Anxiety, Somatoform, and Dissociative Disorders Outline and Case Analysis

ANXIETY DISORDERS: As for the DSM-IV-TR, the featured symptoms of these disorders are fear and anxiety in abnormal contexts, which do not justify those feelings (American Psychiatric Association, 2013). As for these disorders, one feels anxious or terrified, whereas with the occurrence of a minor threat or when a threat does not occur. The intensity of anxiety is another means to define these disorders (Hansell & Damour, 2008). Biological components are a means to address functioning of the limbic system, autoimmune processes, autonomic nervous system, neural transmission, and the inherited factors, which predispose one to anxiety. Genetic vulnerabilities seem to have a part in the majority most anxiety disorders. The emotional components include underlying and unaddressed experiences or concerns. Cognitive components address the results of negatively distorted or abnormal thinking and emotions as for each situation. Behavioral components address the involuntary and voluntary actions based on one's anxiety.

Disorders	Definition
Panic Disorder without Agoraphobia	·         Is episodes of terror, which are acute, and these episodes occur without any real danger ·         Features are panic attacks with overwhelming anxiety ·         Panic attacks are recurrent and unexpected with ongoing impairment or distress ·         This disorder is without a phobia (agoraphobia)
Panic Disorder with Agoraphobia	·         Is a disorder with episodes of terror, which are acute and these episodes occur without any real danger ·         With agoraphobia means having a type of phobia ·         Features are panic attacks with overwhelming anxiety and urges to seek help or escape
Agoraphobia without History of Panic Disorder	·         Agoraphobia without a history of panic disorder results in a fear of developing symptoms, which are panic like
Specific Phobia	·         Is a phobias, which is not an agoraphobia or social phobia ·         Common types are natural environment, animal, and situational types
Social Phobia	·         Is a phobia, whereas the focus are fears of social situations, or other activities with a chance of observation or judgment ·         Occurs somewhat less often in men and more women
Obsessive-Compulsive Disorder	·         Is an anxiety disorder, whereas compulsive rituals are the result of anxiety-producing unwanted and distressing thoughts; which significantly disrupt daily functioning
Posttraumatic Stress Disorder	·         PTSD is a disorder, whereas remarkable posttraumatic anxiety symptoms occur from a traumatic experience more than a month after such an experience ·         PTSD results from an experience of a traumatic event, which involved the possibility of serious injury or death; one’s response to such an experience involves intense horror, helplessness, or fear ·         Flashbacks are a common symptom of PTSD ·         Various of anxiety symptoms occur after a traumatic experience
Acute Stress Disorder	·         Is a disorder, whereas remarkable posttraumatic anxiety symptoms occur from a traumatic experience within a month ·         Various of anxiety symptoms occur after a traumatic experience
Generalized Anxiety Disorder	·         Is a disorder, which involves symptoms of pervasive and chronic nervousness ·         Symptoms are, whereas one feels worried and tense the majority of time, which results in distress and disrupts functioning

SOMATOFORM DISORDERS: As for the DSM-IV-TR, these are disorders, whereas psychological factors cause physical symptoms (American Psychiatric Association, 2013).

Disorders	Definition
Somatization Disorder	·         Is a disorder with recurrent sexual, pseudoneurological, or gastrointestinal symptoms with no physiological cause (Hansell & Damour, 2008)
Undifferentiated Somatoform Disorder	·         Is a disorder that occurs when one has physical complaints for over six months, which are not an attribute of a medical condition (Hansell & Damour, 2008)
Conversion Disorder	·         Is a disorder with characteristics of defined symptoms or deficits in voluntary sensory or motor functions without physiological cause
Pain Disorder	·         Is a disorder that involves experiences of physical pain with no physiological explanation (Hansell & Damour, 2008)
Hypochondriasis	·         Is a preoccupation and fear of the contraction of a serious disease, or the mistaken idea of having such a disease (Hansell & Damour, 2008)
Body Dysmorphic Disorder	·         Is a disorder with a preoccupation of an exaggerated or imagined defect of physical appearance

FACITIOUS DISORDERS: As for the DSM-IV-TR, it categorizes two types of factitious disorders, and these disorders are without reward or benefit, and involve a falsifying psychological or physical signs or symptoms, or a combination of both. 

