5.4 Selection of Categories of Psychological Disorders

Learning objectives

Neurodevelopmental disorders begin during the developmental period. Their symptoms are evaluated in relation to behavior expected for the person's age or maturity range, so the same behavior cannot be interpreted without developmental context.

AP scope element	CED boundary
Selected disorders	Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD)
Symptom frame	Whether behavior is appropriate for age or maturity range
Possible causes	Environmental, physiological, or genetic

A valid description connects the observed pattern to developmental timing and functioning rather than treating one isolated behavior as sufficient. Possible causes identify domains to investigate; they do not prove that one factor produced a disorder.

The CED names ADHD and ASD here but does not supply full diagnostic criteria. Age-inappropriate behavior may be relevant evidence, but diagnosis requires a broader trained assessment.

Area	CED description	Symptom type
Delusion	False belief, such as persecution or grandeur	Positive
Hallucination	False perception involving one or more senses	Positive
Disorganized thinking or speech	May include word salad, a nonsensical string of words	Positive
Disorganized motor behavior	May include catatonic excitement or stupor	Positive or negative manifestation
Negative symptom	Lack of a typical behavior, such as flat affect or movement	Negative

Schizophrenia can be acute or chronic. Positive symptoms add or markedly distort experience or behavior; negative symptoms involve a reduction or absence of typical functioning. Catatonia can appear as excitement or as stupor, so its manifestation determines the classification.

Possible causes suggest genetic or biological links, including prenatal virus exposure and neurotransmitter imbalance described by the dopamine hypothesis. These are risk explanations, not single-case proof.

Hallucinations are perceptions; delusions are beliefs. Schizophrenia is not the same as dissociative identity disorder, and the presence of one unusual experience alone does not establish a diagnosis.

Depressive disorders involve a sad, empty, or irritable mood together with physical and cognitive changes that affect the person's ability to function. The functional effect separates a clinically relevant pattern from an ordinary temporary mood alone.

AP scope	Included content
Selected disorders	Major depressive disorder and persistent depressive disorder
Possible-cause domains	Biological, genetic, social, cultural, behavioral, or cognitive

Relevant evidence can include mood plus changes in areas such as thought, sleep, appetite, pleasure, or other functioning when supported by the scenario. A causal explanation must name the supported domain rather than assume every depressive pattern has the same origin.

Sadness by itself is not equivalent to a depressive disorder. The CED names the two selected disorders but does not provide subtype duration thresholds here, so those thresholds should not be invented.

Bipolar disorders are characterized by periods of mania and periods of depression. Bipolar cycling means these mood periods alternate, and each period can last a different amount of time.

AP scope element	Included content
Selected disorders	Bipolar I disorder and Bipolar II disorder
Defining pattern	Alternating periods of mania and depression
Possible-cause domains	Biological, genetic, social, cultural, behavioral, or cognitive

The key evidence is a pattern across time, not simply intense emotion at one moment. Possible causes may come from several domains, so a biological risk finding and a social stressor can both be relevant without either being a universal cause.

Bipolar cycling is not ordinary rapid mood change in everyday situations. The CED names Bipolar I and II but does not specify their distinguishing episode thresholds here, so the card does not add them.

Disorder	Distinguishing focus
Specific phobia	A particular object or situation, such as heights or spiders
Agoraphobia	Situations such as transport, open or enclosed spaces, crowds or lines, or being outside home alone
Panic disorder	Unanticipated, overwhelming panic attacks involving biological, cognitive, and emotional fear
Social anxiety disorder	Intense fear of being judged or watched by others
Generalized anxiety disorder	Prolonged nonspecific anxiety or fear

The CED includes culture-bound manifestations. Ataque de nervios is associated mainly with people of Caribbean or Iberian descent. Taijin kyofusho, associated mainly with Japanese people, involves fear that others judge one's body as undesirable, offensive, or unpleasing.

Possible causes include learned associations, maladaptive thinking or emotional responses, and biological or genetic sources. The supported cause must be inferred from evidence in the scenario, not from the disorder label alone.

Agoraphobia is not simply fear of open spaces, and social anxiety is not merely shyness. Social anxiety is distinct from, though it may include, agoraphobia.

