Types of Psychological Disorders - MCAT Social and Behavioral Sciences

Post-traumatic stress disorder occurs when a person who has gone through a significant trauma, a life-threatening accident, a natural disaster, or abuse shows stress symptoms that impair the person's ability to function. Psychosomatic disorder is a real, physical disorder that has a psychological cause. Tension headaches have real pain caused by muscle spasm, but stress and anxiety have a role in causing the symptoms. Schizophrenia is a form of psychosis in which there is a loss of contact with reality. MRI and PET scans show brain abnormalities and changes in function. Panic disorder runs in families, but whether it is due to genetics or environment is not clear. Panic disorder is characterized by sudden, brief attacks of intense fear that cause physical symptoms. Epileptic-like activity in the brain is thought to be the cause of intermittent explosive disorder which is characterized by recurrent episodes of aggression toward people or property.

Individuals with a panic disorder suffer from sudden, overwhelming and repeated attacks of terror, which can occur out of nowhere. Major changes in behavior and persistent anxiety over having further attacks are characteristic of panic disorders. Often external stimuli or internal thoughts can trigger these attacks.

The other choices are incorrect. The fear of no escape possibilities in crowded situations is considered to be one criteria of agoraphobia, not of panic disorder. The exaggerated fear of specific objects or situations is characteristic for phobic disorders, not of panic disorder. Last, generalized anxiety disorder is marked by the diffuse state of general worries and fears, which are not based on a specific object or event. This is not the best description listed to fit the characteristics for panic disorder.

Agoraphobia occurs when a patient fears situations that make them feel trapped, embarrassed, or helpless. They may fear an actual event or even simply the anticipation of an event. This is more likely to occur in a crowded area, such as a subway or metro bus, than it would simply interacting with a few strangers at a given time. In other words, they may experience a lack of desire to interact with strangers to avoid embarrassment, but that is not a situation in which they would feel trapped or helpless.

Social anxiety disorder is the correct answer. The fear is judged to be out of proportion to the actual risk of the social interactions and is causing significant impairment in occupational functioning, which is concerning for social phobia. Social anxiety disorder should be suspected when intense fear of social interactions, in which the individual may be scrutinized by others, is out of proportion to the actual threat of the social situation and causes significant impairment in important areas of functioning, and the fear is not better explained by some other mental disorder.

The manic and depressive phases of bipolar disorder can be treated with the mood stabilizer lithium. Lithium is used for the prevention of future depression and suicide and for the prevention of future mania. Schizophrenia is treated with antipsychotic medications. Medications to reduce nightmares, insomnia, and startle reactions are used in the treatment of post-traumatic stress disorder. Benzodiazepines and selective serotonin reuptake inhibitors (SSRIs) are used to treat panic disorders. SSRIs are also used to treat obsessive-compulsive disorder.

Cyclothymic disorder is a mild form of bipolar disorder where a person mood swings over a period of years that go from mild depression to elevated mood and excitement.

Individuals with any form of bipolar disorder will most likely experience some psychotic episodes. During manic episodes, they will have delusions of grandeur, racing ideas and speech, distractibility and high-risk behaviors. They generally sleep and eat less often during these episodes as well. A patient with cyclothymic disorder lacks the vegetative symptoms associated with major depressive disorders. They can concentrate normally and lack both suicidal ideations and feelings of worthlessness when "low."

The correct answer is mood, thinking, sleep, appetite, and behavior. Other functions, such as speech, memory, and movement do not appear different depending on whether the patient is depressed.

Affective disorders are a group of disorders marked by a disturbance of mood. Included in the category is major depression. People with major depression see nothing but sorrow in the future and may not wish to live anymore. Anxiety disorders are characterized by unreasonable anxiety or fear that is inappropriate to the circumstances and disrupts the person's life. Psychosomatic disorder is a real physical disorder that has a psychological cause, such as tension headaches. Dissociative disorder is a type of personality disorder that involves a disassociation of past experiences from present memory. The origin of dissociative disorders is a need to escape extreme trauma, usually some form of abuse. Impulse control disorders are an inability to resist an impulse to perform an action that is harmful to others. Includes in this category are kleptomania and pyromania.

In obsessive-compulsive disorder (OCD), patients have obsessions and compulsions. The obsessions are recurrent thoughts, fears, images, or impulses. The compulsions are recurrent, irresistible actions such as counting, hand washing, or systematically arranging things. People with schizophrenia have hallucinations and suffer from delusions. When there is no identifiable physical cause to explain physical symptoms, a somatoform disorder may be the diagnosis. People who lie, cheat, steal, and have no sense of responsibility exhibit the symptoms of antisocial personality disorder. Impulse control disorders are an inability to resist an impulse to perform an act that is harmful to the individual or others. Substance abuse and chemical dependence fall under this category.

