File Name: understanding the latent structure of the emotional disorders in children and adolescents.zip
- The latent structure of Acute Stress Disorder symptoms in trauma‐exposed children and adolescents
- Classification of mental disorders
- Mental disorder
The latent structure of Acute Stress Disorder symptoms in trauma‐exposed children and adolescents
A mental disorder , also called a mental illness  or psychiatric disorder , is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Many disorders have been described, with signs and symptoms that vary widely between specific disorders.
The causes of mental disorders are often unclear. Theories may incorporate findings from a range of fields. Mental disorders are usually defined by a combination of how a person behaves, feels, perceives, or thinks. A mental disorder is one aspect of mental health. Cultural and religious beliefs, as well as social norms , should be taken into account when making a diagnosis. Services are based in psychiatric hospitals or in the community , and assessments are carried out by mental health professionals such as psychiatrists, psychologists, psychiatric nurses and clinical social workers , using various methods such as psychometric tests but often relying on observation and questioning.
Treatments are provided by various mental health professionals. Psychotherapy and psychiatric medication are two major treatment options. Other treatments include lifestyle changes, social interventions, peer support , and self-help. In a minority of cases, there might be involuntary detention or treatment. Prevention programs have been shown to reduce depression. The definition and classification of mental disorders are key issues for researchers as well as service providers and those who may be diagnosed.
For a mental state to classify as a disorder, it generally needs to cause dysfunction. It has been noted that using the term "mental" i. According to DSM-IV , a mental disorder is a psychological syndrome or pattern which is associated with distress e. DSM-IV precedes the definition with caveats, stating that, as in the case with many medical terms, mental disorder "lacks a consistent operational definition that covers all situations", noting that different levels of abstraction can be used for medical definitions, including pathology, symptomology, deviance from a normal range, or etiology, and that the same is true for mental disorders, so that sometimes one type of definition is appropriate, and sometimes another, depending on the situation.
In , the American Psychiatric Association APA redefined mental disorders in the DSM-5 as "a syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. The terms "mental breakdown" or "nervous breakdown" may be used by the general population to mean a mental disorder. Additionally to the concept of mental disorder, some people have argued for a return to the old-fashioned concept of nervous illness.
About half of them are depressed. Or at least that is the diagnosis that they got when they were put on antidepressants. They go to work but they are unhappy and uncomfortable; they are somewhat anxious; they are tired; they have various physical pains—and they tend to obsess about the whole business. There is a term for what they have, and it is a good old-fashioned term that has gone out of use.
They have nerves or a nervous illness. It is an illness not just of mind or brain, but a disorder of the entire body. We have a package here of five symptoms—mild depression, some anxiety, fatigue, somatic pains, and obsessive thinking. We have had nervous illness for centuries. When you are too nervous to function But that term has vanished from medicine, although not from the way we speak The nervous patients of yesteryear are the depressives of today.
That is the bad news There is a deeper illness that drives depression and the symptoms of mood. We can call this deeper illness something else, or invent a neologism, but we need to get the discussion off depression and onto this deeper disorder in the brain and body. That is the point.
In eliminating the nervous breakdown, psychiatry has come close to having its own nervous breakdown. Both of these list categories of disorder and provide standardized criteria for diagnosis.
They have deliberately converged their codes in recent revisions so that the manuals are often broadly comparable, although significant differences remain. Other classification schemes may be used in non-western cultures, for example the Chinese Classification of Mental Disorders , and other manuals may be used by those of alternative theoretical persuasions, for example the Psychodynamic Diagnostic Manual.
In general, mental disorders are classified separately from neurological disorders , learning disabilities or intellectual disability. Unlike the DSM and ICD, some approaches are not based on identifying distinct categories of disorder using dichotomous symptom profiles intended to separate the abnormal from the normal. There is significant scientific debate about the relative merits of categorical versus such non-categorical or hybrid schemes, also known as continuum or dimensional models.
A spectrum approach may incorporate elements of both. In the scientific and academic literature on the definition or classification of mental disorder, one extreme argues that it is entirely a matter of value judgements including of what is normal while another proposes that it is or could be entirely objective and scientific including by reference to statistical norms.
Some neurologists argue that classification will only be reliable and valid when based on neurobiological features rather than clinical interview, while others suggest that the differing ideological and practical perspectives need to be better integrated. The DSM and ICD approach remains under attack both because of the implied causality model  and because some researchers believe it better to aim at underlying brain differences which can precede symptoms by many years.