Construct	CED meaning	Role in the cycle
Obsession	Intrusive thought	Produces a concern or distress that the person experiences
Compulsion	Intrusive, often repetitive behavior intended to address an obsession	Acts as the attempted response to the obsession

The selected disorders in AP scope are obsessive-compulsive disorder and hoarding disorder. Possible causes may involve learned associations, maladaptive thinking or emotional responses, and biological or genetic sources.

A repetitive action counts as a compulsion in this framework when it is intended to address an obsession, such as reducing anxiety linked to the intrusive thought. Repetition alone does not reveal the function of the behavior.

An obsession is not ordinary enthusiasm, and a compulsion is not merely a preferred routine. The CED names hoarding disorder but does not provide separate criteria here, so none are inferred.

Dissociative disorders involve disruptions or separations in normally integrated experience. The CED domains include consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior.

AP scope element	Included content
Selected disorders	Dissociative amnesia, with or without fugue, and dissociative identity disorder
Possible causes	Experience of trauma or stress

To recognize this category, identify which aspect of experience is disconnected—for example memory or identity—rather than looking for a hallucination or delusion. Trauma or stress is a possible causal context, not proof from symptoms alone.

Dissociation is not the same as schizophrenia. The CED names amnesia with and without fugue but does not give a separate fugue criterion here, so the card does not invent one.

Trauma and stressor-related disorders begin with exposure to a traumatic or stressful event followed by psychological distress. The selected disorder in AP scope is posttraumatic stress disorder (PTSD).

CED-listed possible symptoms are hypervigilance, severe anxiety, flashbacks to traumatic or stressful experiences, insomnia, emotional detachment, and hostility. A scenario may show more than one because the category includes cognitive, emotional, behavioral, and arousal-related effects.

The diagnostic learning link is temporal and contextual: a trauma or stressor is experienced, and continuing psychological distress follows. Possible causes therefore involve the experience of trauma or stress.

Experiencing stress or one short-lived reaction does not by itself establish PTSD. The CED supplies a category pattern, while diagnosis requires trained assessment of the complete presentation.

Feeding and eating disorders involve altered consumption or absorption of food that impairs physical health or psychological functioning. The impairment is part of the category definition; a food preference alone is not enough.

AP scope element	Included content
Selected disorders	Anorexia nervosa and bulimia nervosa
Possible-cause domains	Biological, genetic, social, cultural, behavioral, or cognitive

A description should identify the altered food-related pattern and its effect on health or psychological functioning. A cause explanation should name the supported domain and avoid assuming that culture, biology, or cognition acts alone in every case.

The CED names anorexia nervosa and bulimia nervosa but does not give their differential diagnostic criteria in this Objective. Do not infer a diagnosis from body size, one meal, or appearance.

Personality disorders involve an enduring pattern of internal experience and behavior that deviates from the person's culture, is pervasive and inflexible, begins in adolescence or early adulthood, remains stable over time, and causes personal distress or impairment.

Cluster	CED description	Selected disorders
A	Odd or eccentric	Paranoid, schizoid, schizotypal
B	Dramatic, emotional, or erratic	Antisocial, histrionic, narcissistic, borderline
C	Anxious or fearful	Avoidant, dependent, obsessive-compulsive personality

Possible causes may involve biological, genetic, social, cultural, behavioral, or cognitive sources. The classification focuses on a stable pattern across contexts and time, not on one isolated trait or reaction.

A personality trait is not automatically a personality disorder; the pattern must be enduring, pervasive, inflexible, culturally deviant, and linked with distress or impairment. Obsessive-compulsive personality disorder is listed in Cluster C and is not the same label as obsessive-compulsive disorder.

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—5.5 Treatment of Psychological DisordersRead

5.4 Selection of Categories of Psychological Disorders

Learning objectives

Neurodevelopmental Disorders Begin During Development

Schizophrenia Symptoms Add, Disorganize, or Remove Function

Depressive Disorders Combine Mood Change and Impaired Function

Bipolar Disorders Alternate Mania and Depression

Anxiety Disorders Differ by the Focus of Fear

Obsessions and Compulsions Form a Thought–Action Cycle

Dissociation Disrupts Integration of Experience

PTSD Links Trauma Exposure to Continuing Distress

Feeding and Eating Disorders Impair Health or Function

Personality Disorders Are Enduring, Pervasive Patterns

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