Category: Psychopathology

Introduction

Munchausen syndrome is described as a fictitious mental disorder in which a person pretends to be sick by exaggerating false symptoms. Similarly, another person may lie about sickness of another individual under his or her care, a condition commonly known as Munchausen syndrome by proxy.

Common victims of adult perpetration are children under the age of six years and the concept is internationally viewed as abuse of children (Cleveland Clinic 1). This research paper gives a detailed analysis of the Munchausen syndrome featuring symptoms, causes, diagnosis, treatment and prevention among others.

Overview

Munchausen syndrome is an example of a fictitious disorder which is either generated or self-induced. These disorders can either be psychological or of physical depending on an individual. It is regarded as one of the most severe manifestation of fictitious disorder. According to psychologists and other scholars, Munchausen syndrome is not easily treated and although medical attention is always important in preventing extreme injuries or even death which may result from chronic conditions (Mayo Clinic Staff 1).

Symptoms

It is important to note that Munchausen syndrome mainly revolves around false manifestation of illness among people as away of meetings certain psychological needs. Since most victims never discover the cause of their deception, it is usually difficult to notice that manifested symptoms could be part of a fatal disorder (Cleveland Clinic 1). Due to the complexity of this order, there are several symptoms manifested by victims and these may vary from an individual to another.

Dramatic narrations about imaginary health problems are common. This is aimed at convincing the public and those around that in deed the person is sick. Frequent hospitalization is also common even though doctors may not diagnose anything serious (Mayo Clinic Staff 1). Another common symptom observed is inconsistency in manifested symptoms. As a result, different tests give results that are neither related nor show any similar pattern.

Consequently, the conditions may worsen for no reason causing the patient to go for advance medical procedures. Unlike other genuine patients, people suffering from Munchausen syndrome are always eager to for risky operations and avail themselves for numerous laboratory tests and medication from different medical centers.

Moreover, such people avoid visitors and would expect very few people to call on them while in hospital (Mayo Clinic Staff 1). They further ensure that medical experts do not interact with visitors and family members. Last but not least, Munchausen syndrome patients constantly ask for alternative medication and pain relievers even when they are feeling well.

Causes

The exact cause of Munchausen syndrome remains unknown to medical practitioners around the world. Even as researchers continue unraveling the truth behind the causes of this disorder, it is believed that Munchausen syndrome affects people who may have suffered a severe illness in their childhood or may have experienced some physical or emotional abuse (Cleveland Clinic 1).

Other arguments suggest that Munchausen syndrome occurs as a defense mechanism against certain impulses of aggressiveness and sex. It has also been thought to be a form of self punishment imposed by individuals upon themselves.

Social problems which result into extreme levels of stress have also been blamed for this disorder. While these efforts remain focused on discovering the root cause of Munchausen syndrome, it is important to note that most people affected with fictitious disorders are never honest when being assisted, thus making it hard for psychologists to identify causal effects (Cleveland Clinic 1).

Risk factors

As mentioned in the above segment, Munchausen syndrome may occur as a result of a previous experience or traumatizing event in an individual’s life. These predisposing factors put several people at the risk of developing fictitious disorders in future. Personality disorders which affect mental stability of a person may increase their possibility of developing the disorder (Mayo Clinic Staff 1).

Another risk factor is the unfulfilled dream of becoming a medical expert. It is believed that people who set unachievable goals of becoming medical practitioners have a higher tendency of developing Munchausen syndrome. Above all, it is worth noting that the risk factors for this disorder vary and that there are no specific predisposing factors listed by psychologists.

Complications

People affected with Munchausen syndrome usually experience emotional imbalance to the extent of risking their lives to become sick and seek unwanted medication. Besides multiple disorders associated with this class of patients, they are likely to suffer a myriad of complications some of which may be fatal or cause permanent health problems (Cleveland Clinic 1).

Psychologists affirm that Munchausen syndrome can cause death in severe cases that result in bodily injuries and faked medical conditions. Victims also suffer injuries, pain and wounds emanating from major surgeries and other dangerous medical procedures conducted to correct non-existing conditions. In relation to these procedures, patients may end up losing their body organs or limbs as medical practitioners struggle to correct an amorphous medical condition.

In addition, Munchausen syndrome results into financial crisis as a lot of resources are used up treating an exaggerated illness which may take a lifetime to heal. Due to frustrations and unfruitful efforts, patients may resort to drug and substance abuse as a way of draining their sorrows and frustrations (Mayo Clinic Staff 1). The ultimatum of all this is a life full of problems which may include strained family relationships, inability to work and the likelihood of becoming a social misfit in the family and in the wider community.

Treatment

Treatment is generally difficult because of the unknown cause. As a result, no specific therapies have been developed for the treatment of this fictitious disorder. It has to be double emphasized that people with this disorder never wish to seek proper medication (Mayo Clinic Staff 1).

It is therefore advisable for family members and people with close links to approach them politely in order for them to understand the need for better medication. Treatment of this condition mainly focuses on correcting conditions being manifested other than dealing with the entire problem. This treatment basically encompasses behavior counseling and psychotherapy. Medication may also be applied to deal with other health disorders. Psychiatric hospitalization is usually advised for cute cases.

Prevention

There is no universal prevention method known to deal with Munchausen syndrome. It is therefore upon parents and individuals to guard against major predisposing factors which children and other members of the family could be exposed to. Proper treatment of chronic diseases is essential for all family members.

Exposure to trauma and stress should be minimized or eliminated to maintain a stable mental health. Lastly, young people need to be advised on setting realistic and achievable goals in life to avoid future frustrations arising from unfulfilled dreams and ambitions (Ciccarelli and White 455).

Conclusion

From this research analysis, it is more evident than not that Munchausen syndrome has no cure, no known causes and no therapy. As a fictitious disorder, it has posed challenges in its treatment. Maintaining good mental health is imperative in staying safe from Munchausen syndrome.

Works Cited

Ciccarelli, Saundra, and White Noland. Psychology: An Exploration. Toronto: Pearson Education, Limited, 2009. Print.

Cleveland Clinic. Munchausen Syndrome. The Cleveland Clinic Foundation, 2010. Web. <https://my.clevelandclinic.org/health/diseases/9833-factitious-disorder-imposed-on-self-munchausen-syndrome>.

Mayo Clinic Staff. Munchausen syndrome. Mayo Clinic, 2011. Web. <https://www.mayoclinic.org/diseases-conditions/factitious-disorder/symptoms-causes/syc-20356028>.

This research study was done to determine contingent negative variation in psychopaths. It rectified diagnostic and methodological problems witnessed in previous studies in order to bring out the definite findings on contingent negative variation in psychopaths. It sampled 29 male prisoners who had volunteered for study.

They were grouped into two; psychopaths and nonpsychopaths based on psychopathy check list score. Psychopaths forewarned reaction time task guided by time duration was performed in relation to warning stimulus and imperative stimulus and recorded on psychopathy check list. These results were later analyzed to determine psychopath’s contingent negative variation (Adelle & Robert, 1989).

