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Anxiety
Disorders - Although anxiety symptoms can
present in a wide variety of forms, all are organized around the
central components of "nervousness" and/or reactions to
being so agitated. The person, when anxious, has begun to
substitute maladaptive approaches for more reality-based responses
to problems. The anxiety may be be based on present, past, or
future (even imagined) events. That is why we are able to be
anxious over things that have never and may not even be likely to
happen. We create these events in our fantasy and then become
frightened over their "potential" for occurrence.
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Mood
(Affective) Disorders - are still sometimes
referred to as affective disorders or disorders in the appropriate
experience and expression of emotion. The mood episodes are
components of the mood disorders, more or less their building
blocks, and the episodes include: Major Depressive Episode,
Manic Episode, Hypomanic Episode and Mixed Episode.
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Schizophrenia
& Other Psychotic Disorders - are still
quite often misunderstood by individuals not involved in the care
of such patients or not personally exposed to patients with the
disorders. Psychotic disorders are chracterized by a difficulty
with reality testing - differentiating what is real from
what is imagined, and the disorders may be characterized by false
belief systems referred to as delusions and often by auditory
and/or visual hallucinations. The individuals capacity to deal
with their work is severely impaired during the occurrence of
their disorders. While extreme environmental situations may
produce psychotic symptoms, it is generally accepted that many of
the psychotic disorders are attributable to a defect in brain
chemistry and the way in which the brain processes its
electrochemical impulses.
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Sexual
& Gender Identity Disorders - Sexual
Dysfunctions are characterized by disturbance in sexual desire and
the physical changes that characterize the response cycle of
sexual excitation and sexual activity. They are dysfunctions when
they case personal distress and/or interpersonal (social)
difficulties. They can arise in the area of desire, excitement,
orgasm, and/or resolution. They can be of lifelong or acquired
duration and can be generalized to many situations or situational
and occur only in specific situations. They can be due to
psychological factors or due to a combined physical and
psychological problem.
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Somatoform
Disorders - the physical symptoms suggest a
medical condition, but in the absence of objective clinical
findings, the disorder is judged to be not physical but
Somatoform. The disorder resembles a physical problem. The
patient, however, either does not have the disorder or his/her
symptoms are markedly more extreme than would be indicated by the
physical findings.
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Factitious
Disorders - are not synonymous with
fictitious. Factitious is not the same as the act of malingering.
Malingering does not constitute a mental disorder; factitious
disorder does constitute impaired psychological functioning.
Factitious Disorder involves voluntary amplification or production
of physical and psychological symptoms due to internal motivation,
an unconscious need to maintain oneself in the role of patient.
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Sleep
Disorders - Sleep disorders can be primary in
which there is a defect in the sleep timing mechanism (sometimes
called sleep architecture) called dyssomnias and by parasomnias
which includes nightmare disorder. Sleep disorders may also arise
from medical conditions, another psychological problem such as
anxiety and/or depression or even induced by substance (Eg.
alcohol).
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Eating
Disorders - severe disturbances in eating
behavior. Obesity, while a health hazard, has not itself been
shown to be associated with a psychological disorder. Eating
disorders include anorexia nervosa and bulimia nervosa. In both
disorders there is a disturbance in the perception of body shape
and weight.
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Adjustment
Disorders - arise in response to one or more
stressors that occur within three months of the onset of the
patient's symptoms. The symptoms can be emotional and/or
behavioral. It is characterized a significant impairment in social
and/or occupational functioning.
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Personality
(Characterological) Disorders - refers to an
enduring pattern of experience and behavior that differs
from the expectancies of your culture. It may manifest itself as
problems in the ways you interpret events around you, the way in
which you express your emotions, the means by which you interact
with others or how you handle your impulses. People with a
personality disorder display their maladaptive patterns in a range
of social and interpersonal interactions, and the pattern causes
problems in social and occupational functioning.
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Impulse
Control Disorders - the failure to resist an
impulse, drive or temptation to perform an act that may be harmful
to self or others and is followed by pleasure and relief and then
often followed by guilt and remorese.
