Phobias are characterized by exaggerated, persistant, irrational, and disruptive fears of a particular object, a particular event, or a particular setting, or fears of a general kind of object, event, or setting. A fear is classified as a phobia either when it is substantially greater than what seems justified or when it has no basis in reality. People with phobias are aware that their fears are irrational and would like to overcome them, but they have a great deal of difficulty doing so. About 6% of the population say that their phobias are at least somewhat disruptive of their lives. Phobias can be specific, social, or complex.
Specific phobias are characteristics by marked, persistant, irrational fears of objects, such as spiders, snakes, rats, high places, and darkness. About 11% of the population reports a specific phobia at some point in their lifetime.
Social phobias are characterized by extreme fear of being criticized, of being embarassed, or of being otherwise subject to ridicule, such as when meeting new people or speaking in public. Slightly under 3% of the population reports such a phobia at some point in their lifetime.
Panic Disorder is characterized by brief, abrupt, and unprovoked but recurrent episodes during which a person experiences intense and uncontrollable anxiety. The person suddenly feels apprehensive or even terrified, experiencing difficulty breathing, heart palpitations, dizziness, sweating, and trembling. Persons with this disorder may fear either losing control of themselves or going crazy. They may fear they are having a heart attack. Panic attacks often lead to agorpahobia, because the individual is afraid of leaving his or her house will lead to a panic attack. Panic disorders afect about 1.5% of the population.
Generalized Anxiety Disorder is characterized by general, persistant, constant, and often debilitating high levels of anxiety; the anxiety is accompanied by physiological symptoms typical of a hyperactive autonomic nervous system, and that can last any length of time, from a month to years. The cause for such anxiety is difficult to identify. About 5% of people report experiencing this disorder at some point in their lives.
Stress disorders are characterized by an extreme reaction to a highly stressful event or situation, such as rape or combat. Stress disorders often are linked to adjustment disorders. Variations include posttraumatic stress disorder and acute stress disorder.
In posttraumatic stress disorder, a person experiences a psychological reenactment of a past traumatic event, such as recurring nightmares or repeated wakeful resurfacing of painful memories if the event while consciously engaged in other activities. He or she may experience flashbacks that are so strong that the person may believe that he or she is reliving the event. The event may be participation in a war or exposure to a disaster, such as flood, fire, earthquake, tornado, or serious accident. Some victims are so plagued by these recurrences that they may become apathetic and detatched.
In acute stress disorder, a brief mental disturbance arises in response to a traumatic event, lasting fewer than four weeks. Persons may experience a sense of detatchment from the physical and social worlds, distortions or other changes in perceptions, and disturbances of memory.
Obsessive-compulsive anxiety disorder is characterized by unwanted, persistent thoughts and irrisistible impulses to perform a ritual to relieve those thoughts. About 2.5% of the population is affected by this disorder.
An obsession is an unwanted, persistent thought, image, or impulse that cannot be suppressed. Obsessives are unhappy with the obsession and with being unable to keep it out of their minds. For example, one woman obsessively had thoughts that her children were being kidnapped.
A compulsion is an irresistible impulse to perform a relatively meaningless act repeatedly and in a stereotypical fashion. Compulsive persons are often aware of the absurdity of their behavior and yet are unable to stop it. Compulsive hand washers may wash their hands several hundred times a day. In addition to being time-consuming, compulsions can be costly to a person's well-being. Other common compulsions are counting things to make sure they are all there, checking the placement of objects, and checking that appliances are turned off.
Persons with major depression have persistent feelings for at least six weeks of sadness, discouragement, and hopelessness. It may seem to them that nothing is right with their lives. Typical cognitive symptoms of depression are low self-esteem, loss of motivation, and pessimism. Depressed people often generalize, so that a single failure, or an event that they interpret as indicating a failure, is assumed to foreshadow worse things. They often have a very low level of energy and may slow down their body movements and even speech. Typical somatic symptoms are difficulty in sleeping and in waking up, so that the person may have trouble falling asleep or may sleep most of the time.
