Psychological disorders are characterized as behaviors or mental processes that impair functionality or cause various kinds of distress. Behaviors that are expected, such as anxiety before a big interview, are not classified as psychological disorders. The only behavior that is not an acceptable response or thought process to a specific event is included in psychological disorders. The Diagnostic and Statistical Manual (DSM) is the most widely used organization scheme used to classify psychological disorders. Rather than characterize one aspect of a person’s personality, DSM aims to create a multi-axial system of assessment that provides a wide range of information about a person’s overall functionality. The DSM is broken down into 5 different sections or axes. Axis I includes clinical syndromes, axis II personality disorders, axis III general medical conditions, axis IV psychosocial and environmental problems, and finally axis V includes global assessment of functioning.
Personality disorders are broken down into six broad categories: anxiety disorder, dissociative disorders, somatoform disorders, mood disorders, schizophrenia, and personality disorders. Let’s take a look at them individually…
Anxiety is a natural response to external stimuli. Notwithstanding, maladaptive reactions to anxiety can lead to anxiety disorders. Anxiety disorders are accompanied by several physical and behavioral characteristics such as nervousness, inability to relax, fear of losing control, elevated blood pressure, faintness, and arousal of the sympathetic branch of the autonomic nervous system. Types of anxiety disorders include phobias, panic disorder, general anxiety disorder, and posttraumatic stress disorder (PSTD). Phobias entail a persistent fear of a specific object or situation. These fears can range from fears of insects to a fear of heights. However, panic disorder is characterized as a recurrence of attacks of extreme anxiety in the absence of external stimuli. This type of anxiety disorder is not usually linked to external stimuli but rather comes “out of the blue”. Generalized anxiety disorder is not so much anxiety about a single external stimulus but rather anxiety about all external stressors. Physical characteristics of this disorder may include shakiness, inability to relax, racing heart, light-headedness, and feelings of dread.
Obsessive-compulsive disorder is a maladaptive response to an external stressor. The obsession might be having clean hands. The stress of keeping hands clean leads to temporary relief of the stressor through the compulsive behavior, which only intensifies the obsession of cleanliness. Likewise, PTSD is a maladaptive reaction but to a traumatic event such as physical attacks, combat, near death experiences, or terrorist attacks. Symptoms of this disorder are the avoidance of stimuli associated with the event, intense fear, and reliving of the event. Psychodynamic psychologists believe that anxiety disorders are a result of unconscious childhood conflicts that have not yet been resolved; whereas, cognitive theorists hold that exaggerated consequences play a major role. Biological causes of anxiety disorders center around unbalanced levels of serotonin, norepinephrine, and gamma-aminobutyric acid (GABA). Medical treatments for anxiety disorder include benzodiazepines, a class of drugs that reduce anxiety, and reduction of the causal stimuli.
Dissociative disorders involve the separation of mental processes such as thoughts, emotions, identity, memory, or consciousness. Some of the different types of dissociative disorders are dissociative identity disorder (formerly multiple personality disorder), dissociative amnesia, dissociative fugue, and depersonalization disorder. Specifically, dissociative identity disorder (DID) entails the integration of two or more personalities into one person. There is some dispute over whether DID should be a distinct disorder but rather an extension of excessive role-playing. Next, dissociative amnesia is attributed to the loss of personal memories or self-identity. This type of disorder does not usually affect skills or general knowledge but rather specific events or names. This type of disorder is not caused by organic external stimuli, such as intoxication, but most common follows extremely traumatic events such as warfare. Furthermore, dissociative fugue involves dissociative amnesia but also entails fleeing to a new location where the past life is forgotten. However, depersonalization disorder is characterized as a persistent or recurrent feeling of detachment from one’s own experiences or body making it difficult for the person to focus clearly on events. Dissociative disorders are usually the result of early childhood trauma at the hand of a caregiver or relative. Psychodynamic theorists expound that these disorders are caused by mass repression of unacceptable impulses. Learning theorists, however, explain that dissociative disorders are a learned response to feelings of anxiety, guilt, and shame.
Somatoform disorders are characterized by physical complaints that cannot be explained medically. Different types of this disorder are conversion disorder and hypochondriasis. Conversion is the physical manifestation of a maladaptive reaction to anxiety or unconscious conflict. Some specific applications of this disorder could be paralysis or even blindness. For instance, during World War II many night pilots developed night blindness in response to the stressors of the bombing. On the other hand, hypochondriasis is the persistent belief that illness exists in spite of medical evidence to the contrary. In conclusion, psychodynamic theorists hold that somatoform disorders are the expression of the psychological conflict between the I.D. and the Superego. Learning theorists, however, explain that conversion disorders are caused by a learned response to undesirable stressors. Cognitive theory, on the other hand, says that over-exaggerated physical ailments might contribute to hypochondriasis.
