The Social Phobia and Anxiety Inventory: Problem of Underlying Medical Conditions

2007 ◽  
Vol 101 (3) ◽  
pp. 697-706
Author(s):  
Douglas M. Klieger ◽  
Heather K. Johnson
Keyword(s):  
Social Phobia ◽  
Medical Condition ◽  
College Men ◽  
Medical Conditions ◽  
Inventory Problem ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
The Social ◽  
Score Inflation ◽  
Fourth Quartile

The study investigated the possibility of score inflation in the Social Phobia and Anxiety Inventory due to underlying medical conditions in respondents. The Diagnostic and Statistical Manual of Mental Disorders provides an exclusionary rule disallowing a diagnosis of social phobia when the fear is based on the presence of a medical condition. A computer-administered procedure, designed to simulate visually this paper-and-pencil inventory was created and compared to the original in a pilot study with r of .94 between the two procedures. Analysis indicates such medically based responding is common among college men and women ( N = 127, M age = 19.0). Specifically, 50% of respondents reported 0 or 1 medical condition(s), while those in the fourth quartile averaged 43 medical bases for their responses. The most frequent self-reports of medical conditions were stuttering (2.8%), acne (2.4%), dry mouth (2.1%), obesity (.9%), and scars (.9%). Several possible solutions were discussed in view of the overall conclusion of a substantive basis for medical responding on this inventory.

scholarly journals Medical mimics: Differential diagnostic considerations for psychiatric symptoms

2016 ◽  
Vol 6 (6) ◽  
pp. 289-296 ◽  
Author(s):  
Jerry McKee ◽  
Nancy Brahm
Keyword(s):  
Psychiatric Symptoms ◽  
Age Of Onset ◽  
Medical Condition ◽  
Clinical Situation ◽  
Symptom Presentation ◽  
Psychiatric Symptomatology ◽  
Statistical Manual ◽  
Diagnostic Categories ◽  
Diagnostic And Statistical Manual ◽  
Underlying Medical Condition

Abstract Patients with underlying medical disease can present to the health care system with psychiatric symptoms predominating. Identification of an underlying medical condition masquerading as a psychiatric disorder can be challenging for clinicians, especially in patients with an existing psychiatric condition. The term medical mimic or secondary psychosis has been used to describe this clinical situation. Diagnostic categories from The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, that may encompass medical mimics include substance-induced disorders, which includes medications, and unspecified mental disorder due to another medical condition in situations where the clinician may lack needed information for a complete diagnosis. At this time, there is no single diagnostic test or procedure available to differentiate primary versus secondary psychosis on the basis of psychopathology presentation alone. When considering a diagnosis, clinicians should evaluate for the presence of atypical features uncharacteristic of the psychiatric symptoms observed; this may include changes in functionality and/or age of onset and symptom presentation severity. The purpose of this work is to provide a structured clinical framework for evaluation for medical mimics, identify groups considered to be at highest risk for medical mimics, and present common syndromic features suggestive of a medical mimic. Selected case scenarios are used to illustrate key concepts for evaluating and assessing a patient presenting with acute psychiatric symptomatology to improve judgment in ruling out potential medical causality.

Social Anxiety and Premorbid Personality Disorders in Paranoid Schizophrenic Patients Treated With Clozapine

CNS Spectrums ◽  
2000 ◽  
Vol 5 (9) ◽  
pp. 29-43 ◽  
Author(s):  
Stefano Pallanti ◽  
Leonardo Quercioli ◽  
Adolfo Pazzagli
Keyword(s):  
Social Anxiety ◽  
Mental Disorders ◽  
Social Phobia ◽  
Personality Disorders ◽  
Paranoid Schizophrenia ◽  
Anxiety Symptoms ◽  
Premorbid Personality ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm Iv

