Adult Psychopathology and Diagnosis

Adult Psychopathology and Diagnosis
Contents
Contributors
Preface
About the Companion Website
Part I: Overview
Chapter 1: Mental Disorders as Discrete Clinical Conditions: Dimensional Versus Categorical Classification
Diagnostic Boundaries
Depression
The Continuum of Depression
Subthreshold Major Depression
Alcohol Abuse and Dependence
Personality Disorders
Boundaries with Other Mental Disorders
Boundaries with Other Personality Disorders and Normal Personality
Intellectual Disability
Dsm-5 and Dimensional Classification
References
Chapter 2: Promise and Challenges with the Research Domain Criteria Framework
Research Domain Criteria: Description and Reasons for Development
The RDoC Matrix
Illustrative Example for the Rdoc Matrix
RDoC Critiques and Responses
Examples of Individual Research Projects Using Rdoc-Compatible Methodologies
Summary
References
Chapter 3: The Problem of Dual Diagnosis
Methodological Issues in the Assessment Diagnosis
Sample Selection Influences Findings
Study Methods and Assessment Measures Influence Findings
There Is No Single Definition of Dual Diagnosis
Findings From Major Epidemiological Studies
Dual Diagnosis Is Highly Prevalent in Community Samples
High Prevalence Rates of Dual Diagnosis Persist Over Time
Dual Diagnosis Is Only One Part of the Comorbidity Puzzle
Gambling Disorder
Tobacco Dependence
Cross-National Epidemiological Studies
Prevalence of Dual Diagnosis in Age-Related Subgroups
Interplay of Psychiatric Disorders and Comorbid Medical Conditions
Findings From Studies of Clinical Samples
Dual Diagnosis in General Psychiatric Patients
Dual Diagnosis in Samples of Patients with Specific Disorders
Dual Diagnosis in Patients with Primary SUDs
Clinical Impact of Dual Disorders
Impact of Dual Diagnosis on Functioning
Symptoms, Course of Illness, and Life Functioning
Cognitive Functioning
Treatment Noncompliance and Violence
Impact of Dual Diagnosis on Clinical Care and Related Factors
Service Utilization and Health Care Costs
Physical Illness
Legal Problems
Homelessness
Issues for Women with Serious Mental Illness and Substance Abuse
Provision of Treatment and Treatment Outcome
Impact of Dual Disorders on Assessment and Diagnosis
Symptom Overlap
Multiple Impairments Owing to Different Disorders
Substance-Induced Disorders Resemble Psychiatric Disorders
Implications for Nosology
Impact of Dual Diagnosis on Psychopathology Research
Diagnostic and Sample Selection Issues in Psychopathology Research
Interpretation of Psychopathology and Treatment Outcome Research
Theories of Dual Diagnosis
Common Factors Models
Secondary Substance Abuse Models
Secondary Psychiatric Disorder Models
Bidirectional Models
Summary and Future Directions
References
Chapter 4: Structured and Semistructured Interviews for Differential Diagnosis: Fundamental Issues, Applications, and Features
Basic Issues Regarding Structured and Semistructured Interviews
Applications of Structured and Semistructured Interviews
Research
Clinical Practice
Clinical Training
Advantages and Disadvantages of Structured and Semistructured Interviews
Advantage: Increased Reliability
Advantage: Increased Validity
Advantage: Utility as Training Tools
Disadvantage: May Hinder Rapport
Disadvantage: Limited by the Validity of the Classification System Itself
Disadvantage: The Trade-Off of Breadth Versus Depth
Weighing Advantages and Disadvantages
Structured and Semistructured Interviews for Differential Diagnosis
Anxiety Disorders Interview Schedule for DSM-5
Diagnostic Interview Schedule for DSM-5
Schedule for Affective Disorders and Schizophrenia
Structured Clinical Interview for DSM-5 Disorders
Semistructured Interviews for Personality Disorders
Diagnostic Interview for Personality Disorders
International Personality Disorder Examination
Structured Clinical Interview for DSM-5 Personality Disorders
Structured Interview for DSM-IV Personality
The Cultural Formulation Interview (CFI) of DSM-5
Summary and Conclusions
References
Chapter 5: Impact of Race, Ethnicity, and Culture on the Expression and Assessment of Psychopathology