Mood disorders are characterized by disturbances in mood that are either extreme, persistent or out of keeping with the events the person has experienced. Common forms of mood disorder are major depression and bipolar disorder. Major depression or major depression disorder (MDD) brings with it dampened mood, changes in appetite and sleep patterns, and lack of interest or pleasure. In extreme cases of MDD psychotic behaviors may be observed such as hallucinations and delusions, such as believing that their body is rotting away. Bipolar disorder (formerly known as manic-depression) involves swings between two extreme poles. Bipolar disorder consists of two phases: manic and depression. During the manic phase, a person may show excessive excitement, exhibit flight of ideas or pressured speech. The depression phase usually includes sleeping more than usual, social withdrawal, and irritability. In conclusion, MDD is caused by continuation of external stressors without resolution. These stressors could include persistent failure at work or marital discourse. According to the psychodynamic approach, depression is the expression of anger turned inward. Likewise, bipolar disorder is seen as different states of ego/superego dominance. However cognitive theory dictates that negative interpretation of life events is what leads to depression and bipolar disorder.
Schizophrenia is a chronic life-long disorder which is characterized by a break with reality, disturbances in thinking, and disturbing behavior or emotional responses. Other symptoms of this disorder include hallucinations, delusions, and bizarre, irrational behavior. The different types of schizophrenia are paranoid schizophrenia, disorganized schizophrenia, and catatonic schizophrenia. Paranoid schizophrenia entails delusions of grandeur and/or persecution which can bring about agitation, confusion, fear, and vivid hallucinations. However disorganized schizophrenia includes loss of control in the bladder and bowels, incoherent speech, highly inappropriate behavior, and extreme social impairment. On the other hand, catatonic schizophrenia has more to do with disturbed motor activity and mutism (loss of speech). In conclusion, genetics has a large role in schizophrenia, as well as damage during pregnancy. Major physiological impairment of the central nervous system plays a key role in the development of schizophrenia. In fact, according to the Diathesis-Stress Model of Schizophrenia inherent causes of schizophrenia, such as genes or prenatal damage, plus environmental stressors give rise to schizophrenia. Lastly, it is thought that increased concentration of dopamine at the synapses and large numbers of dopamine receptors contribute to the progress of schizophrenia.
Personality disorders are enduring patterns of maladaptive behaviors that are sources of distress to the individual or others. The types of personality disorders are a paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder, borderline personality disorder, histrionic personality disorder, narcissistic personality disorder, antisocial personality disorder, avoidant personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder. The first disorder, paranoid personality disorder, is toned down version paranoid schizophrenia. A paranoid personality disorder is characterized as mistrust of others, a general suspicion of the motives and intentions of others, and a tendency to interpret other people’s behavior as threatening; however, this disorder does not cause the unorganized behavior of paranoid schizophrenia. Schizoid personality disorder includes social detachment and isolation due to lack of strong emotions such as anger, joy, or sadness.
Likewise, schizotypal personality disorder involves difficulties forming close relationships but also includes peculiarities of thought such as excessive fantasy or suspiciousness. On the other hand, borderline personality disorder entails stormy and tumultuous moods as a result of failure to develop a stable self-image. People with this disorder tend to act impulsively or in other words act out behavior. Furthermore, histrionic personality disorder involves overly dramatic and emotional behavior usually as a result of unfulfilled needs for reassurance, praise, and approval. People that have narcissistic personality disorder base their self-image on constant admiration and praise. They usually have an over-inflated or grandiose self-image because they see themselves as having special talents or beauty. Next, antisocial personality disorder has more to do with disregard for other’s interests, needs, and feelings than actual anti-social behavior. Conversely, avoidant personality disorder involves a strong fear of rejection which results in few friends and close relationships. Then, dependent personality disorder is characterized as excessive dependence on others and difficulty during independent decision making. Lastly, obsessive-compulsive disorder is an excessive need for orderliness and attention to detail, perfectionism, and overly rigid ways of relating to others.
In the movie As Good As It Gets Jack Nicholson portrays a man that undoubtedly exhibits most of these personality disorders, but most prominently obsessive-compulsive personality disorder. In conclusion, the psychodynamic model indicates that the resolution of the Oedipus complex is crucial to the proper balance between the superego and ego. On the other hand, learning theorists believe that personality disorders are learned maladaptive behaviors. Both genetic and environmental factors come to bear when trying to ascertain the causes of personality disorders. Some of the root causes of personality disorders might be abnormalities in the prefrontal cortex of the brain, lack of warmth during childhood, parental rejection or neglect, the use of harsh punishments while growing up.h punishments while growing up.
In conclusion, the psychodynamic model indicates that the resolution of the Oedipus complex is crucial to the proper balance between the superego and ego. On the other hand, learning theorists believe that personality disorders are learned maladaptive behaviors. Both genetic and environmental factors come to bear when trying to ascertain the causes of personality disorders. Some of the root causes of personality disorders might be abnormalities in the prefrontal cortex of the brain, lack of warmth during childhood, parental rejection or neglect, the use of harsh punishments while growing up.h punishments while growing up.
In conclusion, psychological disorders have many causes and many ways of manifesting themselves. Some of them are understood only superficially while others are a proverbial black box for now.
Nevid, J.S., Rathus, S.A. (2005). Psychology and the challenges of life: Adjustment in the new millennium. Danvers, M.A.: Wiley.