Past research studies indicated that; psychopath’s anticipatory autonomic responses are different, they showed a weak behavioral activation system, normal behavioral activation system and are more responsive to rewarding than in punishment.

They also, indicated that a slow negative potential shift occurred in intervals between warning stimuli and imperative stimuli and it failed to show classic condition response by showing little or no contingent negative variation activity warning intervals. This scenario relates to Gray’s theory in that rewarding psychopaths prompted them to exhibit certain behavior, while punishment inhibited the same behavior (Adelle & Robert, 1989).

Raine and Venables criticized earlier research studies on psychopath’s contingent negative variation by concluding that there was no way of knowing whether or not any of the antisocial subjects would meet the criteria for psychopathy.

They added that previous studies were based on false premise concluding that psychopaths are generally poor at learning relation between events. They also highlighted that although autonomic data indicated that psychopaths are not fearful in anticipation of aversive stimulation there was no reason to assume that they were unaware of contingencies involved (Adelle & Robert, 1989).

Forth and Hare predicted that psychopaths were incapable of having cognitive or motivational process thought to underlie the contingent negative variation and they had the ability to focus on attention on events that interest them.

They also predicted that, psychopath’s contingent negative variation in tasks that are sufficiently interesting and motivating was larger than those of normal individuals. The difference between the early contingent negative variation and late contingent negative variation is that, early contingent negative variation reaches its maximum within the first few seconds after the warning stimulus.

It is largest over frontal regions and reflects task demands as well as the physical properties, significance, processing and warning stimulus. Late contingent negative variation peaks just before the imperative stimulus. It is largest over precentral and central regions and it may reflect motor preparation and response demand (Adelle & Robert, 1989).

In reference to early contingent negative variation and late contingent negative variation for psychopaths, this study had predicted that; psychopaths are interested in paying close attention to task relevant their demands, early contingent negative variation would be larger than those of nonpsychopaths, all subjects would be motivated to respond rapidly to imperative stimulus there by maximizing gains and minimizing loses, no group difference in the late contingent negative variation or in reaction time, and that psychopaths would show an enhanced early contingent negative variation and a normal late contingent negative variation (Adelle & Robert, 1989).

In this study, 29 white male inmates were voluntarily picked from provincial prison. Inclusion criteria included; age between 18 and 45 years, normal hearing and free from neurological impairment. To measure psychopathy; researcher used institutional files and conducted a semi structured interview to complete psychopathy checklist.

Participants completed the state trait anxiety inventory. Each participant was given 20 trials to push a button as quickly as possible in response to a 1300 Hz single tone. The reaction time of each participant was ordered from slow to fast and his criterion defined as the time falling at the 75^th percentile of his distribution. The prediction of a difference for early contingent negative variation in psychopaths was lower than for non psychopaths. This difference was not statistically significant (Adelle & Robert, 1989).

There was no significant group or condition difference in the number of failures to respond faster than individually set reaction time threshold. Apparently, psychopaths could not be distinguished from non psychopaths on the basis of their performance. The difference for late contingent negative variation was not significant.

Interpretation of the early contingent negative variation difference was significantly larger in psychopaths than in nonpsychopaths. Psychopaths are proficient at allocating attention resources to events that interest them and are not deficient in psychological processes that underlie contingent negative variations (Adelle & Robert, 1989).

The weakness of this study was that the research design used lacked sufficient power to detect a reliable group difference. Research results did not confirm to predictions that psychopaths differ from the others in their ability to maintain attention during a long fore period and in the face of external distractions (Adelle & Robert, 1989).

This research study concludes by indicating that sufficiently motivated psychopaths show no evidence of electrocortical or behavioral impairment in contingent negative variation. It also indicates that, psychopaths are proficient in focusing attention on events of immediate interest to them (Adelle & Robert, 1989).

Reference

Adelle, E. F., & Robert, D. H. (1989). The contingent negative variation in psychopaths. The society for psychophysiological research, 26(6), 676- 681.

Introduction

Psychological researchers have for a long time made attempts to understand normal and abnormal human behavior. According to Amrend and Stonrned, abnormal psychology can be defined as a branch of psychology that deals with mental disorders, emotions and the causes of abnormal behavior, usually referred to as psychopathology (1995). The study covers the causes and measures of dealing with the condition.

It also focuses on that behavior which does not fall within the confines of what can be termed normal behavior limits hence regarded as abnormal.

There is no clear cut between normal and abnormal behavior across human beings. The determination of acceptable behavior has been known to vary from one culture to another. This is because of the difference in the way people behave in different societies and cultures.

With psychology, in general, dealing with the study of human behavior and behavior change; abnormal psychology is therefore a branch of psychology that investigates people’s maladjusted behavior relative to the socially approved behavior (Masterpasqua, 2009).

This field of psychology deals with disorders in behavior on the basis of human behavior resulting from a thought process. This implies, therefore, that behavior disorder results from a disorder in human thoughts.

There is no ideal behavior or perfect behavior, but that behavior which is perceived by the greater majority to be the normal behavior (Masterpasqua, 2009). This explains why there is some significant variation from one culture to another as a far as the determination of normal and abnormal behavior is concerned.

If a certain behavior is generally acceptable by the majority, then it is regarded as normal. The acceptable ways of conducting oneself in the society are transferred from one generation to another through social learning, genetic components, judgment and social interaction in general.

Origins of Abnormal Psychology

The origin of abnormal psychology can be traced back to the ancient times. People have been trying to examine the behavior of people against the conventionally accepted normality. People have tried to investigate the causes of such abnormal behavior.

Abnormal behavior was initially considered as being caused by spirits, demons and some supernatural forces beyond human control. The causes of abnormal behavior can be categorized into three major factors: supernatural, biological and psychological.

During the Stone Age period, any abnormal behavior was considered as punishment from God or gods for that matter. The behavior was believed to be caused by evil spirits which had to be exorcised in order to bring the individual to normalcy.

The means and ways in which the spirits were exorcised varied from one community to the other. According to a research by Shieff, Smith and Wadley, the spirits could be exorcised by drilling a hole in the person’s head in order to allow the evil spirits to escape (2007).

In some instances, others used to torture the person possessed by the spirits with an aim of compelling the spirits to come out of the victim. Other religious practices could also be done to exorcise the demonic spirits. The practices and beliefs were adhered to until towards the end of 15th century.

At the beginning of the 16th century, psychologists and physicians of the time were convinced that abnormal behavior manifestations that were experienced as a result of cognitive disorders were closely linked to the movements of celestial bodies like the moon and stars. The movements were thought to bring with it demons and evil spirits.

Greek physicians, on the other hand, thought that abnormal behavior was biological and could be treated just like any other mental disease (Amrend & Stonrned, 1995).

