Chapter 8 Somatoform disorders can be classified as a group of physical ailments which may not have conventional physiological basis but rather psychological basis. Such disorders may fail to get explained by any medical disorder, any other mental disorder or even substance abuse. However, the medical symptoms the patients seem to exhibit or complain about may stem from both psychological as well as medical condition. The diagnosis is critical over here as proper discerning has to be done between physical or psychological source to ascertain the actual cause of the symptoms.
Hypochondriasis is one such challenge which is characterized by being overcome and agitated by a constant preoccupation of symptoms of ailment or a series of medical conditions being present in the patient which actually doesn’t get confirmed by any medical tests or diagnosis. The fear of being sick is so much that the patient becomes incapable of leading a normal healthy life. Somatization Disorder is rather a chronic disorder where the patient feels the symptoms in real in various parts of the body and there isn’t any kind of pretensions. But such symptoms also fail to indicate any medical condition.
Pain disorder is another such somatoform disorder which causes enough pain in certain anatomical parts of the body but fails to give any substantial medical condition to be the source of pain. In conversion disorder which is also a somatoform disorder the patient’s voluntary movements and senses are highly affected. In contrast to the above types of conditions where the patient isn’t pretending malingering and factitious disorders are characterized by symptoms which are deliberately faked or pretended with (as in case of malingering) or without (as in case of factitious) any plausible motives. Body Dysmorphic disorder is characterized by the patient’s extreme preoccupation with a made-up or slight defect on the face or any other localized area enough to render him incapable of performing normal activities. Dissociative disorders are characterized by breaks in memory, awareness, identity and may be even perception. Chapter 9 Eating disorder is a condition in which the patient may either eat too less or too much thus causing severe dietary imbalances that may eventually cause extreme physical ailments or obesity.
The most common eating disorders are Anorexia Nervosa, Bulimia and Binge Eating. Factors like age of onset and gender differences fall under the various clinical aspects of eating disorders. Anorexia Nervosa is characterized by extreme small intakes of food and self starvation leading to extreme weight loss. Bulimia Nervosa is characterized by excessive eating but using inappropriate methods like self induced vomiting, extreme exercise or laxatives and diuretics to maintain ideal weight. Binge eating disorder consists of excess overeating which can become compulsive and the patient has no control over it. There is usually a psychological aspect like stress, need for approval or depression that usually triggers such conditions.
Various health risks may be associated with eating disorders like remaining extremely unwell, health complications, challenged immune system and even sudden death due to starvation. Bulimia may cause electrolyte imbalance and hydrokalemia, heart abnormalities, hand calluses and so on. Causal factors include biological, socio cultural factors and family environment.Treatment of eating disorders consists mainly of removing the thoughts which trigger such behaviors.
Cognitive Behavior Therapy is very effective and anorexia patients must be first brought to healthy weight. Family therapy is also a better option to treat such disorders. Causal factors of obesity include biological factors, psychosocial factors, socio-cultural factors and also learning perspective. Risks of obesity are numerous including both psychological and physiological risks. Heart diseases, stroke, hypertension, pulmonary insufficiencies, arthritis and various other diseases become more incident with obesity. Treatment of obesity is difficult and treatments include psychological treatment for behavior management, dietary changes, medications and also joining weight-loss groups.
Hence, preventing obesity is rather a better choice. Chapter 10 Personality Disorders are a cluster of mental disturbances that affect the individual’s thinking pattern, behavior pattern and render him incongruent in relation to various situations, individuals and even to himself. These disorders are usually long standing and are characterized by chronic dysfunctional patterns. Chronic interpersonal difficulties and problems regarding the sense of the self are the two most significant characteristics of personality disorders.
Clinical aspects of personality disorders include being pervasive and inflexible while being stable and of long standing. Significant distress is caused in at least two of the following areas which are cognition, impulse control, affectivity and interpersonal relations. Distress is caused both to others and the self. Personality disorders are a result of continuous maladaptive thinking about and relating to the world. However, there are certain difficulties in doing research on personality disorders which include difficulties in diagnosing personality disorders and difficulties in studying the causes of personality disorders.
Personality Disorders are classified into Cluster A, Cluster B and Cluster C. Cluster A includes paranoid, schizoid and schizotypal disorders. Cluster B includes histrionic, narcissistic, antisocial and borderline disorders while cluster C includes avoidant, dependent and obsessive-compulsive disorders. Treatment of personality disorders is often challenging and difficult given the characteristics of the same.
Specific disorders may be treated by adapting therapeutic techniques in particular ways. Treatment of cluster A and B disorders like shizotypal doesn’t seem very promising while treatment of cluster C disorders like dependent and avoidant seem to be more promising. Antisocial Personality Disorder is characterized by pervasive pattern of disregard for and violation of others rights. This is done through continuous deceitful, aggressive and antisocial behaviors.
Psychopathy is often misleading as psychopaths may seem charming and friendly on the surface but may be highly manipulative and deceitful underneath who may be using others ruthlessly to fulfill their own motives. They lack sense of outcomes and may sometimes even be aggressive and remorseless.