Disorders	Definition
Factitious Disorder Imposed on Self	·         Is a disorder without reward or benefit and involves a falsifying psychological or physical signs or symptoms, or a combination of both on oneself
Factious Disorder Imposed on Another	·         Is a disorder without reward or benefit and involves a falsifying psychological or physical signs or symptoms, or a combination of both on another

DISSOCIATIVE DISORDERS: As for the DSM-IV-TR, dissociation is the feature symptom of these disorders. These types of disorders are those with dissociative symptoms that do not occur in appropriate contexts. As for the continuum of dissociative experiences, these disorders are severe enough to disrupt functioning (Hansell & Damour, 2008).

Disorders	Definition
Dissociative Amnesia	·         Is a disorder without an ability to remember personal information that is important, usually resulting from a stressful or traumatic nature
Dissociative Fugue	·         Is an unexpected and sudden travel from one’s home, and one forgets his or her past and personal identity (Hansell & Damour, 2008)
Dissociative Identity Disorder	·         Is a disorder with the presence of two or more identity states or personalities, which are distinct and recurrently control one’s behavior

          As for the biological, emotional, cognitive, and behavioral components of somatoform, and dissociative disorders, they overlap, interact, and complement one another. The biological components address the genetic link and development of these disorders because family members tend to have the same disorders. As for emotional components, individuals with these disorders report multifaceted and severe traumatization. Sexual and physical trauma often predicts these disorders. As for cognitive components, psychological factors may have a role in the severity and perception of pain. As for behavioral components, there is apparently an association between emotional well-being, physical pain, and behavior. Physical pain and physical symptoms affect one’s behavior.

Case Analysis

          In 1920, American psychologist John B. Watson wanted to conduct an anxiety-inducing experiment in opposition of Sigmund Freud’s case study involving Little Hans. Therefore, Watson performed his experiment on Little Albert; a nine month old child. Because of Albert’s age, he had not yet to develop fear responses to several objects often feared by children older than him. Watson subjected Albert to classical conditioning procedures. At first, Watson would expose Albert to various stimuli to determine what his reaction would be. At 11, months old, Watson exposed Albert to distressing noises anytime he was playing with a white lab rat. Once Watson paired the distressing noise with the lab rat a number of unreported times, Albert would become upset at the presence of the lab rat, even without the presence of the distressing noise. Little Albert not only exhibited anxiety at the presence of the white lab rat but also at the presence of a sealskin coat. Watson made the assumption that Little Albert’s fear extended to animals and other objects, which were furry (Hansell & Damour, 2008). Little Albert developed a fear or phobia and his mother removed him for the experiment before the removal of his phobia. Watson declared that his experiment was successful because he was able to produce a phobia in Little Albert through a means of conditioning. Little Albert suffered from specific phobia.

Components of Specific Phobia

          As for the DSM-IV-TR, a specific phobia is a phobia which is not an agoraphobia or social phobia. Common types of phobias are of the natural environment, animal, and situational types. When an exposure to a phobic stimulus occurs the result is a panic attack. However, with a specific phobia, a panic attack is bound situationally to a specific phobic stimulus.

Biological

            Biological components of specific phobia address functioning of the limbic and autonomic nervous system, autoimmune processes, neural transmission, and factors, inherited factors, which predispose one to specific phobia. Specific phobia has a tendency of a family link. Studies report that two thirds to three fourths of individuals have specific phobia have one first-degree relative with this same specific phobia; however, there are no adoption or twin studies that rule out a substantive contributor of nongenetic transmission of this phobia (Sadock & Sadock, 2008). Genetics can have a role or a part in the biology, such as with the limbic and autonomic nervous system. Research does show that anxiety development and genetics have a correlation. Genetics affects anxiety disorders in different ways, and gender may also have an effect in the development of specific disorders.  

Emotional

            The emotional components of specific phobia, includes experiences or underlying concerns, which have yet to be openly addressed. Underlying conditions may be a prelude to specific phobia. 