AbstractThe concept of anxiety as a distinct comorbid disorder in schizophrenia has recently been rediscovered after having been neglected for a long period of time due to both theoretical and clinical approaches adopted from the appearance of the first edition of the Diagnostic and Statistical Manual of Mental Disorders in 1950. This rediscovery was accentuated by the fact that the concept of comorbidity in various psychiatric disorders has recently won widespread favor within the scientific community, and that the use of atypical neuroleptic medication to treat patients with schizophrenia has been reported to lead to the emergence of anxiety symptoms. Of the atypical neuroleptic medications used to treat schizophrenia, clozapine has most frequently been reported to induce anxiety symptoms. In this paper, 12 cases of patients with paranoid schizophrenia who developed social phobia during clozapine treatment are reported, and their response to fluoxetine augmentation is assessed. Premorbid personality disorders were also investigated; patients were assessed using the Structured Clinical Interview for DSM-III-R—Patient Version and the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (DSM-III-R=Diagnostic and Statistical Manual of Mental Disorders, Third Edition Revised; DSM-IV=Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition). In addition, the Scale for the Assessment of Negative Symptoms, the Scale for the Assessment of Positive Symptoms, the Liebowitz Social Anxiety Scale (LSAS), the Frankfurt Beschwerde Fragebogen (Frankfurt Questionnaire of Complaints), and the Brief Psychiatric Rating Scale were used to rate clinical symptomatology. All patients were reevaluated after 12 weeks of cotreatment with clozapine and fluoxetine. In 8 (66.6%) of the 12 cases, symptoms responded (≥35% LSAS score reduction) to an adjunctive regimen of fluoxetine. Furthermore, in 7 (58.3%) of the 12 cases, an anxious personality disorder (avoidant=33.3%; dependent=25%) was identified, but no significant differences in the prevalence of comorbid personality disorders emerged in comparison with a group of 16 patients with paranoid schizophrenia treated with clozapine who did not show symptoms of social phobia. The clinical relevance of the assessment and treatment of anxiety disorders is discussed in light of a clinical therapeutic approach that overcomes the implicit hierarchy of classification. Considering that the onset of anxiety-spectrum disorders (such as social phobia) can occur during the remission of psychotic symptoms in clozapine-treated patients with schizophrenia, a comprehensive approach to pharmacological therapy for patients with schizophrenia (or, at least for those treated with clozapine) should be adopted.

Where Are the Social Workers? One Social Worker’s Road to Active Opposition to the New DSM

2014 ◽  
Vol 16 (1) ◽  
pp. 63-79 ◽  
Author(s):  
Jack Carney
Keyword(s):  
Social Workers ◽  
Interrater Reliability ◽  
Psychosocial Treatment ◽  
Biomedical Model ◽  
Treatment Interventions ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
The Social ◽  
Psychoactive Medications

This article consists of a topical/historical compilation of events surrounding the protests that stalked the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) prior to and since its publication in May 2013, including a national boycott launched in February of this year. To summarize, the new DSM has been challenged for its lack of construct validity and its poor interrater reliability; for its reliance on the biomedical model to explain causality, to the exclusion of environmental and psychosocial factors; for its medicalization of the disorders it proposes to include in the new DSM and its consequent reliance on psychoactive medications for treatment of these disorders, again to the virtual exclusion of other largely psychosocial treatment interventions; and, ultimately, for its continued pathologization of human behaviors ordinarily considered normative. This article concludes by questioning the hegemonic role assumed by psychiatry in determining the categorization of disordered behaviors with no input from other professions and mental health system stakeholders. Social workers and the organizations that represent them, particularly the National Association of Social Workers, are also challenged for their continued passive acceptance of a very flawed DSM.

