PCHP - Personality Clinical and Health psychology
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Abnormal psychology, frequently called psychopathology, is the study of people suffering from mental, emotional and often physical pain. Although people with psychopathological problems can have unusual experiences, most of the time these experiences are same in nature to other people's experiences but taken to an extreme degree (e.g. sadness turning into depression).
Some behaviours that seem abnormal to us are normal in other cultures or situations. When we determine whether something is normal, we have to look at the context or circumstances in which the behavior occurs. In addition to context, there are a number of criteria that must be taken into account when determining whether certain behavior is abnormal.
Cultural relativism theory states that there are no universal standards or rules to judge a behavior as abnormal. Instead, behavior can only be abnormal according to the prevailing cultural norms. Therefore, definitions of abnormality differ between cultures.
Opponents of cultural relativism believe that it can be dangerous if cultural norms dictate what is normal and abnormal. For example, throughout history, different societies have labelled certain individuals and groups as abnormal to provide justification for controlling those groups. Think of what Hitler did to the Jews. Also, such abuse often took place when slavery was legal. For example, slaves who tried to escape were diagnosed with drapetomania, a disease that caused them to desire freedom.
Gender also affects whether something is labelled as abnormal. For example, men who show sadness or fear, or who choose to stay at home with children while their wife works, are often seen as abnormal. Women who are aggressive or who do not want children are also viewed as abnormal. On the other hand, aggression in men and chronic anxiety in women are seen as normal, because these behaviours are in line with societal expectations based on sex.
In any case, it is clear that culture and gender influence the expression of abnormal behavior and the way such behavior is viewed. Furthermore, culture and gender can have an impact on determining which types of treatment for abnormal behaviours are acceptable.
Another approach of assessing abnormality is to think of how unusual the behaviour is. Behavior that is deviant or unusual is seen as abnormal, while typical or standard behavior is considered normal. In a sense, such attitude is linked to the relativistic criterion, because the unusual nature of behavior is partly dependent on cultural norms of that behavior.
The relativistic criterion has some shortcomings. For example, how unusual a behavior has to be to call it abnormal? Is a behavior abnormal if less than 10% of the population displays it, or if less than 1% displays it? In addition, plenty of rare behaviours are positive for the individual and society, making it strange to call such behaviours abnormal. People who exhibit such rare but positive behaviours are often called eccentric.
According to the distress criterion a behavior can be seen as abnormal if it causes a feeling of distress (discomfort) to a person displaying that behavior. According to this criterion, a behavior is not considered abnormal when it violates societal norms but does not cause any inconvenience to the individual. Opponents of this theory state that people are not always aware of the problems that their behavior causes for themselves and for others. In addition, certain behavior can cause a lot of discomfort to others, even if this is not the case with the person himself. In such case we should call the behavior abnormal, even though it does not cause a feeling of discomfort to the individual.
Some people argue that we should not label behavior as abnormal unless it is part of a mental illness. This implies that a disease process, as high blood pressure or diabetes, is the cause of the behavior. However, there are no biological tests available to diagnose psychological abnormalities. Many theorists believe that this is because mental health problems do not come from some abnormal genes or disease processes and that we can never develop a simple or definitive test to determine if someone has a mental disorder. A diagnosis of such a disorder is simply a label for a set of symptoms. Therefore, a diagnosis does not refer to an identifiable physical process found in all people who have similar symptoms.
Modern assessments of abnormality are not based on one of the previous criteria, but are influenced by an interplay of four dimensions, often called the four D’s: Dysfunction, Distress, Deviance and Dangerousness.
Behaviours and feelings are dysfunctional if they hinder someone's functioning in daily life. The more dysfunctional the behavior, the greater the chance that it will be labelled as abnormal.
Behaviours and feelings that cause distress to the individual and the persons around him are also often seen as abnormal.
Highly deviant behaviours, such as chronic lying and stealing, lead to assessments of abnormality.
Behaviours that are dangerous (dangerous) to the individual, such as self-harm, or to others, such as severe aggression, are also seen as abnormal.
