Mental disorders are complex conditions that affect a person’s thinking, feeling, behavior, and overall functioning. Understanding the different categories and criteria for these disorders is crucial for accurate diagnosis and appropriate support. This guide provides a detailed overview of the Behavioral Diagnosis List, outlining various mental disorders and their key characteristics.
Categories of Mental Disorders
Mental disorders are categorized to help clinicians and individuals understand the range of conditions and their specific features. These categories are based on shared symptoms, patterns of behavior, and underlying causes. Below is a breakdown of the major categories of mental disorders.
Neurocognitive Disorders
Neurocognitive disorders are characterized by a significant decline in cognitive function from a previous level of performance. This decline can affect various cognitive domains, including memory, executive function, attention, language, and social cognition.
Key Features:
- Cognitive Decline: A noticeable decrease in one or more cognitive abilities.
- Functional Impairment: The cognitive decline interferes with daily functioning and independence.
- Varied Causes: Can be caused by medical conditions, neurological disorders, substance use, or be degenerative in nature.
Examples of Neurocognitive Disorders:
- Major Neurocognitive Disorder
- Alzheimer’s Disease
- Vascular Dementia
- Dementia due to Medical Conditions (e.g., HIV, Parkinson’s, Traumatic Brain Injury)
- Substance-Induced Cognitive Disorder
Schizophrenia Spectrum and Other Psychotic Disorders
Schizophrenia spectrum and other psychotic disorders are defined by disturbances in thought, perception, and behavior. Psychotic symptoms, such as delusions and hallucinations, are hallmark features of these conditions.
Key Features:
- Psychotic Symptoms: Presence of delusions (false beliefs) and hallucinations (sensory experiences without external stimuli).
- Disorganized Thinking: Difficulties in organizing thoughts, often evident in speech.
- Abnormal Behavior: Grossly disorganized or catatonic behavior.
- Functional Decline: Significant impairment in social, occupational, or self-care functioning.
Examples of Schizophrenia Spectrum and Psychotic Disorders:
- Schizophrenia
- Schizoaffective Disorder
- Delusional Disorder
- Psychotic Disorder due to another Medical Condition
Depressive, Bipolar and Related Disorders
Depressive, bipolar, and related disorders are mood disorders characterized by significant disturbances in mood regulation. These disorders involve periods of intense sadness, loss of interest, or elevated mood, impacting daily life and functioning.
Key Features of Depressive Disorders:
- Depressed Mood: Persistent sadness, emptiness, or hopelessness.
- Loss of Interest: Diminished pleasure in activities.
- Physical Symptoms: Changes in appetite, weight, sleep, and energy levels.
- Cognitive Symptoms: Feelings of guilt, worthlessness, difficulty concentrating, suicidal thoughts.
Examples of Depressive Disorders:
- Major Depressive Disorder
- Persistent Depressive Disorder (Dysthymia)
- Depressive Disorder due to another Medical Condition
Key Features of Bipolar Disorders:
- Manic Episodes: Elevated mood, increased energy, impulsivity, racing thoughts, and decreased need for sleep.
- Depressive Episodes: Periods of low mood, similar to depressive disorders.
- Mood Swings: Alternating periods of mania and depression.
Examples of Bipolar Disorders:
- Bipolar I Disorder
- Bipolar II Disorder
- Cyclothymic Disorder
- Bipolar Disorder due to another Medical Condition
Intellectual Disorder
Intellectual disorder (intellectual disability) is characterized by limitations in both intellectual functioning and adaptive behavior, originating before the age of 22. Adaptive behavior encompasses conceptual, social, and practical skills.
Key Features:
- Subaverage Intellectual Functioning: Significantly below average cognitive abilities, often measured by IQ tests.
- Adaptive Functioning Deficits: Difficulties in everyday life skills, such as communication, self-care, social skills, and practical skills.
- Early Onset: The disorder manifests before the age of 22.
Anxiety and Obsessive-Compulsive Disorders
Anxiety and obsessive-compulsive disorders are characterized by excessive fear, worry, and anxiety, or by repetitive thoughts and behaviors. These disorders can significantly impact daily life, causing distress and avoidance of certain situations.
Key Features of Anxiety Disorders:
- Excessive Worry: Persistent and uncontrollable worry about various topics.
- Physical Symptoms: Restlessness, fatigue, difficulty concentrating, muscle tension, sleep disturbance.
- Avoidance: Avoiding situations or triggers that provoke anxiety.
Examples of Anxiety Disorders:
- Generalized Anxiety Disorder
- Social Anxiety Disorder
- Panic Disorder
- Agoraphobia
Key Features of Obsessive-Compulsive Disorder (OCD):
- Obsessions: Intrusive, unwanted, and distressing thoughts, urges, or images.
- Compulsions: Repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession.
Somatic Symptom and Related Disorders
Somatic symptom and related disorders involve prominent physical symptoms that cause significant distress and functional impairment. These symptoms are not fully explained by a medical condition and may be associated with excessive thoughts, feelings, and behaviors related to the symptoms.
Key Features:
- Physical Symptoms: Presence of distressing physical symptoms like pain, fatigue, or neurological symptoms.
- Unexplained Symptoms: Symptoms are not fully explained by medical evaluation.
- Excessive Focus: Disproportionate thoughts, feelings, and behaviors related to health concerns.
Examples of Somatic Symptom and Related Disorders:
- Somatic Symptom Disorder
- Illness Anxiety Disorder
- Conversion Disorder
Personality and Impulse-Control Disorders
Personality and impulse-control disorders are characterized by enduring patterns of inflexible and maladaptive traits that cause significant distress or impairment in social, occupational, or personal functioning. These patterns are typically evident in adolescence or early adulthood.
