In accordance to the Diagnostic and Statistical Manual of Mental Disorders, biological, emotional, cognitive, and behavioral components of anxiety, mood/affective, and dissociative/somatoform disorders have been analyzed and reviewed in regards to abnormal and normal behavior. What are their foundations are and how do they differ?
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To Thine Own Self Be True
When Polonius is about to send his son Laertes off to Paris to spy on Hamlet he gives him this sage advice: This above all: to thine own self be true, And it must follow, as the night the day, Thou canst not then be false to any man. Farewell, my blessing season this in thee! Hamlet Act 1, scene 3, 78-82 What Polonius seems to be telling his son is that the way forward, no matter what befalls him and what he may come up against, the only way to be fair to himself and to others is know himself and to be true to that knowledge. In following this advice he may just be able to survive the craziness of the events that are about to submerse him and at the very least in the end he will still know who he is and where he belongs.
This ability to know them selves and control their outcomes is compromised in individuals who suffer from somatic, dissociative, unipolar and bipolar depression. To be true to self and to be their true self is the ultimate challenge. All four of these conditions are considered indicative of some level of intrapersonal conflict. In the case of somatic and dissociative disorders, there may be some level of trauma involved. These factors would argue for a biopsychosocial perspective in the development and diagnosis of somatic and dissociative disorders and unipolar and bipolar depression. In distinguishing between the various components of these disorders, it is useful to look at how each disorder presents itself and the symptoms involved.
Somatoform disorders are psychological disorders whose symptoms are exhibited physiologically. The word somatic itself means affecting the body as distinct from the mind. It is, like dissociation, an anxiety disorder. In essence, the patient suffering from psychological stress and anxiety develops physiological symptoms that have no medical foundation or cause. The DSM IV (Diagnostic and Statistical Manual) divides these disorders into to distinct categories – hysterical and preoccupation.
Hysterical Somatoform Disorders
A patient with a hysterical somatoform disorder will exhibit physical changes as a result of their psychological condition. These disorders are difficult to diagnose because they may be hard to distinguish from real organic biological disorders and may result in miss diagnosis on both ends of the spectrum. To help make the diagnosis a medical doctor may have to match the symptoms to what is known about the systems, operation and organization of the human body and ferret out inconsistencies. There are three hysterical somatoform disorders. A brief description of each follows.
Conversion disorder is a condition in which psychosocial conflict or need is converted into physical ailment or impairment, such as, paralysis, blindness or numbness. The DMV IV indicates the following conditions to validate this diagnosis:
- One or more physical symptoms or deficits affecting voluntary motor or sensory function that suggest a neurological or other general medical condition.
- Psychological factors judged to be associated with the symptom or deficit.
- Symptom or deficit not intentionally produced or feigned.
- Symptom or deficit not fully explained by a general medical condition or a substance.
- Significant stress or impairment.
This rare diagnosis affects women twice as much as men, appears suddenly, last for weeks, and usually is the result of extreme stress and last for weeks.
Somatization disorder, also known as Briquet’s syndrome, is a disorder that consists of recurring physical ailments that have little or no organic basis. Sufferers of the disorder will experience a number of ailments in these categories: pain symptoms (headaches, chest pains, and the like), gastrointestinal symptoms (nausea, diarrhea, for example), a sexual symptom (erectile difficulties, for example), and a neurological symptom (double vision, paralysis, for example) People with this disorder usually see many doctors in search of relief, and will exaggerate and dramatize their symptoms. Besides anxiety these patients also exhibit symptoms of depression. The DSM-IV lists the following for somatization disorder:
- History of physical complaints, beginning before the age of 30, that occur over a period of several years and result in treatment being sought or in significant impairment.
- Physical complaints over the period include: four pain symptoms, two gastrointestinal symptoms, one sexual symptom, and one neurological-type symptom.
- Physical complaints not fully explained by a known general medical condition or a drug, or extending beyond the usual impact of such a condition.
- Symptoms not intentionally produced or feigned.
The disorder runs in families and begins between early adolescence and young adulthood. Somatization disorder typically lasts for many years, and will not go away without therapy.
Pain Disorder Associated with Psychological Factors
The key symptom of pain disorder associated with psychological factors is pain. Psychosocial factors have an influence on the onset, severity, or continuation of pain. The DSM-IV describes the disorder as the following:
- Significant pain as the primary problem.
- Psychosocial factors judged to have the major role in the onset, severity, exacerbation, or maintenance of the pain.
- Symptom or deficit not intentionally …