People with obsessive-compulsive disorder often feel the need to perform certain rituals or routines repeatedly. These individuals are often compelled by intrusive thoughts. An individual compelled to perform repeated behavior, such as continually locking and unlocking a door, will often feel distressed by these intrusive thoughts and the need to perform certain behaviors. Someone with obsessive-compulsive disorder cannot simply feel dismissive toward these thoughts, which is part of the distress they experience. While performing these rituals can sometimes cause a temporary sense of relief, this relief does not last for the rest of the day. It is only a transient sense of relief that may come from temporarily satisfying the intrusive thoughts. An individual compelled to perform repeated behavior would have no particular reason to feel content or relaxed.

Trichotillomania is associated with irresistible urges to perform unwanted repetitive behavior, which falls under the obsessive-compulsive spectrum. Although the disorder may cause anxiety to an individual, it does not fit on the anxiety spectrum of behavioral disorders. The autism and bipolar disorder spectrums do not include behaviors or characteristics that are associated with trichotillomania.

Obsessive compulsive disorder, or OCD, is related to a decrease in bioavailable "serotonin" levels. This may be due to alterations serotonin transporter (SERT) function, which increase SERT activity, thus clearing serotonin from the synaptic cleft more rapidly and leading to a shorter duration of effect. While any of the other signaling molecules listed may affected in OCD, serotonin is the only neurotransmitter known to have a direct association with the disorder.

In the context of obsessive compulsive disorder, an obsession refers to "persistent or recurrent involuntary thoughts and/or images which are intrusive and cause marked distress or anxiety." These thoughts often lead to compulsions, or repetitive behavior that an individual feels driven to perform according to rigid rules or rituals.

While it may occur in children under five, obsessive compulsive disorder generally presents either in childhood (age 10-12) or in early adulthood (ages 18-22). Onset after age 25 is less common, and onset in middle age is rare.

Dissociative disorders are characterized by periods of altered mental status (e.g. disruptions in memory, perception, self-identity, and/or awareness) that occur frequently enough to disrupt a person's ability to function normally. They are thought to be potential results of psychological trauma, but may also result from medication and/or drug use. Dissociative identity disorder, dissociative amnesia, and depersonalization disorder are all considered dissociative disorders.

On the other hand, schizophrenia is a psychotic disorder; although it may include occasional episodes of dissociation, the episodes where individuals lose touch with reality are characterized more by delusions and hallucinations, not a loss of memory or awareness. Individuals with schizoid personality disorder—which is a personality disorder, not a dissociative disorder—have little interest in close relationships with others and are generally "cold" or detached in affect. Post-traumatic stress disorder is an anxiety disorder characterized by sudden episodes of worry, unease, apprehension, and fear due to some emotional trigger that causes flashbacks to the traumatic event and hyperarousal during the event.

“Factitious disorders” are psychiatric or behavioral conditions in which an individual knowingly fabricates or exaggerates illness in order to receive medical treatment, sympathy, or care. Factitious disorders are distinguished from “hypochondriasis,” “conversion disorders,” and “somatic symptom disorders” in that the individual is consciously creating their symptoms, while in the other disorders listed they are not.

Borderline personality disorder is a diagnosis in people who are impulsive, unstable in mood, and manipulative. They can be charming and friendly one minute and angry, irritable, and sarcastic the next. People who need to escape from extreme trauma, most often from sexual or physical abuse in childhood, may develop distinct different personalities. This is termed dissociative identity disorder. People who lie, cheat, steal, and have no sense of responsibility and no anxiety of guilt about their behavior are described as having an antisocial personality disorder. People with schizophrenia experience hallucinations and delusions. Generalized anxiety disorder consists of persistent, excessive worrying and uncontrolled anxiety that has lasted for at least six months.

"Borderline personality disorder" is characterized by difficulty regulating behavior or thoughts, extreme fluctuations in mood, unstable relationships due to idealization or demonization, fear of abandonment or other attachment disorders, and impulsive or reckless behavior.

The other choices are incorrect. "Obsessive-compulsive disorder" is typified by repetitive, unwelcome thoughts that compel the individual to perform ritualistic acts. "Paranoid personality disorder" is a condition of pervasive, long-standing paranoia and general mistrust of others. "Schizotypal personality disorder" is an antisocial disorder: individuals experience social anxiety, the urge to isolate themselves from others, and odd behavior or beliefs.

The DSM IV criteria for diagnosis of borderline personality disorder includes at least five of the following symptoms:

• Extreme reactions to abandonment, real or perceived
• A pattern of tumultuous relationships with family, friends, and romantic interests, often vacillating from extreme idealization to extreme dislike or devaluation.
• Distorted and unstable self-image, which can result in sudden changes in feelings, opinions, values, plans, or goals
• Impulsive and destructive behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating
• Recurring suicidal behaviors or self-harming behavior
• Intense and highly changeable moods
• Chronic feelings of emptiness and/or boredom
• Inappropriate, intense anger or problems controlling anger
• Having stress-related paranoid thoughts or severe dissociative symptoms, such as feeling cut off from oneself, observing oneself from outside the body, or losing touch with reality.