Together, these four D's form the professional definition on the basis of which behaviours are assessed as abnormal, or maladaptive. Despite the fact that these criteria provide much clarity, the don't answer all the questions. How much emotional pain or damage does a person have to experience? To what extent must the behavior hamper a person's functioning? We assume that each of the four D's is on a continuum. There is no clear-cut distinction between what is normal and what is abnormal.
There are three types of theories that have tried to describe the causes of abnormal behavior. The biological theories have conceptualized abnormal behavior as a physical illness caused by problems in the bodily systems. The supernatural theories have conceptualized abnormal behavior as a result of divine intervention, curses, demonic possession or sinning. The psychosocial theories have conceptualized abnormal behavior as a result of traumas, such as the death of a loved one or chronic stress.
Our understanding of the views on abnormal behavior of prehistoric people is deduced from archaeological findings. Since the invention of written language, people have been writing about abnormal behaviours.
Historians speculate that even prehistoric men already had a concept of insanity, which probably originated from supernatural beliefs. A person displaying strange behaviour was considered to be possessed by evil spirits. The treatment for this was exorcism - the expulsion of the evil spirit from the body. This was done by making the body unfit for the mind to live in it, which often involved extreme measures, such as starving or beating the person. The "treatment" sometimes involved killing a possessed person or drilling holes in the skull to let evil spirits leave.
The old Chinese medicine doctrine was based on the concept of yin and yang. The human body would contain a positive force (yang) and a negative force (yin), which confronted and complemented each other. When the two forces were in balance, the individual was healthy. If not, illness (including insanity) could be the consequence.
Another theory stated that human emotions were controlled by the internal organs. When the vital air flowed through one of those organs, the individual experienced a certain emotion. Thus, the heart was related to pleasure, the lungs to grief and the liver to anger. This theory encouraged people to live in an orderly and harmonious way in order to promote the proper movement of the vital air. Although these explanations are mainly biological, later religious interpretations of abnormal behavior arose with the dawn of Buddhism.
Ancient scripts from Egypt that contain a list of disorders and the treatment used at that time have been found. Disturbances in women were often attributed to a 'walking uterus'. It was assumed that the uterus could become detached and could move through the body, causing it to disrupt the other organs. The later Greeks retained this theory and called it hysteria (from hysteria, which means uterus). Nowadays, the term hysteria refers to physiological symptoms that are probably the result of psychological processes.
Most Greeks and Romans saw craziness as a disease of the gods. The sick retreated into temples of the god Aesculapius, where priests held healing ceremonies. However, Greek physicians usually rejected supernatural explanations of abnormal behavior. For example, Hippocrates believed that abnormal behavior was another disease of the body. According to him, the body consisted of four basic humors (fluids): blood, phlegm, yellow bile and black bile. All diseases, including abnormal behavior, were caused by a poor balance of these four humors. Hippocrates divided abnormal behavior into four categories: epilepsy, mania, melancholy and brain fever. Treatments were aimed at rebalancing the four fluids.
In those times, the state took no responsibility for insane people. There were no asylums or institutions to take care of them. Rights could be taken from those people, such as the right to marry or the right to decide about their possessions.
Although the Middle Ages are often seen as a time when people were obsessed with the supernatural, this was not the case until the late Middle Ages. Many people believed in the supernatural, but there is strong evidence that doctors and government officials associated abnormal behavior with physical causes or traumas and not with witchcraft or demons.
Some historians say that people accused of witchcraft were probably mentally ill. Those people probably suffered from delusions (false beliefs) or hallucinations - signs of some psychological disorders. However, it is also possible that such confessions were forced by the means of torture or in exchange for a postponement of execution. The theory that 'witches' were actually mentally ill was crushed by the church with the support of the state.
A psychic epidemic is a phenomenon in which a large number of people exhibit unusual behavior that seems to have a psychological cause. In the Middle Ages there was dance frenzies, in which people would be wildly dancing in the house, in the street and in the church, while calling out the names of demons and not paying attention to the fact that others were looking at them. This was often dismissed as possession by the devil.
Even today we observe such psychic epidemics. In 1991 there was great panic at the school in Rhode Island, where many students and teachers thought that they inhaled toxic gases and actually began to show physical symptoms. There was great chaos in which everyone was evacuated and many people were admitted to the emergency room. No gases were found, and the event was eventually perceived as an outbreak of mass hysteria caused by the fear of chemical warfare during the Persian Gulf War.