According to the physicians, the brain is responsible for all the behavior changes and when there is a problem in the brain, the individual’s behavior could be affected directly. It was later argued that behavior, to a great extent, was influenced by the social factors in the society. From this perspective, abnormal behavior was seen to be related to the psychological status of a person.

It is evident, therefore, that the evolution of abnormal psychology has transcended abstract beliefs of ancient ages to a more modern scientific understanding of the same condition. In the 21^st century, physicians can offer therapeutic care for the patients with mental challenges that may manifest through abnormal behavior(Shieff et al., 2007). This has offered a good foundation for the development of abnormal psychology.

Models of Psychology

There are three approaches or models that can be used in the study of abnormal psychology. The approaches include: biological, psychosocial and socio-cultural models.

Biological Model

The model is also referred to as the medical model from the fact that the model deals with physiological body functioning as well as the functioning of the brain. The approach views abnormal behavior as a disease which can be treated using medical means. Abnormal behavior is diagnosed and appropriate cure prescribed.

The causes of abnormal behavior, according to this model, may be due to; inheritance, disease, body hormonal imbalance, malnutrition and neurochemical disorder (Amrend & Stonrned, 1995). Although the model deals with medical approach, there is a social connection with biological mechanism.

For example, mood and anxiety are believed to be predisposed by certain genetic makeup in the DNA. The biological model offers a limited explanation of abnormal behavior because it fails to explain the changes in behavior as a result of social influence of the environment.

Socio-cultural Model

According to this model, behavior is developed as a result of learning and coping in the immediate social environment such as the family, school and community. The culture of a particular community, for example, influences the behavior of the people within that community. The model proposes that abnormal behavior is a product of negative cultural practices. Masterpasqua, a specialist in the field of abnormal psychology, suggests that learning of behavior is influenced by the social group and the cultural pressure that surrounds an individual (2009). The pressure build up over a period of time and causes behavior change. The model gives a clear explanation of how to change behavior by modifying the social environment.

Psychosocial Model

This model explains abnormal behavior from a psychological perspective. According to the proponents of this model, abnormal behavior is caused by unsupportive environment during the development of an individual.

The abnormal behavior results when the environment is psychologically unfavorable and may lead to mental illness or disorder. The psychological tension, as argued by Amrend and Stonrned (1995), causes unresolved conflicts in the unconscious mind that may consequently affect the mental functioning and physiological state of the body.

Abnormal behavior results from the interference of the normal behavior development process. When there is an unresolved conflict in a certain stage, there is a likelihood that the conflict will be passed on to subsequent stages, leading to the development of an abnormal behavior.

Conclusion

The paper has discussed the various origins of abnormal psychology and how it has evolved over time into a scientific discipline. It has also analyzed the hypothetical viewpoints and interpretations of biological, psychosocial, and socio-cultural models. These models provide useful perspectives for understanding abnormal psychology.

This field has clearly undergone significant transformation to what it is at present. With time, researchers have come up with convincing theories to explain the probable causes of abnormal psychology and how it can be treated.

References

Amrend, G. N. & Stonrned, P. N. (1995). The Diagnosis of Abnormal Psychology. British Journal of Psychotherapy, 42 (2), 180-196

Masterpasqua, F. (2009). Psychology and Epigenetics. General Psychology, 13 (3), 194-201

Shieff, C., Smith, G. T. & Wadley, J. P. (2007). Self-Trephination of the Skull with an

Electric Power Drill. British Journal of Neurosurgery, 15 (2), 156-158

Diagnosis is an important tool in the medical profession and it is used in a broad spectrum of settings. In psychology, diagnosis precedes treatment and management of mental disorders. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders has been providing guidelines for making diagnoses of various mental disorders (Lloyd-Richardson 3; Muehlenkamp and Gutierrez 62).

The latest edition is DSM-V, which has made great improvements in enhancing the diagnosis of children and mental disorders that affect adolescents.

The newly published edition of DSM made important updates on the disorder criteria in a way that better deals with the experiences and symptoms of children. Instead of separating childhood disorders, it demonstrates how they can develop further in life and affect the developmental continuum.

Nonetheless, some children and adolescent disorders have not been captured in the new edition manual. Given a chance to be in the committee for a new edition of the Diagnostic and Statistical Manual of Mental Disorders, I would include non-suicidal self-injury (NSSI) as a new child/adolescent disorder.

The rationale for my diagnosis would be that NSSI is a personality disorder that affects adolescents and young adults. This rationale is based on the recent increase of this disorder in many adolescents and the lack of diagnosis criteria for use by mental health practitioners.

New Child/ Adolescent Diagnosis

Non-suicidal self-injury could be termed as an act of causing injuries to oneself, which is not intended to lead to death. About one-third of adolescents in the United States is said to have engaged in non-suicidal self-injury (Lloyd-Richardson 4). This is a common disorder that makes individuals in the adolescence stage to exhibit self-harming attributes.

NSSI is characterized by cutting or burning oneself, hitting, pinching, banging or punching walls and other objects. Thus, it has been found to induce pain, break bones, ingest toxic substances, and interfere with the healing of wounds (Lloyd-Richardson 3).

Patients with NSSI report feeling minimal or no pain when carrying out these self-harming behaviors. Patients also report that the self-harming behavior becomes addictive and the person is unable to control or stop his or her impulses for self-harm.

The following characteristics should be the basis of diagnosis of NSSI in adolescents (Muehlenkamp and Gutierrez 64):

• Depression.
• Anxiety.
• Eating disorders.
• Substance use disorder.
• Elevated rates of emotional reactivity, intensity and hyperarousal.
• Increased avoidance behavior.
• Decreased emotional expressivity.
• Scars caused by self-harming behavior.

Other associated disorders are the following:

• Developmental disabilities.
• Eating disorders.
• Borderline personality disorder.

Adolescents with NSSI are likely to report being bullied by their peers, experiencing confusion with their sexual identity, undergoing stress within their social environment, for instance, in the family or at school.

Factors such as family conflicts, child molestation, and drug and substance abuse could lead to NSSI cases. Thus, it is important for parents and/or guardians to assess their children to ensure that they are not exposed to situations that could result in self-harm.

Case Description

Lauren is a 16-year-old girl who was sexually abused by her uncle when she was 10. She was afraid to tell anyone of the ordeal, but her mother, Kimberly, discovered that her daughter was walking in a funny way and had become withdrawn.

She asked Lauren what was going on and she told her about what her uncle had done to her. Her mother took her to hospital immediately and reported the case to the police. The perpetrator was charged and jailed for 20 years. Lauren underwent therapy and attained full recovery.

However, her abuser was recently released because of good behavior and Lauren saw it on the news. As a result, she has been withdrawn and prefers to be locked up in her room upstairs for long hours. Her mother noticed that she wears long sleeved clothes recently and one time she noticed some wounds on her wrist. This prompted her to bring Lauren in for therapy. During the session, Lauren is quiet and withdrawn.

