoholics that
NICOTINE reduce withdrawal Nicotine replacement theys ee this as effective support for alcoholics
symptoms and therapy (patch, gum, in terms of denouncing alcohol use.
cravings spray, lozenge and
inhaler)

Bupropion (Zybian)

ALCOHOL Reduce reinforcing Naltrexone

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 PYROMANIA
− Involves having an irresistible urge to set fires
− These individuals will also be preoccupied with
fires and associated equipment involved in
setting and putting out these fires.

TREATMENT FOR IMPULSE CONTROL

DISORDER
− CBT is a widely used form of therapy that helps
individuals to learn how to modify potentially
detrimental thought patterns and behaviors
− Dialectical behavior therapy helps people control
self-harm behaviors such as suicidal attempts,
thoughts, or urges as well as drug use.
NON-SUBSTANCE/ADDICTIVE DISORDERS − Contingency management offers rewards for
engaging in healthy behaviors or avoiding
GAMBLING DISORDER unhealthy behavior such as drug use.
− Characteristics of people having gambling
disorder is the same w/ patterns of behavior NEURODEVELOPMENTAL DISORDERS
observed in substance-related disorder − disorders that are revealed in a clinically
− Research suggest that among pathological significant way during a child’s developing years
gamblers, 14% have lost at least one job, 19% and are of concern to families and educators
have declared bankruptcy, 32% have been − these difficulties often persist through adulthood
arrested and 21% have been incarcerated. and are typically lifelong problems.
− Reseachers see the same pattern how − seen mostly in children, although the problem
substance use abusers/addicts to the same
are still evident up until adulthood yet behaviors
pattern of pathological gamblers.
usually appear in children and could be
− Treatment is difficult for this disorder
− Treatment is often similar to substance diagnosed at that time.
dependece treatment and there is a parallel
Gambler’s Anonymous that incorporates the 12- Distinguishing Normal and Abnormal
step program. − development in children are technically spin
− Mentality “isang panalo lang, bayad lahat utang rapidly in a sense in the things they learn and
ko” they can learn many abilities
− child develops one skills before acquiring the
IMPULSE-CONTROL DISORDER next
− any disruption in the development of early skills
INTERMITTENT EXPLOSIVE DISORDER will, by the very nature of this sequential process,
− They act on aggressive impulses that result in disrupt the development of later skills
serious assaults or destcution of property − some workers in the field as symptoms of
− Controversial disorder; 1. validating aggressive abnormality.
impulses could be used as insanity defense
− if 6 months - 1year, wala pa ring monosyllabic
terms (e.g., ma-ma, ba-ba, de-de) that is
KLEPTOMANIA
− Recurrent failure to resist urges to steal things consider delay. therefore, the developmental
that are not needed for personal use or their process already disturbed.
monetary value.
− Magkaiba ito sa magnanakaw, kleptomania only ATTENTION-DEFICIT/HYPERACTIVITY DISORDER
have urges pero di nila ginagamit ang bagay, − pattern of inattention, such as being
kadalasan after masatisfy ang urge na manguha disorganized or forgetful about school or work-
and iiwan ang kinuha kung saan-saan. related tasks, OR of hyperactivity and impulsivity.

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− people with this disorder have a great deal of duties in the workplace (e.g., loses focus,
difficulty sustaining their attention on a task or side-tracked).
activity
ο Often has trouble organizing tasks and
− hyperactivity and problems sustaining
activities.
attention,impulsivity - acting apparently without
thinking - is a common complaint made about ο Often avoids, dislikes, or is reluctant to do
people with ADHD. tasks that require mental effort over a long
DSM 5 differentiates two categories: period of time (such as schoolwork or
 INATTENTION homework)
− people may appear not to listen to others;
they may lose necessary school ο Often loses things necessary for tasks and
assignments, books, or tools; and they activities (e.g. school materials, pencils,
may not pay enough attention to details, books, tools, wallets, keys, paperwork,
making careless mistakes. eyeglasses, mobile telephones)
− hindi siya malikot, they cannot maintain ο Is often easily distracted
attention at a task on hand.
ο Is often forgetful in daily activities.
 HYPERACTIVITY AND IMPULSIVITY
Hyperactivity and Impulsivity: Six or more
− hyperactivity includes fidgeting, having trouble
symptoms of hyperactivity-impulsivity for children
sitting for any length of time, always being on the
up to age 16 years, or five or more for adolescents
go.
age 17 years and older and adults; symptoms of
− impulsivity includes blurting out answers before
hyperactivity-impulsivity have been present for at
questions have been completed and having
least 6 months to an extent that is disruptive and
trouble waiting turns.
inappropriate for the person’s developmental level:

DIAGNOSTIC CRITERIA ο Often fidgets with or taps hands or feet, or

squirms in seat.
A. People with ADHD show a persistent pattern
of inattention and/or hyperactivity–impulsivity that ο Often leaves seat in situations when
interferes with functioning or development: remaining seated is expected.

