Definition of the major DSM IV-TR categories of anxiety, somatoform, and dissociate disorders
The DSM IV-TR categorizes anxiety into post-traumatic stress disorder, acute stress disorder, obsessive-compulsive disorder, phobias, panic disorder and generalized anxiety disorder. According to Hansell & Damour, 2008, p.115), anxiety disorders arise when an individual encounters unpleasant emotions characteristic of sense of danger, and physiological arousal.
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Somatoform disorders include hypochondriasis, pain disorder, body dysmorphic disorder, and somatization. These disorders focus on complaints without physical reason, or legitimate and unintended symptoms (Hansell & Damour, 2008, p. 233).
The DSM categories of dissociative disorders are dissociative fugue, dissociative amnesia, dissociative identity disorder, and depersonalization disorder (Feinstein, 2011, p. 916. The classification of dissociative disorders under the DSM eliminates chances of misdiagnosis of the disorder with other categories such as schizophrenia and borderline personality (Mayou et al., 2005, p.853).
Examination of the various classifications of anxiety, somatoform, and dissociative disorders
Individuals suffering from anxiety, somatoform, and dissociate disorders experience fatigue, weakness, pain, and medical symptoms (Feinstein, 2011, p.917). The impact of these mental disorders varies from minor disturbance in the life of an individual to major problems in the daily activities of the person. Generalized anxiety disorder is chronic and persists for a long period. People who suffer from generalized anxiety disorder lack control over their anxiety. In most cases, muscle tension, fatigue, and restlessness appear.
Obsessive-compulsive disorder causes overwhelming persistence of some habitual behavior (Hansell & Damour, 2008, p.205). The most common anxiety disorder is acute stress disorder. Symptoms of acute stress disorder may arise from a natural disaster, or a sudden loss of a loved one or employment. Phobias involve persistent unreasonable fear. Acute stress disorders and post-traumatic stress disorders concern various anxiety symptoms happening in traumatic events.
Individuals suffering from somatoform experience gastrointestinal, pseudoneurological, and sexual symptoms with no physiological factors (Mayou et al., 2005, p. 799; Hansell & Damour, 2008, p.205). Pain disorders involve physical pain without any physiological cause. Hypochondriacs have tendencies of believing that they have a serious disease. The DSM created the category of somatoform disorders to cover conditions displaced by the changing classification (Feinstein, 2011, p.916).
People experience dissociative fugue when they start to wander in confusion. They lack the ability to recall their own identity or recognize their surroundings or their own family (Mayou et al., 2005, p. 813). Depersonalization disorder causes observable distress. The symptom of dissociative amnesia is an inability to remember personal information, particularly of stressful nature. Dissociative identity disorder involves at least two personality states that control the person’s behavior.
Summary of the biological, emotional, cognitive, and behavioral components of anxiety, somatoform, and dissociative disorders.
The biological aspects of anxiety disorders include the role of genetic factors, autoimmune processes, neurotransmitters, the limbic system, and the automatic nervous system (Hansell & Damour, 2008, p.142). Behavioral components include operant conditioning, classical conditioning, and modeling. The cognitive component involves negative distorted thoughts. Emotionally, people with anxiety disorders have tendencies of withdrawal. They experience emotional numbness or disengagement.
The biological components of somatoform and dissociation disorders are depression and anxiety. Hence, the same systems in the body form the focus of treatment. Emotionally, people suffering from somatoform and dissociation disorders repress their feelings on grounds that they are intolerable. The cognitive component of somatoform and dissociation disorders is the destructive interpretation of physical symptoms (Hansell & Damour, 2008, p.242). The behavioral components include reinforcements and social learning.
Brief overview of Mary’s post-traumatic stress disorder
Mary, a 37-year-old woman with three children enrolled for business classes at a neighboring college after her youngest child joined preschool. At a certain point, a stranger attacked Mary and raped her. Following the ordeal, Mary underwent medical treatment. She also reported the matter to the police. Fortunately, she came across the photograph of her assailant and the police arrested and jailed him immediately.
Although Mary’s assailant received a long jail term, Mary failed to recover emotionally. She experienced nightmares for months, in which a faceless man was pursuing her.
Mary never discussed the rape with anyone, not even her family or friends. She stopped attending her business classes due to lack of interest in the studies and the fear of going back to the place where a stranger raped her. Mary continued feeling nervous and edgy, even in her own home. Mary’s persistent fear and disturbances worried her husband so much that he advised her to seek therapy (Hansell & Damour, 2008, p.150).
Analysis of the biological, emotional, cognitive, and behavioral components of the disorder from the selected case
The emotional component of Mary’s case is her loss of enthusiasm in the business classes. She also experienced withdrawal as she evaded discussing the rape ordeal with her friends and family. Mary’s effort to avoid thinking and feeling about the rape resulted in general feelings of emotional disengagement or numbness. The biological component is the automatic nervous system. Mary found it difficult to get over the ordeal because it affected her nervous system.
The more she thought about it, the more she got nervous and edgy. The cognitive perspective (Hansell & Damour, 2008, p.242) relates to Mary’s persistent nightmares that a faceless man was pursuing her. She anticipated a similar ordeal in the future, despite her assailant having been put behind bars. The behavioral component relates to Mary’s avoidance of the business classes. The operant conditioning of her behavior is avoidance and escape. She refused to go back to college because of fear of experiencing rape again.
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Feinstein, A. (2011). Conversion disorder: advances in our understanding. Canadian Medical Association Journal, 183(8), 915-20.
Hansell, J. & Damour, L. (2008). Abnormal Psychology (2nd ed.). Hoboken, NJ: Wiley.
Mayou, R., Kirmayer, L. J., Simon, G., Kroenke, K., & Sharpe, M. (2005). Somatoform disorders: time for a new approach in DSM-V. American Journal of Psychiatry, 162(5), 847-855.