She is not willing to share her experiences with me. When I ask her if she has done anything to harm herself, she appears defensive. After several attempts and getting Lauren to come alone to sessions, she opens up about the abuse. Her mother is a single parent. They live in a suburban neighborhood and she is afraid that if her uncle would attack her again, her mother would not be able to defend her.

Lauren says that she has been experiencing panic attacks, especially when she is alone in the house. She describes it as a paralysis where she is unable to move, sweats profusely and feels like she is having a heart attack. She has also had sleep difficulties because she has nightmares and flashbacks of her rape ordeal. She says that cutting her wrists calms her down and makes her forget her fears.

My diagnosis is post-traumatic stress disorder and non-suicidal self-injury. Post-traumatic disorder is triggered because of her perpetrator’s release from prison, which has been a reminder of the original effect.

This can be inferred from the patient’s panic attacks, nightmares and insomnia. Non-suicidal self-injury has been the patient’s mechanism for dealing with PTSD. Cutting herself removes her from the situation and helps her to remember that she is still alive.

My recommended treatment is trauma-focused cognitive-behavioral therapy, combined with family therapy for PTSD and providing alternative strategies for coping with stress as a treatment for NSSI. I will also encourage Lauren’s mother to make a report to the police of any attempts by the perpetrator to see Lauren again or any threats.

She should also give Lauren a sense of security by ensuring that she feels safe within their home and in school. I will encourage Lauren to take self-defense classes so that she feels more secure and in control in case of an attack.

Article Analysis

I chose to analyze the article on ‘Diagnosing the wrong Deficit’ based on the two concepts of the need to carefully examine developmental history and to ‘look for a horse not a zebra when you hear the hoof beat’ (Thakkar par. 1). In the article, the author describes a patient who came to him to confirm if he had attention-deficiency hyperactivity disorder (Thakkar par. 2).

He had the typical symptoms of the disorder, including procrastination, forgetfulness, a propensity to lose things and the inability to pay attention consistently. However, the patient’s case was a violation of one important criterion of A.D.H.D, which is the symptoms. The patient’s symptoms dated back to the day when his job required him to wake up at five in the morning.

However, he was a night owl. The therapist diagnosed him with sleep disorder and the patient made a full recovery (Thakkar par. 7). This was a difficult condition to diagnose, but the experience of the therapist helped him to make the right diagnosis.

From this case, the importance of examining the developmental history of a patient is seen. In fact, all psychologists based in learning institutions should always aim at establishing developmental histories of their clients in order to arrive at the right diagnoses.

It can be established that, if the therapist had failed to study the patient’s developmental history, he could not have noticed that the most important criterion for diagnosis of A.D.H.D was not met.

As a result, the therapist could have made a misdiagnosis, which could have led to the lack of the patient’s recovery. Treating the wrong disorder may cause frustration in both the patient and therapist and may even lead to the development of other disorders.

Another lesson can be learned on the need to ‘look for a horse not a zebra when you hear the hoof beat’ (Thakkar par. 12). It is important not to make a diagnosis based on probability. Occasionally, one may make a diagnosis because the patient had several symptoms that matched a given illness or disorder. In this case, if the therapist had based his diagnosis on probability, he could have made a misdiagnosis of sleep disorder.

It is also important to analyze all probable diagnoses in detail before making a conclusion, but in most cases, the simplest diagnosis is usually the correct one. If the therapist had over analyzed the symptoms looking for the ‘zebra’, he could have misdiagnosed the patient.

Works Cited

Lloyd-Richardson, Elizabeth E. “Non-Suicidal Self-Injury in Adolescents.” Prevention researcher 17.1 (2010): 3-7. Print.

Muehlenkamp, Jennifer J., and Peter M. Gutierrez. “Risk for suicide attempts among adolescents who engage in non-suicidal self-injury.” Archives of Suicide Research 11.1 (2007): 69-82. Print.

Thakkar, Vatsal G. Diagnosing the wrong deficit. 2013. Web.

Dr. Robert D. Hare and Dr. Paul Babiak, specialists in psychopathy studies, were interviewed on the subject of corporate psychopaths who commit fraud thus causing serious damage to organizations, their affiliates, and clients. It is emphasized that not all psychopaths are fraudsters, but some fraudsters are psychopaths. The interview is focused on who psychopaths are, why they are dangerous to corporations, and how corporate psychopaths can be detected and treated.

First of all, the interviewees speculate on what constitutes psychopathy. Associated with the lack of compassion and the inability to experience deep emotions, psychopathy causes egocentric, manipulative, and remorseless actions. Psychopaths only care about their well-being and ignore the needs, feelings, or problems of other people. They are also incapable of feeling guilty. However, people may display irresponsible or predatory behavior that does not make them psychopaths. There are scientific methods of diagnosing psychopathy. They are based on the ability to bond emotionally, care for others, etc. On the scale of 0 to 24, most people receive a score of 0 or 1, meaning they are not psychopaths, although they may or may not at times do things associated with psychopathic personalities. Probable psychopathy starts at a score of 18 out of 24.

The next concern is why psychopaths are a threat to corporations where they work. By definition, psychopaths do not pursue corporate goals or serve clients’ interests. They are only after their profit. Corporate psychopaths lie to their supervisors, colleagues, and clients about their backgrounds, experiences, actions, etc. They strive for gaining access to resources, for which purpose they are ready to do things considered immoral. Once they have access, they tend to abuse it. Hare and Babiak mention cases where corporate psychopaths committed fraud that cost their companies millions of dollars. After taking as much as possible from their positions, psychopaths leave for other corporations, thus completing the three-phase behavior pattern of assessment, manipulation, and abandonment. Sometimes they are not even reported because their previous employers do not want to admit that they had hired a psychopath, we’re manipulated and failed to detect the manipulation.

Therefore, it is critical to identify psychopathic fraudsters. The problem is that psychopathy often features excellent mimicking and pretending skills. For example, psychopaths know how to make good first impressions. That is why corporate psychopaths are difficult to detect at the job interview stage as well as after they are hired. They secure their positions in corporations by manipulating decision-makers and getting formal and informal leaders to like them. A way to reduce the risk of hiring a psychopath is to check all the facts on a person’s resume and have several HR specialists interview the person. However, if a psychopath is already hired and his or her fraudulent actions are exposed, it is suggested by Hare and Babiak to avoid labeling a person a psychopath because it is “rarely useful.” Instead, a standard procedure should be conducted with presenting verified facts and, if necessary, beginning legal actions.

Hare and Babiak conclude that psychopaths cannot be “rehabilitated” because they are aware of their motivation and comprehend the consequences of their actions. Thus, the main concern is that organizations should be aware of corporate psychopaths’ manipulative strategies. It will help avoid damage from psychopathic fraudsters.

Background

Human development is a systematic process that begins at conception and ends when an individual dies. Therefore, human development is characterized by several stages, which are influenced by heredity, genetics, and environmental factors (society, family, and culture). Conversely, the developmental history (Developmental screening) of an individual entails a set of procedures and questions, which are administered by psychologists and psychiatrists on their patients to elucidate the root cause of their present psychopathological condition (Santrock, 2010).

