Instructor:    Otto Wahl  Phone: 860-768-5385  Office:  East 177H hours:
e-mail: owahl@hartford.edu Fax: 860-768-4814  Office hours:  W  10:30-11:30
Class location:  East 110
 

I. Goals of the course

As will be clear in your readings and our discussions, DSM-IV-TR is hardly the definitive word on what psychiatric disorders exist and how they are best defined.  Many believe there are other, better ways to conceptualize the conditions that DSM refers to as “mental disorders.”  Nevertheless, the DSM is the accepted categorization system in the United States and required for many kinds of services and payments.  It also does provide a structure for thinking about psychiatric disorders, recognizing them, and arriving at treatment decisions.   Therefore, one focus of the course will be learning the diagnostic criteria for the major disorders included in the current DSM, although we will also be discussing its limitations.

I believe it is important, also, to understand psychiatric disorders from the perspective of people who experience them.  Those with psychiatric disorders are more than just a bundle of symptoms that lead to a diagnosis, and their illnesses affect their lives in more ways than just being “sick.”  Thus, your assigned readings include first person accounts from people who have experienced the disorders you will be learning about.  In addition, the course will include videos that show real people living with these disorders.

Furthermore, as you may know, I have long been interested in the public’s misconceptions about mental illnesses and factors that contribute to such misunderstanding.  In particular, I am interested in the way mental illnesses are presented in the mass media.  Media depiction of mental illness, then, will be another theme of the course, and, as you can see from the syllabus, the topic for student presentations and papers.

The instructor for this course will also include curriculum material that addresses the importance of empirically supported evidence, multiple critical viewpoints, and the current literature concerning relevant interventions, assessments, diagnoses, theoretical constructs, and other clinical issues and/or techniques relevant to the topic area.  An empirically supported approach is consistent with the Program’s mission of providing training where scientific knowledge is integrated with clinical practice (practitioner-scholar model), as well as with the American Psychological Association (APA) Ethics Code concerning ethical teaching approaches and service delivery.

In addition, the instructor for this course will strive to ensure inclusion of curriculum material consistent with the program’s mission of Affirmative Diversity.  The aim of such inclusion is to help foster social and political awareness of, interest in, respect for, and competence in understanding all groups, and skills in providing services to people of diverse backgrounds.
 
 
 
 

II. Textbooks/readings

 American Psychiatric Association (2000).  Diagnostic and statistical manual of mental disorders (4th edition--text revision).  Washington, D.C.: American Psychiatric Association.

Wahl, O. F. (1999).  Telling is risky business: Mental health consumers confront stigma.  New
Brunswick, NJ: Rutgers University Press.

Selected articles, as listed below (IV).  Note:  The literature on psychiatric disorders is immense, and no selection could provide all the information one needs to know about these disorders.  I make no claim, then, that the assigned readings will allow you to become truly knowledgeable about these disorders.  Rather, readings were selected to touch on a variety of different issues and to give students an idea of the many facets that may be considered related to psychiatric diagnosis. Some readings provide broad reviews of what is known about specific disorders.  Others highlight prominent controversies.  Still others deal with diversity issues—gender differences, age differences, and international perspectives.  As noted above, first person perspectives on disorders are also included.
 

III. Examinations and grades

 A.  There will be two quizzes (5 questions each) during the semester, as indicated in the schedule below (IV).  Quiz questions will be identification, definition, and explanation of concepts and terms. Each quiz will count 15% toward the semester grade.

 B.  There will be a final (take-home) exam which will ask for differential diagnosis based on a client vignette.  More detailed instructions for the exam will be provided in a separate handout.  Counts 30% toward the semester grade.

C.  The remaining 40% of the semester grade will be based upon a paper and class presentation concerning a news media depiction of the psychiatric disorder being covered.  This assignment has two parts.

1. Class presentation:  You are to locate an example of an item in the news media that communicates information about the psychiatric disorder we are discussing in class. News media include newspapers, news magazines, and internet news sites.  The item does not have to focus on the disorder, although it may, but it must communicate identifiable information about the disorder.  It may be an article about a scientific discovery, a new treatment, a diagnosis given for individuals mentioned in a crime story, a controversy related to the disorder, a feature article about an individual with the disorder, a movie review for a film with a mentally ill character, etc.. The item also needs to have been published within the past 2 years.  If you are uncertain whether the item will be appropriate for class presentation, check with the instructor prior to your presentation.  You should make copies of the item and distribute them to class members at least one week prior to your presentation.  On your scheduled presentation date, you will give a brief (15-20 minute) presentation to the class, pointing out the accuracies, inaccuracies, omissions, and implications in the news media depiction.
 

2. You must also prepare a paper discussing the news item, using five or more articles from the current scientific literature to examine the accuracy of information in the media depiction.  [Note:  While you may reference your texts, these will not count toward the five articles.  Also, references need to be primary sources and no more than one may be an online publication.]    The paper should summarize the news item, examine the accuracy and inaccuracy of the information, and discuss the potential consequences of any inaccuracies or omissions.  The paper should be typed, double-spaced, follow APA format guidelines, and be 4-5 pages in length (not counting title, abstract, and reference pages).  Papers should be completed independently by each student and must be submitted to the instructor at the time of the class presentation.

