69.1 – Describe somatic symptom and related disorders .

2. 69.1 – Describe somatic symptom and related disorders. • Somatoform disorders occur when people experience psychological problems associated with physical symptoms that are not linked to a physical cause.

3. 69.1 – Describe somatic symptom and related disorders. Types of Somatoform Disorders 1) Conversion Disorder • sensory and motor failure, blindness, deafness, or paralyzed limbs with no identifiable physical cause. • usually first appears in childhood or adolescence, and under extreme stress. • person usually does not show much concern for inoperative sensory and motor functions. 2) Hypochondriasis • intense feelings of having a physical illness with no justifiable cause. • person believes he or she already has disease, whereas people with anxiety disorders have a fear of getting sick. • very quickly seek medical treatment. 3) Somatization Disorder • people report multiple physical ailments rather than an isolated disease or condition. 4) Pain Disorder • reported severe pain without any known physical cause.

4. 69.1 – Describe somatic symptom and related disorders. Causes of Somatoform Disorders • Early on, many children learn that special attention and privileges are granted with they are sick. This rationalization may carry over to adolescence and adulthood; they may hope that if they act sick they will get attention from others. The diathesis-stress model indicates that somatoform disorders are the result of people being overly sensitive to physical sensations, including everyday aches and pains. This usually occurs during long periods of stress.

5. 69.2 – Describe dissociative disorders, and discuss why they are controversial. • Dissociative disorders are rare occurrences that involve sudden and mostly temporary disruptions to a person’s memory, consciousness, and identity. For anywhere ranging from a few hours to a few years, a person with a dissociative disorder may experience a loss of memory of who he or she is or where he or she has lived; certain other memories may also be temporarily lost. Limited research has been conducted on dissociative disorders, but certain observations have revealed that some memory loss and other disruptions in identity are legitimate. Controversy and differences of opinion remain among researchers concerning the origins and symptoms of dissociative disorders.

6. 69.2 – Describe dissociative disorders, and discuss why they are controversial. Types of Dissociative Disorders 1) Dissociative Fugue • sudden loss of memory resulting in a new identity and moving to a new location (amnesia coupled with active flight). • person doesn’t have recall of previous life. 2) Dissociative Amnesia • a sudden loss of memory. • person has no recall of previous life, but does not move to a new location as with dissociative fugue. 3) Dissociative Identity Disorder (DID) – formally called Multiple Personality Disorder • person exhibits more than one personality that is unique by style of thinking, speaking, acting, feeling, and memories.

7. 69.2 – Describe dissociative disorders, and discuss why they are controversial. Causes of Dissociative Disorders • Researchers have also suggested the some people experience memory and identity loss as the results of an episodic traumatic event the person did not want to cope with, or could not resolve. For example, severe child abuse has been implicated in the onset of dissociative disorders, particularly DID. Psychodynamic (Freudian) therapists believe that dissociative disorders develop as a result of a defense mechanism, repression, which blocks unwanted impulses and memories from entering consciousness. According to the psychodynamic perspective, a person experiencing dissociative symptoms may have created a “new person” who now acts out the unacceptable impulses and copes with the traumatic evens. This, in turn, becomes a dissociative person’s way of dealing with conflicts and concerns that he or she could not handle.

8. 69.2 – Describe dissociative disorders, and discuss why they are controversial. Causes of Dissociative Disorders • Social-cognitive therapists suggest that in any given situation, people act differently depending on both the circumstances and the setting of a situation. A person may become increasingly rowdy at a football game even though such behavior is not in his or her true nature. But for some people, acting like “another person” become extreme to the point at which others hardly recognize the individual.

9. 69.2 – Describe dissociative disorders, and discuss why they are controversial. Causes of Dissociative Disorders • Even though researchers have observed actual dissociative symptoms, question remain. Dissociative identity disorder is fairly rare. The book and movie Sybil, about a woman with multiple personalities, brought multiple personality disorders into public consciousness, which in turn caused clinicians to look for symptoms in their patients. This led to a lot of possible cases of multiple personality disorder, but many were later refuted.