Bipolar disorder, or manic-depressive disorder, is a mood disorder in which the individual alternatives between periods of depression and mania. When a person suffering from bipolar disease swings to the manic phase, the most prominent symptom of mania is a mood in which a person feels highly energetic and extrememly joyful. Manic persons may believe there is no limit to their possible accomplishments and may act accordingly (for example, one individual tried to climb Mount Everest as an impromptu outing, equipped with only a cotten jacket and a pocket knife). Manic individuals often have trouble focusing their attention and may move from one activity to another in quick succession. Occasionally, the manic person will suffer from other delusions - false beliefs that contradict known facts. Delusions may be the result of distorted thought processes. Manic individuals may spend money wildly, attempt to start numerous projects they cannot finish, or become hypersexual. Consequently, they may end up bankrupt, fired from their jobs, or divorced by their mates. On the other hand, persons who are experiencing mania have a greatly reduced need for sleep and tend to be immune from the fatigue that would hit most people after very strenuous periods of activity.
Personality disorders and most of the other psychological disorders described here are rarely life threatening. Depression can be, however, and severe depression often precedes suicide, or at least suicide attempts.
This type of schizophrenia is characterized by profound psychological disorganization. People with this type of schizophrenia may experience hallucinations and delusions, and their speech is often incoherent. For example, when a 23 year old schizophrenic was asked, "How have you been feeling?" he answered flatly, "I'm as sure as you can help me as I have ice cubes in my ears." People with disorganized schizophrenia show flat affect, and may grimace or have fatuous smiles for no particular reason. They may giggle in a childish manner, invent words, and experience rapid mood swings.
People with catatonic schizophrenia experience predominantly negative symptoms. These people often exhibit stupor and immobility for long periods of time. Victims often stare into space, seemingly detached from the rest of the world. Because catatonics move so little, their limbs may become stiff and swollen. This form of schizophrenia is less common today than it was in the past.
People with this kind of schizophrenia may have delusions of persecution, hearing voices criticizing them or threatening them. Or they may have delusions of grandeur, hearing voices tell them how wonderful they are. Paranoid schizophrenics are particularly susceptible to delusions of reference, taking an insignificant event and interpreting in as though it has great personal meaning to them.
Undifferentiated Schizophrenia
This is a catchall category used for schizophrenic symptoms either that do not quite fit any of the other patterns or that fit more than one pattern.
This is a diagnosis applied to persons who have had at least one schizophrenic episode and who currently show some mild symptoms but do not exhibit profoundly disturbed behavior.
Dissociative Amnesia is characterized by sudden memory loss of declarative knowledge and usually affects the recollection of events that took place during and immediately after a stressful event. In addition, the person has difficulty remembering most of his or her own important details, such as name, address, and family members. The amnesic is able to function relatively normally, though. The duration of the amnesia may be from several hours to several years. Recovery of the lost information is usually as rapid as the loss was, after which the episode ends and the memory loss is not repeated.
When suffering from dissociative fugue, a person responds to severe stress by starting a whole new life and experiencing total amnesia about the past. He or she assumes a new identity, may take a new job, and behaves as though he or she were a totally different person, perhaps even with a new personality. Recovery time is a variable. When a person does recover, he or she may not be able to remember anything that took place during the fugue.
Dissociative Identity Disorder
Dissociative identity disorder typically arises as a result of extreme early trauma - usually severe child abuse - and is characterized by the appearance of two or more identities (alters) within the same individual, in which each identity is relatively independent of the others, has a stable life of its own, and occasionally takes full control of the person's behavior. One personality may know about the existance of the others. Because this disorder seems to be linked to early emotional trauma, such as child abuse, it may begin early, when the child first experiences the serious emotional problem. The disorder is even more common in women than men, perhaps because of the greater likelihood that women will have been subjected to sexual abuse as children. Individuals with this disorder tend to have a rich fantasy life and are also susceptible to self-hypnosis. Once they discover, unconsciously, that they can create another identity through self-hypnosis, they are relieved of some of the emotional burden facing the primary identity. Later, when they confront an emotional trauma that cannot readily be handled by their existing identities, they create another identity to deal with the new problem. Persons who develop multiple personalities in childhood may not know about the other personalities until adulthood. Recovery takes extensive thereapy.
There is controversy over whether dissociative identity disorder really exists. Almost certainly, some cases that have been described as presenting this order have been misdiagnosed, especially in highly suggestible people. It has been suggested, for example, that some clients may wish to believe they suffer from this disorder or that therapists may implant the idea of this disorder in the clients. At present, therefore, we cannot say for sure whether the disorder is a genuine one or not.
