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, people with anorexia nervosa have a significant low body weight. The DSM-V suggests that a BMI of 18.5 is the lower limit of a healthy body weight. Anorexia nervosa is mild if the BMI is greater than or equal to 17, on average if the BMI is 16 to 16.99, and serious if the BMI is 15 to 15.99. The severity is determined not only by the BMI, but also on the basis of clinical symptoms, the degree of functional impairment, or the need for supervision.
The prevalence of anorexia nervosa is higher since working with the DSM-V, because two criteria that were still in the DSM-IV have been removed. The first criterion was that someone had to be at least 15% below the normal body weight, and that women should have amenorrhea. Not all girls met this, so the prevalence was lower.
Ten to fifteen years after diagnosis, about 70% are no longer diagnosed with anorexia nervosa, but many of them continue to have eating problems or other psychopathology, such as depression. People with the binge / purge type often have more comorbid mental disorders than people with the restricting type. In particular, impulsive, suicidal and self-damaging behavior occurs.
The important characteristics of bulimia nervosa are uncontrolled binge eating, followed by actions that prevent weight gain. The definition of binging, the uncontrolled binge eating, is described in the DSM-IV when, in a short time (such as 1 to 2 hours), it is consuming an unusually high amount of food in a given situation and can not control it. They eat more than a normal person in such a situation and can eat in that time frame. Binge eating can vary in size per person. Most people with these binge eating are actually not hungry at all. At such a moment they lose control of their eating behavior.
As with patients with anorexia, the self-esteem of a bulimic patient is highly dependent on their figure and body weight. However, they have no disturbances in their body image. After the binge eating they want to make sure they do not arrive. Surrendering is often associated with bulimia. However, excessive exercise or fasting can also be used by patients to control their weight. In the DSM-V the criteria for bulimia nervosa have been relaxed compared to the DSM-IV. The minimum number of times per week in which binge / purge behavior is to be shown is reduced from 2 to 1 time per week. The prevalence will therefore increase. Bulimia nervosa is more common in Western cultures than in non-Western cultures. It often occurs in adolescence. Bulimia can also cause serious medical complications and result in death. One of the most serious complications is an imbalance of electrolytes, which is due to the loss of fluid after excessive and chronic vomiting. Suicide is also 7.5 times more common in people with bulimia nervosa. Bulimia nervosa is often chronic.
People with Binge-eating disorder appear in behavior on people with bulimia nervosa but do not show the actions to compensate for the binge eating and to prevent them from arriving, such as vomiting, fasting or excessive exercise. These people are often too heavy, disgusted by their bodies and are ashamed of their behavior. They can often eat throughout the day without any planned eating moments for breakfast or lunch. There are also people who eat a lot at certain scheduled times. They usually do this as a result of stress, depression or anxiety. People with this disorder often have obesity and a history of dieting. Most people have family with obesity. This eating disorder is also more common in women. People with binge-eating disorder often also have depression or an anxiety disorder. In addition, they are more likely to have alcohol abuse and personality disorders. This disorder also appears to be chronic.
Some people present patterns of behavior that are very similar to anorexia or bulimia nervosa, but does not fully meet the criteria of these disorders. This eating disorder is called partial syndrome eating disorder . For example, people with this syndrome suffer from a binge only a few times a month. They can weigh too little, but are not far below their normal weight. They derive their self-esteem from their weight. The symptoms are therefore the same as those of anorexia or bulimia, but they are not serious enough to get the diagnosis of this eating disorder. The people with this syndrome often have psychological problems such as an anxiety disorder, substance abuse, depression and sometimes suicidal tendencies. They have a lower self-esteem, poorer health and a lower appreciation for life than healthy people.
The DSM-V has added a new diagnostic category called other specified feeding or eating disorder. This includes expressions of eating disorders that cause clinically significant stress or defects, but do not meet the diagnostic criteria for one of the eating disorders discussed. The partial-syndrome eating disorder just discussed falls within this new category. In the DSM-IV this category was called 'eating disorders not otherwise specified' (EDNOS). EDNOS is often as severe and persistent as bulimia nervosa or anorexia nervosa. The DSM-V category of other specified feeding or eating disorder includes disorders such as atypical anorexia nervosa, in which all criteria for anorexia nervosa are met, except for the underweight. Another example is bulimia nervosa of low frequency and / or limited duration. All criteria for bulimia are met, except that the binge eating and compensation behavior occurs less than once a week or for less than three months. A final example is the night eating syndrome, a new disorder in the DSM-V. People with this disorder eat excessive amounts of food after dinner and at night. They often suffer from insomnia and believe they must eat to fall asleep. People with this disorder are often overweight and often have depression.