Around the eleventh or twelfth century, the first special facilities were created in hospitals for people who exhibited abnormal behavior. In those early hospitals, the mentally ill were often kept against their will and in very harsh, inhuman conditions. The law stated that family members and friends of a mentally ill person were obliged to keep, bind, or chain this person to a house, beat him or take any necessary actions to keep a person in check so that no one is hurt by the mentally ill. It was not until 1774 that a law was passed in England aimed at improving the terrible living conditions of asylum patients. The medical theories of the times also contributed to suffering of the mentally ill. For example, drawing enormous amounts of blood from the body was believed to restore balance of the body and the mind.
Fortunately, in the eighteenth and nineteenth centuries a more humane treatment methods were developed for people with mental problems. The theory was that people developed problems because of the stress induced by rapidly changing social situation in the times. Therefore, considered as treatment was relaxation in serene and physically attractive environment. The patients were free to walk through the asylum and received clean, sunny rooms and good food. The approach was exceptionally successful. Many people who had been locked up for years got their behavior under control and were able to live reasonably normal again; some of them could even leave asylums.
Unfortunately, the moral treatment movement grew too rapidly. As more people were admitted to new asylums, practitioners no longer had enough time to give patients the individual attention. As a result, previous big success was followed by a rather modest success and sometimes even by a serious failure. By the beginning of the twentieth century, many asylums again resembled a kind of a storage place for the mentally ill. Effective treatments did not develop until well into the twentieth century.
Despite the poor treatment of the mentally ill at the time, in the early twentieth century great progress was made in scientific research on disorders. This research laid the foundation for the biological, psychological and social theories of abnormality that hold today.
In 1845 Wilhelm Griesinger published 'The Pathology and Therapy of Psychic Disorders', in which he stated that all psychological disorders can be explained by the brain pathology. In 1883, one of Griesinger's followers, Emil Kraepelin, published a book in which he developed a scheme for classifying symptoms into discrete disorders. This scheme has served as a basis for the classification systems we use today.
An important discovery was that of syphilis causing a form of insanity. This discovery gave a lot of weight to the idea that biological factors can be the cause of abnormal behavior.
Franz Anton Mesmer developed mesmerism, a method based on animal magnetism. He believed that a magnetic fluid runs in human body and it needs to be well distributed for people to stay healthy. He treated the hysterical disorders through a ritual. Patients would be sat in the dark room around a container with different chemicals. Then Mesmer would enter, in a special garment, and while playing music, he would touch every patient with the purpose of redistributing their magnetic fluids by his magnetic power and presence. Although Mesmer was eventually convicted as a charlatan, his results continued to be debated. The effects of the treatment are now attributed to the state of trance in which the patients would end up. This was later called hypnosis.
The effects of hypnosis were confirmed by Bernheim and Liebault, led by Charcot, who showed that hypnosis could induce symptoms of hysteria by suggesting these symptoms when the patients were under hypnosis. These experiments have made a significant contribution to the progress of psychological perspectives on abnormality.
One of Charcot's students was Sigmund Freud. In his work Freud became convinced that much of people's mental life takes place outside of consciousness. He worked with Breuer on research into hypnosis and the value of catharsis (a great release of emotion under hypnosis). They found that discussing the patient's problems often goes better under hypnosis because the patient is less censored. Their research became the basis for psychoanalysis, the study of the unconscious.
While the psychoanalytic theory had arisen, the roots of behaviourism were planted in Europe and later in America. Ivan Pavlov developed methods and theories for understanding behavior in terms of stimuli and responses, rather than in terms of the internal workings of the unconscious mind. His research into drooling dogs when they had to deal with stimuli other than food is world-famous. It gave rise to the theory of classical conditioning. Enthusiastic about classical conditioning, American psychologist John Watson investigated relevant human behaviours (such as phobias) and explained them as acquired solely through conditioning.
At the same time, Thorndike and Skinner investigated how the consequences of behavior influence the likelihood that this behavior will be repeated. They argued that behavior that is followed by positive consequences will be repeated more often than the behavior that is followed by negative consequences. This became known as operant conditioning.
