3.

Binge-Eating Disorder
➔ Individuals who experience marked distress
because of binge eating but do not engage in
extreme compensatory behaviors
Abnormal Psychology 2 ➔ Was a disorder under study in DSM –IV TR but
August 2024
PSYCHOMETRICIAN LICENSURE EXAM became a full-fledged disorder in DSM V
Prepared by Kay Vardeleon, RPsy, RPm, CSCOP
CAUSES OF EATING DISORDERS
➔ Anorexia and particularly Bulimia are the most
I. Eating and Sleep-Wake Disorders
culturally specific psychological disorders yet
identified → “glorification of slenderness” in
EATING DISORDERS society
➔ Typical family of someone with anorexia is
1. Bulimia Nervosa successful, hard-driving, concerned about external
➔ Eating a large amount of food—typically more junk appearances, and eager to maintain harmony
food than fruits and vegetables --- than most ➔ Eating disorders seem to run in families, but it is
people will eat under similar circumstances. not clear what is inherited. Speculation is
➔ Just as important as the amount of food eaten is emotional stability and poor impulse control are
that the eating experience is considered as out of the genetic predispositions for eating disorders.
DR. CARL E. BALITA REVIEW CENTER
control. ➔ Young girls with eating disorders have diminished
➔ Another important criterion is that the individual sense of personal control in their own abilities and
attempts to compensate for the binge-eating and talents, and a strikingly low self-esteem
the potential weight gain, almost always by
purging techniques. TREATMENTS:
➔ The distinction between purging type (e.g. ➔ Drug treatments have not been found effective for
vomiting, laxative and diuretics) and the non- anorexia nervosa but antidepressants seem to
purging type (e.g. exercise and or fasting) was work for Bulimia.
dropped in the DSM 5 because the non-purging ➔ Short Term CBT: targets problem eating behaviors
type is quite rare. and associated attitudes about the overriding
importance and significance of body weight and
2. Anorexia Nervosa shapes
➔ People are so successful at losing weight they put ➔ In Anorexia, the goal is to restore the patient’s
their lives in danger weight to at least within the low average range. If
➔ They have an intense fear of obesity and the patient refuses to eat, inpatient treatment is
relentlessly pursue thinness. DSM 5 specifies that recommended.
Anorexics are those with 15% below ideal body
weight SLEEP-WAKE DISORDERS
➔ DSM 5 Types:
a) Restricting Type: individual diet to limit calorie Sleep-Wake Disorders are divided into two categories:
intake. a) Dyssomnias : difficulties in getting enough sleep,
b) Purging Type: rely on purging. (Unlike those problems with sleeping when you want to and
with bulimia, binge-eating purging Anorexics complaints about the quality of sleep.
binge on relatively small amounts of food and b) Parasomnias: Abnormal behavioural or physiological
purge more consistently, in some cases each events that occur during sleep, such as nightmare
time they eat.) and sleepwalking.
➔ Anorexics generally suffer from poor body image

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1. Insomnia Disorder c) Sleep-related hypoventilation which is a
➔ Actually applies to a number of complaints e.g. decrease in airflow without a complete pause
difficulty initiating sleep, difficulty maintaining in breathing.
sleep, and non-restorative sleep.
5. Circadian Rhythm Sleep Disorder
2. Hypersomnolence Disorder ➔ Characterized by disturbed sleep (either insomnia
➔ Involve sleeping too much or excessive sleepiness during the day) brought
about by the brain’s inability to synchronize its
3. Narcolepsy sleep patterns with the current patterns of day and
➔ a condition characterized by an extreme tendency night
to fall asleep whenever in relaxing surroundings. ➔ Several types
➔ Some with narcolepsy experience cataplexy, a a) Jet lag type: cause by rapidly crossing
sudden loss of muscle tone which lasts from multiple timezones
several seconds to several minutes and is usually b) Shift work type: associated with work
preceded by strong emotion such as anger or schedules
happiness c) Delayed sleep phase type: Sleep is delayed
➔ Cataplexy result from a sudden onset of REM later than normal bedtime
sleep d) Advanced sleep wake type: early to bird, early
➔ 2 characteristics of people with Narcolepsy to rise
a) Sleep paralysis: a brief period after e) Irregular sleep wake type: people who
DR. CARL E. BALITA REVIEW CENTER