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Malingering
- Although not a psychological disorder, malingering is a pattern
of behavior that is particularly distressing. The deliberate
exaggeration of psychological and/or physical complaints for
purposes of tangible gain (Eg. monetary rewards, etc) is referred
to as malingering. The use of the health care system and its
resources are severely impacted by patients who malinger. Access
to clinicians by patients with valid concerns can be obstructed as
well as costs escalated by needless tests for falsified symptoms.
Definition:
Personality Disorder refers to an enduring pattern of experience
and behavior that differs from the expectancies of your culture. It
may manifest itself as problems in the ways you interpret events
around you, the way in which you express your emotions, the means by
which you interact with others or how you handle your impulses. People
with a personality disorder display their maladaptive patterns in a
range of social and interpersonal interactions, and the pattern causes
problems in social and occupational functioning.
Paranoid
Personality Disorder is characterized by a pervasive distrust
and suspiciousness of others. The motives of others are seen as evil.
There is not sufficient justification for their believe that they are
being harmed, exploited or deceived. They are preoccupied with doubts
of loyalty and trustworthiness of others and they are unlikely to
confide in others because they believe data will be used against them.
Such individuals, by adulthood, read critical or threatening meaning
into benign events or remarks. They bear grudges for even minor
insults and are quick to anger and counterattack. Not infrequently,
they believe that they are being betrayed by their sexual partner.
Most often such individuals do not perceive themselves as having a
problem and that any suggestion that they need assistance is proof to
then that they are, indeed, under attack.
Schizoid
Personality Disorder: represents a pattern of detachment from
relationship and a restricted range of emotional expression beginning
by adulthood. The individual prefers solitary activities, has little
sexual interest, lacks close friends, does not seek to be part of a
family, appears indifferent to both praise and criticism and seems
aloof, cold and remote with little emotional variability.
Schizotypal
Personality Disorder: characterized by a pervasive pattern of
social and interpersonal deficits. The person is uncomfortable and has
minimal capacity for close relationship. Such individuals may have
eccentricities in thought and behavior as well as perceptual
distortions. They may have exceptionally odd or superstitious beliefs,
strange sensations and concepts as to the functioning of their bodies,
unusual patterns of speech, be excessively suspicious and unable to
adequately express emotions. They have few friends and appreciable
social anxiety arising from their fears of others. This pattern is
noted by early adulthood and results in a very constricted and
isolated lifetyle.
Antisocial
Personality Disorder: refers to a developmental defect in an
individual over 18 years of age in which the individual fails to
conform to the lawful restrictions of society is deceitful for
purposes of pleasure and/or profit acts upon impulse, is irritable if
not aggressive, shows a disregard for others is irresponsible in work
and honoring financial promises lacks remorse for what he/she has
done; does not benefit from past punishment. There is evidence of a
conduct disorder prior to age 15, and the problem is not due to some
mood or thought disorder.
Borderline
Personality Disorder is characterized by unstable and intense
relationships, fluctuating self-image, impulsive self-damage (such as
substance abuse or sexual excesses), emotional instability, intense
anger, suicidal gestures and often paranoid ideation. Borderline
patients do not know the true cause of their mood swings, dysphoric
periods or self-destructive tendencies. They will falsely attribute
causation to others, to outside events or to circumstances other than
their own fragile personality development.
Histrionic
Personality Disorder: these individuals are shallow and attention
seeking. They need to be the center of attention, and they are often
seductive with rapidly shifting superficial emotional expression. They
misassess their relationships, are self-dramatizing and attempt to
draw attention to themselves by their physical appearance. There is
additional discussion of this personality disorder in the January,
1998 issue of The Psychological letterŪ.