Cognitive

            Cognitive distortions and a negative view of specific natural environments, animals, and situations are the pessimism of specific phobia. Anxiety is often results from thought processes, which are dysfunctional and maladaptive cognitive schemas. One often interprets a situation inappropriately and focuses on inappropriate perceived dangers, which are normal. One also may underestimate his or her emotional ability to manage certain challenges, which he or she faces.

Behavioral

            Behavioral components of anxiety disorders, such as specific phobia include involuntary and voluntary actions based on one's anxiety. When certain situations provoke anxiety one will typically avoid such future similar situations that perpetuate anxiety or act out. Anxious thoughts, which are unrelenting, can result in symptoms and patterns of behavior that are inappropriate fears in an average situation.

Conclusion

          Watson tested his theory of classical conditioned by using Little Albert, whom he subjected to emotional distress, which resulted in anxiety and phobia as a nod to the case study of Little Hans, which Freud performed. Themes central to specific phobia are genetic predispositions, unaddressed, underlying, and emotional experiences. Yet, specific phobia has other components along with biological, emotional, such as cognitive and behavioral components. Specific phobia is a condition with common types of phobias, such as natural environment, animal, and situational types without agoraphobia. Themes central to specific phobia are genetic predispositions, unaddressed, and underlying and emotional experiences. Yet, specific phobia has other components along with biological, emotional, such as cognitive and behavioral components. These components also interact with one another. 

Reference

Hansell, J., & Damour, L. (2008). Abnormal psychology (2nd ed.). Hoboken, NJ: Wiley.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Meyer, R., Chapman, L. K., & Weaver, C. M. (2009). Case studies in abnormal behavior. (8th ed.). Boston, MA: Pearson/Allyn & Bacon.

Sadock, B.J., & Sadock, V.A. (2008). Concise Textbook of Clinical Psychiatry (3rd ed.). Philadelphia, MA: Lippincott Williams & Wilkins.

Disorders Outline and Case Analysis

Disorders Outline

MOOD DISORDERS: The main symptom that occurs in mood disorders is a substantive mood disruption. The characteristics of mood disorders are intense and extreme moods, which seem rather unsuitable in the context within, which mood disorders occur. Mood disorders are a combination of the mood episodes, such as major depressive, hypomanic, and manic episodes. Mood disorders are a result of genetic components or factors; as a result of twin studies.

Disorder	Definition
Depressive Disorders	·         The common feature of every depressive disorder is the presence of empty, sad, or irritable mood, accompanied by cognitive and somatic changes, which significantly affect one’s ability to function (American Psychiatric Association, 2013). ·         The difference of these disorders is the issues of presumed etiology, or timing, and duration.
Major Depressive Disorder	·         This is a disorder with an occurrence of one or more than one major depressive episodes without a history of hypomanic or manic episodes (Hansell & Damour, 2008). Every individual who experiences one episode will not experience another episode; however, the more episodes one experiences then he or she is likely to continue having episodes. ·         The main aspect of a major depressive episode is it last for at least 2 weeks, whereas one is either depressed mood or has a loss of pleasure or interest in regards to nearly any activity. ·         Symptoms: diminished capacity for one to enjoy normal activities, daily depression, weight loss or gain, hypersomnia or insomnia, fatigue, agitation, feelings of excessive guilt or worthlessness, suicidal ideation, and inability to concentrate.
Single Episode	·         This is when only a single episode of any mood disorder occurs.
Recurrent	·         Recurrent is when an episode of any mood disorder occurs often or repeatedly.
Dysthymic Disorder	·         This disorder last for two years or more with a consistent depressed mood and with other symptoms, which are not severe enough for meeting the criteria for a major depressive episode (Hansell & Damour, 2008). ·         It is depression, which is less severe than a major depressive episode, but it is more chronic. ·         The diagnostic criteria for dysthymic disorder: depressed mood for most days for at least two years, insomnia or hypersomnia, fatigue, difficulty with making decisions, poor concentration, poor appetite or over-eating, and feelings of hopelessness (Hansell & Damour, 2008)
Bipolar Disorders	·         These are mood disorders whereas one experiences abnormal low and high moods, and are either a combination of episodes, which are either major depressive and manic, or major depressive and hypomanic.
Bipolar I Disorder	·         This disorder is a combination of major depressive and manic episodes. Whereas normal mood interruption occurs because of either major depressive or manic episodes, or occasionally from mixed episodes whereas both major depressive and manic symptoms are present and involve the recurrence of both types of episodes.
Bipolar II Disorder	·         This disorder is a combination of major depressive and hypomanic episodes, in which normal mood interruption occurs because of either major depressive or hypomanic episodes; and involves the recurrence of both types of episodes (Hansell & Damour, 2008). ·         Normally accompanied by impairment in social and work functioning.
Cyclothymic Disorder	·         This disorder is a mild form of bipolar disorder combination of depressive and hypomanic mood swings, which are less severe than those that occur with Bipolar I and II disorders. ·         Although, this occurs chronically for at least two years (Hansell & Damour, 2008). Mood alternates between dysthymic lows and hypomanic highs.