awakening when they can’t move or speak experience varied sleep cycles
and is often frightening to those who go f) Non-24 hour sleep wake type: sleeping on 25
through it or 26 hour cycles and sleeping and sleeping
b) Hypnogogic Hallucinations: vivid and often later each day.
terrifying experiences that begin at the start of ➔ Scientists believe that the hormone melatonin,
sleep and are said to be unbelievably realistic also called the “Dracula Hormone” contributes to
because they include not only visual aspects setting our biological clocks and tells us to sleep.
but also touch, hearing, and even the
sensation of body movement. TREATMENTS FOR SLEEP-WAKE DISORDERS
➔ Phototherapy: using bright light to trick the brain
4. Breathing – Related Sleep Disorders into readjusting the biological clock.
➔ Sleepiness during the day or disruptive sleep at ➔ Phase delays (moving bedtime later) and phase
night that has a physical origin namely problems advances (moving bedtime earlier) seems to work.
with breathing while asleep ➔ Sleep hygiene: changes in lifestyle such as
➔ Breathing while asleep could be labored avoiding caffeine and nicotine , or going to bed at
(hypoventilation) or extreme that they stop a specific time each day.
breathing altogether called sleep apnea. ➔ Scheduled awakenings, or waking a child briefly
➔ 3 Types of Sleep Apnea: approximately 30 minutes before a typical episode
a) Obstructive Sleep Apnea Hypopnea occurs, can help in night terrors.
Syndrome which occurs when airflow stops ➔ Relaxation exercises and medical interventions
despite continued activity by the respiratory have also helped.
system. Obesity is somewhat related to this
syndrome.
b) Central Sleep Apnea which involves complete
cessation of respiratory activities for brief
periods and is associated with central
nervous system disorders

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 II. Sexual Dysfunctions, Paraphilic ➔ Disorders of sexual arousal that cause distress or
impairment to the individual or cause personal
Disorder, and Gender Dysphoria.
harm or risk of harm to others.
SEXUAL DESIRE DISORDERS ➔ NOTE: DSM V does not consider a paraphilia a
1. Male Hypoactive Sexual Desire Disorder disorder unless it is associated with distress and
➔ little or no interest in any type of sexual activity impairment or harm or the threat of harm to
among men. others.

2. Female Sexual Interest/ Arousal Disorder 1. FETIHISTIC DISORDER

➔ little or no interest in any type of sexual activity ➔ A person is sexually attracted to non-living
among men. objects.
➔ There are many types of fetishes as there are
SEXUAL AROUSAL DISORDERS objects
➔ 3 classes of objects or activities:
1. ERECTILE DISORDER a) Inanimate object
➔ Problem is not desire but becoming physically b) Source of specific tactile stimulation e.g.
aroused. rubber,
➔ For men, it is reflected by an inability to become c) Part of the body e.g. foot, buttocks (called
rigid for penetration, for females it is inability to partialism)
achieve sufficient lubrication.
DR. CARL E. BALITA REVIEW CENTER