As a result, most psychologists and psychiatrists use a developmental history questionnaire, which is made up of several sections relative to specific cases being analyzed to measure the physical and mental conditions of the patient. Therefore, a standard developmental history questionnaire, which measures the physical and mental development conditions of a seven-year-old child, is made up of about nine sections. The sections include general demographics; conception and delivery; infancy and toddler years; pre-school years; elementary school years; family and home, reasons for referral, medical status, and contact persons.

Case Summary

This essay presents a case study on the developmental history of a seven-year-old boy who is a slow learner. The subject child was born to an alcoholic mother who is addicted to non-prescription drugs. In addition, the child’s mother is a single parent with two other children. The child’s mother is also a high school dropout who lives below the poverty line and works as a full-time cashier at Wal-Mart. Therefore, when she was pregnant with the subject child, the mother was fond of smoking, drinking alcohol, and taking non-prescription drugs. As a result, the boy was born prematurely and weighed four and a half pounds. Furthermore, his developmental period was characterized by slow growth; development of a poor and tiny posture; poor communication, social, and learning skills; difficulty in talking, and at the age of seven, the boy still has a speech therapy problem. Additionally, the child is on medication to treat Autism.

Case Analysis

From the discussions above, it is notable that the child’s medical and psychological conditions are influenced by several risk factors present in different stages of his developmental period. Therefore, we can apply different sections of the developmental history questionnaire to analyze the current case. Here, there are five major sections, which provide important insights into the development of the current medical and psychological conditions of the subject child.

First, considering the child’s developmental history during conception and delivery, one can note several risky behaviors that can affect the health of the fetus. During pregnancy, the fetus depends on its mother for nutritional nourishment. Therefore, a pregnant woman should consume a balanced diet, which is made up of all the five food groups such as proteins, minerals, carbohydrates, and vitamins. As a result, inadequate nutritional intake can severely affect the fetus or cause various pre-natal complications (Santrock, 2010). Therefore, in the current case, it is notable that the child’s mother did not consume adequate nutrients to support the growth processes of the fetus because she was an alcoholic and a drug addict. Consequently, the child was born prematurely and underweight because the mother did not provide the infant with sufficient nourishment. Conversely, most non-prescription drugs can act as teratogens, which are drugs that can cause abnormal growth during the pre-natal stage of development.

Secondly, the infancy and toddler growth period in the developmental history of a child occurs at age 0-2 years old. This period is characterized by the rapid development of the nervous system particularly the brain. Here, adequate nourishment of the toddler particularly through breastfeeding is imperative to enhance normal brain development. Unfortunately, the developmental history in the current case shows that the mother is an alcoholic and a drug addict. Therefore, chances are that the toddler did not receive sufficient nourishment during this period. As a result, the normal growth characteristics such as the development of language and speech; gross motor (development of posture); normal social interactions; and development of fine movements were incomplete (Santrock, 2010). Therefore, the child’s slow growth, poor speech, tiny and poor posture, and other psychopathological conditions are attributable to his inadequate nutritional nourishment during the early stages of growth.

Additionally, the third section in the developmental history questionnaire looks at the period between 2-5 years of age. Here, a psychologist seeks to evaluate the child’s learning skills through analyzing the child’s ability to interact with the outside world and the ability to explore, absorb, and develop unique social skills such as playing and responding to rewards and punishments. In the current case, probably, the poor nutritional nourishment of the subject child during his early stages of development influenced his neural development and as a result, the child developed Autism.

Here, Autism is a disorder, which is associated with neural development and is characterized by poor development of social and communication skills during the early childhood stage. However, the early symptoms of Autism can also be replicated in later stages of life-span development such as when a child enters elementary school. The elementary school forms the fourth stage in the analysis of the developmental history of an individual. Here, studies note that the child may experience a slow learning experience due to the inability to process information in the brain (Santrock, 2010). This condition is attributable to the symptoms of Autism because the disorder alters the normal functions of the nerves in terms of connecting and transferring information through synapses. Therefore, Autism alters the normal processes of cognitive and language development. As a result, patients with Autism may experience prolonged absenteeism from school, poor grades, resentful and avoidant attitudes towards school and learning, and lack of interest in social activities such as extra-curricular activities.

Lastly, most Autism patients can also encounter various challenges in the family and at home, which form the immediate social environment for children. At this stage, studies show that the prevalence of social problems such as alcoholism and chemical dependence may deny the patient the opportunity to recover and develop the ability to learn from the immediate social surroundings (Santrock, 2010). As a result, the patient especially the subject child in the current case study lacks the motivations and behavioral interventions, which are imperative during the recovery period for Autism patients.

Conclusions

This essay presents a case study, which highlights the importance of using the developmental history of different patients in the studies aimed at delineating the historical and current events in a patient’s life, which can be attributed to their present psychopathological or medical conditions. Therefore, the current case study is significant in developmental history (developmental screening) because it presents the researcher (Psychologist) with the opportunity to make sound judgments and decisions on the way forward for the patient in question. Additionally, the current case provides sufficient information, which is important to psychologists and psychiatrists in terms of enabling them to recommend referrals relative to the patient’s medical and psychopathological conditions.

Reference

Santock, J.W. (2010). A topical approach to life-span development (5^th ed.). New York: McGraw-Hill Higher Education.

Historic Information

Ted Bundy, in full Theodore Robert Bundy, was born on 24th November 1946 in Burlington, Vermont, USA. His mother conceived him outside wedlock and this pilled immense pressure on her, causing her to deny her child. Bundy was raised by his grandparents in a home devoid of love and care. Later on, he began school and the height of his academic achievements was attaining a law degree (McCann, 2021). At the height of his psychopathic disorder, Ted is poised to have killed a total of 30 women, although researchers suspect the number to be around 100. Bundy once escaped from prison in 1977, and this made him a sensational figure in America despite his heinous crimes. At last, Bundy was sentenced to death and executed in Florida’s electric chair in 1989.

Physical Features

At the height of his murder crimes against women, Bundy was approximately 1.78 meters tall and weighed 75 kilograms. These physical attributes may explain his ability to overpower and murder his victims. He was largely considered attractive by the universal standards of the time, and this would explain his ease in attracting his victims.

Triggers

Bundy’s psychopathic disorder was triggered by his upbringing and background. He was born in a home that did not offer him a sense of belonging, and that is dangerous for a child’s development. The choice of his mother to disown him compelled Ted to adapt other coping mechanisms that would enable him to belong with other people (McCann, 2021). Bundy had a strained relationship with his stepfather and this made him shy while dealing with other people, hence being bullied by other children. The bullying amounted to physical and emotional abuse, which affected Ted’s ability to forge and maintain healthy relationships. Bundy’s grandfather was also a trigger contributing to his disorder as he physically assaulted his animals and Ted’s grandmother. The absence of healthy relationships to emulate in the future made it difficult for Bundy to create his own. The abuse of his grandmother also availed a misguided notion within Bundy that women were not deserving of affection, hence his tendency to murder them.

