5 Steps to a 5 AP Psychology, 2010-2011 Edition (62 page)

Somatoform disorders are characterized by physical symptoms such as pain, paralysis, blindness, or deafness without any demonstrated physical cause. Somatoform disorders are different from psychosomatic disorders such as ulcers, tension headaches, and cardiovascular problems. Although the causes of both somatoform and psychosomatic disorders are psychological and the symptoms are physical, with somatoform disorders, no physical damage is done. Somatoform disorders include somatization disorder, conversion disorder, and hypochondriasis.

•
Somatization disorder
is characterized by recurrent complaints about usually vague and unverifiable medical conditions such as dizziness, heart palpitations, and nausea, which do not apparently result from any physical cause. To be classified as having a somatization disorder, an individual needs to have complained about, taken medicine for, changed lifestyle because of, or seen a physician regarding many different symptoms.

•
Conversion disorder
(known as
hysteria
in the Freudian era) is characterized by loss of some bodily function, such as becoming blind, deaf, or paralyzed, without physical damage to the affected organs or their neural connections. It is often marked by indifference and quick acceptance on the part of the patient. The symptoms usually last as long as anxiety is present.

• Suffering from
hypochondriasis
, a person unrealistically interprets physical signs—such as pains, lumps, and irritations—as evidence of serious diseases. The person consequently becomes anxious and upset about the symptoms. You probably know someone who thinks a headache is a sign that he/she is developing a brain tumor or that a bit of scar tissue is the beginning of cancer. Hypochondriasis differs from somatization in that those with hypochondriasis show excessive anxiety about only one or two symptoms and the implications they could have for potential future diseases.

Psychoanalyst Sigmund Freud’s explanation attributes somatoform disorders to bottled-up emotional energy that is transformed into physical symptoms. Behaviorists explain that
operant responses are learned and maintained because they result in
rewards
. Cognitive behaviorists continue that the rewards enable individuals with somatoform disorders to avoid some unpleasant or threatening situation, provide an explanation or justification for failure, or attract concern, sympathy, and care. Social cognitive theorists think that individuals with somatoform disorders focus too much attention on their internal physiological experiences, amplifying their bodily sensations, and forming disastrous conclusions about minor complaints.

Dissociative disorders are psychological disorders that involve a sudden loss of memory (amnesia) or change in identity. If extremely stressed, an individual can experience separation of conscious awareness from previous memories and thoughts. Dissociative disorders include dissociative amnesia, dissociative fugue, and dissociative identity disorder.

•
Dissociative amnesia
is a loss of memory for a traumatic event or period of time that is too painful for an individual to remember. The person holds steadfast to the fact that he/she has no memory of the event and becomes upset when others try to stimulate recall. In time, parts of the memory may begin to reappear. A woman whose baby has died in childbirth may block out that memory and perhaps the entire period of her pregnancy. When more emotionally able to handle this information, the woman may gradually come to remember it.

•
Dissociative fugue
is a memory loss for anything having to do with personal memory. It is accompanied by flight from the person’s home, after which the person establishes a new identity. All skills and basic knowledge are still intact. The cause of the fugue is often abundant stress or an immediate danger of some news coming out that would prove embarrassing to the individual.

•
Dissociative identity disorder
(DID), formerly called multiple personality disorder, is diagnosed when two or more distinct personalities are present within the same individual. Although extremely unusual, it is most common in people who have been a victim of physical or sexual abuse when very young. Amnesia is involved when alternate personalities “take over.” Missing time is one of the clues to this diagnosis. Each alternate personality has its own memories, behaviors, and relationships, and might have different prescriptions, allergies, and other physical symptoms. Although there has been some interesting work done by the National Institute for Mental Health that lends credibility to this diagnosis, many professionals are still skeptical about it.

Psychoanalysts explain dissociative disorders as repression of anxiety and/or trauma, caused by such disturbances of home life as beatings, rejection from parents, or sexual abuse. Many social learning theorists are skeptical about DID, and think that individuals displaying the disorder are role playing. They question why dissociative identity disorder, also known as multiple personality, has become so much more prevalent since publication of books and production of films dealing with the disorder, and why different personalities pop out, in contrast to years ago when alternate personalities emerged very slowly.

Mood disorders are psychological disorders characterized by a primary disturbance in affect or mood that colors the individual’s entire emotional state. This disrupts the person’s normal ability to function in daily life. Two types of mood disorders are unipolar (depressive) and bipolar (manic-depressive) disorders. Most are treated at least in part by drugs, suggesting a biological etiology or cause. The prevalence of depression has been increasing, affecting at least twice as many women as men.

Because it occurs so often, depression has been called the “common cold of psychological disorders.”

•
Major depressive disorder
, or unipolar depression, involves intense depressed mood, reduced interest or pleasure in activities, loss of energy, and problems in making decisions for a minimum of 2 weeks. The individual feels sad, hopeless, discouraged, “down,” and frequently isolated, rejected, and unloved. In addition to this sadness, there are a series of changes in eating, sleeping, and motor activity, and a lack of pleasure in activities that usually caused pleasure in the past. Cognitive symptoms include low self-esteem, pessimism, reduced motivation, generalization of negative attitudes, exaggeration of seriousness of problems, and slowed thought processes. Suicidal thoughts, inappropriate guilt, and other faulty beliefs may also be present.

•
Depression with seasonal pattern
, also known as
seasonal affective disorder
, is a type of depression that
recurs
, usually during the winter months in the northern latitudes. One hypothesis why this happens is that shorter periods of and less direct sunlight during winter disturbs both mood and sleep/wake schedules, bringing on the depression.