Obesity is defined as a BMI of 30 or more (weight / height2). It is not an eating disorder in the DSM-V, but it is a risk for a person's health because of a higher risk of heart disease, strokes, diabetes and cancer. The higher your BMI, the greater the chance of dying earlier.
We live in a poisonous society, where you can find food with a lot of calories that is cheap. We play less, and often do not get the necessary movement. Not everyone who comes in such an environment is overweight or even obese. Genes influence how your metabolism works and how much fat you store.
Many people diets to no longer have excess weight. Many do not keep the whole diet full and are disappointed with the results, because more is promised than is realized in them. There are even medicines to lose weight, although they do have side effects. The best way to eat fewer calories and exercise more. There are also possible operations, such as a stomach reduction. It is difficult to get weight off, but even harder to keep it off.
Cultural and historical trends
It is said that eating disorders are culture-related because they occur mainly in the West, where thin is the ideal image. There is also a historical trend for eating disorders. The number of cases of anorexia and bulimia increased between 1930 and 1970 and then remained almost the same. In Curaçao, where mostly black people live, there is less of an eating disorder. This while the disorders on Curaçao do occur.
Statements for eating disorders
It is very plausible that the development of an eating disorder is caused by a combination of biological, cultural-social and psychological factors.
There is evidence that the predisposition for both anorexia and bulimia nervosa is hereditary: 33-84% is in the genes. Much biological research is performed on the hypothalamus, because the hypothalamus plays a major role in regulating eating behavior. The hypothalamus receives messages about food intake and nutritional values and ensures that people stop eating when they are satisfied. These messages are delivered by neurotransmitters and hormones. The deviant eating behavior can be caused by these substances being out of balance or improperly regulated, or by problems in the structure of the hypothalamus.
People with anorexia nervosa have a less well functioning hypothalamus, and abnormal levels of the neurotransmitters serotonin and dopamine The only question is whether this is the cause or the result of the behavior of anorexia patients.
Many people with bulimia show abnormalities in the neurotransmitter serotonin. A lack of serotonin seems to make the body hungry for carbohydrates.
How it is that people with anorexia or bulimia have such a wrong self-image can unfortunately not be explained biologically.
Cultural-social norms regarding beauty ideals play an important role in eating disorders. In the past 45 years the ideal image of women has become thinner. This slimming ideal, which is mainly promoted by advertising, influences the self-image and causes the feeling not to comply with the norm. Role models such as actresses and models are almost always slim and promoting this idea of beauty. Anorexia and bulimia are more common in women than in men, probably because thinness is more valued in women than in men In women's magazines there are also more diets. The social pressure to be thin and beautiful is even more emphasized in TV shows with make-overs. All these things can be a reason for an eating disorder. Of course there is also social pressure in your environment, namely of family and friends.
These disorders occur less frequently in less developed countries. Certain groups within a culture, such as athletes, also have an increased chance of developing unhealthy eating behavior, especially if their body weight is experienced as an important factor in mutual competitions. Women who practice a sport in which you have to be thin, such as gymnastics, often struggle with their bodies during puberty. For their sport a girl's body is desired and not the curves of a woman. They try to counteract the origin of the female forms through diets.
Eating disorders are also more common among athletes, especially those who do sports where weight is an important factor in the competition. Think of dancing, horseback riding, wrestling and bodybuilding.
Eating disorders can sometimes be a way to deal with painful emotions. Thin people then develop anorexia or bulimia, people with preponderance develop binge eating to deal with their problems (binge-eating disorder).
Having depressive symptoms has proven to be a predictive factor in the development of an eating disorder. A distinction is made between two types of deviant eating patterns in which binge eating is central to the regulation of emotions: the dieting subtype and the depressive subtype. People with the dieting subtype are very concerned about their figure and their body weight. They vomit or do exercises to prevent them from arriving. People with the depressive subtype of eating patterns also worry about their figure and weight, but suffer from depressive feelings and low self-esteem; they often eat to not feel anything. They have greater social and psychological problems.
For people with an eating disorder the appearance is very important. They think that achieving the ideal, slender figure produces social and psychological benefits. Eating disorders are common in people who are dissatisfied with their bodies, are often perfectionists and have low self-esteem. Other research has shown that people with eating disorders are more attracted by the opinions of others, want to conform more to the wishes of others and are rigid in their opinion about themselves and others (something is either good or bad). Many are obsessed with their eating habits and plan their days around it.
Girls with eating disorders were often very good and listened carefully to what the parents said. They used to be very good at everything they did, want to achieve a lot, are dutiful and are often compliant daughters who want to be perfect. The parents often have high expectations of the child and the child is not allowed to express negative feelings. In these families the family members are very dependent on each other and it is difficult to develop their own identity. They do not learn to identify their own feelings and desires and therefore do not learn to deal with negative emotions. If even physical sensations, like hunger, are not recognized, this can lead to anorexia nervosa.
