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PSYC 526
Imad Mansour

CHAPTER 17 The Nature and Causes of Mental Disorders ANXIETY, SOMATOFORM, AND DISSOCIATIVE MENTAL DISORDERS Often referred to as neuroses, anxiety, somatoform, and dissociative mental disorders are strategies of perception and behaviour that have gotten out of hand. People who have neuroses experience anxiety, fear, and depression, and generally are unhappy. However, unlike people who have psychoses, they do not suffer from delusions or severely disordered thought processes and hey almost universally realize that they have a problem.  Anxiety Disorders Fear and anxiety are the most prominent symptoms. Anxiety is a sense of apprehension or doom that is accompanied by certain physiological reactions (e.g. accelerated heart rate, sweaty palms, and tightness in the stomach. o Panic Disorder: Description Panic is a feeling of extreme fear mixed with hopelessness or helplessness. People with panic disorder suffer from episodic attacks of acute anxiety—periods of acute and unremitting terror that grip them for lengths of time lasting from a few seconds to a few hours. Shortness of breath, clammy sweat, and irregularities in heartbeat, dizziness, faintness, and feelings of unreality are often symptoms of panic attacks. Between panic attacks, people with panic disorder tend to suffer from anticipatory anxiety—a fear of having a panic attack. Anxiety is a normal reaction to many stresses of life and none of us is completely free from it. o Panic Disorder: Possible Causes  Genetic and Physiological Causes. A considerable amount of evidence implicates biological influences in the development of panic disorder. It appears to have a substantial hereditary component. People with panic disorder show physiological response patterns that seem to be biological controlled (e.g. breathing irregularly).  Cognitive Causes. The cognitive approach focuses on expectancies. People who suffer from panic attacks appear to be extremely sensitive to any element of risk or danger in their environment: these people expect to be threatened by environmental stressors and downplay or underestimate their abilities to cope with them. o Phobic Disorders: Description  Phobias are persistent, irrational fears of specific objects or situations. The term phobic disorder should be reserved for people whose fear makes their lives difficult. There are three types of phobia: agoraphobia, social phobia, and specific phobia. Agoraphobia is a mental disorder characterized by fear of and avoidance of being alone in public places; this disorder is often accompanied by panic attacks. Social phobia is a mental disorder characterized by an excessive and irrational fear of situations in which the person is observed by others. Specific phobia is an excessive and irrational fear of specific things, such as snake, darkness, or heights. o Phobic Disorders: Possible Causes  Environmental Causes—Learning. Not all phobias are learned through classical conditioning. Most do not remember a specific cause for their phobia.  Genetic Causes. Some suggest that a tendency to develop a fear of certain kinds of stimuli may have a biological basis that reflects the evolution of our species. The idea is that because of our ancestors’ history in relatively hostile natural environments, a capacity evolved for especially efficient fear conditioning to certain classes of dangerous stimuli. o Obsessive-Compulsive Disorder: Description People with an obsessive-compulsive disorder—recurrent, unwanted thoughts or ideas and compelling urges to engage in repetitive ritual-like behaviour—suffer from obsessions—thoughts will not leave them—and compulsions—behaviours that repeat some action over and over even though it serves no useful purpose. Unlike people with panic disorder, people with obsessive-compulsive disorder have a defence against anxiety—their compulsive behaviour. Obsessions are seen in many mental disorders, including schizophrenia. However, unlike those with schizophrenia, people with OCD generally recognize that their thoughts and behaviours are senseless and wish that they would go away. Most compulsions fall into four categories: counting, checking, cleaning and avoidance. o Obsessive-Compulsive Disorder: Possible Causes  Cognitive Causes. These people believe they should be competent at all times, avoid any kinds of criticism at all costs, and worry about being punished by others for behaviour that is less than perfect.  Genetic Causes. Evidence is beginning to accumulate suggesting that obsessive- compulsive disorder may have a genetic origin. One example is Tourette’s syndrome which entails muscular and vocal tics, including making facial grimaces, squatting, pacing, twirling, barking, sniffing, coughing, grunting, or repeating specific words (esp. Vulgarities).  Somatoform Disorders The primary symptoms are a bodily of physical problem for which there is no physical problem for which there is no physiological basis. The two most important form of these disorders are somatisation disorder and conversion disorder.  Somatization Disorder: Description It involves complaints of wide-ranging physical ailments for which there is no apparent biological basis. It is characterized by persistent complaints of serious symptoms for which no physiological cause can be found. Somatization disorder resembles another somatoform disorder called hypochondriasis—involves persistent and excessive worry about developing a serious illness. Patients often misinterpret the appearance of normal physical aches and pains.  Somatization Disorder: Possible Causes Somatization disorder tends to run in families and is closely associated with antisocial personality disorder.  Conversion Disorder: Description Conversion disorder is characterized by physical complaints that resemble neurological disorders but have no underlying organic pathological basis. The symptoms include blindness, deafness, loss of feeling, and paralysis. There is unresolved intrapsychic conflict which in converted into a physical symptoms which are not often related to the individual’s personal and work lives.  Conversion Disorder: Possible Causes Psychoanalysts suggest that conversion disorders as primarily sexual in origin. Behaviour analysts however have suggested that conversion disorders can be learned for many reasons (e.g. a patient often mimics the symptoms of a friend).  Dissociative Disorders In dissociative disorders anxiety is reduced by a sudden disruption in consciousness, which may produce changes in a person’s memory or even his or her identity.  Description A relatively simple form of this disorder is called dissociative amnesia—a dissociative disorder characterized by the inability to remember important events or personal information. It is related instead to diverse traumatic events. A more extreme form of dissociative amnesia is called dissociative fugue—an amnesia with no apparent organic cause, accompanied by adoption of a new identity and relocation. Following a stressful situation, the person cannot identify him of herself, cannot remember his or her past, will relocate to a new area, adopt a new identity, and may establish a new family or career. Dissociative identity disorder is a very rare disorder in which two or more distinct personalities exist within the same person; each personality dominates in turn (e.g. like in Anniyan (yes I do watch Tamil movies jackass)).  Possible Causes They are usually explained as responses to severe conflicts resulting from intolerable impulses or as responses to guilt
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