Personality Traits

Bundy was intelligent and charming in public, attributes that made him easily attract women. He was confident and flaunted his achievements with ease, owing to his eloquent nature. Bundy was also learned, having attained a law degree, and this knowledge enabled him to navigate the constraints of the law successfully through many murders (McCann, 2021). Bundy was also secretive, to the extent he managed to dupe his wife and conceal all his murders from her. Bundy was calculative, making plans and seeing them to completion, an indicator of immense focus and scathing tactic.

Information Release

Releasing the profile of a psychopath disorder patient to the public may encourage the rising of a copycat. Additionally, the copycat can analyze the profile and modify the shortcomings of the original murder, making the criminals difficult to apprehend (Gross, 2020). Releasing the profile of a psychopath such as Ted Bundy reveals details the general public may not be ready to accept about such a respected member of the community. Other people may become remorseful and attack the criminal, subverting the right channels of accessing justice, in some instances killing the individual.

Information Released and Justification

Information released to the general public includes the physical appearance of the individual and the profile of his victims. This serves to increase vigilance amongst the groups at risk and encourages them to carefully vet people and protect themselves (Gross, 2020). Releasing identities also discourages a serial killer at large to scale down their crimes, providing authorities with sufficient time to apprehend them. Information regarding the personality traits of the serial killer also boosts vigilance in the general public and should be released.

Information not Released and Justification

Information regarding the methods employed by serial killers should be withheld to prevent the uprising of copycats. Providing information regarding the means of execution avails the ammunition required by copycats to engineer the perfect crimes. Information regarding the residence of such a criminal is also withheld to prevent unlawful handling of their innocent relatives, allowing the law to take charge (Gross, 2020). Information regarding the parentage of these criminals should also be withheld to ensure people take personal responsibility for their actions.

References

Gross, M. (2020). Serial Murder and Media Coverage. Honors Undergraduate Theses.

McCann, B. J. (2021). Duplicity and the Depraved Uncanny in Mediations of Ted Bundy. Women’s Studies in Communication, 44(3), 1–20.

Introduction

Sociopaths and psychopaths are individuals who possess certain common personality traits and characteristics (such as the absence of empathy towards others), which make them dangerous. However, these two types of people also have some differences, and it is paramount to understand these if one is to be able to distinguish between the two and behave accordingly. In this paper, the similarities and differences between the sociopath and the psychopath will be explained; the levels of threat that they pose will be compared; distinguishing between such people will be discussed, and recommendations pertaining to conducting subject interviews with such people will be supplied.

The Mental States of the Sociopath and the Psychopath

The sociopath and the psychopath are individuals characterized by several dangerous personality traits; they share some of these traits, whereas other characteristics are different (Pescosolido, Martin, McLeod, & Rogers, 2011). Generally speaking, the sociopath and the psychopath are both predisposed towards violence, lack remorse, are indifferent towards others, and do not care about laws or ethics (Siciliano, 2014). However, there are important differences. More specifically, sociopaths are inclined towards worrying and anxiety and lose their temper easily; they are often poorly educated, have bad employment, and are viewed by others as disturbed (Siciliano, 2014). However, they are able to form emotional bonds with others, although this is rather difficult for them and does not often happen (Pescosolido et al., 2011; Siciliano, 2014).

It is assumed that the roots of sociopathy are in the social environment in which the person develops (e.g., childhood abuse can considerably contribute to sociopathy) (Pemment, 2013). On the other hand, psychopaths are persons who have not developed conscience and empathy towards others (Pescosolido et al., 2011, p. 143), probably due to genetic causes (Yildirim & Derksen, 2013). However, they are capable of achieving a high level of intelligence and usually behave in a manner that people without such disorders would (Siciliano, 2014). Therefore, it is possible for them to manipulate others into having an impression that they are common people with no psychological/psychiatric disorders (Leedom, Geislin, & Hartoonian Almas, 2012). In fact, psychopaths may have spouses and children who do not suspect anything (Leedom et al., 2012; Siciliano, 2014). The crimes of an intelligent psychopath are often well-planned and hard to solve.

The Threats Posed by the Sociopath and the Psychopath

Both the sociopath and the psychopath are extremely dangerous types of people who are capable of committing serious crimes resulting in the suffering and deaths of a large number of people (Pemment, 2013). In particular, psychopaths usually pose a considerable danger to society due to the fact that they are often intelligent and capable of carefully planning and thoroughly calculating the details of their crimes; their lack of empathy permits them to do so even better (Siciliano, 2014). As a result, it is usually very difficult to solve the crimes of these people (Siciliano, 2014). On the other hand, it is argued that the sociopath usually poses a greater amount of danger to the society due to the fact that they are much greater in numbers, are capable of “metastasizing” rapidly, and are responsible for a large proportion of violent crimes (Pescosolido et al., 2011, p. 143).

Therefore, it might be possible to conclude that sociopaths present a greater danger to Homeland Security due to their inclination towards violent behaviors, lack of self-control, and poor ability to be reasoned with (Pescosolido et al., 2011). Sociopaths are apparently greatly inclined towards large-scale crime such as a terrorist act, whereas psychopaths will tend to practice caution, consequently harming a smaller number of people.

Distinguishing Between a Sociopath and a Psychopath

Generally, it should not be very difficult to distinguish between a sociopathic and a psychopathic individual. It is stated that there exist four major aspects of psychopathy (Mokros et al., 2015). These dimensions are a) interpersonal (superficial charm, glibness, tendency to engage in manipulations, and grandiose behavior); b) affective (the dearth of empathy, feeling of guilt or remorse; general callousness); c) lifestyle (orientation towards the parasitic way of life, impulsivity, and behaviors aimed at attaining stimulation); d) anti-social (behavioral issues such as delinquent behaviors, criminality) (Mokros et al., 2015; Pescosolido et al., 2011). On the contrary, sociopaths will tend to demonstrate somewhat different tendencies in their behavior; they will not usually engage in manipulative behaviors and will rarely be oriented towards a parasitic manner of life (Pescosolido et al., 2011).

In addition, it is stressed that psychopaths are often characterized by reduced responsivity to threats (that is, they react to threats in a more reserved manner); the low incidence of internalizing disorders (such as depression or anxiety); and reduced levels of behavioral inhibition combined with normal or high levels of behavioral activation (Yildirim & Derksen, 2013, p. 1257). Simultaneously, sociopaths tend to have normal or higher than average emotional responsivity to threats; normal or higher than average incidence of internalizing disorders (such as depression or anxiety); high levels of behavioral activation; and normal or high levels of behavioral inhibition (Yildirim & Derksen, 2013, p. 1257).