The high degree of comorbidity between disorders in categorical models such as the DSM and ICD have led some to propose dimensional models. Studying comorbidity between disorders have demonstrated two latent unobserved factors or dimensions in the structure of mental disorders that are thought to possibly reflect etiological processes. These two dimensions reflect a distinction between internalizing disorders, such as mood or anxiety symptoms, and externalizing disorders such as behavioral or substance abuse symptoms.
The p factor model supports the internalizing-externalizing distinction, but also supports the formation of a third dimension of thought disorders such as schizophrenia. There are many different categories of mental disorder, and many different facets of human behavior and personality that can become disordered. Anxiety disorder : Anxiety or fear that interferes with normal functioning may be classified as an anxiety disorder.
Mood disorder involving unusually intense and sustained sadness, melancholia, or despair is known as major depression also known as unipolar or clinical depression. Milder but still prolonged depression can be diagnosed as dysthymia.
Bipolar disorder also known as manic depression involves abnormally "high" or pressured mood states, known as mania or hypomania , alternating with normal or depressed moods. The extent to which unipolar and bipolar mood phenomena represent distinct categories of disorder, or mix and merge along a dimension or spectrum of mood, is subject to some scientific debate.
Psychotic disorder : Patterns of belief, language use and perception of reality can become dysregulated e. Psychotic disorders in this domain include schizophrenia , and delusional disorder.
Schizoaffective disorder is a category used for individuals showing aspects of both schizophrenia and affective disorders. Schizotypy is a category used for individuals showing some of the characteristics associated with schizophrenia but without meeting cutoff criteria. Personality disorder : Personality —the fundamental characteristics of a person that influence thoughts and behaviors across situations and time—may be considered disordered if judged to be abnormally rigid and maladaptive.
A number of different personality disorders are listed, including those sometimes classed as "eccentric", such as paranoid , schizoid and schizotypal personality disorders; types that have described as "dramatic" or "emotional", such as antisocial , borderline , histrionic or narcissistic personality disorders; and those sometimes classed as fear-related, such as anxious-avoidant , dependent , or obsessive-compulsive personality disorders.
The personality disorders, in general, are defined as emerging in childhood, or at least by adolescence or early adulthood. The ICD also has a category for enduring personality change after a catastrophic experience or psychiatric illness. If an inability to sufficiently adjust to life circumstances begins within three months of a particular event or situation, and ends within six months after the stressor stops or is eliminated, it may instead be classed as an adjustment disorder.
There is an emerging consensus that so-called "personality disorders", like personality traits in general, actually incorporate a mixture of acute dysfunctional behaviors that may resolve in short periods, and maladaptive temperamental traits that are more enduring.
Eating disorder : These disorders involve disproportionate concern in matters of food and weight. Sleep disorder : These conditions are associated with disruption to normal sleep patterns. Sexual disorders and gender dysphoria : These disorders include dyspareunia and various kinds of paraphilia sexual arousal to objects, situations, or individuals that are considered abnormal or harmful to the person or others.
Impulse control disorder : People who are abnormally unable to resist certain urges or impulses that could be harmful to themselves or others, may be classified as having an impulse control disorder, and disorders such as kleptomania stealing or pyromania fire-setting.
Various behavioral addictions, such as gambling addiction, may be classed as a disorder. Obsessive-compulsive disorder can sometimes involve an inability to resist certain acts but is classed separately as being primarily an anxiety disorder. Substance use disorder : This disorder refers to the use of drugs legal or illegal, including alcohol that persists despite significant problems or harm related to its use.
Substance dependence and substance abuse fall under this umbrella category in the DSM. Substance use disorder may be due to a pattern of compulsive and repetitive use of a drug that results in tolerance to its effects and withdrawal symptoms when use is reduced or stopped. Dissociative disorder : People who suffer severe disturbances of their self-identity, memory and general awareness of themselves and their surroundings may be classified as having these types of disorders, including depersonalization disorder or dissociative identity disorder which was previously referred to as multiple personality disorder or "split personality".
Cognitive disorder : These affect cognitive abilities, including learning and memory. This category includes delirium and mild and major neurocognitive disorder previously termed dementia. Developmental disorder : These disorders initially occur in childhood. Some examples include autism spectrum disorders, oppositional defiant disorder and conduct disorder , and attention deficit hyperactivity disorder ADHD , which may continue into adulthood.