➔ The old and somewhat derogatory terms are 2. VOYEURISTIC AND EXHIBITIONISTIC
impotence and frigidity, but they are imprecise DISORDER
labels. ➔ Voyeuristic Disorder: is the practice of observing,
➔ Erectile Dysfunction increases rapidly after age 60 to become aroused, an unsuspecting individual
undressing or naked.
2. Orgasm Disorders ➔ Exhibitionistic Disorder: Achieving sexual arousal
➔ Inability to achieve orgasm despite adequate and gratification by exposing genitals to
sexual desire and arousal is commonly seen in unsuspecting strangers.
women and less commonly seen in men.
➔ Males who achieve orgasm only with great 3. TRANSVESTIC DISORDER
difficulty or not at all meet the criteria for a ➔ Sexual arousal is strongly associated with the act
condition called delayed ejaculation. In women, of (or fantasies of) dressing in clothes of the
the condition is referred to as female orgasmic opposite sex or cross-dressing
disorder.
4. SADISM AND SEXUAL MASOCHISM
SEXUAL PAIN DISORDERS DISORDERS
➔ Both are associated with either inflicting pain or
1. Genito-pelvic pain/penetration disorder humiliation (sadism) or suffering pain or
➔ A disorder specific to women which refers to humiliation (masochism), and becoming sexually
difficulties with penetration during attempted aroused is associated specifically with violence
intercourse or significant pain during intercourse. and injury in these conditions.
➔ Most common presentation is vaginismus: pelvic ➔ Hypoxiphilia: self-strangulation to reduce the flow
muscles in the outer third of the vagina undergo of oxygen to the brain and enhance the sensation
involuntary spasms when intercourse is affected. of orgasm.

PARAPHILIC DISORDERS 5. SADISTIC RAPE

➔ Many rapists meet the criteria for Antisocial
Personality Disorder

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 ➔ Rapes are described as opportunistic: an Impulse Control Disorders: represent a number of
aggressive or antisocial individual with a marked related problems that involve the inability to resist
lack of empathy or disregard for inflicting pain on acting on a drive or temptation.
others (as opposed to planned rapes out of
vindictiveness or anger) Levels of Involvement:
a) Substance Use: is the ingestion of psychoactive
GENDER DYSPHORIA substances in moderate amounts that does not
significantly interfere with social, educational and
Gender Dysphoria occupational functioning.
➔ is present if a person’s physical sex (male or b) Intoxication: our physiological reactions to
female anatomy also called “natal sex”) is not ingested substances --- drunkenness or getting
consistent with a person’s sense of who he or she high.
really is or with his or her experienced gender c) Substance Abuse: defined in terms of how
➔ If natal sex is female but the experienced gender significantly it interferes with a user’s life.
is strongly male, the individual is referred to as a d) Substance Dependence: the person is
transsexual man or transman. A natal male would physiologically dependent on the drug or drugs,
be a transwoman. requires increasingly greater amounts of the drug
➔ If they have undergone sex reassignment surgery, to experience the same effect (tolerance) and will
then they are called post transition. respond physically in a negative way when the
➔ Gender dysphoria can occur among individuals substance is no longer ingested (withdrawal). Can
DR. CARL E. BALITA REVIEW CENTER

with Disorder of Sexual Development, formerly also be defined in terms of “drug seeking
known as intersexuality or hermaphroditism, who behaviors.”
are born with ambiguous genitals.
* DSM IV considered substance abuse and substance
ASSESSING AND TREATING PARAPHILIC use as 2 separate diagnosis. DSM V combined the two
DISORDERS: based on the research that they co-occur.
➔ Covert sensitization: patients associate sexually
arousing images in their imagination with some Substance:
reasons why the behavior is harmful or dangerous ➔ chemical compounds that are ingested to alter
➔ Orgasmic Reconditioning: patients are instructed mood or behavior.
to masturbate to their usual fantasies but to ➔ Six categories:
substitute more desirable ones before ejaculating a) Depressants: substances that result in
➔ Drug Treatments: Most popular drug used is an behavioural sedation and can induce
antiandrogen called cyproterone acetate. This relations. Includes: alcohol, barbiturates, and
form of chemical castration eliminates sexual benzodiazepines.
desire and fantasy b) Stimulants: substances that cause users to be
more active and alert and can elevated mood.
III. SUBSTANCE-RELATED, ADDICTIVE Example: amphetamines, cocaine, nicotine
AND IMPULSE CONTROL and caffeine.
c) Opiates: major effect is to produce analgesia
DISORDER
temporarily (reduce pain) and euphoria.
Example: heroin, opium, codeine, and
Substance-related and addictive disorders: which are
morphine.
associated with the abuse of drugs and other
d) Hallucinogens: Substances that can alter
substances people take to alter the way they think, feel
sensory perception and can produce
and behave. A new addition to this category in the
delusions, paranoia, and hallucinations.
DSM V is gambling disorder.
Cannabis and LSD and included in this
category.
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 e) Other Drugs of Abuse: Drugs abused that major age appropriate societal norms or rules are
does not fit neatly into the above categories. violated.
Example: anabolic steroids and other over the a) Two subtypes: childhood-onset (onset is prior
counter medications. t o age 10) and adolescent-onset (absence of
f) Gambling Disorder: As with ingestion of the symptom prior to age 10).
substances just described, individuals who b) DSM V adds a subtype “with callous-
display gambling disorder are unable to resist unemotional presentation) to show that client
the urge to gamble, which in turn, results in presents in a way that shows characteristics
negative consequences e.g. divorce, loss of similar to adults with psychopathy.
employment. ➔ Oppositional Defiant Disorder: a pattern of
angry/irritable mood,
IMPULSE CONTROL DISORDERS argumentative/defiant behavior, or vindictiveness
➔ Intermittent Explosive Disorder: Clients have lasting at least six months."
episode in which they act on their aggressive
impulses that results in serious assaults or 2. Communication and Learning Disorders
destruction of property. ➔ Language disorder: a child’s delay in using spoken
➔ Kleptomania: a recurrent failure to resist urges to and written language and is characterized by
steal things that are not needed for personal use small vocabulary, grammatically incorrect
or for their monetary value. sentences, and/or trouble understanding words or
➔ Pyromania: an impulse-control disorder that sentences.
DR. CARL E. BALITA REVIEW CENTER