Therefore, it should be easy to distinguish between sociopaths and psychopaths on the basis of their behaviors and social life (charming, manipulative, grandiose behaviors, and parasitic lifestyles of psychopaths versus disturbed, anxious, unpredictable behaviors of sociopaths), and on the basis of personal communication (reserved responses to threats in psychopaths versus high responsiveness to threats in sociopaths; low frequency of internalizing disorders in psychopaths versus high frequency of that among sociopaths).

Approaches to Sociopaths and Psychopaths in a Subject Interview

When conducting a subject interview with sociopaths and psychopaths, it is of paramount importance to take into account the different traits that these types of people possess. More specifically, during a subject interview with a sociopath, it might be advised to make sure that the interviewed person does not feel that they are being threatened; it is essential to take into account that the sociopath often has internalized disorders such as depression or anxiety (Yildirim & Derksen, 2013), so using methods which may lead to an aggravation of these is not recommended if the interviewed sociopath is to remain calm. On the other hand, while interviewing a psychopath, the risk to trigger a highly emotional response is lower (Yildirim & Derksen, 2013), so it is possible for an interviewer to behave in a somewhat more straightforward manner in this situation. In addition, it should be stressed that, because both sociopaths and psychopaths do not feel empathy or remorse (Pescosolido et al., 2011), it ought not to be expected that they admit having done something wrong simply because they start feeling guilty during the interview.

Conclusion

On the whole, it should be stressed that both sociopaths and psychopaths lack empathic feelings towards others and have an inclination towards violence, which makes them dangerous to society. Whereas psychopaths are often capable of making and maintaining the impression of a normal person and plan and commit their crimes carefully, sociopaths are often distressed individuals who may engage in mass violence. It is pivotal to be able to identify these people so as to prevent the harm that they might cause to others; for civilians, it is recommended to behave cautiously with such persons.

References

Leedom, L. J., Geislin, E., & Hartoonian Almas, L. (2012). “Did he ever love me?” A qualitative study of life with a psychopathic husband. Family and Intimate Partner Violence Quarterly, 5(2), 103-135.

Mokros, A., Hare, R. D., Neumann, C. S., Santtila, P., Habermeyer, E., & Nitschke, J. (2015). Variants of psychopathy in adult male offenders: A latent profile analysis. Journal of Abnormal Psychology, 124(2), 372.

Pemment, J. (2013). Psychopathy versus sociopathy: Why the distinction has become crucial. Aggression and Violent Behavior, 18(5), 458-461.

Pescosolido, B. A., Martin, J. K., McLeod, J. D., & Rogers, A. (Eds.). (2011). Handbook of the sociology of health, illness, and healing: A blueprint for the 21st century. New York, NY: Springer.

Siciliano, R. (2014). Psychopath vs. sociopath: What’s the difference?The Huffington Post. Web.

Yildirim, B. O., & Derksen, J. J. (2013). Systematic review, structural analysis, and new theoretical perspectives on the role of serotonin and associated genes in the etiology of psychopathy and sociopathy. Neuroscience & Biobehavioral Reviews, 37(7), 1254-1296.

Introduction

Criminals that commit violent crimes are likely to be skilled manipulators, and they develop these skills through learning how to approach different people. The same was said about Ted Bundy (born Theodore Robert Cowell, 1946-1989), one of the most notorious serial killers in the criminal history of the United States. Many of his friends or acquaintances who reflected on their interactions with Bundy mentioned that he was always friendly, charming, and seen as “one of the guys.” As disturbing as such recollections may seem today, as the world knows of his crimes, manipulation and the ability to be liked by everyone is one of the most prominent traits of psychopathic antisocial behavior.

Main body

Through exploring Bundy’s past, it becomes evident that he was not born a psychopath. The series of events that occurred to him in his childhood made it more likely for the boy to start exhibiting behaviors that would eventually contribute to violent crimes. The true identity of Ted’s father has never been known, and the boy was raised believing that his mother was his sister (Dimitropoulos, 2018).

After his mother married John Bundy, Ted lived in the shadow of his stepfather’s real children, not getting enough attention and support from adult authority. The lack of authority made the boy fantasize about being someone else; he mimicked the voices and accents of politicians he heard on the radio and had dreams of becoming a powerful politician himself. Slowly, the boy started developing the qualities of a master manipulator. In high school, he had some outstanding aspirations of becoming a president and wanted to convince everyone that he was the one to be dealt with.

Some of the most recognizable characteristics of psychopathic antisocial behavior, which can be attributed to Bundy, exhibited included the desire for power, viewing others as puppets in his ‘game’, manipulation, the gratification for having listeners (an audience), strategic planning, sexual satisfaction in choices that he made, and the feeling that something was operating inside him (Puder, 2019).

In his taped interviews, Bundy seems to be reflecting on his actions from a third-person perspective. When speaking of himself, he says “he decides upon young and attractive women being his victim,” as if referring to someone else who had committed the crimes (Berlinger, 2019). In this quote, it is evident that Ted distances himself from his acts and plays the role of an analyst rather than the one who committed crimes. In addition, such a standpoint is evidence of the lack of remorse, which is another manifestation of psychopathy.

Lykken’s fearlessness hypothesis also applies to the exploration of Bundy’s psychopathy. According to the theory, the fearlessness that an individual possesses increases the likelihood of developing such behaviors as “interpersonal dominance, risk-taking, and persuasiveness, which, in turn, can be manifested in either socially praiseworthy (e.g., daring acts of heroism) or socially proscribed (e.g., criminality) behaviors” (Costello, Unterberge, Watts, & Lilienfeld, 2018, p. 2).

During his interviews, Bundy did not show any physical or psychological reaction to stress, pointing to the existing dysfunction in his emotional processing. In the interview with James Dobson, Bundy applies persuasiveness and interpersonal dominance through manipulating his interviewer. When asked whether he feels remorse for the murders of his victims, he is not concerned with answering the question but rather with preserving his self-image, praising himself for seeking the help of God and becoming a better person.

Throughout his rant about his greatness and humility, he has a smile on his face, closes his eyes from time to time, and shakes his head in denial despite allegedly telling the truth, all of which indicate deception and the attempt to manipulate his audience (Ramos, 2017). It is also evident that Bundy enjoys being listened to, which is another important trait of psychopathy.

When questioned about the numerous crimes that he committed, Bundy was forced to reflect on how his crimes began and the way his victims were chosen. It must be mentioned that he only killed young and attractive women, which points to his desire to gain control and power along with intimate gratification. While Bundy attributed his obsession with young women to pornography to encouraging “something inside him” to kill young women, it is more likely that the absence of sincere, loving feelings toward another person increased his aggression. Ted’s psychopathy characteristics of risk-taking and predatory aggression elevated after receiving the gratification from murders, leading to further crimes necessary to sustain his desires.

Conclusion

Thus, Ted Bundy is considered an epitome of a psychopath among scholars. His charm, handsomeness, and large ego allowed him to deter the attention of others from his negative qualities. The high self-esteem and the sense of self-importance prevented the criminal from showing any sense of remorse for the committed murders even on the very day when he was executed on the electric chair. The psychological profile of Ted Bundy is expected to be explored for decades further, which points to the complexity and multi-dimensionality of a devious personality.

