02. Problems and Levels

[sincerely yours staff]

adjustment disorders ,

All of the disorders in this category relate to a significantly more difficult adjustment to a life situation than would normally be expected considering the circumstances. While it is common to need months and perhaps even years to feel normal again after the loss of a long time spouse, for instance, when this adjustment causes significant problems for an abnormal length of time, it may be considered an adjustment disorder.

The disorders in this category can present themselves quite differently. The key to diagnosing is to look at (1) the issue that is causing the adjustment disorder and (2) the primary symptoms associated with the disorder.

_{Example:
Adjustment Disorder Unspecified, Adjustment Disorder with Anxiety, Adjustment Disorder with Depressed Mood, Adjustment Disorder with Disturbance of Conduct, Adjustment Disorder with Mixed Anxiety and Depressed Mood, Adjustment Disorder with Mixed Disturbance of Emotions and Conduct}

anxiety disorders ,

Anxiety Disorders categorize a large number of disorders where the primary feature is abnormal or inappropriate anxiety. Everybody has experienced anxiety. Think about the last time a loud noise frightened you and remember the feelings inside your body. Chances are you experienced an increased heart rate, tensed muscles, and perhaps an acute sense of focus as you tried to determine the source of the noise. These are all symptoms of anxiety. They are also part of a normal process in our bodies called the 'flight or flight' phenomenon. This means that your body is preparing itself to either fight or protect itself or to flee a dangerous situation.

These symptoms become a problem when they occur without any recognizable stimulus or when the stimulus does not warrant such a reaction. In other words, inappropriate anxiety is when a person's heart races, breathing increases, and muscles tense without any reason for them to do so. Once a medical cause is ruled out, an anxiety disorder may be the culprit.

_{Example:
Acute Stress Disorder, Agoraphobia (with or without a history of Panic Disorder), Generalized Anxiety Disorder [GAD], Obsessive-Compulsive Disorder [OCD], Panic Disorder (with or without Agoraphobia), Phobias (including Social Phobia), Posttraumatic Stress Disorder [PTSD]}

dissociative disorders ,

The main symptom cluster for dissociative disorders include a disruption in consciousness, memory, identity, or perception. In other words, one of these areas is not working correctly and causing significant distress within the individual.

_{Example:
Dissociative Amnesia, Dissociative Fugue, Dissociative Identity ( Multiple Personality) Disorder, Depersonalization Disorder}

eating disorders ,

Eating disorders are characterized by disturbances in eating behavior. This can mean eating too much, not eating enough, or eating in an extremely unhealthy manner (such as binging or stuffing yourself over and over). Many people argue that simple overeating should be considered a disorder, but at this time it is not in this category.

_{Example:
Anorexia Nervosa, Bulimia Nervosa}

impulse-control disorders ,

Disorders in this category include the failure or extreme difficulty in controlling impulses despite the negative consequences. This includes the failure to stop gambling even if you realize that losing would result in significant negative consequences. This failure to control impulses also refers to the impulse to engage in violent behavior (e.g., road rage), sexual behavior, fire starting, stealing, and self-abusive behaviors.

_{Example:
Intermittent Explosive Disorder, Kleptomania, Pathological Gambling, Pyromania, Trichotillomania}

mood disorders ,

The disorders in this category include those where the primary symptom is a disturbance in mood. In other words, inappropriate, exaggerated, or limited range of feelings. Everybody gets down sometimes, and everybody experiences a sense of excitement and emotional pleasure. To be diagnosed with a mood disorder, your feelings must be to the extreme. In other words, crying, and/or feeling depressed, suicidal frequently. Or, the opposite extreme, having excessive energy where sleep is not needed for days at a time and during this time the decision making process in significantly hindered.

_{Example:
Bipolar Disorder, Cyclothymic Disorder, Dysthymic Disorder, Major Depressive Disorder}

paraphilias ,

Paraphilias all have in common distressing and repetitive sexual fantasies, urges, or behaviors. These fantasies, urges, or behaviors must occur for a significant period of time and must interfere with either satisfactory sexual relations or everyday functioning if the diagnosis is to be made. There is also a sense of distress within these individuals. In other words, they typically recognize the symptoms as negatively impacting their life but feel as if they are unable to control them.

_{Example: Exhibitionism, Fetishism, Frotteurism, Pedophilia, Sexual Masochism, Sexual Sadism, Transvestic Fetishism, Voyeurism}

sleep disorders ,

Primary Sleep disorders are divided into two subcategories: Dyssomnias are those disorders relating to the amount, quality, and timing of sleep. Parasomnias relate to abnormal behavior or physiological events that occur during the process of sleep or sleep-wake transitions. We use the perm primary to differentiate these sleep disorders from other sleep disorders that are caused by outside factors, such as another mental disorder, medical disorder, or substance use.

_{Example:
Dyssomnias; Primary Insomnia, Primary Hypersomnia, Narcolepsy
Parasomnias; Nightmare Disorder, Sleep Terror Disorder, Sleepwalking Disorder}

psychotic disorders ,

The major symptom of these disorders is psychosis, or delusions and hallucinations. Delusions are false beliefs that significantly hinder a person's ability to function. For example, believing that people are trying to hurt you when there is no evidence of this, or believing that you are somebody else, such as Jesus Christ or Cleopatra. Hallucinations are false perceptions. They can be visual (seeing things that aren't there), auditory (hearing), olfactory (smelling), tactile (feeling sensations on your skin that aren't really there, such as the feeling of bugs crawling on you), or taste.