Behaviourism has had a major impact on psychology and it is the basis of many effective psychological treatments that are used today.
In the 1950s, some people argued that behaviourism was limited because it did not take into account the internal thought processes that influence the relationship between stimulus and response. It was not until the 1970s that the focus of psychology shifted to studying cognitions - thought processes that influence emotion and behavior. For example, Bandura argued that the extent to which people think they can influence certain events (self-efficacy beliefs) is crucial for mental health.
Beck introduced rational-emotive therapy. This was controversial, because therapists sometimes had to challenge patients hard to change their irrational thought patterns. The treatment method eventually became very popular and Beck's cognitive therapy has become one of the most commonly used therapies for many disorders.
In the mid-Twentieth century, much progress was made in the medical treatment of some important forms of abnormality. In particular, the discovery of phenothiazines (which counteract hallucinations and delusions) caused many people who had been in institutions for years to return to society. In addition, new forms of psychotherapy have been developed that are very effective in treating a wide range of psychological problems.
Patients' rights movement arose around 1960. It postulated that patients with mental problems can recover better if they are integrated into society, with the support of treatment within the community. This was called deinstitutionalization. This process had a huge impact on the lives of people with serious psychological problems. Many patients experienced a major improvement in their quality of life and suddenly had a lot more freedom.
We can still observe this today. The work in the community is often done by social workers, therapists and doctors. In halfway houses patients in a structured environment can get used to living in society, having a job and their family and friends. Day treatment centres ensure that patients receive treatment during the day, but promises to let them be back home by night. People with acute problems can go to inpatients wards of psychiatric hospitals.
A problem with these developments was that community-based treatment centres could not cope with the large numbers of patients who had left the institutions. Many of these patients ended up in care homes or at their family's home, where they were not provided with the right treatment. Others ended up on the streets.
Managed care is a collection of methods for a coordinated care that starts with monitoring and ends with determining what kind of care should be provided and financially covered. The goal is to aid with existing medical problems and to prevent future medical problems. Healthcare providers often receive a monthly fixed amount of money per patient and then must decide how they can provide the best care to each patient with that money.
The advantage of this approach is that patient's family doesn't have to search for suitable care, but the primary care provider can find and can ensure that the patient has access to such care. This prevents the patient from slipping between the meshes and falling outside the treatment. Unfortunately, mental health care is not always fully covered by insurance. Many American states have also lowered the subsidy for mental health care, therefore leaving plenty of poor without access to the proper health care needed.
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Abnormal psychology, frequently called psychopathology, is the study of people suffering from mental, emotional and often physical pain. Although people with psychopathological problems can have unusual experiences, most of the time these experiences are same in nature to other people's experiences but taken to an extreme degree (e.g. sadness turning into depression).
Some behaviours that seem abnormal to us are normal in other cultures or situations. When we determine whether something is normal, we have to look at the context or circumstances in which the behavior occurs. In addition to context, there are a number of criteria that must be taken into account when determining whether certain behavior is abnormal.
Cultural relativism theory states that there are no universal standards or rules to judge a behavior as abnormal. Instead, behavior can only be abnormal according to the prevailing cultural norms. Therefore, definitions of abnormality differ between cultures.
Opponents of cultural relativism believe that it can be dangerous if cultural norms dictate what is normal and abnormal. For example, throughout history, different societies have labelled certain individuals and groups as abnormal to provide justification for controlling those groups. Think of what Hitler did to the Jews. Also, such abuse often took place when slavery was legal. For example, slaves who tried to escape were diagnosed with drapetomania, a disease that caused them to desire freedom.
Gender also affects whether something is labelled as abnormal. For example, men who show sadness or fear, or who choose to stay at home with children while their wife works, are often seen as abnormal. Women who are aggressive or who do not want children are also viewed as abnormal. On the other hand, aggression in men and chronic anxiety in women are seen as normal, because these behaviours are in line with societal expectations based on sex.
In any case, it is clear that culture and gender influence the expression of abnormal behavior and the way such behavior is viewed. Furthermore, culture and gender can have an impact on determining which types of treatment for abnormal behaviours are acceptable.
