Anxiety, Mood, and Dissociative Disorders

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Table of Contents

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Causes of anxiety, mood and dissociative disorders
References List

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DSM IV disorder	Definition	Symptoms	Criteria	Additional information
Anxiety Disorders: Panic attack Agoraphobia Social phobia Obsessive-Compulsive Disorder (OCD) Posttraumatic Stress Disorder Generalized Anxiety Disorder (GAD)	A sudden onset of severe apprehension, terror, or fearfulness, often associated with a feeling of imminent doom. Anxiety about, or avoidance of, places or circumstances from which escape may be challenging or embarrassing or in which rescue is inevitable in the incident of Panic attack or Panic-like symptoms. Critical anxiety induced by experience of certain types of social or performance circumstance, often culminating to avoidance behavior. Describe an obsession and/or compulsions. Implies a repeated traumatic experience characterized by elevated arousal and unresponsiveness towards stimuli. A minimum of six months of persistent and severe anxiety and worry.	Fear & worry Feelings of dread/apprehension Problem concentrating Eeling nervous & jumpy Anticipation Irritability Restlessness Feeling of mind blankness	Six months duration of symptoms for GAD Obsession & compulsion taking more than one hour a day for OCD Fear of social or performance situation (Social Phobia)	There are other forms of anxiety disorders besides these.
Mood disorders Major Depressive Disorders, Dysthymic Disorder Bipolar I Disorders Bipolar II Disorders	A minimum of 2 weeks of withdrawal or depressed mood coupled with a minimum of four extra symptoms of depression A minimum of 2 years of depressed mood, in addition to depressive symptoms that do not satisfy criteria for a Major Depressive Episode One or more Mixed or Manic Episodes, in conjunction with Major Depressive Episode One or more Major Depressive Episodes coupled by a minimum of one Hypomanic Episode	Personality change Depression Agitation Aggression	Depressed mood or drastic diminished interest or enjoyment in almost all activities	Scientist has categorized Mood disorders into three major groups; Depressive Disorders, Bipolar Disorders, & two disorders based on etiology.
Dissociative Disorders Dissociative amnesia Dissociative Fugue Dissociative identity Disorder Depersonalization Disorder	A patient presents problem with remembering some critical personal details, which does not pass for normal forgetfulness. A sudden journey away from home or own regular place of job combined with an inability to remember own past and confusion about individual identity or the assumption of novice identity. An expression of two or more unique identities or personality conditions that recurrently control the individual’s behavior in conjunction with an inability to remember critical personal information and that is too complicated to be explained with usual forgetfulness. It signifies a recurrent or persistent sense of being detached from own mental functions or body coupling the intact reality assessment.	Memory loss Switching to alternate identities Developing physical distance from true identity An abrupt sense of being outside oneself	A patient experiences an inability to remember personal details for once or more than once. A patient indicates presence of two or more unique identities, with a minimum of two of them recurrently taking control of the person’s behavior. A sudden predominant disturbance, unexpected journey away from home or workplace accompanied with inability to recall own past. Persistent experience of depersonalization and are not linked to any other mental disorder and cause extreme distress.	The important element in the Dissociative Disorders is interference in normal the normal integrate function of perception, identity, memory, or consciousness.

Causes of anxiety, mood and dissociative disorders

Biological components

Anxiety, Mood and Dissociative disorder involves malfunction in various physiological elements including:

The Autonomic Nervous System

The sympathetic division stimulates survival responses to perceived threats by signaling the adrenal glands to produce adrenaline and noradrenaline, which induces the heart to beat faster, increase breathing rate and intensity, dilate the pupils, and tense the muscle. An animal flees or attacks upon sensing danger because of extreme arousal of the sympathetic nervous division. The parasympathetic system reverses the activity of the sympathetic system when the danger passes, and restores the body to its resting, pre-anxiety state.

Panic attacks arise due to stimulation of the fight-or-flight response that happens inappropriately even without any actual threat. Individuals with history of panic attacks often tend to develop an intense panic attacks whereas individual without history of the attacks will not. This trend implies previous experience of threat have been encoded in the brain.