D.  Grades will be based on total accumulation of points, as follows:

 A = 94-100  Percentage weights for the different assignments will translate to the
 A- = 90-93  same number of points toward a final grade.  For example, an
 B+ = 87-89  assignment listed as counting 40% would be worth 40 points.
 B = 83-86
 B- = 80-82
 C+ = 77-79
 C = 73-76
 F = < 73

 It is expected that assignments will be turned in on time.  However, in the extraordinary event
that an assignment is turned in late, there will be a loss of 3 points for each day past the due date.

 There will be no make-up opportunities for missed examinations.
 

Need for accommodations:  Every student with a documented physical, psychiatric, or learning disability has the Program’s commitment and support in obtaining accommodations, academic adjustments, and/or other auxiliary aids.  When seeking accommodations, students with a disability must identify themselves as an individual with a disability in a timely manner to the Coordinator of Services for Students with Medical, Physical, and Psychological Disability within the Student Affairs office at the University (see http://www.hartford.edu/support/desc.asp?id=9), and to the Associate Director/Coordinator of Student Affairs of the GIPP.  The student should also consult with the instructor at the beginning of the course for specific needed accommodations.”
 
 

PLEASE NOTE:  The Instructor for this course will be on a brief medical leave from Feb. 19th to March 18th.  During this time, classes will be taught by guest lecturers.  Specific information about guest lecturers will be provided when the full schedule has been confirmed.
 
 

IV.   Class Topics and Reading Assignments
 

1/26 Introduction to the course:  Syllabus and assignments
 

2/2 Classification:  DSM-IV—organization, issues, controversies, and limitations

 DSM-IV-TR:
  Introduction, pp. xxiii-xxxv.
          Cautionary statement, p. xxxvii
  Use of the Manual, pp. 1-12.
  Multiaxial Assessment, pp. 27-37.
  Outline for cultural formulation and glossary of culture-bound syndromes, pp. 897-903.

 Halgin, R. P. (2005).  Taking sides: Clashing views on controversial issues in Abnormal
  Psychology.  Dubuque, Iowa: McGraw-Hill.
   “Is the DSM-IV a useful classification system?” pp, 2-12.

  Maddux, J. (1993). The mythology of psychopathology: A social cognitive view of deviance,
  difference, and disorder.  The General Psychologist, 29, 34-45.
 

2/9 Beyond symptoms

 Telling is risky business:
  Chap. 4: Isolation and rejection, pp. 43-60.
  Chap. 5: Discouragement and lowered goals, pp. 61-78.
  Chap. 8: Impact of stigma, pp. 127-142.
  Chap. 10: Consumer messages about stigma, pp. 162-169.

Corrigan, P. W., Markowitz, F. E., & Watson, A. C. (2004).
Structural levels of mental illness stigma and discrimination. Schizophrenia Bulletin, 30, 481-491.
 

2/16   Organic mental disorders

 DSM-IV-TR:
  Delerium, dementia, and amnestic and other cognitive disorders, pp. 135-180.

Riley, K. P., Snowden, D. A., Desrosiers, M. F., & Markesbery, W. R. (2005).  Early linguistic
ability, late life cognitive function, and neuropathology: Findings from the Nun Study. Neurobiology of Aging, 26, 341-347.

 Swenson, C. R. (2004). Dementia diary: A personal and professional journal. Social Work, 49,
  451-460.
 
 

2/23   Anxiety Disorders I

 DSM-IV-TR:
  Anxiety Disorders, pp. 429-484.
  Differential Diagnosis of Anxiety Disorders, pp. 754-755.

 Deacon, B. J., & Abramowitz, J. S. (2004).  Cognitive and behavioral treatments for Anxiety
  Disorders, Journal of Clinical Psychology, 60, 429-441.

 Tukel, R., Ertekin, E., Batmaz, S., Alyanak, F., Sozen, A., Aslantas, B., Atli, H., & Ozyildirim,
I (2005). Influence of age of onset on clinical features in obsessive-compulsive disorder. Depression and Anxiety, 21, 112-117.

 Hull, M. K. (1995). Learning to live with myself and my OCD.  Journal of the California
  Alliance for the Mentally Ill, 6, 25-27.
 

3/2 Mood disorders

 DSM-IV-TR:
  Mood Disorders, pp. 345-428.
  Differential diagnosis of mood disorders, pp. 752-753.

 Potash, J.B., & DePaulo, J. R. (2000). Searching high and low: A review of the genetics of
  bipolar disorder. Bipolar Disorders, 2, 8-26.

 Manning, M. (1994).  Undercurrents: A therapist's reckoning with her own depression.  New
  York: HarperCollins, pp. 106-125.

 Jamison, K. R. (1995).  An unquiet mind: A memoir of moods and madness. New York: Alfred
  A. Knopf, pp. 68-80.
 

3/9 Schizophrenia I—symptoms and subtypes; QUIZ I

 DSM-IV-TR:
  Schizophrenia, pp. 297-319.
  Other psychotic disorders, pp. 319-343.
  Differential diagnosis of psychotic disorders, pp. 750-751.

