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Eye on Psi Chi: Winter 2007
Senioritis: A (Tongue-in-Cheek) Proposal for an Addition
to the DSM-V

Heidi J. Hendricker, Brandy Priest, Joy B. Kafrouni, Sarah J. Spavone, Justine K. McCullough, and Heather Hasas, PhD, LaGrange College (GA)

This "spoof" of the Diagnostic and Statistical Manual of Mental Disorders (DSM) is not intended to make light of that book, the disorders listed in it, or the people who suffer from those disorders. It is, instead, merely an attempt to present a psychological syndrome often discussed by lay people in DSM style.
Diagnostic Features
The essential feature of Senioritis is persistent apathy towards school or school-related activities. The affected individual must also experience two or more additional symptoms drawn from a list that includes increased participation in extracurricular hedonistic activities; malingering or feigning illness in order to avoid presence in a school setting; cognitive impairments; changes in sleep patterns; and procrastination. In order for a diagnosis of Senioritis to be given, the individual must be at least 16 years old, and a currently (or recently) enrolled student. The symptoms must persist for most of the day, nearly everyday, for at least one month. The degree of impairment associated with an episode of senioritis varies, but diagnosis requires that there be clinically significant interference in academic functioning. In some cases, severe symptoms may prevent students from being accepted into top-choice colleges or graduate schools, or interfere with potential employment prospects.
For a diagnosis of Senioritis to be given, the individual must be at least 16 years of age and a currently or recently (within the last six months) enrolled student [Criterion B]. In most cases, the individual is a currently enrolled senior at a high school, college, or university, but cases are sometimes observed in juniors or even sophomores, and residual symptoms may extend past graduation, or, in some cases, after withdrawal, suspension or expulsion from an academic program. This syndrome may also be observed in students in graduate programs, especially near the end of such programs.
The state of mind of an individual suffering from Senioritis is characterized as being apathetic towards scholastic endeavors [Criterion A1]. People who previously found school interesting and thought-provoking may lose interest and decrease involvement in activities they once found worthwhile and even necessary. People affected with Senioritis will often make negative comments such as, "I don't care anymore," "I'll do it tomorrow," "I've done my time," and "Why does it matter, now that I've already been accepted?"
Many individuals experiencing episodes of Senioritis report increased participation in hedonistic activities [Criterion A2]. They may attend more social gatherings outside of school (e.g., parties and raves). In these settings, individuals may increase their use of certain legal and illegal substances such as alcohol, tobacco, or "recreational" drugs. These hedonistic activities may have physical consequences (e.g., a swelling of the lower abdomen a.k.a. "beer gut," blood shot eyes, and slower and uncoordinated movements). Others may spend more time engaging in passive leisure activities like napping, tanning, or watching game shows on television.
Malingering or feigning of illness in order to avoid a school or school-related setting often increases [Criterion A3]. Coughing, body aches, vomiting, and limping may arise with no biological basis. When taken to a physician, no underlying medical causes for these symptoms are found. Symptoms of illness are usually induced or exaggerated by the afflicted person. For example, sticking finger down the throat to induce vomiting or pressing hot towels against the forehead to simulate fever may be seen. Most of these episodes occur in the morning or night before a scholastic endeavor.
Many individuals with Senioritis report cognitive impairments [Criterion A4] such as an inability to focus or concentrate during class or studying, obsessive thoughts of graduation and/or liberation from school, excessive daydreaming and distraction in academic settings, and selective memory loss in relation to academic assignments. This selective memory loss is usually characterized by the ability to remember phone numbers and party dates, while forgetting assignment due dates, class times, and materials covered in lecture.
Sleep changes are also common [Criterion A5]. The amount of sleep may increase or decrease, and sleep may occur at inappropriate times (e.g., during class). Disruptions to night-time sleep may lead to increases in absenteeism, and to physical symptoms such as puffy eyes, dark circles under the eyes, and uncoordinated gait.
Procrastination [Criterion A6] may also occur. Affected students may not begin assignments in time to finish them and, as a result, may submit assignments late or not at all. Procrastination may also lead to cramming behavior or to taking tests without sufficient preparation. Finally, procrastination may lead to frequent tardiness.
Although the degree of impairment may vary, symptoms of Senioritis typically cause a significant degree of impairment in relation to scholastic endeavors [Criterion C]. Less commonly, social and occupational functioning may also be adversely impacted. Impairment is notable enough that although many cases of Senioritis are self-identified, parents and educators report a significant portion of the afflicted.
By definition, Senioritis is not due to the direct physiological effects of a general medical condition such as hypothyroidism or insomnia or to psychological disorders such as attention deficit hyperactivity disorder, post-traumatic stress disorder, or major depressive disorder [Criterion D]. The symptoms are also not better accounted for by family issues (e.g., death or divorce), or other interpersonal issues [Criterion E].