Another approach of assessing abnormality is to think of how unusual the behaviour is. Behavior that is deviant or unusual is seen as abnormal, while typical or standard behavior is considered normal. In a sense, such attitude is linked to the relativistic criterion, because the unusual nature of behavior is partly dependent on cultural norms of that behavior.
The relativistic criterion has some shortcomings. For example, how unusual a behavior has to be to call it abnormal? Is a behavior abnormal if less than 10% of the population displays it, or if less than 1% displays it? In addition, plenty of rare behaviours are positive for the individual and society, making it strange to call such behaviours abnormal. People who exhibit such rare but positive behaviours are often called eccentric.
According to the distress criterion a behavior can be seen as abnormal if it causes a feeling of distress
.....read moreA theory is a set of ideas that provide a framework. Based on this framework, questions can be asked about a particular phenomenon and information collected and interpreted about this phenomenon. A therapy is a treatment, often based on a theory about a disorder, that deals with the factors that cause the disorder according to the theory.
There are different approaches for explaining psychological complaints. For example, when it comes to anxiety, the biological approach symptoms suggests that the symptoms can be caused by a genetic predisposition to anxiety. The psychological approach seeks the explanation in a person's beliefs, life experience and relationships. The sociocultural approach looks at the cultural values or social environment of a person. These different approaches are often seen as incompatible. People seek either a biological explanation or a socio-cultural explanation. This is also called the nature-nurture debate : is the explanation in someone's nature, or in education (or environment).
Although it is tempting to look for a single explanation, theoreticians often start from the biopsychosocial approach, which recognizes that it is often a combination of biological, psychological and socio-cultural factors. Vulnerability to a disorder can also lie with each of these factors and therefore does not always have to be genetic. Only vulnerability is not enough to develop a disorder, only when another trigger occurs (e.g. stress), the disorder could really develop.
Treatments have also been developed for each approach. The biological approach mainly requires medication, from the psychological and sociocultural approach it usually concerns psychotherapy. Both types of treatment have proved effective and are often used together, in an integrated approach.
The famous story of Phineas Gage describes how this man, one day through an accident at work, received a thick iron rod through his skull and brain. Miraculously, he survived this accident and he recovered completely physically. His personality, however, had changed completely: from a responsible, friendly and intelligent man, he had suddenly changed into a capricious person who had no respect for social norms. His sense of responsibility was completely gone.
Later research showed that Gage mainly suffered damage to the frontal lobe. People who have damage to this part of the brain often have trouble taking rational decisions in social situations and have trouble processing information about emotions. They can still solve logic and abstract problems, just like Gage still could.
Brain dysfunction is only one of the three possible biological causes of abnormality. The other two are biochemical imbalances and genetic abnormalities. These three causes can also influence each other. For example, brain dysfunction can be the result of genetic factors and this can cause biochemical imbalance.
The brain can be subdivided into three main areas: the hindbrain, midbrain and forebrain. The back brains contain the medulla (controls breathing and reflexes), punch (important for attention and timing of sleep), reticular formation (controls arousal and attention to stimuli) and cerebellum (is involved
.....read moreAn assessment is the process of collecting symptoms and seeing what causes them. A diagnosis is a label for a number of symptoms that often occur together.
There are modern methods for diagnosing. Assessment techniques must be valid and reliable. In addition, they must be standardized.
To say that a test is valid: the test must actually measure that for which it was designed. The validity for testing psychological disorders is not very large, because there are no good objective methods for determining these.
There are different types of validity:
The reliability is the certainty that the outcome of the measurement remains the same. Different types of reliability:
To prove validity and reliability, you can standardize the data collected of a test, so that there is no variation between tests in how this is done.
A lot of information for an assessment comes from an interview, which often includes an investigation into the mental status.
There are five types of information:
Clinicians increasingly use structured interviews: a series of questions about the symptoms.
In order to quickly determine what the symptoms are, a symptom questionnaire can be filled out. A frequently used questionnaire is the Beck Depression Inventory (BDI): here you have to judge for yourself which description best suits how you felt during the past
.....read moreDue to evolution, humans and animals have an automatic reaction to danger: the fight or flight response (fight or flight). The psychological changes that arise during this response are due to the activation of two systems: the autonomic nervous system and the adrenal cortical system.