_{Example:
Brief Psychotic Disorder, Delusional Disorder, Schizoaffective Disorder, Schizophrenia, Schizophreniform, Shared Psychotic Disorder}

sexual disorders ,

The primary characteristic in this category is the impairment in normal sexual functioning. This can refer to an inability to perform or reach an orgasm, painful sexual intercourse, a strong repulsion of sexual activity, or an exaggerated sexual response cycle or sexual interest. A medical cause must be ruled out prior to making any sexual dysfunction diagnosis and the symptoms must be hindering the person's everyday functioning.

Gender Identity Disorder has also been placed in this category, although no outward dysfunction needs to be present for this disorder. Basically, it includes strong feelings of being the wrong gender, or feelings that your outward body is inconsistent with your internal sense of being either male or female.

_{Example:
Dyspareunia, Female Orgasmic Disorder, Female Sexual Arousal Disorder, Gender Identity Disorder, Hypoactive Sexual Desire Disorder, Male Erectile Disorder, Male Orgasmic Disorder, Premature Ejaculation, Sexual Aversion Disorder, Vaginismus}

somatoform disorders ,

Disorders in this category include those where the symptoms suggest a medical condition but where no medical condition can be found by a physician. In other words, a person with a somatoform disorder might experience significant pain without a medical or biological cause, or they may constantly experience minor aches and pains without any reason for these pains to exist.

_{Example:
Body Dysmorphic Disorder, Conversion Disorder, Hypochondriasis Disorder, Pain Disorder, Somatization Disorder}

substance disorders ,

The two disorders in this category refer to either the abuse or dependence on a substance. A substance can be anything that is ingested in order to produce a high, alter one's senses, or otherwise affect functioning. The most common substance thought of in this category is alcohol although other drugs, such as cocaine, marijuana, heroin, ecstasy, special-K, and crack, are also included. Probably the most abused substances, caffeine and nicotine, are also included although rarely thought of in this manner by the layman.

_{Example:
Substance Abuse, Substance Dependence}

personality disorders ,

Personality Disorders are mental illnesses that share several unique qualities. They contain symptoms that are enduring and play a major role in most, if not all, aspects of the person's life. While many disorders vacillate in terms of symptom presence and intensity, personality disorders typically remain relatively constant.

To be diagnosed with a disorder in this category, a psychologist will look for the following criteria:

• Symptoms have been present for an extended period of time, are inflexible and pervasive, and are not a result of alcohol or drugs or another psychiatric disorder. The history of symptoms can be traced back to adolescence or at least early adulthood.
  
• The symptoms have caused and continue to cause significant distress or negative consequences in different aspects of the person's life.
  
• Symptoms are seen in at least two of the following areas:
  
  • Thoughts (ways of looking at the world, thinking about self or others, and interacting)
    
  • Emotions (appropriateness, intensity, and range of emotional functioning)
    
  • Interpersonal Functioning (relationships and interpersonal skills)
    
  • Impulse Control

_{Example:
Antisocial Personality Disorder, Borderline Personality Disorder, Narcissistic Personality Disorder}

others,

anything else that is not listed. XD


all the information found on AllPsych

[sincerely yours staff]

the risk levels ,

LEVEL ONE ,
patients on level one aren’t really a threat at all, and normally have full privileges. these kids are usually quite calm and tame, and some of the time have been placed here wrongly by their overprotective parents. other times it’s simply that they’re further along in their recovery, or are in a stable state of mind.

LEVEL TWO ,
two’s don’t ever really get in enough trouble to end up in isolation, but they’re not as calm as the level ones. these type of kids might frequently have panic attacks, but they will willing seek out a member of staff to help them, thus eliminating most of the risk from this. they don’t really cause harm to others, and rarely cause harm to themselves, and if they do are willing to ask for help.

LEVEL THREE ,
these are the ‘average’ patients of hawthorne house. they cause trouble every now and again, but never anything serious enough to put anyone or themselves in mortal peril. they don’t normally end up in isolation, except maybe for a few hours now and again to cool off, and the majority of the time, although they might be up to a bit of mischief (like any normal teenager) they can be relied on to be safe enough to be allowed to roam free.

LEVEL FOUR ,
level four patients are often quite volatile, and maybe several times a month end up under sedation, in isolation, or under one-on-one observation (not as much as the level fives, but still quite a bit). nearly all of them are on psychotropic medication to control themselves (as are the level fives), since they pose possible grievous danger to themselves and those around them. in an incident, staff would first try to talk to them to calm them down, but wouldn’t hesitate to use sedation if necessary.

LEVEL FIVE ,
these are the patients who pose high danger (possibly mortal danger in certain circumstances) to both themselves and those around them. they often have some sort of criminal record, and are kept under stricter observation than the other patients. staff will quick to use sedatives on these patients without second thought in an incident, and isolation is like a second home to them.