Relevance of Ethnic Identity and Acculturation InAdultPsychopathology
Relevance of Sociocultural Factors in Adult Psychopathology
Expression/Assessment of Psychopathology
Expression of Psychopathology Differs Across Cultural Groups
Expression of Psychopathology Differs Within National Borders
Prevalence Rates May Differ for Cultural Reasons
Stigma and Somatization of Distress Across Cultures
Spirituality and Religion
Racism and Discrimination
Language and Symptom Expression
Treatment Issues
Clinician and Client Interplay
Role of Stereotypes, Biases, and the Clinician's Culture
Culture as an Integral Part of Assessment
Mistrust of Medical Institutions and Establishment
Lack of Awareness Can Result in Misdiagnosis
Conclusions
References
Part II: Specific Disorders
Chapter 6: Schizophrenia Spectrum and Other Psychotic Disorders
Introduction
Description of the Disorder
Clinical Picture
Diagnostic Considerations
Substance Use Disorders
Mood Disorders
Schizoaffective Disorder
Epidemiology
Psychological and Biological Assessment
Psychological Assessment
Family Assessment
Biological Assessment
Etiological Considerations
Behavioral Genetics and Molecular Genetics
Neuroanatomy and Neurobiology
Learning, Modeling, and Life Events
Sex and Racial-Ethnic Considerations
Course and Prognosis
Case Study
Case Identification
Presenting Complaints
History
Assessment
Summary
References
Chapter 7: Bipolar and Related Disorders
Description of the Disorder
Epidemiology
Age at Onset
Gender and Racial-Ethnic Issues
Clinical Picture
Suicide
Functional Impairment
Medical Comorbidity and Mortality
Course and Prognosis
Psychosocial Predictors of the Course of Bipolar Disorder
Psychosocial Predictors of Depression Within BD
Psychosocial Predictors of Mania
Goal Dysregulation
Sleep and Schedule Disruption
Treatment of BD
Pharmacological Treatments
Psychotherapy as an Adjunct to Medication Maintenance
Diagnostic Considerations
The Bipolar Spectrum
Diagnosis in Children and Adolescents
Dual Diagnosis
Diagnostic Assessment Methods
Etiological Considerations
Heritability
Neurotransmitter Dysregulation
Dopamine
Serotonin
Inflammatory Markers
Brain Regions Involved in Bipolar Disorder
Case Study
Case Identification and Presenting Complaints
Summary
References
Chapter 8: Depressive Disorders
Description of the Disorders
Major Depressive Disorder
Specifiers
Persistent Depressive Disorder
Specifiers
Premenstrual Dysphoric Disorder
Substance/Medication-Induced Depressive Disorder
Depressive Disorder due to Another Medical Condition
Other Specified Depressive Disorder and Unspecified Depressive Disorder
Diagnostic Specifiers
When Depression Is not a Depressive Disorder
Clinical Picture
Diagnostic Considerations
Medical Illness
Drug and Alcohol Use and Abuse
Grief and Bereavement
Depression Due to Other Psychiatric Disorders
Late-Life Depression
Epidemiology
Community Samples
Prevalence by Gender
Prevalence by Age Cohort
Prevalence in Racial/Ethnic Minorities
Prevalence in Special Settings
Psychological Assessment
Screening Instruments
Structured and Semi-Structured Clinical Interviews
The Structured Clinical Interview for DSM-5 Disorders
Composite International Diagnostic Interview
The Mini-International Neuropsychiatric Interview
Comment
Etiological Considerations
Familial and Genetic Factors
Neuroanatomy and Neurobiology
Neuroanatomy and Neurocircuitry
Neurochemistry and Transmitters
Psychological Factors
Life Events
Gender, Race, and Ethnicity
Course and Prognosis
Course
Prognosis
Treatment
Case Studies
Major Depression
Case Identification
Presenting Complaints
History
Assessment
Persistent Depressive Disorder
Case Identification
Presenting Complaints
History
Assessment
Unspecified Depressive Disorder
Case Identification
Presenting Complaints
History
Assessment/Treatment
Summary
References
Chapter 9: Anxiety Disorders
Description of the Disorders
Panic Disorder
Agoraphobia
Generalized Anxiety Disorder
Social Anxiety Disorder
Specific Phobias
Diagnostic Considerations
Epidemiology
Panic Disorder
Prevalence
Gender
Age of Onset
Comorbidity
Clinical Course
Agoraphobia
