Disorders

INTRODUCTION

Defining Abnormal Behaviour

As we launch out on this our investigation of Somatoform Disorders, it must be deemed important to have some idea regarding what psychologists see a 'disorder' and why. Even before this, however, we must grasp the concept of abnormal behaviour as it leads to the diagnosis, treatment, and cure of a disorder.

There have been so many definitions offered regarding abnormal behaviour that they have been classified as follows:

a) The Conceptual Definitions: These define abnormal behaviour as, "A deviation from what is considered normal or most prevalent in the sociocultural context" (Sue, Sue, and Sue 1997). Here, the basis of the diagnosis of normality or abnormality is found by the use of statistical data, which will highlight the most common behaviour patterns (labeling them as 'normal'), and isolating the least common ones (referring to those as 'abnormal'). It is said that these statistics form the basis for diagnosing a mental disorder.

b) The Practical Definitions are based on clinical standards regarding the effect of the behaviour on the person exhibiting it and others around him or her. This seems logical because it is these effects that bring the problem to the attention of medical doctors and psychologists.

c) Integrated Definitions: This refers to a particular set of definitions of abnormal psychology that carry different implications. The first states that there is no such thing as mental illness but "problems of living" (Thomas Szasz, 1987). The second definition states that abnormal behaviour occurs where there is a, "Failure of a mental mechanism to perform a natural function for which it was designed by evolution" (Wakefield, 1992).

d) The DSM-IV Definition describes abnormal behaviour as that which departs from some norm and that harms the affected individual and others.

NOTE!

The diagnosis of a disorder will only be made if a particular abnormal behaviour pattern has been in existence consistently over a specific time-period.

Somatoform Disorders are diagnosed in the face of physical symptoms that seem as if they are part of a general medical condition, however no general medical condition, other mental disorder, or substance is present (http://www.askjeeves.com). It tends to occur because of some psychological conflict or need (Sue, Sue, and Sue, 1997). The DSM-IV classification states that for an accurate diagnosis to be made, the symptoms must cause clinically significant distress or impairment in social, occupational, or other areas of functioning. {These disorders are often first encountered in general medical settings because of the physical symptoms that are thought to exists!}

There are several classifications of Somatoform Disorder, which include the following:

i) Somatization Disorder,

ii) Undifferentiated Somatoform Disorder,

iii) Conversion Disorder,

iv) Pain Disorder,

v) Hypochondriasis,

vi) Body Dysmorphic Disorder, and

vii) Somatoform Disorder Not Otherwise Specified (DSM-IV)

SOMATIZATION DISORDER

This is diagnosed when there is a pattern of recurring, multiple, and 'clinically significant' bodily complaints. The term 'clinically significant' is used in this way to describe a situation where medical treatment (the taking of medication) is required, or where significant interference occurs regarding social, occupational, or some other important area of functioning.

If a diagnosis for this disorder is to be deemed accurate, then it must take the following criteria into consideration:

Ð"? The complaints must begin before the patient is 30 years old, and occur over a period of several years.

Ð"? There must be a history of pain located at, at least, four sections of the body (e.g. the head, abdomen, back, joints, extremities, chest, etc.), or pain associated with menstruation, sexual intercourse, or urination.

Ð"? Two gastronomical complaints e.g. nausea, diarrhea, and bloating.

Ð"? One sexual symptom, such as sexual indifference, irregular menstruation, or erectile dysfunction.

Ð"? There also must be a history of at least one symptom, other than pain, that suggests a neurological condition e.g. lack of coordination and balance, paralysis, hallucinations, ect.

Persons who are afflicted with this disorder tend to describe their symptoms in exaggerated terms, but with very little specific information. They often seek treatment from several physicians at the same time, which tend to lead to complicated and sometimes hazardous combinations of treatment.

Common behaviour patterns seen in persons affected by somitization disorder (or hysteria, as it was formally called) include:

Ð'§ Impulsive behaviour

Ð'§ Antisocial behaviour

Ð'§ Suicide threats

Ð'§ Suicide attempts

Ð'§ Marital discord

Somatization Disorders are very rare having a "prevalence rate" of only 2%. It has been found to affect females more than it does males, Blacks more than any other race, and it is twice as likely to occur among persons with less than a high school education (Sue, Sue, and Sue, 1997).

UNDIFFERENTIATED SOMATOFORM DISORDER

The essential feature of this disorder, according to the DSM-IV, is that there are complaints of chronic fatigue, loss of appetite, gastrointestinal or genito-urinary symptoms that persist for six months or more.

CONVERSION DISORDER

Persons with this type of disorder will complain about problems affecting motor functions (paralysis, loss of vocals and balance, weakness, urinary retention), as well as sensory functions (loss of feeling, loss of pain sensation, impaired sight and