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The following are brief diagnostic descriptions of common emotional and behavioral disorders digested from the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision, of the American Psychiatric Association. These descriptions and accompanying brief screening instruments may be helpful to visitors to my website in better understanding the emotional and behavioral challenges faced by them and their families.

DIAGNOSTIC DESCRIPTIONS OF
COMMON BEHAVIORAL HEALTH PROBLEMS

Alcohol Abuse - A maladaptive pattern of drinking marked by: drinking at times and places where it would be dangerous, continued drinking despite adverse consequences (DUI, loss of job, educational difficulties, health problems, loss of a relationship, family difficulties).

Screening Instrument
yes no   Have you ever drank in a situation where it is physically dangerous?
yes no   Have you ever had legal problems related to your drinking?
yes no   Have you continued drinking despite adverse drinking-related consequences?
yes no   Has drinking ever stopped you from fulfilling work, school or family obligations?
yes no   Has a family member ever complained to you about your drinking?


Anger and Rage Issues - Characterized by recurrent, inappropriate expressions of anger that result in an impairment of functioning in an important sphere of life (e.g.: work, school, family, etc.), and where the angry reaction is out of proportion to the precipitating incident.

Screening Instrument
yes no   Has a family member ever expressed concern about your anger?
yes no   Have you ever been counseled or disciplined at work due to your anger?
yes no   Do you often feel remorseful after expressing anger?
yes no   Have you ever injured another person or yourself during an angry episode?

Anxiety - Non-specific feelings of fear or phobic avoidance. A certain amount of anxiety is normal, but persistent, abiding anxiety that interferes with normal functioning may indicate an anxiety disorder. Abnormal anxiety is characterized by heart palpitations, sweating, trembling/shaking and/or nausea.

Screening Instrument
yes no   Do you worry a lot and find it difficult to control your worrying?
yes no   Do you often feel restless, keyed-up or on edge?
yes no   Do you often notice increased muscle tension?
yes no   Does your anxiety ever interfere with social or occupational functioning?
yes no   Do you have recurrent difficulty falling asleep?


Attention Deficit/Hyperactivity Disorder (ADHD) - A disorder, usually beginning in childhood, marked by a persistent pattern of inattention and/or hyperactivity-impulsivity. ADHD is often first noticed in a school environment and those suffering from the disorder typically underperform academically. The disorder has three subtypes: ADHD - Primarily Hyperactive Type (impulsivity, impatience, blurting out answers, difficulty waiting one's turn, etc.), ADHD - Primarily Inattentive Type (daydreamy, easily distracted, difficulty following through, etc.) and ADHD Combined Type (combination of symptoms).

Screening Instrument
yes no   Do you often have trouble sustaining attention at work or play?
yes no   Do you have trouble listening when in conversation?
yes no   Are you often easily distracted?
yes no   Do you fidget or squirm when seated for an extended period?

Bipolar Disorder - A mood disorder marked by instability of mood. There are two types of Bipolar Disorder: Type 1 characterized by mood swings where a depressed or normal mood is indispersed by manic episodes. A manic episode is characterized by inflated self-esteem or grandiosity, a decreased need for sleep, flights of ideas, impulsivity, irritability and psychomotor agitation. Bipolar Disorder Type 2 is marked by depressed or normal mood indispersed by hypomanic episodes. Hypomania is a more mild form of mania with many of the same signs and symptoms of mania but with less energy and severity.

Screening Instrument
yes no   In the last year, have there been periods of time where you needed less sleep?
yes no   In the last year, have you engaged in impulsive spending, traveling or gambling?
0 yes no   Are there times when your thoughts race?
yes no   Do you have periods of being easily distractible?
yes no   In the last year, have there been times of markedly increased sexual activity?

Chronic Pain - Physical pain lasting more than six months. Chronic pain can lead to depression, irritability, anxiety, social isolation and a physical dependence of pain-relieving drugs.

Screening Instrument
yes no   Have you been suffering pain for more than six months?
yes no   Has your pain prevented you from working, socializing or recreating?
yes no   Are you concerned that you have become physically dependent on pain meds?
yes no   Has your mood suffered because of your pain?

Co-Dependency - Co-Dependency describes a situation where an individual is excessively dependent on another for their emotional well-being. In couples where one is alcoholic, the other often goes to great lengths to "clean up" after the drinker - making excuses for drinking-related bad behavior, being careful not to upset the alcoholic, or going to unusual lengths to prevent the alcoholic from drinking. Though co-dependency is often seen in the context of alcoholism, co-dependent relationships can spring-up around: mental illness, a narcissistic or over-controlling spouse, drug abuse or addiction or chronic illness.

Screening Instrument
yes no   Do you spend a lot of time worrying about the behavior of another?
yes no   Have you ever made excuses for the bad behavior of another?
yes no   Do you get upset when a family member is upset?
yes no   Are you happy only when your significant other is happy?

Compulsive Use of Pornography - Actually an impulse-control disorder marked by an inability to resist the impulse, drive or temptation of view pornography (either in print, on video or on the Internet). The affected person usually experiences an increasing sense of tension and arousal that leads to viewing pornography and some feeling of relief and gratification while or after viewing pornography.