Inattention: Six or more symptoms of inattention ο Often runs about or climbs in situations where
for children up to age 16 years, or five or more for it is not appropriate (adolescents or adults
adolescents age 17 years and older and adults; may be limited to feeling restless).
symptoms of inattention have been present for at
ο Often unable to play or take part in leisure
least 6 months, and they are inappropriate for
activities quietly.
developmental level:
ο Is often “on the go” acting as if “driven by a
ο Often fails to give close attention to details or
motor”.
makes careless mistakes in schoolwork, at
work, or with other activities. ο Often talks excessively.
ο Often has trouble holding attention on tasks ο Often blurts out an answer before a question
or play activities. has been completed.
ο Often does not seem to listen when spoken to ο Often has trouble waiting their turn.
directly.
ο Often interrupts or intrudes on others (e.g.,
ο Often does not follow through on instructions butts into conversations or games)
and fails to finish schoolwork, chores, or

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 − boys are 3 times more likely to be diagnosed
B. Several inattentive or hyperactive-impulsive with ADHD than girls. if babae usually inattentive
symptoms were present before age 12 years.
at kapag naman combined mas mataas ang
C. Several symptoms are present in two or more chance sa lalaki.
settings, (such as at home, school or work; with
friends or relatives; in other activities).
Causes
D. There is clear evidence that the symptoms − ADHD is more common in families in which one
interfere with, or reduce the quality of, social, person has the disorder
school, or work functioning. − ADHD is considered to be highly influenced by
E. The symptoms are not better explained by genetics
another mental disorder (such as a mood disorder, − prenatal smoking seemed to interact with this
anxiety disorder, dissociative disorder, or a genetic predisposition to increase the risk for
personality disorder). The symptoms do not hyperactive and impulsive behavior.
happen only during the course of schizophrenia or
another psychotic disorder. Treatment
− Psychosocial and biological intervention
− Behavioral interventions to help these children at
home and in school.
Note:
− Drugs such as methylphenidate (Ritalin
− sa ADHD, pwedeng impulsivity/hyperactivity
(common), Adderall) and several nonstimulant
lang and pwede ring inattention lang and pwede
medications such as atomoxetine (Strattera),
ring parehas na inattentive and
guanfacine (Tenex), and clonidine have proved
hyperactivity/impulsivity.
helpful in reducing the core symptoms of
− if adolescents, usually 5 symptoms would be
hyperactivity and impulsivity and in improving
enough to meet criteria A.
concentration on tasks
− present prior to the age of 12, nangyayari na
during childhood.
SPECIFIC LEARNING DISORDER
− the main criteria is C, dapat hindi lang sa iisang
− Characterized by performance that is
setting siya nagpapakita ng symptoms ng ADHD.
substantially below what would be expected
− inattention, hyperactivity and impulsivity often
given the person’s age, intelligence quotient (IQ)
cause other problems that appear secondary to
score and education.
ADHD
− Significant discrepancy between a person’s
− secondary consequences:
academic achievement and what would be
 children with ADHD are likely to be
expected for someone of the same age -
unpopular and rejected by their peers.
referred to by some as “unexpected
 academic performance might suffer
underachievement”
− Diagnosis of specific learning disorder requires
Statistics
that person’s disability not be caused by sensory
− prevalence of ADHD suggest that the disorder is
difficulty, such as trouble with sight or hearing,
found in about 2.5% of the child populations
and should not be the result of poor or absent
across all regions of the world
instruction
− different rates of diagnosis, some have argued
− Specifiers for disorder of reading
that ADHD in children is simply a cultural
(Dyslexia),written expression, or mathematics to
construct meaning that the behavior of these
highlight specific problems for remediation. As
children is typical from a developmental
with other disorders clinicians rate the disorder
perspective
on levels of severity.