Attention-Deficit Hyperactivity Disorder
Attention-deficit hyperactivity disorder (ADHD) is characterized by a difficulty in focusing attention for reasonable amounts of time. Children with this disorder tend to be impulsive and disruptive in social settings. They are often unable to sit still and constantly seem to be seeking attention. This disorder is much more common in boys than in girls and usually appears before age 7. As many as 3% to 5% of children may have this disorder. Psychologists do not know what causes this disorder, but it is generally believed to reflect an organic brain dysfunction. It is often treated with a stimulant called Ritalin. Because the prevalence of this disorder has grown over the last decade, some believe that the diagnosis is being abused by educators and parents who simply wish to make normally energetic and at times unruly children less troublesome.
Conduct disorders are characterized by habitual misbehavior, such as stealing, skipping school, destroying property, fighting, being cruel both to animals and to other people, and frequently telling lies. Children with this disorder may misbehave independently or in groups or gangs. This disorder is often a precursur to antisocial personality disorder, a disorder that frequently involves unlawful behavior and is discussed here.
Pervasive Developmental Disorder
Pervasive developmental disorder (PDD) is also known as autism. It is characterized by three main symptoms: (1) minimal or no responsiveness to others and seeming obliviousness to the surrounding world; (2) impairment in communication, both verbal and nonverbal; and (3) highly restricted range of interest, sitting alone for hours, immobility or rocking back and forth, and staring off into space. PDD occurs in only about 0.04% of the population and is four times as likely to occur in boys as in girls. Infants with PDD do not cry when left alone and do not smile when others smile at them. Even by age 5, many PDD children are unable to use language.
Many children with PDD show a striking lack of both intellectual development and speech development. Clinicians originally believed that PDD might be a childhood form of schizophrenia. They now believe that PDD and childhood schizophrenia are now different disorders. Children with schizophrenia often show a family history of schizophrenia, but those with PDD do not. Also, the drugs that alleviate symptoms of schizophrenia are not effective with PDD.
The individual is suspicious of others, expects to be poorly treated, and blames others for things that happen to him or her.
The individual had difficulty forming relationships with other people. He or she tends to be indifferent to what others think about, say about, or feel towards him or her.
Schizotypal Personality Disorder
The individual has serious problems with other people and shows eccentric or bizzare behavior. He or she is susceptible to illusions and may engage in magical thinking, believing that he or she has contact with the supernatural. This disorder may be a mild form of schizophrenia.
Borderline Personality Disorder
Victims show extreme instability in moods, self-image, and relationships with other people.
Narcissistic Personality Disorder
The individual may have an inflated view of himself or herself and is intensly self-centered and selfish in his or her personal relationships. The individual lacks empathy for others and often uses others for his or her own ends. He or she often spends time fantasizing about past and future successes.
Histronic Personality Disorder
The individual generally acts as though he or she is on stage, is very dramatic, and continually tries to draw attention to him- or herself. The individual is lavish in his or her emotional displays, but shallow in the depth of his or her emotions. He or she often has trouble in relationships and tends to be manipulative and demanding.
The individual is reluctant to enter into close personal relationships. He or she may wish for closeness but be so sensitive to rejection that he or she becomes afraid to be close to others. This individual often has very low self-esteem and devalues much of what he or she does.
Dependent Personality Disorder
The individual lacks self-confidence and has difficulty taking personal responsibility for himself or herself. The individual subordinates his or her own needs to those of loved ones, partly in fear of losing the loved ones if the individual's needs are expressed. He or she is extremely sensitive to criticism. This disorder is more common in women than in men.
Obsessive-Compulsive Personality Disorder
The individual displays excessive concern with details, rules, and codes of behavior; the individual also tends to be perfectionistis and to require everything be done just so; the individual further tends to be highly work oriented. He or she often has trouble relating to other people and tends to be cold and distant in interpersonal relationships. The disorder is more common in men than in women. (This disorder differs from obsessive-compulsive anxiety disorder, in which the person experiences feelings of dread if the compulsive behaviors are not performed.)
Antisocial Personality Disorder
The individual had a tendency to be superficially charming and appears to be sincere. In fact the individual is insincere, untruthful, and unreliable in relations with others. He or she has virtually no sense of responsibilty and feels no shame or remorse when hurting others. The individual also tends to process information in a way that views too many acts toward him or herself as aggressively motivated and in need of an aggressive response. The person is extremely self-centered and is incapable of genuine love and affection. Typically, people with this disorder are poised, calm, and verbally facile. This disorder can run in families. The evidence shows both genetic and environmental contributory factors. People with this disorder may have low natural baseline levels of arousal and may seek stimulation through antisocial means in order to arouse themselves and this make their lives less seemingly dull. This disorder is more common in men than in women. People with antisocial personality disorder are prone to run into trouble with the law.