•
Bipolar disorder
is characterized by mood swings alternating between periods of major depression and mania, the two poles of emotions. Symptoms of the manic state include an inflated ego, little need for sleep, excessive talking, and impulsivity.
Rapid cycling
is usually characterized by short periods of mania followed almost immediately by deep depression, usually of longer duration. Newer drug treatments, including lithium carbonate, have proved successful in bringing symptoms under control for many sufferers.

Biological psychologists have evidence from family studies, including twin studies, that there is a genetic component involved in mood disorders. Too much of the neurotransmitter norepinephrine is available during mania, too little of norepinephrine or serotonin during depression. Prozac, Zoloft, and Paxil increase availability of serotonin by blocking reuptake. PET and fMRI scans reveal lowered brain energy consumption in individuals with depression, especially in the left frontal lobe, associated with positive emotions; and MRI and CAT scans show abnormal shrinkage of frontal lobes in severely depressed patients. Psychoanalysts attribute depression to early loss of or rejection by a parent, resulting in depression when the individual experiences personal losses later in life and turns anger inside. Behaviorists say that depressed people elicit negative reactions from others, resulting in maintenance of depressed behaviors. The social cognitive (cognitive-behavioral) perspective holds that self-defeating beliefs that may arise from
learned helplessness
influence biochemical events, fueling depression. Learned helplessness is the feeling of futility and passive resignation that results from inability to avoid repeated aversive events. According to psychologist Martin Seligman, a negative explanatory style puts an individual at risk for depression when bad events occur. When bad events happen, people with a negative (pessimistic) explanatory style think the bad events will last forever, affect everything they do, and are all their fault; they give stable, global, internal explanations. Cognitive viewpoints include Aaron Beck’s theory (cognitive triad) that depressed individuals have a negative view of themselves, their circumstances, and their future possibilities, and that they generalize from negative events; and Susan Nolen-Hoeksema’s rumination theory that depressed people who ruminate are prone to more intense depression than those who distract themselves.

Schizophrenia is a broad umbrella of symptoms and disorders characterized by
psychosis
or lack of touch with reality evidenced by highly disordered thought processes. Patients with schizophrenia can show abnormal thinking, emotion, movement, socialization, and/or perception. Because one cause of schizophrenia is an excess of dopamine, anti-psychotic drugs are effective
in treating some symptoms in about 50% of the sufferers. A positive symptom of schizophrenia isn’t something that is good, but a behavioral excess or peculiarity rather than an absence. Delusions and hallucinations, two frequent signs of schizophrenia, are both positive symptoms.
Delusions
are erroneous beliefs that are maintained even when compelling evidence to the contrary is presented.
Hallucinations
are false sensory perceptions, such as the experience of seeing, hearing, or otherwise perceiving something that is not present. Lack of emotion, sometimes called flat affect; social withdrawal; apathy; inattention; and lack of communication are examples of negative symptoms of schizophrenia. Four types of schizophrenia are disorganized, catatonic, paranoid, and undifferentiated.

• Symptoms of
disorganized schizophrenia
include incoherent speech, inappropriate mood, hallucinations, and delusional thought patterns. People with disorganized schizophrenia may make no sense when talking and act in a very bizarre way that is inappropriate for the situation (e.g., laughing in the back of the church during a funeral). Silly, childlike behavior is typical.

•
Paranoid schizophrenia
is characterized by delusions of grandeur, persecution, and reference. The delusions typically form an elaborate network resulting from misinterpretation of reality. For example, people with paranoid schizophrenia often think that they are special and have been selected for exceptional attention (delusions of reference). They often misinterpret occurrences as directly relevant to them, such as lightning being a signal from God. They frequently believe that such attention is because of their specialness, and that they are world leaders (delusions of grandeur). They then think that others are so threatened that these other people plot against them (delusions of persecution). Suffering delusions of persecution, people are fearful and can be a danger as they attempt to defend themselves against their imagined enemies.

•
Catatonic schizophrenia
is characterized by disordered movement patterns, sometimes immobile stupor or frenzied and excited behaviors. People suffering from this disorder might remain in one position, becoming “statues” with what is called
waxy flexibility
or holding postures that would normally be impossible to maintain by others.

•
Undifferentiated
or
simple schizophrenia
is marked by disturbances of thought or behavior and emotion that do not fit neatly into any of the above categories. One area of dysfunction is noted and yet the person may be perfectly normal in every other aspect of life.

Biological psychologists attribute some positive symptoms of schizophrenia, such as hallucinations and delusions, to excessively high levels of the neurotransmitter dopamine, and some negative symptoms, such as lack of emotion and social withdrawal, to lack of the neurotransmitter glutamate. Brain scans show abnormalities in numerous brain regions of individuals with schizophrenia. These abnormalities may result from teratogens such as viruses or genetic predispositions. The
diathesis-stress
model holds that people predisposed to schizophrenia are more vulnerable to stressors than other people. Thus, only people who are both predisposed and also stressed are likely to develop schizophrenia. Psychoanalysts attribute schizophrenia to fixation at the oral stage and a weak ego. Behaviorists assume that schizophrenia results from reinforcement of bizarre behavior. Humanists think schizophrenia is caused by lack of congruence between the public self and actual self.

Schizophrenia is NOT split personality! People with schizophrenia experience a split with reality. People with dissociative identity disorder show two or more personalities.