In adolescence, especially girls develop an eating disorder due to separation anxiety of the parents and fear of independence. This is especially the case with families who are too involved, where especially little freedom is given to girls. Control over the food gives them the feeling of regaining control over their lives.
Treatments of eating disorders
Treatments for anorexia nervosa
People with anorexia nervosa often do not want psychotherapy. They want to keep control over their behavior and can hardly deal with a therapist's attempts to change behaviours. They also want to keep their weight and body as it is now, they often do not want to arrive at a healthy weight. Winning the trust of the patient is therefore very important. Most anorexia patients are first forced into hospital because their underweight has reached an extreme form. If there is therapy to be given, gaining trust is even more difficult, because the patient has to come against her will. Psychotherapy helps, but it is a lengthy process. The patient must first reach a healthy weight and then the self-image must rise. Unfortunately, many people with this disorder fall back into old habits after the therapy has been completed.
In individual therapy the emphasis is placed on learning to recognize one's own feelings and the trust in them. Only then can people react to feelings of hunger in the right way. This therapy is usually cognitive behavioral therapy, in which the patient is confronted with the overvaluation of being thin. The patient must also arrive at a healthy weight in a natural way. In behavioral therapy patients are rewarded when they arrive in body weight. Because taking food often provokes fear and tension, they also learn relaxation exercises, which they can use during eating. Another frequently used method is family therapy. The anorexia patient and the family are treated as a unit. Sometimes parents must first be reminded of the severity of the eating disorder because they consciously or unconsciously stimulated eating behavior. The therapist will map the interaction problems within the family and show the role of anorectic behavior within the family. Often the parents are over-protective, controlling, have too high expectations and children are not allowed to express their feelings. The therapy lasts half a year to a year, with ten to twenty sessions.
Psychotherapy is usually a very lengthy process. Usually it takes years before the anorexia patient is cured. It often happens that people return to old habits or to bulimia nervosa after a good period of time.
Therapy for bulimia nervosa and binge-eating disorder
Cognitive behavioral therapy appears to be most effective for the treatment of bulimia nervosa. Cognitive behavioral therapy is based on the assumption that anxiety about the figure and body weight are the central characteristics of the disorder. Wrong cognitions are identified, and the patient is confronted with this. In addition, healthy eating patterns are taught using behavioral therapeutic methods. The patient must eat three healthy meals per day. Here, 'forbidden food' as bread must also be reintroduced into the diet. In interpersonal therapy, the therapist tries to solve the interpersonal problems related to the patient's eating problem with bulimia. Supportive-expressive therapy has the same goal as the interpersonal therapy, but in this therapy the therapist deals with the patient in a non-directive manner. The patient must talk about the problems related to the eating disorder.
Only behavioral therapy can be given. Here the diet is adjusted, with food that is healthier and prevents a binge.
For bulimia nervosa, cognitive behavioral therapy works best because it addresses both the thoughts and the behavior. This is also the best approach for binge eating disorder.
Because depression is often associated with eating disorders, antidepressants are prescribed to patients. By tricyclic antidepressants take bingeing and vomiting sometimes get bulimia nervosa patients more control over their eating behavior. Patients, however, fall back into their old behavior when the medication is stopped. Research into the effects of SSRIs also shows a decrease in bingeing and vomiting, but no change in behavior. Antidepressants are not effective in anorexia patients and SSRIs can only help anorexia patients when they have reached their normal weight.
What does abnormality mean? - Chapter 1 (Abnormal Psychology)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 more Which theories and treatments of abnormality exist? - Chapter 2 (Abnormal Psychology)A 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 more How can you assess and diagnose abnormality? - Chapter 3 (Abnormal Psychology)An 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 more Which anxiety disorders exist? - Chapter 4 (Abnormal Psychology) Due 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 more Which somatic symptom disturbances and dissociative disorders do exist? – Chapter 5 (Abnormal Psychology)In 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 more What is the relationship between mood disorders and suicide? - Chapter 6 (Abnormal Psychology)Two 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 more What does the schizophrenic spectrum and related psychotic disorders look like? - Chapter 7 (Abnormal Psychology)A 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:
Which personality disorders exist? - Chapter 8 (Abnormal Psychology)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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Which eating disorders exist? - Chapter 9 (Abnormal Psychology)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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Nice going! Roos Heeringa contributed on 14-01-2021 13:29
it looks like this is one of your posts belonging to the bundle 'PCHP - Personality Clinical and Health psychology', very nice that you made this bundle! It seems to me you have covered all relevant topics, is this correct?
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