Prevalence
Gender
Age of Onset
Comorbidity
Clinical Course
Generalized Anxiety Disorder
Prevalence
Gender
Age of Onset
Comorbidity
Clinical Course
Social Anxiety Disorder
Prevalence
Gender
Age of Onset
Comorbidity
Clinical Course
Specific Phobia
Prevalence
Gender
Age of Onset
Comorbidity
Clinical Course
Assessment
Clinical Interviews
Self-Report Measures
Behavioral Assessments
Biological Assessment
Treatment
Pharmacological Treatments
Panic Disorder
Generalized Anxiety Disorder
Social Anxiety Disorder
Specific Phobia
Cognitive-Behavioral Treatments
Panic Disorder
Generalized Anxiety Disorder
Social Anxiety Disorder
Specific Phobia
Other Psychological Treatments
Combined Pharmacological and Psychological Treatments
Predictors of Treatment Outcome
Etiology
Behavioral Genetics
Biological Considerations
Hypothalamic-Pituitary-Adrenal Axis
Autonomic Inflexibility
Neurological Considerations
Panic Disorder
Social Anxiety Disorder
Specific Phobia
Generalized Anxiety Disorder
Specific Genes
Personality and Temperament
Anxiety Sensitivity
Behavioral Inhibition and Shy Temperament
Behavioral Considerations
Classical Conditioning
Operant Conditioning
Vicarious Conditioning
Informational Acquisition
Preparedness Theory
Cognitive Considerations
Content-Specific Cognitions and Related Variables
Cognitive Processes and Related Variables
Socialization and the Social Environment
Culture
Life Events
References
Chapter 10: Obsessive-Compulsive and Related Disorders
Etiological Considerations
Behavioral and Molecular Genetics
Neuroanatomy and Neurobiology
Learning, Modeling, and Life Events
Cognitive Influences
Sex and Racial-Ethnic Considerations
Course and Prognosis
Case Studies
Obsessive-Compulsive Disorder
Identifying Information and Presenting Problem
Assessment and Treatment
Body Dysmorphic Disorder
Identifying Information and Presenting Problem
Assessment and Treatment
Hoarding Disorder
Identifying Information and Presenting Problem
Assessment and Treatment
Trichotillomania
Identifying Information and Presenting Problem
Assessment and Treatment
Excoriation (Skin-Picking) Disorder
Identifying Information and Presenting Problem
Assessment and Treatment
References
Chapter 11: Trauma and Stressor-Related Disorders: Post-traumatic Stress Disorder, Acute Stress, and Adjustment Disorders
Clinical Features
Diagnostic Considerations
Epidemiology
Psychological and Biological Assessment
Etiological Considerations
Behavioral and Molecular Genetics
Neuroanatomy and Neurobiology
Learning, Modeling, and Life Events
Cognitive Influences
Sex and Racial-Ethnic Considerations
Course, Prognosis, and Treatment
Case Studies
Post-Traumatic Stress Disorder
Adjustment Disorder
Summary
References
Chapter 12: Somatic Symptom and Related Disorders
Description of the Disorders
Specific Disorders
Clinical Picture
Somatic Symptom Disorder
Illness Anxiety Disorder
Conversion Disorder (Functional Neurological Symptom Disorder)
Psychological Factors Affecting Other Medical Conditions
Factitious Disorder
Other Specified Somatic Symptom and Related Disorder and Unspecified Somatic Symptom and Related Disorder
Diagnostic Considerations (Including Dual Diagnosis)
Epidemiology
Psychological and Biological Assessment
Etiological Considerations
Behavioral Genetics and Molecular Genetics
Neuroanatomy and Neurobiology
Learning, Modeling, and Life Events
Cognitive Influences
Sex and Racial-Ethnic Considerations
Course and Prognosis (Including Issues of Treatment)
Case Study
Case Identification
Presenting Complaints
History
Assessment (Related To DSM-5 Criteria)
Summary
References
Chapter 13: Dissociative Disorders
Dissociative Amnesia
Epidemiology
Dissociative Fugue
Diagnostic Considerations
Epidemiology
Depersonalization/Derealization Disorder
Diagnostic Considerations
Epidemiology
Dissociative Identity Disorder
Diagnostic Considerations
Epidemiology
Psychological Assessment
Structured Interview Measures
Self-Report Measures
Case Example
Case Identification and Presenting Complaints
History
Assessment
Etiological Considerations
Behavioral Genetics
Biology
Learning, Modeling and Life Events