Screening Instrument
yes no   Do you spend more than an hour a week viewing pornography?
yes no   Has a loved one ever expressed concern about your use of pornography?
yes no   Have you ever felt remorseful about your use of pornography?
yes no   Have you ever tried to quit or cut-down your use of pornography?
yes no   Have you ever lied about your use of porn?

Depression - A mood disorder characterized by an abiding depressed mood that results in a marked impairment in social, occupational or educational functioning. Persons suffering from depression often show flat or blunted affect, sleep disturbances (sleeping more or difficulty sleeping), and change in eating habits. Depressed people can also be irritable and withdrawn.

Screening Instruments
yes no   Have your sleeping habits changed in the last year?
yes no   Have your eating habits changed in the last year?
yes no   Do you often feel sad or hopeless?
yes no   Has your energy level gone down in the last year?
yes no   Do you suffer from low self-esteem?

Drug Abuse - A maladaptive pattern in the use of one or more mood-altering drugs marked by: using at times or places where it would be dangerous to use, continued use despite adverse consequences (drug-related arrest, loss of job, educational difficulties, health problems, loss of relationship, family difficulties).

Screening Instrument
yes no   Has your substance use resulted in school or work problems?
yes no   Have you ever used a drug in an environment where it is dangerous?
yes no   Has your drug use ever resulted in legal problems?
yes no   Have you continued using after experiencing drug-related problems?

Drug Addiction - A chronic and progressive disorder marked by a loss of control over the use of one or more mood-altering drugs. Evidence of loss of control can be: using in amounts greater than intended, using on occasion when the person planned not to, continued use after acknowledging that drug use is a problem, unsuccessful effort(s) to quit using or cut down amount used, withdrawal symptoms when not using, of an impairment of functioning in an important sphere of life (work, education, family, etc.).

Screening Instrument
yes no   Do you need more of your drug of choice to get desired results?
yes no   Have you ever experienced withdrawal symptoms when not using?
yes no   Have you ever failed in an attempt to quit or cut down your use?
yes no   Have you ever used more than you intended?
yes no   Have you ever used on an occasion when you planed not to?

Trauma - Trauma can occur following an event that involves the threat of death or serious injury or a threat to one's personal integrity; or witnessing the death, injury or threat of violation of personal integrity of another person. The traumatized person's response to the event typically involves intense fear, helplessness or horror. Symptoms of emotional trauma include a re-experiencing of the event, avoidance of objects, places and situations reminiscent of the trauma, hyper-arousal, nightmares, and daytime intrusive thoughts of the trauma.

Screening Instrument
yes no   Do you have recurrent, distressful memories of a traumatic event?
yes no   Have you had nightmares related to a traumatic event?
yes no   Do you have thoughts of a past painful event that you try to suppress?
yes no   Do you notice a sense of detachment or estrangement from others?
yes no   Do you have difficulty recalling important aspects of past painful episodes?


Family/Relationship Conflict - Frequent or recurrent argument, feuding, or angry interactions with a loved one or within a family. In conflicted families, disagreements go unresolved, discussions erupt into arguments and interaction becomes difficult and emotionally risky. Family members have difficulty "fighting fair" and tend to hold grudges and take sides.

Screening Instrument
yes no   Hardly a week goes by without having a heated argument within the family.
yes no   Normal, everyday discussions suddenly erupt into shouting matches.
yes no   In my family, we hide or gloss over problems rather than discussing them.
yes no   In my family, members take sides against each other.
yes no   Members of my family have gone long periods without talking to each other.

Family of Origin Issues - Family of Origin Issues refer to emotional and psychological problems related to spending one's childhood and adolescence in a family marked by physical and emotional violence, poverty, chronic illness, the repeated violation of personal boundaries or rigidity of rules and standards. People with Family of Origin Issues often suffer anxiety, avoidance and have difficulty forming intimate relationships.

Screening Instrument
yes no   In regard to family relationships I guess at what normal is.
yes no   In my adult life, I have had difficulty forming intimate relationships.
yes no   Even today, I dread being around members of my family of origin.
yes no   I cringe when I hear people arguing.

Grief and Loss - Grief and Loss Issues describe impairment of social and occupational functioning by the symptoms of grief. Symptoms of grief include prolonged emotional distress related to the loss, significant level of impairment of social or emotional functioning, and may precipitate substance abuse or the worsening of another, preexisting mood disorder.

Screening Instrument
yes no   I have had difficulty bouncing back from a significant loss.
yes no   My mood has deteriorated after a significant loss.
yes no   After my loss I have frequently been troubled by dark thoughts.
yes no   I have socialized significantly less after my loss.

Impulse Control Issues - Described in psychological literature as "a failure to resist an impulse, drive or temptation to act in a way that is harmful to others." People suffering from Impulse Control Issues often feel an increasing sense of tension and arousal leading up to committing an impulsive act, and feel pleasure and relief after acting-out impulsivity. The major Impulse Control Disorders are: Intermittent Explosive Disorder - a failure to resist impulses that result in a serious assaultive act; Kleptomania - failure to resist impulses to steal unnecessary items; Pyromania - failure to resist impulses to set fires; Pathological Gambling (described under Problem Gambling); and Trichotillomania - a failure to resist impulses to pull out one's hair.