SUBSTANCE-RELATED DISORDERS:  The DSM-IV-TR divides these disorders into substance use and substance-induced disorders. The DSM-IV-TR also distinguishes between substance-induced and substance-induced mental disorders. These are the result of general medical conditions and disorders with unknown causes. Substance-related disorders are the result of genetic, biological, and behavioral factors.

Disorder	Definition
Alcohol-Related Disorders	·         These types of disorders relate to or are the result of alcohol consumption.
Alcohol Dependence	·         Also referred to as alcoholism; often accompanied by personality disturbances, depression, anxiety, and general impairments in functioning (Hansell & Damour, 2008).
Alcohol Abuse	·         This is a maladaptive pattern of drinking alcohol, which leads to clinical significant distress or impairment, and disrupts daily functioning.
Amphetamine- (or Amphetamine-like)-Related Disorders	·         These disorders relate to or are the result of using amphetamines. ·         Characteristics of amphetamine dependence: compulsive drug use and drug-seeking, which leads to molecular and functional and molecular changes within the brain (American Psychiatric Association, 2013)
Caffeine-Related Disorders	·         These disorders relate to or are the result of using caffeine. ·         Symptoms: insomnia, restlessness, diuresis, nervousness, excitement, and gastrointestinal disturbance, muscle twitching, and thinking or talking in a manner of rambling (American Psychiatric Association, 2013).
Cannabis-Related Disorders	·         These disorders relate to or are the result of using cannabis. ·         The main features of these disorders are the compulsive usage, tolerance of the effects of cannabis, and withdrawal symptoms. ·         Diagnosis of these disorders involves the presence of problematic psychological or behavioral or changes, which include social withdrawal, and impaired judgment, anxiety, motor coordination, and euphoria (American Psychiatric Association, 2013).
Cocaine-Related Disorders	·         These disorders relate to or are the result of using cocaine. ·         These are either cocaine use disorders or cocaine-induced disorders. ·         Acute (short-term) symptoms: psychosis, intense feeling of happiness, elevated anxiety, elevated self-esteem, a state of increased sensory sensitivity, and alertness ·         Chronic (long-term) symptoms: psychosis, hallucinations, irritability, and elevated anxiety
Hallucinogen-Related Disorders	·         These disorders relate to or are the result of using hallucinogens. ·         These disorders produce similar psychological and physical effects. ·         Psychological symptoms: delusions of physical invulnerability, paranoia, anxiety attacks, long-term memory loss, and psychological drug dependence
Inhalent-Related Disorders	·         These disorders relate to or are the result of using inhalants. ·         These disorders are inhalant abuse and inhalant dependence substance use disorders. ·         Inhalant abuse at least one or more symptoms occurring during a 12-month time frame: social and legal problems, and danger to oneself ·         Inhalant dependence at least two or more symptoms occurring during a 12-month time frame: loss of control, harm to oneself, and inability to stop using
Nicotine-Related Disorders	·         These types of disorders relate to or are the result of using nicotine. ·         Tobacco’s feature psychoactive ingredient is what causes nicotine disorders. ·         Psychologically and physically, nicotine is an addictive drug. ·         Nicotine is a psychoactive drug; therefore, its use within these disorders changes mood and alters brain chemistry.
Opioid-Related Disorders	·         These disorders relate to or are the result of using opioids. ·         Opioid abuse and dependence are substance use disorders, and intoxication and withdrawal are substance related disorders.
Phencyclidine-(or Phencyclidine-like)-Related Disorders	·         These disorders relate to or are the result of using phencyclidines. ·         Symptoms: physiological changes to the circulatory and nervous system, disturbances in behavior and thinking, and can cause psychotic, anxiety, and mood disorders, and hallucinations ·         Psychiatric and social symptoms: impaired judgment, agitation, schizophrenic-like psychoses, and hallucinations of touch, sight, or sound
Sedative, Hypnotic, or Anxiolytic-Related Disorders	·         These disorders relate to or are the result of using sedatives, hypnotics, or anxiolytics. ·         These disorders are the cause of mental and physiological slowing of one’s body. ·         These disorders work by increasing the amount of the neurotransmitter gamma-aminobutyric acid (GABA) in the brain (American Psychiatric Association, 2013). ·         Symptoms: depression of the nervous system and causes sleepiness, reduced anxiety and pain, and muscle relaxation
Polysubstance-Related Disorder	·         This disorder relates to or is the result of indiscriminately using at least three classes of substances. ·         Indiscriminately using sedatives, hallucinogens, and cocaine warrants a polysubstance dependence diagnosis.

SCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS: have abnormalities in one or more of the five following domains, such as disorganized thinking (speech), hallucinations, and delusions, abnormal or grossly disorganized motor behavior, which includes catatonia, and negative symptoms (American Psychiatric Association, 2013). Most psychodynamic theorists are in agreement, whereas biological and behavioral components contribute to these disorders.

Disorder	Definition
Schizophrenia	·         Schizophrenia is a pattern of severe behavioral and cognitive symptoms, which last for six months or longer and results in significant impairment of life. ·         There are two categories of symptoms, which are positive and negative, or type I and type II.
Paranoid Type	·         This type is a schizophrenia subtype with pronounced auditory hallucinations or delusions.
Disorganized Type	·         This type is a schizophrenia subtype with pronounced disorganized behavior, inappropriate or flat affect, and disorganized speech.
Catatonic Type	·         This type is a schizophrenia subtype with pronounced psychomotoric symptoms that include rigid physical immobility, and extreme or unresponsiveness echopraxia, behavioral agitation, echolalia, muteness, and echolalia.
Undifferentiated Type	·         This type is a schizophrenia subtype with schizophrenic symptoms, which are active but fail at fitting into the disorganized, catatonic, or paranoid subtypes.
Residual Type	·         This type is a schizophrenia subtype that follows at least one schizophrenia episode, whereas there are no pronounced schizophrenia positive symptoms. ·         However, there are some positive symptoms, which are milder and negative symptoms (Hansell & Damour, 2008).
Schizophreniform Disorder	·         Diagnosis of this disorder involves the presence of a psychotic episode with every feature of schizophrenia but has yet to last six months.
Schizoaffective Disorder	·         Diagnosis of this disorder involves the presence of a mood disorder and schizophrenia symptoms (American Psychiatric Association, 2013)
Delusional Disorder	·         This is a disorder with nonbizarre delusions and without any other symptoms, which last one month at least.
Brief Psychotic Disorder	·         Diagnosis involves the presence of a psychotic episode with every feature of schizophrenia but does not last one month; therefore, after recovery functioning returns to a normal baseline.
Shared Psychotic Disorder	·         Diagnosis of this disorder involves the presence of delusions, which developed in a close relationship context with a psychotic individual (Hansell & Damour, 2008).

Case Analysis

          John Forbes Nash, Jr. is one who many individuals consider as to be the greatest mathematical geniuses in history (Meyer, Chapman, & Weaver, 2009). Nash was born in Bluefield, WV into a family where his father was emotionally distant; however, his mother was nurturing and loving. Nash lacked social skills and did not have friends or have any close relationships with others. During his unhappy childhood, Nash lacked social skills and often avoided interactions with others unless forced into social interactions by his parents, and some odd behavior patterns started to emerge. During his life from many accounts of others, Nash spent the majority of his life in delusion, unaccountable for many of his actions. Whereas, his actions were mainly bizarre and maladapted exaggerations of what one considers as normal human behavior. Basically, Nash’s psychotic symptoms manifested gradually throughout his life. However, through his intellectual ability he excelled throughout school, and college later received a Ph.D. from Princeton. Nash in 1994 earned the Nobel Memorial Prize in Economic Sciences; however, for the majority of his life he had to balance mathematical genius against the struggle with suffering from schizophrenia.