Transforming Normality into Pathology: The DSM and the Outcomes of Stressful Social Arrangements

2007 ◽  
Vol 48 (3) ◽  
pp. 211-222 ◽  
Author(s):  
Allan V. Horwitz
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Social Space ◽  
Social Groups ◽  
Unmet Need ◽  
Statistical Manual ◽  
Need For Treatment ◽  
Diagnostic And Statistical Manual ◽  
Psychological Mechanisms ◽  
The Social

The sociology of stress shows how nondisordered people often become distressed in contexts such as chronic subordination; the losses of status, resources, and attachments; or the inability to achieve valued goals. Evolutionary psychology indicates that distress arising in these contexts stems from psychological mechanisms that are responding appropriately to stressful circumstances. A diagnosis of mental disorder, in contrast, indicates that these mechanisms are not functioning as they are designed to function. The American Psychiatric Association's Diagnostic and Statistical Manual, however, has come to treat both the natural results of the stress process and individual pathology as mental disorders. A number of social groups benefit from and promote the conflation of normal emotions with dysfunctions. The result has been to overestimate the number of people who are considered to be disordered, to focus social policy on the supposedly unmet need for treatment, and to enlarge the social space of pathology in the general culture.

Spinning on its Axes: DSM and the Social Construction of Psychiatric Diagnosis

1998 ◽  
Vol 28 (3) ◽  
pp. 525-554 ◽  
Author(s):  
Elizabeth C. Cooksey ◽  
Phil Brown
Keyword(s):  
Medical Model ◽  
Theory And Practice ◽  
Critical Examination ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
The Social ◽  
Psychiatric Profession ◽  
The Impact ◽  
Social Biases

Through a critical examination of the psychiatric profession's heavy reliance on the Diagnostic and Statistical Manual of Mental Disorders, the authors explore the central role of diagnosis in the theory and practice of psychiatry. The set of beliefs that have guided the psychiatric profession since the creation of DSM-III are viewed as being tied to the new extension of the biopsychiatric medical model. From a sociological perspective, the authors address the issue of psychiatric nosology with reference to practice styles and professional dominance, and consider the impact of DSM's intrinsic social biases both within and outside psychiatry's traditionally drawn boundaries. They conclude that working solely within the confines of a medical framework of diagnosis, with little attention to the wider social and cultural contexts that should surround diagnostic practice, psychiatry will be unable to understand and explain the changing needs of its clientele.

Stopping the “Madness”: Positive Psychology and Deconstructing the Illness Ideology and the DSM

2009 ◽  
pp. 60-70
Author(s):  
James E. Maddux
Keyword(s):  
Positive Psychology ◽  
Clinical Psychology ◽  
Interpersonal Skills ◽  
Personal Responsibility ◽  
Well Being ◽  
Worth Living ◽  
Life Worth Living ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
The Social

This chapter describes the traditional view of clinical psychology as a discipline and profession that is steeped in an “illness ideology.” This illness ideology has roots in clinical psychology's early connections with psychiatry and medicine and limits clinical psychology to the study of what is worst and weakest about people rather than what is best and bravest about people. The historical, cultural, and professional causes of this ideology are discussed, with an emphasis on the social construction and deconstruction of the Diagnostic and Statistical Manual of Mental Disorders as the manifestation of the illness ideology that has the greatest detrimental influence on clinical psychology. The chapter also proposes that the illness ideology be replaced with a positive psychology ideology that emphasizes well-being, satisfaction, happiness, interpersonal skills, perseverance, talent, wisdom, personal responsibility, and what makes life worth living.

Stopping the “Madness”

2016 ◽  
Author(s):  
James E. Maddux
Keyword(s):  
Clinical Psychology ◽  
Well Being ◽  
Worth Living ◽  
Life Worth Living ◽  
Statistical Manual ◽  
Diagnostic Categories ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Problems In Living ◽  
The Social

This chapter describes the traditional view of clinical psychology as a discipline and profession steeped in an “illness ideology” that has roots in clinical psychology’s early connections with psychiatry and medicine and limits clinical psychology to the study of what is worst and weakest about people rather than what is best and bravest about people. The historical, cultural, and professional causes of this ideology are discussed, emphasizing on the social construction and deconstruction of the Diagnostic and Statistical Manual of Mental Disorders (DSM) as the manifestation of the illness ideology that has the greatest detrimental influence on clinical psychology. The chapter also proposes that the illness ideology be replaced with a positive psychology ideology that emphasizes well-being, life satisfaction, and what makes life worth living. Updates include discussions of the new DSM-5 and additional research on the problems with using diagnostic categories as a framework for understanding problems in living.