Key Features:
- Inflexible Personality Traits: Rigid and maladaptive patterns of thinking, feeling, and behaving.
- Interpersonal Difficulties: Challenges in relationships and social interactions.
- Functional Impairment: Significant distress or impairment in important areas of life.
Examples of Personality Disorders:
- Borderline Personality Disorder
- Narcissistic Personality Disorder
- Obsessive-Compulsive Personality Disorder
- Antisocial Personality Disorder
Key Features of Impulse-Control Disorders:
- Impulsive Behaviors: Difficulties controlling impulses, leading to harmful or disruptive actions.
Example of Impulse-Control Disorder:
- Intermittent Explosive Disorder
Autism Spectrum Disorder
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication and social interaction, and restricted, repetitive patterns of behavior, interests, or activities.
Key Features:
- Social Communication Deficits: Difficulties with social reciprocity, nonverbal communication, and developing and maintaining relationships.
- Repetitive Behaviors: Restricted, repetitive patterns of behavior, interests, or activities.
- Early Onset: Symptoms are typically recognized in early childhood.
Neurodevelopmental Disorders
Neurodevelopmental disorders are a group of conditions that manifest early in development and are characterized by developmental deficits that produce impairments of personal, social, academic, or occupational functioning.
Key Features:
- Developmental Onset: Conditions emerge during childhood or adolescence.
- Cognitive and Behavioral Deficits: Difficulties in learning, attention, social skills, motor skills, or a combination thereof.
Examples of Neurodevelopmental Disorders:
- Attention-Deficit/Hyperactivity Disorder (ADHD)
- Specific Learning Disorder
- Tic Disorders (e.g., Tourette Syndrome)
Eating Disorders
Eating disorders are characterized by persistent disturbances of eating or eating-related behavior that result in altered consumption or absorption of food and that significantly impair physical health or psychosocial functioning.
Key Features:
- Disturbed Eating Patterns: Abnormal eating behaviors, such as restricting food intake, binge eating, or purging.
- Body Image Concerns: Preoccupation with body weight and shape.
- Physical and Psychological Health Impact: Significant negative consequences for physical and mental well-being.
Examples of Eating Disorders:
- Anorexia Nervosa
- Bulimia Nervosa
- Binge-Eating Disorder
Trauma- and Stressor-Related Disorders
Trauma- and stressor-related disorders develop after exposure to a traumatic or stressful event. These disorders involve a range of symptoms related to the traumatic experience, impacting mood, behavior, and functioning.
Key Features:
- Traumatic Event Exposure: Direct or indirect experience of a traumatic or stressful event.
- Re-experiencing Symptoms: Intrusive memories, nightmares, flashbacks.
- Avoidance Symptoms: Avoiding reminders of the trauma.
- Negative Mood and Cognition: Negative beliefs about oneself and the world, persistent negative emotions.
- Arousal Symptoms: Increased startle response, hypervigilance, sleep disturbance.
Examples of Trauma- and Stressor-Related Disorders:
- Posttraumatic Stress Disorder (PTSD)
- Adjustment Disorders
Paragraph B Criteria: Areas of Mental Functioning
To assess the severity and impact of mental disorders, clinicians evaluate four key areas of mental functioning, known as the Paragraph B criteria:
- Understand, remember, or apply information: This refers to the ability to learn, recall, and use information to perform tasks.
- Interact with others: This involves the ability to relate to and work effectively with supervisors, coworkers, and the public.
- Concentrate, persist, or maintain pace: This relates to the ability to focus attention, stay on task, and maintain a consistent work rate.
- Adapt or manage oneself: This encompasses the ability to regulate emotions, control behavior, and adapt to changes in a work setting.
These criteria help determine the degree of limitation in these areas, ranging from no limitation to extreme limitation, which is crucial in evaluating the impact of a mental disorder on an individual’s ability to function in daily life and work.
Paragraph C Criteria: “Serious and Persistent” Mental Disorders
The Paragraph C criteria are used to evaluate mental disorders that are considered “serious and persistent.” This classification applies when a mental disorder has been documented for at least two years and meets specific conditions:
- Ongoing Need for Support: The individual relies on ongoing medical treatment, therapy, psychosocial support, or a highly structured setting to manage symptoms.
- Marginal Adjustment: Despite treatment and support, the individual demonstrates only marginal adjustment, meaning they have minimal capacity to adapt to changes or increased demands.
These criteria recognize that even with treatment, some mental disorders remain significantly impairing and require long-term support and management.
Evidence and Evaluation of Mental Disorders
Evaluating mental disorders involves gathering evidence from various sources to understand the nature, severity, and impact of the condition. This evidence can include:
- Medical Evidence: Reports from physicians, psychologists, and other mental health professionals, including symptoms, history, examination results, and treatment records.
- Personal Accounts: Information from the individual about their symptoms, daily functioning, and experiences.
- Third-Party Information: Statements from family, friends, caregivers, teachers, or employers who can provide insights into the individual’s behavior and functioning.
- Longitudinal Evidence: Information collected over time to understand the course of the disorder and its impact on functioning.
By considering all relevant evidence, clinicians and evaluators can develop a comprehensive understanding of an individual’s mental disorder and its effects on their life.
Understanding the behavioral diagnosis list and the criteria used to classify and evaluate mental disorders is essential for providing appropriate support and promoting mental well-being. This guide serves as a starting point for gaining knowledge about these complex conditions and the framework used for their diagnosis and assessment.