Conduct disorder, if continuing into adulthood, may be diagnosed as antisocial personality disorder dissocial personality disorder in the ICD. Popularist labels such as psychopath or sociopath do not appear in the DSM or ICD but are linked by some to these diagnoses. Somatoform disorders may be diagnosed when there are problems that appear to originate in the body that are thought to be manifestations of a mental disorder.
This includes somatization disorder and conversion disorder. There are also disorders of how a person perceives their body, such as body dysmorphic disorder. There are attempts to introduce a category of relational disorder , where the diagnosis is of a relationship rather than on any one individual in that relationship. The relationship may be between children and their parents, between couples, or others.
There already exists, under the category of psychosis, a diagnosis of shared psychotic disorder where two or more individuals share a particular delusion because of their close relationship with each other.
Various new types of mental disorder diagnosis are occasionally proposed. Among those controversially considered by the official committees of the diagnostic manuals include self-defeating personality disorder , sadistic personality disorder , passive-aggressive personality disorder and premenstrual dysphoric disorder.
The onset of psychiatric disorders usually occurs from childhood to early adulthood. Some other anxiety disorders, substance disorders and mood disorders emerge later in the mid-teens. The likely course and outcome of mental disorders vary and are dependent on numerous factors related to the disorder itself, the individual as a whole, and the social environment.
Some disorders may last a brief period of time, while others may be long term in nature. All disorders can have a varied course. Long-term international studies of schizophrenia have found that over a half of individuals recover in terms of symptoms, and around a fifth to a third in terms of symptoms and functioning, with many requiring no medication. While some have serious difficulties and support needs for many years, "late" recovery is still plausible.
The World Health Organization concluded that the long-term studies' findings converged with others in "relieving patients, carers and clinicians of the chronicity paradigm which dominated thinking throughout much of the 20th century.
Classification of mental disorders
Transdiagnostic approaches promise robust conceptualizations of pathology and efficient and generalizable treatments by providing researchers with a novel way to integrate basic science, treatment research, and developmental psychopathology. It has inspired innovations in treatment development by distilling the most powerful treatment components from our library of evidence-based treatments. Transdiagnostic approaches have proved especially appealing in the youth domain given high rates of comorbidity and rapid developmental change. The chapter begins with an introduction to transdiagnostic conceptual definitions and history, then reviews state of the art cognitive, behavioral, and social research that explains mechanisms in the onset or maintenance of pathology using a transdiagnostic lens. It concludes with a review of the early efforts of transdiagnostic researchers to develop interventions to address multiple disorders simultaneously in children and adolescents. In all, the chapter provides a comprehensive introduction to the foundation and future directions of this emerging field.
The classification of mental disorders is also known as psychiatric nosology or psychiatric taxonomy. It represents a key aspect of psychiatry and other mental health professions and is an important issue for people who may be diagnosed. There are currently two widely established systems for classifying mental disorders :. Both list categories of disorders thought to be distinct types, and have deliberately converged their codes in recent revisions so that the manuals are often broadly comparable, although significant differences remain. Other classification schemes may be in use more locally, for example the Chinese Classification of Mental Disorders.
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A mental disorder , also called a mental illness  or psychiatric disorder , is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Many disorders have been described, with signs and symptoms that vary widely between specific disorders. The causes of mental disorders are often unclear. Theories may incorporate findings from a range of fields. Mental disorders are usually defined by a combination of how a person behaves, feels, perceives, or thinks.
Investigators are persistently aiming to clarify structural relationships among the emotional disorders in efforts to improve diagnostic classification. The high co-occurrence of anxiety and mood disorders, however, has led investigators to portray the current structure of anxiety and depression in the Diagnostic and Statistical Manual of Mental Disorders DSM-IV, APA as more descriptive than empirical. This study assesses various structural models in a clinical sample of youths with emotional disorders.
Published evaluations of competing models of ASD clustering in youth have rarely been examined. Model specifications for alternative factor models of ASD. This addressed the potentially unhelpful requirement for dissociation to be mandatory for a positive diagnosis.
The Emotional and Affective Composite Temperament AFECT model describes originally six traits of volition, anger, inhibition fear and caution subordinate factors , control, sensitivity, and coping. However, fear and caution have shown opposite relatioships with criteria-variables, indicating factor independence. The current investigation aimed to advance in the evaluation of the psychometric properties of the emotional trait section of the Emotional and Affective Composite Temperament Scale AFECTS by examining the suitability of a 7-factor structure and the reliability of each scale using data from a population-based sample. AFECTS was administered via face-to-face assessments in a single-session, population-based cross-sectional survey.