• Central features – inattention, hyperactivity, and impulsivity

symptoms of inattention,   Excessive daydreaming, forgetfulness, easily distracted, disorganized

Symptoms of hyperactivity and impulsivity cluster

Difficulty keeping still, excessive energy, difficulty working or playing quietly, interrupting others, impatient, act without thinking

Conditions of ADHD 

when present and how diagnosed 

If one has both clusters – ADHD, combined type

Not ADHD if symptoms don’t appear until after age 7.  Symptoms are usually present around age 3 or 4.

Reading Disorder

  Mathematics Disorder

Disorder of Written Expression

• discrepancy between actual and expected reading achievement
• Problem cannot be caused by sensory deficits (e.g.: poor vision)

      Significant impairment in social interactions and communication

      Restricted patterns of behavior, interest, and activities

Onset usually prior to age 3

Problems in socialization and social function 

Autism 

      Poor eye contact, little, if any, interest in relationships

      Loners, lack of enjoyment in activities

      Poor use of nonverbal behaviors

      Lack of emotional reciprocity (can’t empathize or demonstrate “what a happy face looks like”; mirror emotions)

 Problems in communication

      Unusual speech; echolalia (tend to say nothing)

      Poor ability to maintain communication with others

      Lack of make-believe or spontaneous play

Restricted patterns of behavior, interests, and activities (Stereotyped behavior)

      Preoccupation with restricted patterns of interest (obsessive or repetitive type behavior); abnormal in intensity

      May be inflexible in routines or rituals (e.g., types or times of meals)

      Stereotyped motor movements or mannerisms

Preoccupation with parts of objects

• Much like autism but deficits in communication are much less severe.
• Relatively high functioning (main difference from autism)
• Restricted patterns and socialization problems

• Psychosocial “Behavioral” Treatments (address behaviors):

• Biological and Medical Treaments are unavailable.
  -Integrated Treatments (the preferred model)

      Skill building and treatment of problem behaviors

      Communication and language problems

      Address socialization deficits

      Early intervention critical

      Focus on children, their families, schools, parents, and the home

      Build in appropriate community and social support

• Criteria:
• Significantly sub average intellectual functioning (IQ below 70)
• Concurrent deficits or impairments in two or more areas of adaptive functioning
• E.g.: ability to care for oneself, verbal and nonverbal communication skills, function in school or work etc…
• Must be evident before 18 years of age.

Axis II because 

verys table, enduring and engrained

personality at age of 18 still have symptoms when 30 

difficult to treat/resitant to treatment 

absence or insufficiency of normal behavior; emotional/social withdrawal, apathy, and poverty of thought/speech     

Avolition (or apathy) – 

      Alogia –

      Anhedonia – 

      Flat affect – 

• gross misrepresentations of reality that involve strongly held beliefs
• Grandeur, persecution, or paranoia

•       person holds on to these beliefs despite evidence to the contrary

      Hallucinations – experience of sensory events without environmental input

include severe and excess disruptions in speech, behavior, and emotion

      Cognitive slippage , 

      Tangentiality 

      Circumstantiality 

      Loose associations or derailment – 

      Disorganized affect –

Catatonia – spectrum from wild agitation, waxy flexibility, to complete immobility

• Paranoid
• Disorganized
• catatonic 
• undifferentiated 
• Residual 

Paranoid type – intact cognitive skills and affect, and don’t show disorganized behavior

      Hallucinations and delusions center around a theme (grandeur or persecution)

marked disruptions in speech and behavior, flat or inappropriate affect

      Hallucinations and delusions have a theme, but tend to be fragmented

      This type develops early, tends to be chronic, lacks periods of remissions

show unusual motor responses and odd mannerisms

      E.g., echolalia, echopraxia

      Subtype tends to be severe and quite rare

major symptoms of schizophrenia, but fail to meet criteria for another type

• Schizophrenic symptoms for 1-6 months

• Psychotic symptoms from 0-1 month

      Delusions that are contrary to reality without other major schizophrenia symptoms (erotomanic, grandiose, jealous, persecutory, and somatic)

Many show other negative symptoms of schizophrenia

      Affects males and females about equally

      Appears to have a strong genetic component (inherit a tendency for schizophrenia, not a specific form of schizophrenia)

      Risk of schizophrenia in monozygotic twins is 48%, in dizygotic (fraternal) twins is 17%.

One need not show symptoms of schizophrenia to pass on relevant genes.

• enduring and relatively stable predispositions 
• Predispositions are inflexible and maladaptive, causing distress and/or impairment
• Originate in childhood; manifest in adulthood
• Coded on Axis II of DSM-IV
•  3 Clusters

Odd or eccentric 

paranoid, schizoid, schizotypal 

dramatic, emotional, erratic 

antisocial, borderline, histrionic, narcisstic 

Fearful or anxious cluster 

dependent, avoidant, obsessive-compulsive 

A.   Thought to begin in childhood, not adolescence

1.               Manifested in adulthood

2.               Cannot be diagnosed until age 18

B.    Tend to run a chronic course if untreated

Extreme sensitivity to opinions of others

highly avoidant of most interpersoanl relationships 

few close relationships 

are interpersonally anxious, fearful of rejection 

Causes- numerous factors, difficult temperament 

treatment options- ssimilar for social phobia

include social skills and anxiety 

1.               Address legal declaration of mental illness

2.               Address when a person can be placed in a hospital or institution for treatment

3.               Such laws and what constitutes mental illness varies by state

if harm to other person, have to warn that person 

• Definition: if someone seems to be a danger to another, confidentiality must be broken and authorities and the intended victim must be notified
• Patient needs to be admitted to hospital, whether voluntarily or involuntarily
• Tarasoff Case – established limits on confidentiality

1.               Demonstrate that a person has a mental illness and needs treatment

2.               Show that the person is dangerous to self or others

3.               Establish a grave disability

a.    Inability to care for self

• Criminal act was beyond a person’s control due to mental illness
• Knowledge of right vs. wrong, self-control, and diminished capacity