Age of onset and educational circumstances may be indicated with the following specifiers:
High School Senioritis. This specifier should be used if the symptoms of Senioritis occur in a high school student, generally between the ages of 16 and 19 years.
College/Graduate School Senioritis. This specifier should be used if the symptoms of Senioritis occur in an undergraduate or graduate student, generally age 21 or older.
Associated Features and Disorders
Associated descriptive features and mental disorders. Individuals with Senioritis may experience conflict with parents/guardians regarding grades, attendance, and general level of activity. Senioritis may be an underlying cause for disorders such as substance abuse/dependence and sleep disorders.
Associated laboratory findings. Although little systematic empirical research has been dedicated to the study of Senioritis, anecdotal reports suggest that actual physiological changes do occur. Anecdotal reports suggest decreases in activity in the prefrontal cortex during designated academic mental tests when individuals diagnosed with Senioritis are compared to unaffected students. There are also reports of a positive correlation between weight gain and the length of time individuals are affected by Senioritis, and a slightly negative correlation between liver function and the length of time individuals are affected by Senioritis.
Specific Culture, Age, and Gender Features
Senioritis is most often diagnosed in North America, specifically in the United States. This specific disorder may be underdiagnosed elsewhere, probably due to limited research in other cultures.
Senioritis cannot be diagnosed before the age of 16. It is most commonly diagnosed between the ages of 17-18 and 21-22, although some cases can be observed much later as Senioritis also occurs among graduate students and among nontraditional students at the undergraduate level.
Although this disorder appears to be equally common in males and females, anecdotal reports suggest that males tend to manifest their symptoms externally and actively (e.g., in malingering, procrastination, and excessive participation in hedonistic activities), while females tend to internalize and ruminate on their feelings and cognitions, perhaps experiencing a greater sense of apathy.
Onset of symptoms usually occurs between the ages of 17-18 and 21-22. If Senioritis occurs in high school, it appears that there is an increased chance of recurrence in college. Anecdotal reports suggest that the onset of disorder may occur earlier in males (usually around fall semester/quarter of senior year), while onset in females tends to occur later (more frequently in spring semester/quarter of senior year). Apathy is normally the first and most dominant symptom. As the disorder progresses, a noticeable drop in grades and attendance often occur, followed by procrastination, cognitive impairments, and, in some cases, malingering and increased substance use. For the most part onset is gradual; however, it is often triggered by breaks from school, college or graduate school acceptance letters, and offers of post-graduation employment. Symptoms usually subside after final exams and graduation, or, in extreme cases, after expulsion or withdrawal from school.
There is little information on the prevalence of Senioritis beyond the anecdotal reports of students and professors. Professors and students agree that rates of senioritis increase dramatically between sophomore year and junior year, and again between junior year and senior year, generally peaking in the last month or two before graduation.
Familial Pattern
Although Senioritis does not appear to be more common among first-degree biological relatives of individuals diagnosed with this disorder, anecdotal reports do suggest an unusual pattern of increased concordance among sorority sisters and fraternity brothers.
Differential Diagnosis
Although symptoms of Senioritis sometimes resemble symptoms that occur in mood or substance use disorders, when criteria for a mood or substance problem are met, and this diagnosis better accounts for the observed symptoms, no diagnosis of Senioritis is given. Senioritis is distinguished from Major Depressive Disorder in that apathy in Major Depressive Disorder involves most or all aspects of life, while apathy in Senioritis is limited to school or school-related activities. Similarly, Senioritis is also distinguished from Substance Abuse and/or Dependence in that substance misuse is the primary symptom in Substance Abuse and/or Dependence, while substance misuse is merely a secondary symptom, if it occurs at all, in Senioritis.
Senioritis must also be distinguished from general medical conditions such as hypothyroidism. To be diagnosed with Senioritis, physical examination and lab findings must establish that the observed symptoms, such as lethargy and lack of energy, are not due to a dysfunctional thyroid gland or other biological factor. Senioritis must also be distinguished from insomnia in that sleep pattern changes occur exclusively when other symptoms of Senioritis are present.
Attention Deficit Hyperactivity Disorder (ADHD) is distinguished from Senioritis in that in attention deficit hyperactivity disorder the cognitive impairments, such as inability to focus and concentrate, have been present throughout most of a person's life. In Senioritis, these cognitive impairments are not observed, in most cases, until the senior year of high school or college.
Senioritis must also be distinguished from Post-Traumatic Stress Disorder (PTSD) in that with PTSD a traumatic event triggers symptoms like lethargy, apathy, and weight and sleep changes, while in Senioritis, these changes in behavior and cognition occur solely in the context of scholastic activities.