Neurotransmission

Gamma-aminobutyric acid (GABA) functions as an inhibitor in the central nervous system to suppress neurological activity. GABA induces calm in the limbic system after it gets overexcited (Hansell & Damour, 2008, p.35). Seemingly, GABA does not work effectively in the brains of individual afflicted with extreme chronic anxiety, as is the case in GAD.
Norepinephrine is the major neurotransmitter in locus coeruleus, which is associated with sympathetic nervous system. Under-activation of locus coeruleus results in inattentiveness and drowsiness, while over-activation results in distractedness and disorganization. The locus coeruleus becomes hypersensitive when conditioned to fear response, so that it fires even with slight stimulation. Scientists attribute Panic attacks to hypersensitivity of the locus coeruleus to Norepinephrine. Chronic experience of extreme stress may raise the sensitivity of norepinephrine brain receptors (Hansell & Damour, 2008, p. 36). The hypersensitivity translates to overstimulation of the sympathetic nervous system and subsequently the fight-or-flight response.
Serotonin can elicit anxiogenic and anxiolytic effects based on the region of the brain of its release or the type of receptor it stimulates. Serotonin hypoactivity exposes the fight-or-flight system to slight stimulation leading to recurrent panic attack.

Autoimmune Disorders

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections [PANDAS] is a disease in which children who suffer from strep throat infection develop symptoms of OCD. Researchers speculated that antibodies that emanate from immune response to streptococcal infection interact with basal ganglia and caudate nucleus, leading to OCD.

Genetic factors

Genetic material underlies the physiology of the system of an organism. Genetic factors account for 30 to 50% people vulnerability to suffer an anxiety disorder. Nevertheless, the magnitude of genetic impact varies remarkably among the DSM-IV-TR disorders.

Panic disorders seem to be especially heritable; lifetime frequencies of panic disorders in first-degree relatives of individual indicated with the disorder ranges from 7.7 to 17.3% against a range of 0.8 to 4.2% in first-degree relatives of people without panic disorders (Hansell & Damour, 2008, p.36). A specific genetic anomaly that contributes to disturbances in neurotransmission of glutamic acid may be responsible for an early onset of OCD.

Cognitive component

Cognitive component of mood disorders include rumination and hopelessness. Rumination means a continual obsessive thinking about something, while hopelessness means a sense of lack of control about the future and that there is nothing optimistic in the future.

Anxiety patients tend to misjudge events in couple of ways viz. they preoccupy on perceived threats and dangers, they overestimate the seriousness of the perceived threat or danger, and they overly underestimate their capacity to adjust to the dangers and threats they anticipate.

Maladaptive assumptions and ideas influence the sufferer’s thinking and lead them to misconceive events. This can lead to self-stereotyping such as “Unless I do things perfectly, people will think I’m an idiot” (Hansell & Damour, 2008, p.47). Maladaptive ideas are pessimistic expectations concerning the relationship between behaviors and repercussions.

Emotional component (The Limbic System)

The Limbic System forms the basis for emotional responses (including anxiety), learning, inspiration, and some aspects of memory. It comprises of three division including amygdala, hippocampus, and hypothalamus.

The amygdala measures the emotional significance of impulses it receives from the brain cortex, and the encoding of memories seem to involve alterations in the neural course of the amygdala and the Hippocampus (Hansell & Damour, 2008, p.34).

The amygdala relays information to the hypothalamus, which is supposed to be responsible for encoding conditioned emotional responses.

For instance, when a person with a snake phobia sees a snake, the amygdala process the visual input in conjunction with the hippocampus to decode the emotional impact of the snake, and then relay a warning signal to the hypothalamus to activate emergency response (fight-or-flight response).

Behavioral component

Scientists have based behavioral component of disorders into classical conditioning, operant conditioning, and modeling theories. Based on classical conditioning, a phobia can be developed when a neutral stimulus that does not normally elicit fear occur during an intense fear response to a terrifying stimulus.

Based on operant conditioning, once individuals develop a phobic response, they express avoidance of what they fear. The operant conditioning theory posits that people negatively reinforce such avoidance behavior because it removes them from feared unpleasant circumstances (Hansell & Damour, 2008, p.33).

Finaly, prepared conditioning hypothesis that people may express genetic predisposition to fear stimulus inherited from their ancestors.

References List

American Psychiatry Association. (2000). Diagnostic and statistical manual of Mental disorders: DSM-IV-TR (4^th Ed.). Arlington: American Psychiatry Association.

Hansell, J., & Damour, L. (2008). Abnormal Psychology (2^nd Ed.). New York: John Wiley & Sons Inc.

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