The hypothalamus activates the sympathetic part of the autonomic nervous system, which prepares to fight or flight by releasing energy. The hypothalamus also activates the adrenal cortical system by releasing CRF (corticotrophin-releasing hormone), which releases the adrenocorticotropic hormone (ACTH). This hormone causes the cortisol level to rise. Cortisol in the blood and urine is an indicator of stress. We then experience the emotions that come with danger, after which we either confront the danger (fight) or run from it(flight).
People with anxiety disorders follow the same pattern, but with them there is no actual objective danger but rather a more subjective, psychological one.
We refer to anxiety disorder when people are continuously living with fear and normal functioning is thereby impeded. When this happens, people tend to realize the unreal nature of the disorder and suffers from it.
Fear consists of four different types of symptoms.
1. somatic symptoms: physical responses such as sweating and increased blood pressure
2. emotional symptoms: feelings of anxiety and vigilance
3. cognitive symptoms: unrealistic worries such as the feeling that something bad is going to happen
4. behavioral symptoms: such as avoidant or flight behaviours.
Posttraumatic stress disorder and acute stress disorder both occur as a result of an experience of extreme stress. For example, many people developed a stress disorder in America as a result of the 11th of September attacks. Furthermore, it is estimated that 7% of the people experience stress during their lifetime as a result of a traumatic experience.
For a diagnosis of PTSD, from all the symptoms in the DSM, at least the following four are necessary:
Many people with PTSD experience symptoms of dissociation, a process in which parts of the identity, memories or consciousness lose contact with each other. These people can be diagnosed with the subtype PTSD with prominent dissociative symptoms.
An acute stress disorder occurs in traumas that resemble PTSD, only the symptoms of acute stress disorder develop within a month. Dissociative symptoms are common in ASD: stiffening, less awareness of the environment, experiencing the world as a dream. People with ASD have an increased risk of developing PTSD.
.....read moreIn this chapter, the somatic symptom disturbances and the dissociative disorders will be discussed. In somatic symptom disorders , people have physical complaints, without an organic cause. Often the pain comes through painful emotions, thoughts or memories. In dissociative disorders , people develop several independent personalities, as a result of which they suffer from memory loss. This is because some personalities do not communicate with each other, as it were.
Somatic symptom disorders symptom disturbances
The problem with somatic is that it is difficult to determine whether the symptoms have an organic or psychological cause. Often people’s symptoms do not correspond to a physiological process associated with these symptoms. If this is the case, it is assumed that psychological factors are of influence. Another possibility is that people do have a physical illness, but that they still must be discovered or simply can not be found.
The people who have this disorder really feel the pain. It is not that they can influence or control their symptoms.
5 types of somatic symptom disorders are distinguished:
Somatic symptom disorder and Illness Anxiety Disorder
Someone with a somatic symptom disorder has one or more physical symptoms that he or she worries about, and the person spends a lot of time thinking about these symptoms and looking for medical care. It can be pain symptoms, neurological symptoms, gastrointestinal symptoms or symptoms that affect any part of the body. People with somatic symptom disorder have concerns about their health that are excessive given their current physical health. The concerns also continue to exist when they have evidence that they are healthy and interfere with their daily functioning. When they experience a certain symptom, they immediately think the worst, for example that they have cancer.
Illness anxiety disorder is very similar to somatic symptom disorder. The primary distinction in the DSM-V between these two disorders is that people with a somatic symptom disorder actually seek help while people with illness anxiety disorder are afraid that they will get a serious illness, but they do not always experience serious physical symptoms. . When they experience physical symptoms, these people are very concerned, and seek medical help before.
People with somatic symptom disorder or illness anxiety disorder often experience periods of anxiety and depression. They can express their stress in physical symptoms or mask the stress with alcohol abuse or antisocial behavior. Their symptoms and health concerns become their identity. When they are anxious or depressed, they report more physical complaints and then worry when they are not anxious or depressed.
Cognitive factors play a major role in somatic symptom disorder and illness anxiety disorder. People with these disorders have convicted dysfunctional about diseases. They assume that serious illnesses are
.....read moreTwo different mood disorders are discussed below. Bipolar disorder is a disorder with periods of mania and periods of depression. Someone with a unipolar disorder only suffers from depression (not mania). Furthermore suicide is treated, or suicide.
