-
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.
-
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.
-
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.
-
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.
-
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.
-
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.
-
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).
-
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.
-
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.
-
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.
-
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 remorse.
-
Tic
Disorders
-
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.