A. Three or more of the following symptoms must be present for a time period of at least one month. Apathy towards school or school- related activities is required in order to be
diagnosed with Senioritis.
  1. Apathy towards school or school-related activities.
  2. Increased participation in hedonistic activities.
  3. Malingering or feigning symptoms of illness in order to avoid a school setting
  4. Cognitive impairments such as: inability to focus or concentrate on school or school-related activities, selective-memory loss, decrease in ambition, and consuming thoughts of graduation or other liberation from school.
  5. Changes in sleep patterns: an increase or decrease in the amount of sleep, or changes in when and where sleep occurs.
  6. Procrastination, especially in academic pursuits.
B. The individual is at least 16 years old and a currently or recently (within the last six months) enrolled student.

C. Symptoms cause impairments in scholastic or occupational functioning.

D. Symptoms are not due to the physiological effects of a general medical condition such as hypothyroidism or insomnia, or to disorders such as Major Depressive Disorder, Post-Traumatic Stress Disorder, and Attention-Deficit Hyperactivity Disorder.

E. These symptoms are not better accounted for by family issues such a death, chronic disease, or other interpersonal conflicts.

Specify if:
High School Senioritis: if onset is between the ages of 16-19.

College/Graduate School Senioritis: if onset occurs at age 21 or older.

Heidi Hendricker, Brandy Priest, Joy Kafrouni, Sarah Spavone, and Justin McCullough were enrolled in an undergraduate abnormal psychology course when they worked as a group to complete this assignment, developed by course instructor Heather Haas. The goal of the assignment was to acquaint students with the language and format of the DSM by creating a diagnostic "spoof" of an "everyday" psychological disorder.

The students brought a variety of perspectives to bear in the assignment. Heidi Hendricker earned her BA in biology in May of 2006, and began attending medical school at the Mercer University School of Medicine in the fall of 2006. Brandy Priest is a nursing major with a psychology minor. Joy Kafrouni is majoring in international business and minoring in chemistry. Sarah Spavone has interests in sociology and political science, and Justin McCullough was the lone psychology major in the group.

Heather A. Haas, PhD, received her BS in psychology from Rocky Mountain College in Billings, Montana. She earned her MPhil in psychology at St. Andrew's University in Scotland before completing her PhD in personality research at the University of Minnesota. She is currently an associate professor of psychology at LaGrange College in LaGrange, GA.

Copyright 2007 (Volume 11, Issue 2) by Psi Chi, the International Honor Society in Psychology


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