involves having an irresistible urge to set fires. ➔ Social (pragmatic) communication disorder:
IV. NEURODEVELOPMENTAL Despite adequate vocabulary and the ability to
create sentences, patients have trouble with the
DISORDERS
practical use of language; their conversational
interactions tend to be inappropriate.
Neurodevelopmental Disorder ➔ Speech sound disorder. Correct speech develops
➔ Disorders that show themselves early in life often slowly for the patient’s age or dialect.
persists as a person grows older so the term ➔ Childhood-onset fluency disorder (stuttering). The
childhood disorders is often misleading. Because normal fluency of speech is frequently disrupted.
the developmental disorders in this group are all ➔ Specific Learning Disability: A significant
presumed to be neurologically based, DSM V discrepancy between a person’s academic
categorizes them as neurodevelopmental achievement and what would be expected from
disorders. someone of the same age --- referred to by some
as “unexpected underachievement”
1. Attention-Deficit and Disruptive Behavioral a) Clinicians can use specifiers such as
Disorders disorders of reading, written expression or
➔ Attention Deficit and Hyperactivity Disorder: a mathematics to highlight specific problems for
pattern of inattention, such as being disorganized remediation
or forgetful, about school or work-related tasks, or b) Disorders of reading can still be broken down
of hyperactivity and impulsivity. into: problems with word recognition (difficulty
a) DSM V refers to two categories of symptoms: decoding single words sometimes called
- Inattention dyslexia), fluency (problems being able to
- Hyperactivity and Impulsivity read words and sentence smoothly and
b) Genetic evidence reveal that ADHD and automatically) and comprehension (difficulty
learning disabilities may share a common getting meaning from what is read).
cause c) Historically, a specific learning disorder is
➔ Conduct Disorder: repetitive and persistent pattern defined as 2 standard deviations between
of behavior in which the basic rights of others or achievement and IQ
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 numbers in place of comprehensive assessment
3) Autism Spectrum Disorder of functioning. But before the following was
➔ Is a neurodevelopmental disorder that at its core standard as four levels of ID:
affects how one perceives and socializes with a) Mild: IQ score between 50-55 and 70
others. b) Moderate: IQ score 35-40 to 50-55
➔ DSM V combines most of the disorders previously c) Severe: ranging from 20-35 to 35-40
included under the umbrella term “pervasive d) Profound: with scores below 20-25
developmental disorders (e.g. autistic disorder, ➔ Classification of levels of support needed by a
asperger’s disorder, and childhood disintegrative person with an ID is intermittent, limited,
disorder) and included them into this one extensive, and pervasive
category. ➔ Down Syndrome: Most common chromosomal
➔ Rett Disorder, a condition that affects mostly form of ID caused by the presence of an extra 21st
females is also classified under ASD chromosome which is why it is sometimes called
➔ ‘Two major characteristics of ASD: trisomy 21.
a) Impairments in social communication and ➔ Global Developmental Delay: Used when a child
social interaction under the age of 5 seems to be falling behind
b) Restricted, repetitive patterns of behavior, developmentally but you cannot reliably assess
interests or activities. the degree.
➔ DSM V also recognizes that impairments are
present in early childhood and that they limit daily 5) Tic and Motor Disorders
DR. CARL E. BALITA REVIEW CENTER

