Pain disorder: - People who have pain disorder typically experience pain that started with a psychological stress or trauma.
For example, they develop an unexplained, chronic headache after a stressful life event.
Pain is the focus of the disorder. But psychological factors are believed to play a role in the perception and severity of the pain.
People with pain disorder frequently seek medical care. They may become socially isolated and experience problems with work and family life.
Conversion disorder: - This condition strikes when people have neurological symptoms that can't be traced back to a medical cause. For example, patients may have symptoms such as:
• hearing loss
• loss of sensation or numbness
Stress usually makes symptoms of conversion disorder worse.
Body Dysmorphic Disorder: - People with this disorder are obsessed with -- or may exaggerate -- a physical flaw. Patients may also imagine a flaw they don't have.
The worry over this trait or flaw is typically constant. It may involve any part of the body. Patients can be obsessed with things such as wrinkles, hair, or the size or shape of the eyes, nose, or breasts.
In dissociative disorders, a part of an individual's personality becomes separate (dissociated) from other parts, producing a lack of integration of identity, memory, or consciousness. The DSM-IV lists five forms; the three most common follow.
• In dissociative amnesia: An individual develops a sudden inability to recall important personal information (such as her or his name); the disorder often follows psychological trauma. The memory loss cannot be attributed to physical trauma, a particular medical condition, or direct effects of drugs. Memory recall may occur suddenly or gradually.
• People experiencing a dissociative fugue suddenly and unexpectedly travel away from their home or customary place of activities and are unable to recall some or all of their past. They are confused about their personal identity, may not remember who they are, and sometimes assume a new identity. Recovery may be rapid.
• A dissociative identity disorder (formerly, multiple personality disorder) is characterized by the assuming of two or more distinct, integrated personalities, each of which manifests itself at times. The behaviors are accompanied by an inability, too extensive to be explained by ordinary forgetfulness, to recall important personal information. One personality may have no memory of the other. Often these disorders stem from childhood trauma such as sexual abuse.
Mood disorders: -
Mood disorders are characterized primarily by a disturbance in mood. (Remember, however, that all psychological disorders affect one's mood, or affect.) Two mood disorders (from four in the DSM-IV) are described below in more detail.
• In major depressive disorder, a person, for no apparent reason, experiences at least two or more weeks of depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities. To be classified as a major depressive disorder, the episode must be accompanied by clinically significant distress and impairment in social, occupational, or other areas of daily living.
Signs and Symptoms of Bipolar Disorder
Depression – the ‘lows’ of bipolar disorder:
• Feelings of uselessness, hopelessness, excessive guilt
• Loss of interest in work, school, hobbies, people
• Social isolation
• Agitation and irritability
• Low energy and lethargy
• Sad mood
• Changes in appetite or weight – eating too little or too much
• Oversleeping or insomnia
• Suicidal thoughts
• In a bipolar disorder, a person alternates between the hopelessness and lethargy of depression and the overexcited state of mania. Mania is manifested by hyperactivity and wild excitement. A person suffering from this disorder may lose control and act very inappropriately and sometimes destructively. (Subcategories of bipolar disorders are classified depending on the ratios of manic and depressive episodes.)
The causes of mood disorders have been the subject of much research. It is known that genetic factors are involved. (If one identical twin is diagnosed as having a major mood disorder, the chances are one in two that the other twin will also suffer such a disorder.) Biochemical factors also play a role. Norepinephrine, a neurotransmitter, is present in excessive amounts during mania and at low levels during depression. Serotonin, another neurotransmitter, is at low levels during depression. Drugs that regulate the level of these neuro-transmitters (tricyclic antidepressants; monoamine oxidize, MAO, inhibitors; and selective serotonin-reuptake inhibitors, SSRIs) are used for treatment of the depressions. Research has also shown that cognitive factors, such as self-defeating reactions to events, contribute to the development of depression. An individual who accepts sole blame for all of life's happenings is more likely to develop depression.
Signs and Symptoms of Bipolar Disorder
Mania – the ‘highs’ of bipolar disorder:
• Elevated, expansive mood
• Extreme irritability
• Rapid, unpredictable emotional changes
• Racing thoughts, flights of fancy
• Sense of grandiosity, inflated self-esteem
• Decreased need for sleep
Schizophrenia and other psychotic disorders: -
Schizophrenic disorders are severe disorders characterized by distorted thoughts and perceptions, atypical communication, inappropriate emotion, abnormal motor behavior, and social withdrawal. The slow-developing schizophrenia known as chronic or process schizophrenia has a poor prognosis for recovery; when a formerly well-adjusted individual develops schizophrenia (known as reactive or acute schizophrenia), there is a better chance of recovery. The five major types of schizophrenia are as follows.
• Paranoid schizophrenia is characterized by prominent delusions or auditory hallucinations in the context of relative preservation of usual cognitive functioning and affect. (Examples are delusions of persecution, grandeur, or both.) Paranoid schizophrenics trust no one and are constantly on guard because they are convinced that others are plotting against them. They may seek retaliation against imagined enemies.
• Catatonic schizophrenia is evidenced by excessive, sometimes violent motor activity or by a mute, unresponsive, stuporous condition in which a person may retain the same posture for hours. A person may remain in one state for a long period or alternate between violent activity and remaining stiff and immobile, totally unresponsive to the outside world.
• Disorganized (hebephrenic) schizophrenia is characterized by bizarre symptoms, including extreme delusions, hallucinations, and inappropriate patterns of speech, mood, and movement. Inappropriate moods may be manifested by laughing or crying at unsuitable times.
• Undifferentiated schizophrenia is manifested by delusions, hallucinations, incoherent speech, and disorganized behavior. The conglomerate of symptoms fit the criteria of more than one type or of no clear type of schizophrenia.
• Residual schizophrenia is a condition in which at least one episode of schizophrenia has occurred although there are currently no prominent psychotic symptoms (for example, delusions or hallucinations). Certain negative symptoms, those indicating a lack, such as flat affect, poverty of speech, and avolition (lack of using the will, or choosing), continue, however, as do two or more attenuated positive symptoms (eccentric behavior, odd beliefs, and so forth). The course of this type of schizophrenia may be time limited and may represent a transitional phase between remission and a full-blown psychotic episode.
The causes of schizophrenia are complex and still not completely understood. It is known that genetic factors are involved because schizophrenia is found repeatedly in certain families; adult children of schizophrenic parents are more likely to develop schizophrenia than are children of no schizophrenic parents. However, inheritance does not completely explain the etiology (cause) of schizophrenia (only 46% of identical twins of schizophrenic twins develop the disorder), and currently, a biochemical factor is also deemed important. Autopsies on some schizophrenics have found an excess of dopamine receptors, and drugs that block the activity of that neurotransmitter help control schizophrenic symptoms. In addition, misuse of amphetamines, which are similar to dopamine and which may increase the level of dopamine in the brain, produces many symptoms similar to those found in schizophrenia. In the brain structures of schizophrenics, other variations from the norm also occur, such as a smaller thalamus and enlarged ventricles. The complete etiology of schizophrenia remains a focus of research in psychopathology