scholarly journals Identificação e cuidados no transtorno de acumulação

2017 ◽  
Vol 11 (12) ◽  
pp. 5028
Author(s):  
Mariangelli Souza Gargiulo ◽  
Dayane De Aguiar Cicolella ◽  
Karina Amadori Stroschein ◽  
Ana Paula Hossel Garcia
Keyword(s):  
Signs And Symptoms ◽  
Social Identification ◽  
Obsessive Compulsive ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Healthcare Network ◽  
The Social ◽  
La Red ◽  
Care Nursing

RESUMOObjetivo: revisar a literatura científica, nacional e internacional, sobre a identificação e os cuidados no Transtorno de Acumulação, após a inclusão no Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-5). Método: revisão integrativa, realizada nas bases de dados LILACS, MEDLINE e Science Direct, mediante os descritores Terapêutica, Transtorno de Acumulação, Sinais e Sintomas e a palavra-chave Acumulação Compulsiva. Resultados: 754 artigos publicados entre maio de 2013 e junho de 2016. Após critérios e leitura na íntegra, foram selecionados 11 artigos, dando origem a três categorias de análise. Conclusão: os estudos analisados apresentaram dúvidas quanto aos critérios e falhas na identificação social de indivíduos acumuladores. Faz-se necessária uma maior aproximação, com concepção ampliada, de forma a contemplar o acolhimento na rede de atenção em saúde, em virtude do desconhecimento da doença. Descritores: Transtorno de Acumulação; Sinais e Sintomas; Terapêuticas; Cuidados de Enfermagem; Enfermagem; Transtorno Obsessivo-Compulsivo. ABSTRACTObjective: to review the national and international scientific literature on identification and care in Accumulation Disorder after inclusion in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Method: integrative review, performed in the LILACS, MEDLINE and Science Direct databases, using the descriptors Therapeutic, Accumulation Disorder, Signs and Symptoms and the keyword Compulsive Accumulation. Results: 754 articles published between May 2013 and June 2016. Following the criteria and reading in full, 11 articles were selected, giving rise to three categories of analysis. Conclusion: the studies analyzed presented doubts about the criteria and failures in the social identification of accumulating individuals. A closer approximation, with an expanded conception, is necessary in order to contemplate the reception in the healthcare network, due to the lack of knowledge of the disease. Descriptors: Hoarding Disorder; Sings and Symptoms; Therapeutics; Nursing Care; Nursing; Obsessive-Compulsive Disorder.RESUMENObjetivo: revisar la literatura científica, nacional e internacional, sobre la identificación y los cuidados en el Trastorno de Acumulación, tras su inclusión en el Manual Diagnóstico y Estadístico de Trastornos Mentales (DSM-5). Método: revisión integrativa, realizada en las bases de datos LILACS, MEDLINE y Science Direct, mediante los descriptores Terapéutica, Trastorno de Acumulación, Signos y Síntomas y la palabra clave Acumulación Compulsiva. Resultados: 754 artículos publicados entre mayo de 2013 y junio de 2016. Tras criterios y lectura íntegra, se seleccionaron 11 artículos, dando origen a tres categorías de análisis. Conclusión: los estudios analizados presentaron dudas en cuanto a los criterios y fallas en la identificación social de individuos acumuladores. Se hace necesaria una mayor aproximación, con concepción ampliada, para contemplar la acogida en la red de atención en salud, en virtud del desconocimiento de la enfermedad. Descriptores: Terapéutica; Trastorno de Acumulacíon; Signos y Síntomas; Atención de Enfermería; Enfermaría;Trastorno Obsesivo Compulsivo.

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