functioning. ➔ Developmental coordination disorder. The patient

➔ DSM V introduced 3 levels of severity: is slow to develop motor coordination; some also
a) Level 1 Requiring Support have attention-deficit/hyperactivity disorder or
b) Level 2 Requiring Substantial Support learning disorders.
c) Level 3 Requiring Very Substantial Support ➔ Stereotypic movement disorder. Patients
repeatedly rock, bang their heads, bite
4) Intellectual Disability (Intellectual Development themselves, or pick at their own skin or body
Disorder) orifices.
➔ A disorder evident in childhood as significantly ➔ Tourette’s disorder. Multiple vocal and motor tics
below average intellectual and adaptive occur frequently throughout the day in these
functioning. patients.
➔ DSM V identified difficulties in 3 domains: ➔ Persistent (chronic) motor or vocal tic disorder. A
a) Conceptual (e.g. skill deficits in areas such as patient has either motor or vocal tics, but not both.
language, reasoning, knowledge, and ➔ Provisional tic disorder. Tics occur for no longer
memory.) than 1 year.
b) Social (e.g problems with social judgment and ➔ Other or unspecified tic disorder. Use one of these
the ability to make and retain friendships) categories for tics that do not meet the criteria for
c) Practical (e.g. problems managing personal any of the preceding.
care or job responsibilities)
➔ DSM IV TR previously used the term “mental 6) Disorders of Eating, Sleeping and Elimination
retardation” but this was changed in DSM V to ➔ Pica: The patient eats material that is not food
“intellectual disability” to be consistent in changes ➔ Rumination disorder: There is persistent
in terminology in the field. regurgitation and chewing of food already eaten.
➔ Those with severe forms of ID may never learn ➔ Encopresis: At age 4 years or later, the patient
speech as communication repeatedly passes feces into clothing or onto the
➔ The DSM V criteria for ID no longer include floor.
numeric cut-offs for IQ scores, which were present
in previous versions to de-emphasize these

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 ➔ Enuresis: At age 5 years or later, there is repeated
voiding of urine (it can be voluntary or involuntary)
into bedding or clothing.
➔ Non-rapid eye movement sleep arousal disorder,
sleep terror type: During the first part of the night,
these patients cry out in apparent fear. Often they
don’t really wake up at all. This behavior is
considered pathological only in adults, not children

7) Other Disorders or Conditions That Begin in the

Developmental Period
➔ Disruptive mood dysregulation disorder. A child’s
mood is persistently negative between severe
temper outbursts.

REFERENCES:

American Psychiatric Association. (2013). Diagnostic

and statistical manual of mental disorders (5th ed.).
Arlington, VA: Author.
DR. CARL E. BALITA REVIEW CENTER

Barlow, D. H., Durand, V. M., & Stewart, S. H. (2009).

Abnormal psychology: An integrative approach.
Toronto: Nelson Education.

Congress of the Philippines (2017) The Philippine

Mental Health Act.
https://www.pllo.gov.ph/images/.../RepublicActs.../RA.
11036_mental.health.act.pdf Accessed June 2, 2019
Metro Manila.

Lack, Caleb. Abnormal Psychology: An e-text!.

http://abnormalpsych.wikispaces.com/. Accessed June
2, 2019. Published by Lumen Learning, date unknown.

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