Components of Schizophrenia

          Hansell and Damour (2008), “the DSM-IV-TR currently defines schizophrenia in terms of a constellation of severe cognitive and behavioral symptoms that last for a certain length of time (six months or more) and result in significant life impairment” (p. 460). Schizophrenia’s main symptoms are in two categories, which are positive and negative or type I and type II. Pathological excesses are positive symptoms, such as disorganized behavior, thought, and speech, and also hallucinations and delusions (Hansell & Damour, 2008). Pathological deficits are negative symptoms, such as withdrawal, loss of motivation, emotional flatness, and diminished cognitive skills.

Biological

            During the turn of the twentieth century, the development and refinement of the diagnosis of schizophrenia by early pioneers, mainly medical scientists held the belief that schizophrenia was basically biologically the result of a diseased brain and with the possibility of a genetic origin (Hansell & Damour, 2008). Biological research of schizophrenia seemed to support this same view during the twentieth century’s first half; whereas, brain structure abnormalities were discovered in individuals who suffered from schizophrenia. Hansell and Damour (2008), “however, much of this research was conducted by German scientists working during the Nazi era and was tainted by the ethical outrage over Nazi medical experiments” (p. 472). In recent years, by using the techniques of brain imaging it has become easier to study abnormalities in brain functions associated with schizophrenia. Therefore, brain function abnormalities and schizophrenia do share an association. Recent research does show the existence of abnormalities in many neurotransmitter systems of individuals who suffer from schizophrenia (Hansell & Damour, 2008).  

Emotional

          The majority of cases of schizophrenia, whereas the contents of hallucinations and delusions are negatively emotional or even terrify an individual. The negative symptoms of schizophrenia are also emotional flattening. Normally if emotions are displayed they are normally restricted or are inappropriate in context. Basically, schizophrenia disrupts emotional functioning.

Cognitive

           Cognitive theorists developed many ideas that are influential as for the role of schizophrenia and cognitive processes. Some of the focus has been on abnormal attentional processes’ role. An example of this is where schizophrenia’s positive symptoms have a relationship with the problem of overattention; whereas, an individual who suffers from schizophrenia cannot screen out stimuli that are irrelevant. This may be the result of dopaminergic abnormalities; because overattention results in difficulty in the ability to cope with stress and possible psychotic symptoms (Hansell & Damour, 2008). Schizophrenia’s negative symptoms may share a relationship with equally problematic underattention as for stimuli that are important; which, lead to apathy and withdrawal. An example of this is where studies show that an individual with negative symptoms, which are prominent lack a normal orienting response or physical changes with an association of sharpened attention as for stimuli that are novel.   

Behavioral

            The focus of behavioral theorists is of the importance of learning as for the treatment and development of schizophrenia. Specifically, they make the argument, whereas the reinforcing of abnormal responses may contribute to behaviors, which are abnormal of schizophrenia through operant conditioning principles (Hansell & Damour, 2008).    

Conclusion

            Nash is a mathematical genius, who battled schizophrenia throughout his life and even maintained a full remission of schizophrenia for more than 20 years and earned a Nobel Memorial Prize in Economic Sciences. Schizophrenia is a pattern of severe behavioral and cognitive symptoms, which last for six months or longer and results in significant impairment of life. Schizophrenia has several components, such as biological, emotional, cognitive, and behavioral components, which interact to cause this disorder.

Reference

Hansell, J., & Damour, L. (2008). Abnormal psychology (2nd ed.). Hoboken, NJ: Wiley.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013. Web. [access date: 1 June 2013]. dsm.psychiatryonline.org

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.

Meyer, R., Chapman, L. K., & Weaver, C. M. (2009). Case studies in abnormal behavior. (8th ed.). Boston, MA: Pearson/Allyn & Bacon.