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  Problems with social reciprocity (a
Statistics failure to engage in back-and-forth
− Frequency of this diagnosis appears to increase social interactions)
in wealthier regions of the country-suggesting  Nonverbal communication, and
that with better access to diagnostic services,  Initiating and maintaing social
more children are identified relationships
− Difficulties with reading are the most common of − Restricted, Repetitive Patterns of Behavior,
the learning disorders and occur in some form in Interests or Activities
4% to 10% of the general population.  Intense preference for the status quo has
been called maintenance of sameness
Communication and Motor Disorders
− Closely related to learning disorders but comparatively  People with ASD spend countless hours in
begin. Early appearance, wide range of problems later in stereotyped and ritualistic behaviors,
life. making such stereotyped movements as
spinning around in circles, waving their
TYPES DESCRIPTION TREATMENT hands in front of their eyes with their heads
cocked to one side or biting their hands.
Childhood disturbance in Psychological
Onset speech fluency Pharmacological Statistics
Fluency repeating words,
− 1 in 50 school-aged children in US had a
Disorder prolonging sounds,
(stuttering) extended pauses diagnosis under the category of ASD
− In the Philippines, estimated cases of autism
Language limited speech in all Psychological rose from 500,000 in 2008 to one million people
Disorder situations Some cases may in 2014. It is more common among boys (1 in 42)
be self-correcting than girls (1 in 189).

Social problems with the Psychological Causes

(Pragmatic) social aspects of − Psychological and Social Dimensions
Communication verbal and nonverbal
 Historically, ASD was seen as the result of
Disorder communication
failed parenting.
 Before ASD involves a lack of self-
Tourette’s involuntary motor Psychological
Syndrome movements such as pharmacological awareness. Self concept may be lacking
physical twitches or when people with ASD also have cognitive
vocalizations disabilities or delays, not because of the
disorder itself.
− Biological Dimension
AUTISM SPECTRUM DISORDER  ASD has a significant genetic component
− Neurodevelopmental disorder that at its core  Families have one child with ASD have
affects how one perceives and socializes with about 20% chance of having another child
others with the disorder
− Impairments in social communication and social  Premilinary work identifies an association
interaction, and restricted, repetitive patterns of between ASD and an oxytocin receptor
behavior, interests or activities gene
− Impairment in social communication and social  There appears to be an increased risk of
interaction having a child with ASD among older
 Fail to develop age-appropriate social parents
relationships
 Three aspects

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  The theory being proposed is that − Postnatal. For example, infections and head
amygdala in children with ASD is enlarged injury.
early in life − Someones it could be effect of genetically
− Treatment determined diseases such as:
− ASD - typically focused on teaching social skills  Phenylketonuria (PNU)
− Based on the belief that ASD is the result of  Inability to break down a chemicals in
improper parenting and they encouraged ego our diet called phenylalanine
development (the creation of self-image)  People with disorder had ID, seizures,
− Skill building and behavioral treatment of behavioral problems resulting from
problem behaviors. high levels of this chemicals
 Lesch-Nyhan syndrome
INTELLECTUAL DISABILITY (INTELLECTUAL  An X-linked disorder characterized by
DVELOPMENTAL DISORDER) ID, signs of cerebral palsy (Spasticity
− Disorder evident in childhood as significantly or tigthening of the muscles) and self-
below-average intellectual and adaptive injurious behavior, including finger
functioning and lip biting
− DSM 5 identifies difficulties in three domains:  Down syndrome(Trisonomy 21)
 Conceptual (e.g.; skill deficits in areas such  The most common chromosomal form
as language, reasoning, knowledge and of ID was first identified by British
memory) physician Langdon Down in 1866.
 Social (e.g., problems with social judgment
and the ability to make and retain Treatment
friendships,) and − Communication training is important for people
 Practical (e.g., difficulties managing with ID. Making their needs and wants known is
personal care or job responsibilities) essential for personal satisfaction and for
− Individuals with intellectual disability have participation in most social activities.
difficulty learning, the level of challenge − Augmentative strategies may use picture books,
depending on how extensive the cognitive teaching the person to make a request by
disability is pointing to a picture
− The American Association on Intellectual and − Computer assisted devices
Developmental Disabilities (AAIDD), which has
its own, similar definition of intellectual disability NEUROCOGNITIVE DISORDER
has a cutoff score of approximately 70 to 75 − Commonly diagnosed for elder people (middle to
− Classification systems have identified four levels old age)
of ID: mild, which is identified by and IQ score − DSM 5 major and mild neurocognitive disorders
between 50 - 55 and 70; moderate with a range are the main diagnosis
of 35-40 to 50-55; severe ranging 20-25 to 35-40; − It has something to do w/ cognition, there could
and profound which includes people with IQ be problem in cognitive domain of individual.
scores below 20-25 − Disorders under this have deterioratinglevel of
cognition that’s why it usually occurs to older
Causes people.
− Environmental. For example, deprivation, abuse, − Example of cognitive domain: attention. When
and neglect their cognitive domain of attention is
− Prenatal. For instance, exposure to disease or deteriorating they might not be able to do simple
drug while still in the womb task that could be previously done that needing
− Perinatal. Such as difficulties during labor and attention.
delivery − DELIRIUM

