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According to the DSM, the essential feature of this mental disorder is “…the development of clinically significant emotional or behavioral symptoms in response to an identifiable psychosocial stressor or stressors.” The manual defines clinically significant as either: “marked distress that is in excess of what would be expected given the nature of the stressor” or “significant impairment in social or occupational functioning.” DSM provides a number of examples of the kinds of stressors that might precipitate a diagnosis of Adjustment Disorder. These include: ...

Grand Rounds is up at medicblog999. There are both themed posts and open submissions. Plenty of reading for all on a wide range of subjects.

This post was edited and updated on June 24, 2013, to address comments received from readers. I thank them for their input. . . . . . . . . . . . . . . . . DSM-IV’s criteria for a manic episode are given below: A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood, lasting at least 1 week (or any duration if hospitalization is necessary). ...

Grand Rounds is up at Emergiblog, with many interesting posts.

Post edited and updated March 9, 2013, to reflect additional thoughts as a result of interactions with the many people who left comments. I thank them for their input. DEPRESSION – AN ADAPTIVE MECHANISM Contrary to the APA’s assertion, depression is not an illness. In fact, depression is an adaptive mechanism which has served humanity well for millions of years. When things are going well in our lives, we feel good. This good feeling is nature’s way of telling us to keep doing what we’re doing. When our lives are not going well, we feel down or depressed. This is nature’s way of telling us to make some changes. ...

This post was edited and updated on July 7, 2013 in the light of comments from readers. I am grateful for their input. One of the anxiety disorders listed in DSM-IV is posttraumatic stress disorder. The criteria for this condition are listed below: A. The person has been exposed to a traumatic event in which both of the following were present: (1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (2) the person's response involved intense fear, helplessness, or horror. Note: in children, this may be expressed instead by disorganized or agitated behavior ...

Fear is the normal human response to imminent danger. It is an adaptive response, in that it is helpful to survival, and it occurs in almost all animal species. When our cave-dwelling ancestors were attacked by mountain lions, they probably experienced acute fear. This fear gave them an extra burst of energy to flee the danger, or, if flight were impossible, to turn and fight. Today in most parts of the world, there is little danger of attack from wild animals. As areas develop economically and culturally, these kinds of acute dangers are systematically eliminated or at least drastically reduced. Close encounters with tornadoes, hurricanes, rattlesnakes, car accidents, etc., can still arouse full-blown fear responses, but most people in developed countries can go months – even years – without experiencing these kinds of situations. ...

CONDUCT DISORDER The essential feature of Conduct Disorder, according to the APA, is a “repetitive and persistent pattern” of rule breaking or activity which violates other people’s basic rights. The manual identifies four broad categories of behavior under this heading: aggression; destruction of property; theft or deceitfulness; and serious violation of rules. DSM goes on to state that individuals with this disorder display little concern for the feelings or welfare of others, are frequently callous and indifferent to other people’s pain and loss, and show little in the way of feelings of guilt or remorse. Poor frustration tolerance, irritability, temper tantrums, and recklessness are cited as frequently associated features. ...

Attention Deficit/Hyperactivity Disorder is defined as “a persistent pattern of inattention and/or hyperimpulsivity that is more frequent and severe than is typically observed in individuals at a comparable level of development.” There is a requirement that the problem existed before age seven and that some of the problems are present in at least two settings. There also must be clear evidence that the inappropriate activity interferes with the individual’s social, academic, or occupational functioning. With regards to the actual diagnostic procedure, the APA lists eighteen behavioral indicators, nine under the heading “inattention,” six under “hyperactivity,” and three under “impulsivity.” For the diagnosis to be considered positive, the child must exhibit at least six problems from either the inattention list or the hyperimpulsivity lists. ...

Grand Rounds is up at codeblog. Plenty of good reading, including an interesting take on fund raising by Duncan Cross at Don’t Walk.