The Post-Traumatic Versus the Sociocognitive Models of Dissociation
Cognitive Mechanisms of Dissociation
Sleep, Memory, and Dissociation: Possibilities for Theoretical Integration
Signs of Theoretical Convergence
Treatment
Depersonalization and Derealization
Dissociative Identity Disorder
Conclusion
References
Chapter 14: Feeding and Eating Disorders
Description of the Disorders
Clinical Picture
Diagnostic Considerations
Epidemiology
Psychological and Biological Assessment
Structured Interviews
Self-Reports
Medical Assessment
Etiological Considerations
Behavioral Genetics and Molecular Genetics
Neuroanatomy and Neurobiology
Neuropeptides
Monoamines
Structural Abnormalities
Learning, Modeling, and Life Events
Life Events
Distress Tolerance
Cognitive Functioning
Racial-Ethnic Considerations
Course and Prognosis
Case Study
Referral
Presenting Complaints
History
Assessment
Summary
References
Chapter 15: Sleep Disorders
Introduction
Features of Healthy Sleep
Sleep Stages
Sleep Architecture
Sleep Measurement
Self-Report Measures
Actigraphy
Polysomnography
Multiple Sleep Latency Test (MSLT)
Sleep Disorders
Insomnia Disorder
Epidemiology
Etiology
Diagnosis
Comorbid Medical and Psychological Factors
Hypersomnolence Disorder
Epidemiology
Etiology
Diagnosis
Comorbid Medical and Psychological Factors
Circadian Rhythm Disorders
Epidemiology
Etiology
Diagnosis
Comorbid Medical and Psychological Factors
Nightmare Disorder
Epidemiology
Etiology
Diagnosis
Comorbid Medical and Psychological Factors
REM Sleep Behavior Disorder
Epidemiology
Etiology
Diagnosis
Comorbid Medical and Psychological Factors
Non-REM Sleep Arousal Disorders
Epidemiology
Etiology
Diagnosis
Comorbid Medical and Psychological Factors
Case Study
Background and History
Diagnostic Conceptualization
Summary
References
Chapter 16: Sexual Dysfunctions and Paraphilic Disorders
Part I: Sexual Dysfunctions Description of Sexual Disorders
Clinical Picture
Delayed Ejaculation
Erectile Disorder
Female Orgasmic Disorder
Female Sexual Interest/Arousal Disorder
Genito-Pelvic Pain/Penetration Disorder
Male Hypoactive Sexual Desire Disorder
Premature (Early) Ejaculation
Substance/Medication-Induced Sexual Dysfunction
Other Specified Sexual Dysfunction and Unspecified Sexual Dysfunction
Diagnostic Considerations
Epidemiology
Psychological and Biological Assessment
Etiological Considerations
Delayed Ejaculation
Erectile Disorder
Female Orgasmic Disorder
Female Sexual Interest/Arousal Disorder
Genito-Pelvic Pain/Penetration Disorder
Male Hypoactive Sexual Desire Disorder
Premature (Early) Ejaculation
Course, Prognosis, and Treatment
Delayed Ejaculation
Erectile Disorder
Female Orgasmic Disorder
Female Sexual Interest/Arousal Disorder
Genito-Pelvic Pain/Penetration Disorder
Male Hypoactive Sexual Desire Disorder
Premature (Early) Ejaculation
Case Studies
Hypoactive Sexual Desire Disorder in a Man
A Couple-Based Approach to Genito-Pelvic Pain/Penetration Disorder
Summary of Sexual Dysfunctions
Part II: Paraphilic Disorders
Description of Paraphilias
Clinical Picture
Exhibitionistic Disorder
Fetishistic Disorder
Frotteuristic Disorder
Pedophilic Disorder
Sexual Masochism Disorder
Sexual Sadism Disorder
Transvestic Disorder
Voyeuristic Disorder
Other Specified Paraphilic Disorder
Unspecified Paraphilic Disorder
Diagnostic Considerations
Epidemiology
Psychological and Biological Assessment
Self-Report Measures
Psychophysiological Measures
Etiological Considerations
Neuroanatomy and Neurobiology
Learning, Modeling, and Life Events
Cognitive Influences
Course, Prognosis, and Treatment
Case Study
Summary
References
Chapter 17: Gender Dysphoria
Description of the Disorder
History and Terminology
Clinical Picture
Typical Clinical Presentations
Less Common Clinical Presentations
Subtypes of GD in Adults
Subtypes Based on Sexual Orientation
Subtypes Based on Age of Onset
Diagnostic Considerations
Diagnosing GD
Differential Diagnosis
Comorbid Psychiatric Conditions and Dual Diagnoses
Epidemiology
Prevalence and Sex Ratio
Age of Onset
Psychological and Biological Assessment
Psychological Assessment