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− Characterized by impaired consciousness and  Substance/medication use
cognition during the course of several hours or  HIV infection
day  Prion disease
 Confusion, disorientation, inability to focus  Parkinson’s disease
− One of the earliest-recognized mental disorders  Huntingon’s disease
− Most prevalent among older adults, people with  Another medical condition
AIDS (autoimmunodeficiency syndrome) and  Multiple etiologies
patient on medication  Unspecified
− Earliest recognized mental disorder according to NEUROCOGNITIVE DISORDER DUE TO
some literature. ALZHEIMER’S DISEASE
− Appear confused, disoriented and out of touch − Increasing memory impairment and other
with their surroundings multiple behavioral and cognitive deficits,
− They cannot focus and sustain their attention on affecting language, motor functioning, ability to
even the simplest tasks recognize people or things, and/or planning.
− Could last only hours and other cases umaabot − Most prevalent neurocognitive disorder
ng days − Subject of most research
− Mabilis makalimot ang matanda but it is more
PREVALENCE than that in alzheimer’s.
− Estimated to be present in approximately 20% of − People with alzheimer’s have deteriorating
older adults who are admitted into acute care cognitive ability. It may start sa pagkalimot ng
facilities such as emergency rooms paonti-onti until it start to deteriorate in terms of
− Most prevalent among older adults, people functioning even in communication, even motor
undergoing medical procedures, cancer patients functioning until they cannot recognize other
and people with acquired immune deficiency people
syndrome (AIDS) − Progressive kind of disorder

TREATMENT HISTORY
− Pharmacological − 1907 - Alois Alzheimer first described the
 Benzodiazepines disorder
 Antipsychotics (Haloperidol) − Called the disorder an “atypical form of senile
− Psychosocial dementia”
 Reassurance
 Presence of personal objects NOTE: For DSM 5, ididiagnose ito ng major/mild
 Inclusion in treatment decisions neurocognitive then diagnose it again against criteria
of alzheimer’s disease
MAJOR NEUROCOGNITIVE AND MILD
NEUROCOGNITICE DISORDER PREVALENCE
− Major - the cognitive deficits interferes with − More prevalent in women than men
independence with everyday activities. − Varies according to racials identity
Substantial impairment − Also different in who seeks assistance
− Mild - modest, milder ang impairment
− SAME ANG CRITERIA OTHER FEATURES
− SPECIFIERS − Subsumed under the newly named MAJOR
 Alzheimer’s Disease NEUROCOGNITIVE DISORDER
 Frontotemporal lobar degeneration − Mild Neurocognitive Disorder
 Lewy body disease  Subsumed under “cognitive disorder not
 Vascular disease specified” under DSM-IV

CARISSA MAE D. MAGTIBAY | BSP 

CAUSES
− BIOLOGICAL
 progressive brain damage evident in
neurobrillary tangles and neuritic plaque,
confirmed by autopsy but assessed by
simplified mental status exam (MSE)
 involves multiple genes
 beta amyloid - could trigger and progress
alzheimer’s disease, type of hormone in
our body in w/c if nagkaroon ng
overproduction possible leads to
alzheimers