Screening Instrument
yes no   I frequently struggle to resist harmful impulses.
yes no   I have gotten into legal difficulties because of my temper.
yes no   I have shoplifted after age eighteen.
yes no   I sometimes pluck out my hair.

Internet Gaming Addiction - This is a behavioral problem marked by the affected person spending an inordinate amount of time playing computer or Internet games. Players of these games, especially Massively Multiplayer Online Role-Playing Games (MMORPG) often prefer the security of an on-line fantasy world of the MMORPG to the emotional risks of a real-life social environment, and the large amount of time spent playing online can result in a deterioration of real-life social skills.

Screening Instrument
yes no   I spend more than 20 hours a week playing computer or online games.
yes no   I prefer the online social environment to that of the real world.
yes no   A loved one has expressed concern about my computer or online gaming.

Obsessive-Compulsive Disorder - An anxiety disorder marked by recurrent obsessions or compulsions that are excessively time consuming or cause significant distress. Those affected continue compulsive behaviors even after recognizing they are excessive and unreasonable. Obsessive-compulsive behaviors include counting and checking, hand washing, an insistence on symmetry and other behaviors.

Screening Instrument
yes no   I have to check door locks, oven, etc. more than once before I leave the house.
yes no   I wash my hands more than six times a day.
yes no   For me, even numbers are very important.
yes no   Mental obsessions cause me emotional distress.

Oppositional Defiance - A behavioral disorder characterized by a recurrent pattern of negativistic, defiant, disobedient and hostile behavior towards authority figures - typically parents and other adults. Those suffering from this disorder often lose their temper, arguing, and refusing to comply with requests and rules of adults. They are often touchy, easily annoyed by others, spiteful and vindictive.

Screening Instrument
yes no   My child often loses his/her temper.
yes no   My child often argues with adults.
yes no   My child often deliberately annoys people.
yes no   My child is often angry and resentful.

Insomnia/Sleep Disturbance - Difficulty initiating or maintaining sleep or a history of non-restorative sleep that causes difficulty in social, occupational, or other important life areas.

Screening Instrument
yes no   My sleep difficulties result in daytime fatigue.
yes no   I have had difficulty with sleep for a month or more.
yes no   Sleep difficulties run in my family.
yes no   Sometimes I fall asleep when not intending to.

Self-Harming Behavior - Self-Harming Behavior is marked by the intentional injuring of body tissue, most often done without suicidal intention. Self-harm is most common in adolescence and young adulthood, usually first appearing between the ages of 12 and 24. The most common form of self-harm involves cutting of the skin with a sharp object. Self-harmers often feel guilty about the behavior and tend to be quite self-conscious about their scars. Self-harmers often go to great lengths to conceal their harming behavior. It is widely thought that self-harming is a way of coping with emotional pain or communicating distress.

Screening Instrument
yes no   I have intentionally cut or burned myself in the past year.
yes no   I often wear clothing that hides my self-inflicted scars.
yes no   Others don't appreciate the depth of my emotional suffering.
yes no   I often feel numb unless I inflict pain on myself.
yes no   I often feel invisible.

Sex/Relationship Addiction - Sex Addiction describes a pervasive pattern of sexual acting-out. Those affected often engage in sexual activity with relative strangers or with people they are not attracted to, act-out sexually in situations where it is risky, and often feel guilty and ashamed about their sexual activity. Relationship Addiction, a related disorder, refers to a repeated pattern of impulsively engaging in unfulfilling romantic relationships and a dependence on romantic partners.

Screening Instrument
yes no   I often feel guilty about my sexual behavior.
yes no   I have engaged in sexual acts that are against my personal values.
yes no   I tend to go from one romantic relationship to another.
yes no   I feel depressed or anxious when not in a relationship.

Spending Addiction - Spending Addiction describes a pervasive pattern of impulsive spending marked by spending amounts greater than intended, spending more than one can afford, buying items that are unnecessary, continued spending after it has become a problem, and unsuccessful attempts to cut-down the amount of money spent.

Screening Instrument
yes no   I have tried and failed to control my spending.
yes no   I have items at home that are still in their wrapper a month after I bought them.
yes no   A loved one has expressed concern about my spending.
yes no   I spend more than I can afford.

Stimulant-Induced Psychosis - Users of large amounts of psychostimulant drugs, like amphetamines, cocaine or "bath salts" sometimes suffer from stimulant-induced psychosis. Psychosis describes a state where a person loses touch with reality and suffers from delusions and/or hallucinations. In this state, the person can pose a danger to themselves or others. Stimulant-induced psychosis usually clears in 2-3 days once the user's system is free of stimulant drugs.

Screening Instrument
yes no   Is the person concerned about others being "out to get them?"
yes no   Do you suspect the person is using amphetamines, cocaine or "bath salts?"
yes no   Is this person unusually agitated or confused?
yes no   Does this person display disorganized speech?

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