student submission -- gen psych bio-social theory of neurosis

7/29/2019 Student Submission -- Gen Psych Bio-Social Theory of Neurosis

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THE BIO-SOCIAL THEORY OF

NEUROSIS

Dr. C. George Boeree

Shippensburg University



WHAT IS NEUROSIS IS?

Neurosis refers to a variety of

psychological problems involvingpersistent experiences of negative affect

including anxiety, sadness or depression,

anger, irritability, mental confusion, lowsense of self-worth, etc., behavioral

symptoms such as phobic avoidance,

vigilance, impulsive and compulsive acts,lethargy, etc.



The first point to note is that there

are predisposing physiologicalconditions, for the most part

.

temperament trait (or traits)

referred to as neuroticism or

emotional instability. .



The second point is that one’s

culture, upbringing, education,

and learning in general mayprepare one to deal with the

stresses of life, or not. .



The third point concerns the

triggering stressors in people’s

lives which lead to the variousemotional, behavioral, and

cognitive symptoms of neurosis.



Basically, we deal with the world by

using our previously acquired

,coordination with our inherited

capacities, to solve the problems

presented to us as efficiently aspossible.



When we experience repeated occasions of

stress and anxiety, we begin to developpatterns of behavior and cognition

designed to avoid or otherwise mitigate

the problem, such as vigilance, escapebehaviors, and defensive thinking. These

may develop into an array of attitudes

which themselves produce anxiety, anger,sadness, etc.



The family is often the focus in

discussing the origins of neurosis.

First, any genetic predispositions

towards neurosis ma be inherited.

Secondly, the family may have provided

little in the way of preparation for a child

to deal with the stresses of life.

And thirdly, the family may itself be asource of the stress and confusion which

the child may be unable to cope with



A child is still in the process of

learning the skills required tosurvive and thrive in the social

,

susceptible to stress. He or she

needs both parental guidance and a

degree of security. The child needsto know that the parent will be there

for him or her.



Not all neurotics raise neurotic children,and not all neurotics were themselves

raised by neurotic parents. There are

many stressful events which canoverwhelm even fairly emotionally stable

and well educated children, adolescents,

and even adults.



Among these, we can mention the

death of parents, their divorce andremarriage, foster homes,

,

child or the parents, war time

experiences, immigration, poverty

and homelessness, assault, sexualabuse, bigotry, and so on.



Many people develop

neuroses during

adolescence. The sometimes

dramatic physical andemotional changes can by

themselves overwhelm someadolescents.



Many of these issues continue toapply in young adulthood and even

.

need for a partner in life, for anetwork of friends, for a sense of

competence as evidenced by success

in college or in the workplace, and so

on



W HAT IS ANXIETY DISORDERS?

The anxiety disorders are the

most common, or frequently

occurring, mental disorders. as

o t n ng, e av or, an physiological activity.



Anxiety is at the root of many, if notall, of our psychological disorders. It

response, involving the activation of the sympathetic nervous system, in

response to a dangerous situation.



More specifically, anxiety is the

anticipation of danger, learned throughrepeated stress or trauma. Some people

are innately more sensitive to stress, and

so are more likely to experience anxietyand develop anxiety disorders There are

basically five ways in which people

respond to unrelenting stress and trauma

and the anxiety that comes with them:



Anxiety disorders - the subject of this

section.Self-medication, leading to alcoholism

and other drug-dependencies.

Depression - shutting down (a commonwestern response).

Somatization - bodily aches and pains (a

common non-western response).Dissociation - various "trance" states,

and ultimately, psychosis.



P ANIC A TTACKS AND P ANIC DISORDER

A panic attack is a discrete period of

intense fear or discomfort that isassociated with numerous somatic and

cognitive symptoms (DSM-IV). These

symptoms include palpitations, sweating,trembling, shortness of breath, sensations

of choking or smothering, chest pain,

nausea or gastrointestinal distress,

dizziness or lightheadedness, tingling

sensations, and chills or blushing and “hot

flashes.”



Panic disorder is about twice as common

among women as men (American Psychiatric Association, 1998). Age of onset

is most common between late adolescence

and midadult li e with onset relativel

uncommon past age 50. They are the classic example of anticipatory

anxiety: Being afraid of having a panic attack is

the very thing that causes the panic attack!



A GORAPHOBIA

The ancient term agoraphobia is

translated from Greek as fear of an openmarketplace. Agoraphobia today describes

severe and pervasive anxiety about being

in situations from which escape might bedifficult or avoidance of situations such as

being alone outside of the home, traveling

in a car, bus, or airplane, or being in a

crowded area (DSM-IV).