Narcissistic
Personality Disorder is characterized by a pervasive pattern
of self-involvement, need for admiration, lack of concern for others
and a inflated sense of self-importance. Such individuals overestimate
their accomplishments and are offended when they are not praised for
their efforts. In turn, they underestimate the accomplishments of
others. They feel that their rewards are long overdue. They see
themselves as special and/or unique and seek to identify themselves
with famous individuals. They feel that they are understood only by
unique or gifted people who are, in some way, special. They feel that
ordinary people are not competent to understand them. Yet their
self-image is fragile, and they are continually concerned with how
they measure when compared to others. They have a great sense of
entitlement. They expect to be indulged and may be enraged when this
does not occur. Because of this sense of entitlement, they are not
made uncomfortable by exploiting others to insure their needs are met,
and they appear to care little for the distress of others even when
they are the cause of this distress. The are preoccupied with envy,
yet often misperceive that others are envious of them. They not only
devalue others but are patronizing or disdainful of them.
Avoidant
Personality Disorder is characterized by fears of criticism
and disapproval. The person mobilizes all resources to insure that
they are not rejected and are preoccupied with the fears/thoughts of
rejection. Likely for some individuals this spontaneously subsides
when success experiences occur. However, your son is in his mid-teens
and many valuable social experiences are being avoided due to fear of
rejection. It sounds as though you are concerned that this will not
merely subside but is, in fact, increasing over time.
Dependent Personality Disorder refers to those individuals who feel
helpless when being left alone, fearing that they will not be able to
care for themselves, and such individuals will seek another
relationship as soon as the one they are in reaches closure. Such
individuals may have difficulty making every day decisions without
seeking advice from others. They seek someone to assume responsibility
for major areas of their life, will volunteer to do unpleasant tasks
to insure that they receive support from others, and often have fear
of expressing disagreement due concerns over disapproval. Such
individuals display this as a pervasive submissive and clinging
behavior.
Obsessive-Compulsive
Personality Disorder is a developmental defect in which there
is a preoccupation with control and orderliness. The person is often
inflexible/stubborn and may be more invested in work than family,
friends or leisure. Such individuals become detail orientated, and,
for them, organization has more importance that the larger picture of
their lives. Such individuals often cannot allow others to work
effectively, concerned that others cannot work as precisely or
efficiently as they. This need for control can be all consuming such
that the very quality of life, especially family life, is undermined.
Sadistic,
Masochistic, Self-Defeating, Depressive Personality Disorder...(personality
disorders requiring further scientific study for adequate definition)
The term passive-aggressive, currently is used somewhat
interchangeably with the term "negativistic personality
disorder." The term "passive" was/is somewhat confusing
and is meant to imply that the individuals resistance to fulfilling
social and occupational demands is indirect and characterized by
intentional inefficiency, dawdling and procrastination. The person
will often complain of personal misfortune and alternates between
being hostile and then apologetic. The person is critical of
authority, is sullen and argumentative and sees himself/herself as
being misunderstood and unappreciated. When this pattern characterizes
the majority of the individuals interactions, we think of it as a
pervasive personality pattern (disorder)
Depressive Personality Disorder differs from major
depressive disorder and is not episodic in nature, and the symptoms
are not as severe. It is characterized by a pervasive sense of
dejection, cheerlessness, and unhappiness. These gloomy and joyless
individuals feel inadequate and worthless. Their low self-esteem is
displayed as being critical, self-blaming and derogatory. They brood,
worry, are judgmental of others and are prone to periods of guilt and
remorse. Since this is a developmental defect, the impact of
antidepressant medications is currently unknown. Psychological care is
complicated by the patients not being wholly compliant with ongoing
care.
Personality
Disorder Not Otherwise Specified although there are
individuals who meet only the criteria for a specific personality
disorders. There are individuals who do not meet the criteria for a
specific personality disorder and have mixed symptoms of more than one
disorder and the combination of those symptoms causes impairment in
social and occupational functioning. These mixed disorders are
sometimes described as Personality Disorder Not Otherwise
Specified with (for example) paranoid features and
obsessive-compulsive and narcissistic traits. There are individuals
who meet the full diagnostic criteria for more than one personality
disorder and are diagnosed as having (for example) both Dependent
Personality Disorder and Histrionic Personality Disorder. The others
that fall into this "not otherwise specified" classification
are those that we have previously discussed such as individuals with
passive- aggressive or depressive personality characteristics.