People with depression are completely confiscated by the disorder; depression affects the emotions, body functions, behaviours and thoughts of man.
The most important emotional symptoms in someone with a unipolar disorder are the sadness and the loss of all interest in life, which is referred to by the term anhedonia.
Many have also in people with depression body functions changed. These are changes in appetite, sleep and activity. Some people with depression have very little appetite, whereas others, on the other hand, very much.
In their behavior , many depressed people show changes in their way of moving. For example, they move very slowly in everything they do. This is called psychomotor retardation . Many people feel that they have little energy and that they are constantly tired. A small part of the depressed people feels restless. These people have opposite symptoms: psychomotor agitation, in which people feel physically agitated, can not sit still and walk around aimlessly or fidget.
The cognitive symptoms of depression are all kinds of thoughts about, for example, hopelessness, shame and suicide. In serious cases, there are also delusions and hallucinations. Delusions are thoughts that have no basis in reality. Hallucinations are observations that someone has, who are not actually there.
Depression can take different forms. Major depressive disorder is a severe depression that lasts at least two weeks. The diagnosis requires that someone feels depressed or has a loss of interest in daily activities. In addition, at least four other symptoms of depression must be present. According to the DSM-IV, there are two types of unipolar depression: major depression and dysthymic disorder. The difference between these two disorders is that a major depression is of shorter duration, but very intense. Dysthymic disorder is a chronic form of depression, which lasts for at least one year in adolescents and two years in adults. This depression can be less severe a major depressive disorder. A person must have a depressed mood and his interest in life must be lost. In addition, there must be at least four other symptoms of depression for at least two weeks, involving a disruption of daily life. There are two types of major depressions: in the first type (major depression single occurrence) there is only one single depressive episode, while in the second type (major depression periodically) there are two or more episodes with at least two consecutive months without symptoms between the episodes. The DSM-V criteria contain the observation that a normal and expected depressive response to a negative event, such as a loss, should not be diagnosed as a major depressive disorder unless other symptoms such as worthlessness, suicidality and psychomotor retardation are present.
More chronic forms
.....read moreA person suffers from psychosis if he has hallucinations and delusions and can not say with certainty whether his observations are real or not. A form of psychosis that often occurs is schizophrenia. People can sometimes think very clearly and function well, but also have moments when they can no longer take care of themselves.
Schizophrenia occurs in 1 to 2 percent of people in the United States and in 0.5 to 1 percent of all people around the world. Schizophrenia is more common in men than women and is more common in colored people than in whites. About 90% of people with schizophrenia seek help. The disorder often develops in youth or young adulthood.
Schizophrenia is a very complex disorder. A distinction is made between two categories of symptoms, the positive and the negative symptoms. The DSM-V refers to the schizophrenia spectrum, to show that there are five domains of symptoms that define psychotic disorders, and their number, severity and duration distinguish psychotic disorders from each other.
Positive symptoms
Positive symptoms, or Type I symptoms, are characterized by the presence of delusions, hallucinations, disorganized speech and thoughts and disorganized or catatonic behavior. These symptoms can also occur in other disorders, such as bipolar disorder, so that makes the diagnosis for schizophrenia difficult. It is also possible that the symptoms occur in people who actually have no problems. Think of people who hear voices and attribute this to their religion. There are also people who, due to the symptoms, have no control over reality: delusional disorder (delusions).
The rule is that if the positive symptoms only occur during a manic or depressive period, the diagnosis 'mood disorder with psychotic characteristics' is made. If the positive symptoms also occur outside the manic or depressive periods, the diagnosis is made schizophrenia.
Delusions are ideas that the patient thinks are true, while those ideas are very unlikely or even impossible. Many people sometimes have unlikely thoughts, but there are differences between these kinds of thoughts and delusions. When healthy people have unlikely thoughts, they are not completely unbelievable, while delusions are. People with delusions constantly think about it and seek evidence for their ideas, with which they try to convince others. In addition, people with delusions can not accept that their thoughts are not right.
There are four kinds of delusions:
Personality is the collection of characteristics that the person has or shows and that distinguishes him or her from others. It is the way we behave, think, believe and feel. These characteristics make us unique.