Agoraphobia occurs about two times morecommonly among women than men

(Magee et al., 1996).

Since 95% of agoraphobics also have panicdisorder, perhaps the two categories are

really only one.



SPECIFIC PHOBIAS

These common conditions arecharacterized by marked fear of specific

objects or situations (DSM-IV). Exposure

to the object of the phobia, either in reallife or via imagination or video, invariably

elicits intense anxiety, which may include

a (situationally bound) panic attack.



SOCIAL PHOBIA

Social phobia is another example of anticipatory anxiety: The expectation

of social embarrassment causes the

anxiety that leads to socialembarrassment... In the U.S., social

phobia often begins in early adolescence,

when peers often humiliate shy children.



GENERALIZED A NXIETY DISORDER

In Latin America, some people suffer fromsomething called nervous (nerves). They

feel a great deal of anxiety, insomnia,

headaches, dizziness, evenpalpitations. It usually begins with a loss

of someone close, or with family

conflicts. Since family is everything in

many cultures, family problems are often

at the root of psychological problems.



A CUTE AND POST-TRAUMATIC STRESS

DISORDERS

Acute stress disorder refers to the anxiety and

behavioral disturbances that develop within the first month after exposure to an extreme trauma.

Generally, the symptoms of an acute stress

disorder be in durin or shortl ollowin the

trauma. Such extreme traumatic events includerape or other severe physical assault, near-death

experiences in accidents, witnessing a murder,

and combat. The symptom of dissociation, which

reflects a perceived detachment of the mind fromthe emotional state or even the body, is a critical

feature



OBSESSIVE-COMPULSIVE DISORDER

We are beginning to understand some of

the brain activities associated with OCD. The caudate nucleus (a part of the basal

ganglia near the limbic system) is

responsible, among other things, forurges, including things like reminding you

to lock doors, brush your teeth, wash your

hands, and so on.



RELATED DISORDERS

We might also include hypochondriasishere (even though it is "officially"

classified as a somatoform

disorder). People with hypochondriasis(called hypochondriacs) are preoccupied

with fears of having or getting a serious

disease.



Even after being told that they do not

have the disease they are concernedabout, they continue to worry. They often

exaggerate minor abnormalities, go from

doctor to doctor, and ask for repeatedexaminations and medical tests. A guess

at prevalence of hypochondriacs is that it

involves between 4% and 9% of the

population



“Three other disorders

are related toobsessive-compulsive

disorder”



TRICHOTILLOMANIA

is the “recurrent pulling out of one’s hair

for pleasure, gratification, or relief of tension that results in noticeable hair

loss.” (DSM IV) It is not restricted to hair

on head, and may even involve pulling outeyelashes. Trichotillomania is often

associated with stress, but sometimes

occurs while the person is relaxed as well.



It usually starts in childhood oradolescence. 1 to 2% of college

trichotillomania at some time. Thestudents I have known who suffer

from trichotillomania also had OCD.



KLEPTOMANIA

is the “recurrent failure to resist impulses

to steal objects not needed for personaluse or monetary value.” (DSM IV) The

person knows it is wrong, fears being

caught, and feels guilty about it, but can’tseem to resist the impulse. It is rare, but

much more common among women than

among men. It is, as you can imagine,

difficult to differentiate from intentional

stealing!



P ATHOLOGICAL GAMBLING

“recurrent and persistent

maladaptive gamblingbehavior.” (DSM IV) We often call it

.

distorted thinking goes with it -superstition, overconfidence, denial.



Pathological gamblers tend to be

people with a lot of energy who areeasily bored, and the urge to gamble

stress. It may involve 1 to 3% of thepopulation, and two thirds are men.



Mood



As the name implies, mood

disorders are defined bypathological extremes of certain

moo s - spec ca y, sa ness anelation



while sadness and elation are

normal and natural, they maybecome pervasive and debilitating,

,

in the form of suicide or as the resultof reckless behavior. In any one

year, roughly 7% of Americans suffer

from mood disorders.



M AJOR DEPRESSION

The cardinal symptoms of major depressive disorder are depressed mood

and loss of interest or pleasure. Other

symptoms vary enormously. For example,insomnia and weight loss are considered

to be classic signs, even though many

depressed patients gain weight and sleep

excessively.



SUICIDE

is the most dreaded complication of major

depressive disorders. About 10 to 15 percent of

commit suicide (Angst et al., 1999). Majordepressive disorders account for about 20 to 35

percent of all deaths by suicide (Angst et al.,

1999).