10. 69.3 – Explain how anorexia nervosa, bulimia nervosa, and binge-eating disorder demonstrate the influence of psychological and genetic forces. Eating Disorders 1) Anorexia Nervosa • a condition in which a normal-weight person (usually an adolescent woman) continuously loses weight but still feels overweight. 2) Bulimia Nervosa • a disorder characterized by episodes of overeating, usually high-calorie foods, followed by vomiting, using laxatives, fasting, or excessive exercise. 3) Binge Eating Disorder • a disorder characterized by episodes of binge eating, followed by feelings of remorse or disgust, but without purging or fasting.

11. 69.3 – Explain how anorexia nervosa, bulimia nervosa, and binge-eating disorder demonstrate the influence of psychological and genetic forces. Reasons for Eating Disorders • families in which weight is an excessive concern • low self-esteem, perfectionistic standards, overly concerned with others’ opinions • more likely to occur in identical twins rather than fraternal twins • culture, gender, media • changes in body size throughout history

12. 69.4 – Contrast the three clusters of personality disorders, and describe the behaviors and brain activity that characterizes the antisocial personality. • Personality disorders are enduring or continuous inflexible patterns of thinking, feeling, and acting. These disorders tend to start in childhood and continue through adolescence and adulthood. The most striking difference between personality disorders and clinical disorders is that personality disorders tend to be lifelong, pervasive, and inflexible. Individuals with personality disorders also tend to be more resistant to treatment that those with clinical disorders. Personality disorders are grouped into three clusters: odd-eccentric, dramatic-erratic, and anxious-fearful. The odd-eccentric cluster A includes paranoid, schizoid, and schizotypal personality disorders. The dramatic-erratic cluster B includes histrionic, narcissistic, borderline, and antisocial personality disorders. The anxious-fearful cluster C includes dependent, obsessive-compulsive, and avoidant personality disorders.

13. 69.4 – Contrast the three clusters of personality disorders, and describe the behaviors and brain activity that characterizes the antisocial personality. Cluster A: Odd-Eccentric 1) Paranoid • distrust of others, believe people out to harm them • could react with violence to defend themselves 2) Schizoid • no social relationships • the “hermit” 3) Schizotypal • problems with either starting or maintaining relationships • odd perceptions, emotions, thoughts, and behavior

14. 69.4 – Contrast the three clusters of personality disorders, and describe the behaviors and brain activity that characterizes the antisocial personality. Cluster B: Dramatic-Erratic 1) Histrionic • obsessed with being center of attention • very dramatic • emotionally shallow person 2) Narcissistic • exaggerated belief that he or she is very important and has achieved much success • arrogant 3) Borderline • instability of emotions, impulse control, obsessive fear of being alone, difficulty maintaining relationships and routines 4) Antisocial • no feelings of regard for others and their welfare • lack of conscience or remorse • most heavily studied personality disorder • sociopath and psychopath have been used to describe this disorder

15. 69.4 – Contrast the three clusters of personality disorders, and describe the behaviors and brain activity that characterizes the antisocial personality. Cluster C: Anxious-Fearful 1) Dependent • an enormous need to be taken care of • cannot make decisions • very needy 2) Obsessive-Compulsive • obsession with order and control • perfectionist 3) Avoidant • oversensitive to criticism • does not partake in social situations

17. 69.4 – Contrast the three clusters of personality disorders, and describe the behaviors and brain activity that characterizes the antisocial personality. Antisocial Personality Disorder • The antisocial personality disorder has been extensively researched for its implications and the harm it can cause others. No single gene has been identified that would account for this disorder, but research has shown increased chances when relatives have been diagnosed with antisocial personality disorder. Some behavior associated with this disorder can be traced back to early childhood. Boys who exhibit impulsivity in childhood may display aggressive behavior in adolescence. In fact, children who are diagnosed with a conduct disorder during adolescence are more likely to be diagnosed as antisocial once they reach adulthood. Research has found that people with antisocial personality disorder have reduced activity in the frontal lobe, which is responsible for planning and organization. This may explain why people with antisocial personality disorder are impulsive, not thinking things through. Sociocultural factors including a dysfunctional family, lack of positive parenting, attachment problems that appeared in early childhood, and childhood trauma could contribute to antisocial personality disorder. Living in a high-crime neighborhood or growing up in other negative circumstances can also play a role.

18. 69.4 – Contrast the three clusters of personality disorders, and describe the behaviors and brain activity that characterizes the antisocial personality. Antisocial Personality Disorder • As with many other disorders, the biopsychosocial model suggests that biological, psychological, and environmental factors all play a role in developing antisocial personality disorder.