A personality trait is a complex pattern of behavior, thoughts and emotions that remain constant over a longer period of time, and in different situations.
The 'big five' theory states that there are five different factors of personality traits. Everyone satisfies every factor to a certain extent, and how strongly that per factor is the case determines our personality.
The big five:
Definition and diagnosis of personality disorder
A personality disorder is a long-term pattern of unadopted behavior, thoughts and feelings. Personality disorders usually begin in adolescence, or in early adulthood, and sustain a large part of life. To diagnose a personality disorder in a person under the age of eighteen, the personality pattern must be present for at least a year.
In the DSM-IV, personality disorders are on the second axis. This means that these disorders are seen differently from acute disorders. The disorders on the second axis are chronic and penetrating. The DSM-V has rejected this distinction between disorders on As-I and As-II. Personality disorders are therefore no longer on the second axis in the DSM-V. The DSM-V has divided ten personality disorders into three clusters, based on their similarities. The DSM-V admits that this system is limited, not well validated and does not explain the fact that people often have multiple personality disorders from different clusters. The three clusters of the DSM-V are as follows:
Odd-eccentric personality disorders
People with an odd-eccentric personality disorder (from cluster A) behave in ways that strongly suggest schizophrenia. Many scientists therefore believe that this disorder is a weakened version of schizophrenia, or that people with this disorder have a very high chance of developing schizophrenia. Some scientists believe that this disorder should fall under schizophrenia than under the personality disorders, precisely because it appears to be a mild version of schizophrenia.
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Most individuals meet the criteria for two or more eating disorders at different times. Many people do not meet the criteria for an eating disorder, but do show behaviours and concerns that fit in an eating disorder. They are diagnosed with other specified feeding or eating disorder.
People with anorexia nervosa are hungry themselves, while they are already well under a healthy weight. They do this by not eating or eating for a long time. Although they are already very thin, they insist that they have to lose even more weight. People with anorexia refuse to maintain a healthy, normal weight. Although these people are very emaciated, they have an intense fear of weight gain or fat. They have a disturbed idea about their bodies and think they are fatter than they actually are and therefore have to lose weight.
The self-esteem of these people depends entirely on their body weight and the control over their eating behavior; they feel good when they lose weight and are guilty or worthless if they do not succeed. Due to the loss of weight, people with anorexia nervosa are often chronically fatigued. Despite this fatigue, they continue to draw up heavy training programs to lose weight.
Anorexia nervosa usually starts between 15 and 19 years. 90 to 95 percent of all cases with anorexia nervosa are women. Due to the weight loss, the menstrual cycle stops in girls and women with anorexia, this is called amenorrhea . In the DSM-V the criterion for amenorrhea has been removed from the diagnostic criteria, because many girls with anorexia nervosa still have menstrual activity. Anorexia is, in a physical sense, a dangerous disorder. Serious complications such as a very low heart rate or damage to the kidneys may be the result; 5 to 8 percent of people with anorexia will die of it.
There are two types of anorexia nervosa. People with the restricting type of anorexia nervosa refuse to eat, or eat very small amounts, to prevent them from gaining weight. Some do not eat anything for days. People with the restricting type of anorexia nervosa often have a feeling of distrust towards others and the tendency to deny their problems.
The other type is the binge / purge type of anorexia nervosa. These people have binge eating (binges) that alternate with actions to prevent weight gain (purge). This often happens through deliberate vomiting or use of laxatives. People with the binge / purge type of anorexia nervosa often have varying moods, problems with the control of their impulses, problems with alcohol and self-mutilation.
The binge / purge type of anorexia nervosa is very similar to bulimia. The difference is that people with the binge / purge type of anorexia nervosa do not have a healthy weight, while people with bulimia nervosa generally have a healthy weight or even a bit of overweight.
Just like in the DSM-IV,
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Abnormal psychology Lavonda Kamer contributed on 12-06-2023 09:16
I had no idea the study of psychology went back as far as it does?? That is very surprising to me. I am wondering tho, how would we go about
labeling a patient and diagnosing the patient if this patient kept the behaviours under control and wee not noticeable to anyone??? yet the behaaviours and symptoms were life consuming and very uncomfortable to this patient. what would we do in this situation???
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