 Bleuler, E.  (1950).  Dementia praecox or the group of schizophrenias. Translated by J. Zinkin.
  New York: International Universities Press.
        Name and definition of the disease, pp. 7-9.

 Maher, B. (2003). Schizophrenia, aberrant utterance and delusions of control: The disconnection
  of speech and thought, and the connection of experience and belief. Mind and Language,
  18, 1-22.

 Schiller, L., & Bennett, A.  (1994). The Quiet Room: A journey out of the torment of madness.
  New York: Warner Books, pp. 9-18.
 

3/16 SPRING BREAK; NO CLASSES
 

3/23 Schizophrenia II—causes and treatment

 Cather, C. (2005). Functional cognitive-behavioral therapy: A brief, individual treatment for
functional impairments resulting from psychotic symptoms in schizophrenia. Canadian Journal of Psychiatry, 50, 258-263.

 Holzman, P. S., & Matthysse, S. (1990).  The genetics of schizophrenia: A review. Psychological
   Sciences, 1, 279-286.

 Barker, S., Lavender, T., & Morant, N. (2001). Client and family narratives on schizophrenia.
  Journal of Mental Health, 10, 199-212.
 

3/30 Dissociative and Somatoform Disorders

 DSM-IV-TR:
  Dissociative Disorders, pp. 519-533.
  Somatoform Disorders, pp. 485-511.
  Factitious Disorders, pp. 513-517.
  Differential Diagnosis of Somatoform Disorders, pp. 756-757.

 Halgin, R. P. (2005).  Taking sides: Clashing views on controversial issues in Abnormal
  Psychology.  Dubuque, Iowa: McGraw-Hill.
   “Is multiple personality disorder a valid diagnosis?” pp. 42-52.

 Rosik, C. H. (2003). Critical issues in the dissociative disorders field: Six perspectives from
  religiously sensitive practitioners. Journal of Psychology and Theology, 31, 113-128.

 West, C. (1999).  First person plural: My life as a multiple.  New York: Hyperion.
  My guys, pp. vii-x.
  Prologue, pp. 1-3.
 

4/6 Personality Disorders

 DSM-IV-TR:
  Personality Disorders, pp. 685-729.

Critchfield, K. L., & Benjamin, L. S. (2006). Principles for psychosocial treatment of Personality
 Disorder: Summary of the APA Division 12 Task Force/NASPR review. Journal of
 Clinical Psychology, 62, 661-674.

 Green, D. (1997). Here’s what I want you to know. Journal of the California Alliance for the
  Mentally Ill, 8, 68-70.
 
 
 
 

4/13 Substance-Related Disorders

 DSM-IV-TR:
  Substance-Related Disorders, pp. 191-295.

 Valliant, G. E. (2005). Alcoholics Anonymous: Cult or cure? Australian and New Zealand
  Journal of Psychiatry, 39, 431-436.

 Zakrzewski, R. F., & Hector, M. A. (2004). The lived experiences of alcohol addiction: Men of
  Alcoholics Anonymous. Issues in Mental Health Nursing, 25
 

4/20 Sexual disorders and Sexual Dysfunctions; QUIZ II

 DSM-IV-TR:
  Sexual and Gender Identity Disorders, pp. 535-582.

 Seligman, L., & Hardenburg, S. A. (2000).  Assessment and treatment of paraphilias. Journal of
   Counseling and Development, 78, 107-113.

 Halgin, R. P. (2005).  Taking sides: Clashing views on controversial issues in Abnormal
  Psychology.  Dubuque, Iowa: McGraw-Hill.
   “Is sexual orientation conversion therapy ethical?” pp. 364-394.
 

4/27   Childhood Disorders I

 DSM-IV-TR:
  Disorders usually first diagnosed in infancy, childhood, or adolescence, pp. 39-134.

 Wolff, S. (2004). The history of autism. European Child and Adolescent Psychiatry, 13, 201-
  208.

 Verduzzo, Ana (2000).  A teenager’s perspective on having a mental disorder. Journal of the
  California Alliance for the Mentally Ill, 11, 17-20.
 

5/4 Childhood Disorders II

 DSM-IV-TR:
  Impulse-Control Disorder Not Elsewhere Classified, pp. 663-677.
  Eating Disorders, pp. 583-595.

 Colton, A., & Pistrang, N. (2004). Adolescents’ experiences of inpatient treatment for Anorexia
  Nervosa. European Eating Disorders Review, 12, 307-316.
 
 
 
 

5/11 Adjustment, disorders, V-codes, and the future

 DSM-IV-TR:
  Adjustment Disorders, pp. 679-683.
  Other conditions that may be a focus of clinical attention, pp. 731-742.
  Criteria sets and axes provided for further study, pp. 759-818.

 Offman, A., & Kleinplatz, P. J. (2004).  Does PMDD belong in the DSM? Challenging the
medicalization of women’s bodies. The Canadian Journal of Human Sexuality, 13, 17-27.
 
 

5/14  Take-home final due by NOON.