− PSYCHOLOGICAL − Stresses (any kind) might help/hinder the

 old age treatment process for physical diseases.
 stressors (diabetes, high blood pressure, Whenever you are facing stress the activity of
etc.) endocrine system would increased and this
primarily happens thru the activation of
− SOCIO-ECONOMIC STATUS hypothalamic-pituitary-adrenal (HPA) axis.
 may occur more often in people who are Kapag nagincrease ang activity ng endocrine
poorly educated activated by stress it will also increased the
corticotrophin-releasing hormone, then it will aso
PHYSICAL DISORDERS AND HEALTH increased the cortisol (stress hormone) secretion
PSYCHOLOGY
− The shift in focus from infectious disease to
psychological factors has been called the
second revolution in public health
− Health Psychology - branch of psychology
focusing how we could help in strengthening of
the psychological aspects that could help
developing treatment to other physical diseases.
Understanding stresses and how it affect
physical health.
− Psychosocial factors directly affect physical
health in two ways: − Naaactivate ang HPA axis due to stress. Once
 Psychosocial factors disrupt basic magactivate it will influence the endocrine
biological processess which may lead to specifically pituitary gland (master gland) secrete
physical disorders and diseases various hormones, it will be secreted in our
 Risky behaviors cause or contribute to blood streams and it will influence the
variety of physical disorders and disease. distribution of stress hormones. Cortisol leads sa
(e.g., smoking, drinking, poor eating habits, pagtaas ng glucose (sugar) , tumataas din ang
no exercise) sodium retention pati potassium excretion and
suppression of immune system (hindi gumagana
ang immune system)

CARISSA MAE D. MAGTIBAY | BSP 

PHYSICAL DISORDERS GREATLY AFFECTED BY  Many states require patient submit written
STRESS release notice to staff
− Acquired immunodeficiency syndrome (AIDS)  Free to discharge against medical advice
− Cancer − National Mental Health Act of 2009, House Bill
− Cardiovascular problems 1698
− Hypertension  SEC. 24. Voluntary Admission - every
− Coronary Heart Disease patient admitted voluntarily shall have the
right to leave the facility upon the
Legal Issues of Psychopathology recommendation of his attending
How the mental health system responded? psychiatrists. Provided, that the patient
− Clinicians always tries to balance the rights of may be retained for further treatment and
people who have psychological disorder with the care in case of following observations:
responsibility of the society to provide care.  A. There exists a serious likelihood of
danger of harming himself or others;
Arthur’s Case
 B. The severity of the patient’s mental
Arthur was brought to a clinic by family members because he was illness is likely to lead a serious
speaking and acting strangely. He talked incessantly about his deterioration in his condition; and
secret plan" to save all the starving children in the world. His  C. The appropriate treatment can only
family's concern intensified when Arthur said he was planning to
break into the German embassy and present his plan to the
be done by admission to mental
German ambassador. Alarmed by his increasingly inappropriate health facility
behavior and fearing he would be hurt, the family was astounded − INVOLUNTARY ADMISSION
to learn they could not force him into a psychiatric hospital. Arthur  Involuntary commitment or civil
could admit himself-which was not likely, given his belief that
commitment is a civil court process by
nothing was wrong with him-but they had no power to admit him
involuntarily unless he was in danger of doing harm to himself or which a petition is filed to initiate
others. Even if they sincerely believed some harm might be involuntary psychiatric treatment for a
forthcoming, this wasn't sufficient reason to admit him person who needs care but who is unwilling,
involuntarily. The family coped with this emergency as best they or incapacable of volunteering for treatment.
could for several weeks until the worst of Arthur's behaviors
began to diminish.
− CIVIL COMMITMENT
 A person can be legally declared to have a
mental illness and be placed in a hospital
Issues in Arthur’s Case
Why wouldn't the mental health facility admit Arthur, who was for treatment
clearly out of touch with reality and in need of help?  Philippine Mental Health Act (R.A. no.
Why couldn't his own family authorize the mental health facility to 11036) year 2018
act?  Before 2018, sumusunod ang Pilipinas sa
What would have happened if Arthur had entered the German
embassy and hurt or, worse, killed someone? resolution ng United Nation regarding sa
Would he have gone to jail, or would he have finally receive help principle of protecting mental illness and
from the mental health community? improvement of mental health care.
Would Arthur have been held responsible if he hurt other people  Two types of authority permit the
while he was delusional?
government to take actions that are against
a citizen’s will: police power and parens
Mental Health Laws Admission to the Hospital patriae power (if an individual couldn’t act
− VOLUNTARY ADMISSION based on their best interest. Walang
 Happens when a person enters a kakayahang magdecide para sa sarili kaya
psychiatric hospital at his/her own request ang nagdedecide is the court)
or at the suggestion of doctor, parent, or  Criteria for Civil Commitment
guardian  The person has a “mental illness” and
 Patient have the right to demand and is need of treatment
obtain release