Biological Assessment
Clinical Course and Treatment
Clinical Course
Unresolved or Unknown Outcomes
Acceptance of Natal Gender
Part-Time Cross-Gender Behavior
Full-Time Cross-Living and Sex Reassignment
Treatment
Treatment Guidelines
Counseling and Psychotherapy
Cross-Sex Hormone Therapy
RLE in the Desired Gender Role
Sex Reassignment Surgery
Outcomes of Sex Reassignment
Etiological Considerations
Behavioral Genetics and Molecular Genetics
Behavioral Genetics
Molecular Genetics
Neuroanatomy and Neurobiology
Neuroanatomy: Histological Studies
Neuroanatomy: Imaging Studies
Neurophysiology
Learning, Modeling, and Life Events
Cognitive Influences
Sex and Ethnicity Considerations
Case Study
Summary
References
Chapter 18: Substance-Related and Addictive Disorders: Alcohol
Description of the Disorder
Clinical Picture
Diagnostic Considerations
Epidemiology
Psychological and Biological Assessment
Critical Issues in Assessment
Alcohol Use
Alcohol Use Consequences
Co-occurring Disorders
High-Risk Situations and Self-Efficacy
Neuropsychological Functioning
Barriers To Change
Biochemical Measures
Etiological Considerations
Behavioral Genetics and Molecular Genetics
Neuroanatomy and Neurobiology
Learning, Modeling, and Life Events
Cognitive Influences
Sex and Racial-Ethnic Considerations
Course and Prognosis
Case Study
Case Identification
Presenting Complaints
History
Assessment
Summary
References
Chapter 19: Substance-Related and Addictive Disorders: Drugs
Introduction
Diagnostic Considerations
Clinical Picture
Physiological and Psychological Effects
Comorbidity
Assessment
Screening and Treatment Planning
Biological Detection
Etiological Considerations
Genetics
Behavioral Genetics
Molecular Genetics
Gene-Environment Interactions
Learning and Habituation
Executive Functioning
Neuroanatomy and Neurobiology
Brain Reward Circuits
Brain Stress Circuits
Neuroadaptation in Reward and Stress Circuitry
Specific Populations
Sex and Gender
Race and Ethnicity
Sexual Orientation
Course and Prognosis
Case Study
Case Identification
Presenting Complaints
History
Assessment
Summary
References
Chapter 20: Neurocognitive Disorders
Introduction and Recent Developments
Diagnostic Considerations
Clinical Presentation
Delirium
Major and Mild Neurocognitive Disorders
Major or Mild Neurocognitive Disorders of the Alzheimer's Type
Major or Mild Frontotemporal Neurocognitive Disorder
Major or Mild Neurocognitive Disorder With Lewy Bodies
Major or Mild Vascular Neurocognitive Disorder
Major or Mild Neurocognitive Disorder due to Huntington's Disease
Other Conditions Important for Understanding Brain Functioning
The Communicative Disorders
Disorders of Perception and Motility
Amnesia
Pseudodementia
Epidemiology
Psychological and Biological Assessment
Etiological Considerations
Head Trauma
Diseases of the Circulatory System
Degenerative and Demyelinating Diseases
Alcoholism
Toxic, Infectious, and Metabolic Illnesses
Genetic Factors
Course and Prognosis
Summary
References
Chapter 21: Personality Disorders
Defining Personality: Traits, Dynamics, Pathology, and Disorders
Personality Traits
Personality Dynamics
Severity of Personality Pathology
Personality Disorder Style
The Separation of Personality Pathology and Disorder
Diagnostic Considerations: An Historical Backdrop to the Dsm-Iv
DSM-I and DSM-II
DSM-III and DSM-IV
Clinical Picture: the Dsm-5 Section Ii Personality Disorders
Research on the Dsm-5 Section Ii Personality Disorders
Epidemiology
Etiology
Genetics
Neurobiology
Learning and Cognition
Course and Prognosis
Course
Treatment Effects
Assessment
DSM
Trait Models
Psychoanalytic Assessment
Summary
The Dsm-5
Criticisms of the DSM-5 Section II PDs
DSM-5 Section III PDs
The Scientific Validity of DSM-5 Section III PDs
The Clinical Utility of DSM-5 Section III PDs
Case Study
DSM-IV Diagnosis
DSM-5 Diagnosis
Nimh Research Domain Criteria Initiative
DSM-5 and RDoC
Interpersonal Hypersensitivity and the RDoC Negative Valence System
Detachment and the RDoC System for Social Processes
Summary
References
Author Index
Subject Index
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