Completed suicide is more common among those

with more severe and/or psychotic symptoms,

, -

addictive disorders (Angst et al., 1999), as well asamong those who have experienced stressful life

events, who have medical illnesses, and who have

a family history of suicidal behavior (Blumenthal,

1988)



DYSTHYMIA

is a chronic [recurring, usually less

severe orm o epress on.



Depression is related, of course, tosadness. Sadness is a natural response

to difficult circumstances that cannot be

resolved by running away (that would befear) or attacking the problem (that would

be anger).



BIPOLAR DISORDER

is a recurrent mood disorder

featuring one or more episodes of mania or mixed episodes of mania

-

Jamison,1990). Bipolar disorder isdistinct from major depressive

disorder by virtue of a history of

manic or hypomanic (milder and not

psychotic) episodes.



M ANIA is derived from a French word that

literally means crazed or frenzied.The mood disturbance can range

happiness] or elation to irritability toa labile [changeable] admixture that

also includes dysphoria

[unhappiness] (Table 4-4).



C YCLOTHYMIA

is marked by manic and depressivestates, yet neither are of sufficient

diagnosis of bipolar disorder ormajor depressive disorder.



Thought content is usually

grandiose but also can be paranoid. Grandiosity usually

ta es t e orm ot o overva ueideas (e.g., “My book is the best

one ever written”) and of frank

delusions



When people think about

"crazy" people and people inmental institutions the are

often thinking of people withschizophrenia.



Schizophrenia is the primary

example of what psychologists andpsychiatrists used to call a

.

characteristic of people with apsychosis is that they seem to be out

of touch with reality. Mood

disorders, especially mania, used tobe considered psychoses as well.



DELUSIONS

are firmly held erroneous beliefs due to

distortions or exaggerations of reasoning and/or misinterpretations of perceptions

or experiences. Delusions of being followed

or watched are common, as are beliefs that

comments, radio or TV programs, etc., are

directing special messages directly to

him/her.



H ALLUCINATIONS

are distortions or exaggerations of

perception in any of the senses,although auditory hallucinations

“ ” ,

from one’s own thoughts) are themost common, followed by visual

hallucinations.



DISORGANIZED SPEECH / THINKING

also described as “thought

disorder” or “loosening of associations,” is a key aspect of

sc zop ren a. sorgan zethinking is usually assessed

primarily based on the person’s

speech



Grossly disorganized behavior

includes difficulty in goal-directedbehavior (leading to difficulties in

,

unpredictable agitation or silliness,social disinhibition [loss of normal

inhibitions], or behaviors that are

bizarre to onlookers.



C ATATONIC BEHAVIORS

are characterized by a marked

decrease in reaction to the immediatesurrounding environment, sometimes

apparent unawareness, rigid orbizarre postures, or aimless excess

motor activity.

"NEGATIVE" SYMPTOMS OF



"NEGATIVE" S YMPTOMS OF

SCHIZOPHRENIA

Affective flattening is the

reduction in the range andintensit o emotional

expression, including facialexpression, voice tone, eye

contact, and body language.



Alogia, or poverty of speech,is the lessening of speech

fluency and productivity,thought to reflect slowing or

u ,

manifested as laconic [using

few words], empty replies to

questions.



Avolition is thereduction, difficulty, or

inability to initiate and persist in goal-directed

e av or; t s o tenmistaken for apparent

disinterest.



COURSE OF THE DISORDER

It may be abrupt or gradual, but

most people experience someearly signs, such as increasing

soc a w t rawa , oss o

interests, unusual behavior, or

decreases in functioning prior to

the beginning of active positivesymptoms.



CULTURAL V ARIATION

On first consideration, symptoms

like hallucinations, delusions, andbizarre behavior seem easily defined

. ,

increased attention to culturalvariation has made it very clear

that what is considered delusional

in one culture may be accepted as

normal in another (Lu et al., 1995).

S hi h i i



Schizophrenia is more common

in egocentric, as opposed to

sociocentric, cultures. In

egocentric societies, eachperson is seen as more or less

responsible for him- or herself,and others may withdraw from

the sufferer and allow him or

her to fall into isolation.



Cultural psychologist RichardCastillo suggests that city

living, wage labor, and

capitalist society places a lot of

whom are not up to thetask. Independence is

expected, so people who are notcapable of independence are

seen as inadequate.

student submission -- gen psych bio-social theory of neurosis

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