CARISSA MAE D. MAGTIBAY | BSP 

  The person is dangerous to to conform his conduct to
himself/herself or others requirements of law.
 The person is unable to take care for  2. as used in the article, the
himself/herself, a situation considered terms “mental disease or defect”
a “grave disability” do not include an abnormality
− CRIMINAL COMMITMENT manifested only by repeated
 Criminal commitment is the process by criminal or otherwise antisocial
which people are held because (1) they conduct.
have been accused of committing a crime  Diminished capacity (1978) -
and are detained in a mental health facility evidence of abnormal mental
until they can be assessed as fit or unfit to condition would be admissible to
participate in legal proceedings against affect the degree of crime for which
them, or (2) they have been found not an accused could be convicted.
guilty of a crime by reason of insanity. Specifically, those offenses requiring
− The INSANITY DEFENSE intent or knowleddge could be
 The law recognizes that, under certain reduced to lesser included offenses
circumstances, people are not responsible requiring only reckless or criminal
for their behavior and it would be unfair and neglect
perhaps ineffective to punish them  Insanity Defense (1984) - a person
 EVOLUTION OF INSANITY DEFENSE charged with criminal offense should
 M’Naghten rule (1843)- Daniel be found not guilty by reason of
M’Naghten, he held the delusion that insanity if it is shown that, as a result
there is someone who wants to kill of mental disease or mental
him, so he kill the secretary of the retardation, he was unable to
British Prime Minister. [I]t musy be appreciate the wrongfulness of his
clearly provided that at the time of conduct at the time of his offense
committing the act, the party accused − Insanity Plea: NO GUARANTEE to exempt an
was labouring under such a defect of individual from criminal liability
reason, from disease of the mind, as
NGRI GBMI
not to know the nature and quality of Not guilty for Guilty but
the act he was doing; or if he did reason of insanity mentally ill
know it, that he did not know he was
doing what was wrong. Responsibility for Not Responsible Responsible
 Durham rule (1954) - an accused is crime
not criminally responsible if his
unlawful act was the product of Where committed? Forensic Hospital Prison
mental disease or mental defect.
 American Law Institute (ALI) rule Given sentence? NO YES
(1962) :
 1. A person is not responsible for When released? When ni longer End of sentence
criminal conduct if at the time of dangerous and but could then be
such conduct as a result of mentally-ill committed civilly
if dangerous and
mental disease or defect he mentally ill
lacks substantial capacity either
to appreciate the criminality Treatment given? YES POSSIBLY
(wrongfulness) of his conduct or

CARISSA MAE D. MAGTIBAY | BSP 

  Personal problems and conflicts - personal
− Conditions covered by INSANITY matters should not interfere
 Schizophrenia, formerly called dementia − Human Relations
praecox is covered by the term “insanity”  unfair discrimination - bawal mamili ng
 Unlawful act may be due to his mental client
defect, producing an irresistible  Harassment (Sexual and Non)
impulse.  Multiple Relationship
 Kleptomania may be covered by the term  Informed Consent
“insanity − Confidentiality
 Unlawful act may be due to his mental  Maintain Confidentiality
defect, producing an irresistible  Recording
impulse.  Consultation w/ the colleagues
 Somnambulism or sleepwalking is  Duty to warn - responsibility to warn our
embraced in the plea of insanity client as well as the family, if it could harm
 Act was done w/o criminal intent to himself/herself or other people.
 Pedophilia is not insanity
 Despite affliction, subject could
distinguish between right and wrong
− Mental health professionals as expert witnesses
 Judges and juries often have to rely on
expert witnesses, individuals who have
specialized knowledge, to assist the, in
making decisions. We have alluded to
several instances in which mental health
professionals serve in such a capacity,
providing info about a person’s
dangerousness or ability to understand and
participate in the defense.
− Patients’ Rights and Clinical Practice Guidelines
 The right to treatment
 The right to refuse treatment
 The right of research participants

CODE OF ETHICS IN PHILIPPINES FOR

PRACTICING THE PSYCHOLOGY PROFESSION
− COMPETENCIES (KSAO)
 Boundaries of competencies - wag
marunong-runungan, kung hanggang saan
ang kaya mo at ang alam mo yun na lang
muna.
 Maintain competencies- never stop
learning, wag magsettle sa kung ano lang
ang alam.
 Delegation of work to others - we could
delegate work to people but inform the
client first.

CARISSA MAE D. MAGTIBAY | BSP 