References

Berlinger, J. (Director). (2019). Conversations with a killer: The Ted Bundy Tapes. Web.

Costello, T., Unterberger, A., Watts, A., & Lilienfeld, S. (2018). Psychopathy and pride: Testing Lykken’s hypothesis regarding the implications of fearlessness for prosocial and antisocial behavior. Frontiers in Psychology, 9, 1-13.

Dimitropoulos, S. (2018). Ted Bundy’s childhood: Lonely boy to window peeper to serial killer. Web.

Puder, D. (2019). The dark triad (psychopathy, narcissism, Machiavellianism), sexually violent predators, Ted Bundy, and porn. Web.

Ramos, M. (2017). Ted Bundy’s last interview. Web.

Co-occurrence

Comorbidity is a term used to describe the existence of one or more distinct disorders other than the primary disorder with each having its own pathology, etiology as well as treatment implications. Some authors like Israel, Lilienfeld and Waldman have proposed that the term comorbidity be abandoned and be substituted by the term co-occurrence (Samuel & Widiger, 2005).

They argue that diagnostic comorbidity is wide-ranging and therefore the term co-occurrence would provide more clearly descriptive diagnosis and at the same time it does not emphasize the existence of distinct clinical entities. Co-occurring diagnoses suggest the existence of common as well as shared pathologies which is more valid as compared to comorbidity which suggest distinct psychopathologies.

Disordered personalities versus normal personality

Researchers have been able to identify that the disordered personality and normal personality have a common underlying structure in terms of quality of functioning. The structures of disordered personality traits or dimensions resemble the structures of normative traits and dimensions in terms of genetic as well as phenotypic structure which make up personality.

These common underlying structures hold for higher-order traits of personality disorders since the dimensions of personality disorders are highly related to the Big Five Factors of normal personality which include neuroticism, conscientiousness, agreeableness as well as extraversion. These four five-factor model factors correspond quite well with the four domains of disordered personality functioning (Samuel &Widiger, 2005).

Not Otherwise Specified (NOS)

According to Samuel and Widiger (2005) the most commonly applied diagnosis in clinical settings is the NOS which falls under the wastebasket category. It is applied in a situation where a clinician has confirmed that a personality disorder exists in an individual; however, he or she has failed to meet the set diagnostic criteria.

The fact that the diagnosis is the most commonly used implies that the current diagnostic categories do not have clinical utility. The major reason as to why NOS is used commonly is inadequate diagnostic coverage. This implies that the existing DSM-IV diagnostic categories provide inaccurate results as well as misleading descriptions for each patient’s psychopathology and as such they fail to provide adequate diagnostic assessment.

According to (Samuel &Widiger, 2005) the DSM-IV categories have failed to provide accurate assessment and descriptions of a number of conditions for personality disorders such depression and therefore many patients go untreated. Samuel and Widiger (2005) state that most pharmacologic interventions are done by primary care physicians since DSM-IV categories have failed to provide proper diagnosis using the existing diagnostic criteria for personality disorders.

Mixed anxiety-depressive disorder

The anxiety disorder that has been used by the authors to illustrate the existing boundary dispute between the DSM-IV’s categorical models is the Mixed Anxiety-Depressive Disorder (MADD). People diagnosed with MADD have depressive as well as anxious symptoms that call for clinical intervention yet they can not be diagnosed with either of the two.

According to Samuel &Widiger (2005) it was developed as an acknowledgment that a significant number of people suffer clinically considerable mood as well as anxiety disorder symptomatology; however, these symptoms do not meet the attributes for either anxiety or mood diagnosis.

A proposed criterion for diagnosis of MADD was performed for DSM-IV in a field trial by the Mood Disorders Work Group (Samuel &Widiger, 2005). The research involved 7 sample population which included 5 primary care as well as 2 psychiatric outpatient facilities with both of them having more than 550 persons receiving treatment for either anxiety, mood or both disorders.

Samuel and Widiger (2005) reported that those patients who had sub-definitional threshold affective signs showed similar symptoms to patients who had several DSM-III-R anxiety as well as depressive disorders. According to Barlow et al. the results of the study indicated that patients with sub-definitional threshold symptoms do not exhibit any specific pattern for distinguishing between depressive and anxiety symptoms.

The Mood Disorders Work Group therefore concluded that patients with these personality disorders showed almost equally balanced symptoms which are commonly found in depressive as well as anxiety disorders. These disorders were therefore categorized under anxiety disorder not otherwise specific (NOS) as well as in depressive disorder not otherwise specific.

This meant that DSM-IV had to classify mixed anxiety-depressive disorder as one distinct disorder since they exhibit almost similar symptoms difficult to categorize. DSM-IV therefore categorized MADD under mood disorder or anxiety disorder since it had no basis for selecting one category.

In addition, a study on general personality trait that results from neuroticism also provided empirical basis for classifying MADD in DSM-IV (Barlow & Campbell). This meant that MADD could therefore be classified under three categories which include anxiety, personality as well as mood disorder.

Categorical and dimensional models of classification

When considering the usefulness of the categorical model of classification, the major reason as to why it has always been preferred is that they usually appear easier to use (Samuel &Widiger, 2005). One diagnostic label can reveal a significant amount of information useful for clinical treatment in a more vivid manner.

Clinical decisions on administration of medication, insurance coverage as well as hospitalization are always categorical. On the other hand, dimensional models of classification are often viewed as more complex as compared to other diagnostic categories since they generally generate more specific as well as precise information.

Potentially more useful model

A diagnosis model that can be used to solve the dispute between the categorical or dimensional models of classification is the Not Otherwise Specific which falls under the wastebasket category. It is used to provide accurate diagnostic assessment and describe the personality disorder after it has been confirmed that the individual has a mental disorder.

It can be used to provide accurate diagnosis to schizoaffective disorder. It can help develop a criterion for determining the unique distinctions that exist between mood disorders and schizophrenia as well as making differential diagnosis to determine the difference that exist in affective disorder and schizophrenia (Samuel &Widiger, 2005).

Failures of categorical models of classification

Lack of specific treatment strategy that result from the use of categorical models of classification reflects the weakness of the model. According to Samuel and Widiger (2005) people with similar categorical diagnosis may differ significantly on the predominant features of that particular disorder meaning that the intervention and treatment methods undertaken may not yield positive results on some individuals.

A dimensional model of classification can therefore be used to provide a more specific as well as individualized profile description of an individual’s psychopathology. This will help achieve more differentiated as well as specific treatment implications.

Reference List

Samuel, D. B., & Widiger, T. A. (2005). Diagnostic categories or dimensions? A question for the diagnostic and statistical manual of mental disorders, 5^th ed. Journal of Abnormal Psychology, 114 (4): 494-504. Washington, DC: American Psychological Association.