Saturday, September 27, 2014

Sexual and Gender Identity, Personality, and Eating Disorders Outline and Case Analysis of Hilde

The identification of abnormal behavior is the main focus in abnormal psychology.  Society sets the standards for what behaviors are considered normal, however many different cultures may not agree with societal standards on what is considered normal or abnormal.  The Gale Encyclopedia defined abnormal psychology as “behavior that is considered to be maladaptive or deviant by the social culture in which it occurs” ("Abnormal Psychology," 2001).  Examining an individual’s abnormal pattern of behavior, emotion and thought process can help identify a mental disorder that may be present.
The American Psychiatric Association developed a diagnostic and statistical manual of mental disorders.  The manual is known as the DSM-IV and is used to classify “systems of abnormal behaviors which aids psychologist and other mental health professionals in diagnosing and treating mental disorders” ("Abnormal Psychology," 2001).  Every disorder has biological, emotional, cognitive and behavioral components and the “DSM-IV is organized using a multi-axial approach to diagnosis to account for the various ways that mental health can be affected in an individual” (Tan, 2008).
Anorexia nervosa, bulimia nervosa, and binge eating are three eating disorders classified in the DSM-IV-TR.  The National Institute of Mental Health states that “an eating disorder is an illness that causes serious disturbances to your everyday diet, such as eating extremely small amounts of food or severely overeating” (National Institute of Mental Health, 2013).  An individual suffering from with an eating disorder most likely started out either increasing or decreasing the amount of food they consumed and then the desire to either eat more or eat less escalated to a point beyond their control.
Anorexia nervosa is “a disorder involving extreme thinness, often achieved through self-starvation” (Hansell & Damour, 2008 p.279).  Individuals suffering from anorexia nervosa feel that they are overweight even though it is clear that they are not so they obsess over what they eat and controlling their weight.  Many individual’s that suffer from anorexia nervosa may sometimes binge eat then proceed to exercise excessively, diet, make themselves vomit and other methods to rid their bodies of the food they consumed.  Anorexia nervosa causes severe weight loss that creates many psychological and physical problems.
Bulimia nervosa is “a disorder involving repeated binge eating followed by compensatory measures to avoid weight gain” (Hansell & Damour, 2008 p.281).  Individuals suffering from bulimia nervosa experience frequent episodes of consuming abnormal large quantities of food and then forcing themselves to vomit, excessive use of laxatives, vigorous exercising or a mixture of all of these behaviors.  Individual’s suffering from bulimia nervosa develop psychological and physical problems that tend to be overwhelming, similar to those suffering from anorexia bulimia.
Binge eating disorder is “a diagnostic category currently under study that describes recurrent episodes of binge eating not followed by compensatory behaviors” (Hansell & Damour, 2008 p. 283).  An individual that suffers from binge-eating disorder has lost control over their eating habits; therefore they will consume large quantities of food that will cause them to become over-weight.  Individual’s that suffer from binge-eating disorders have issues with obesity and are more likely to develop cardiovascular disease, high blood pressure and other health problems.
The biological explanation of eating disorders puts emphasis on “genetic factors, hormonal and neurotransmitters abnormalities, and structural brain abnormalities” (Hansell & Damour, 2008 p. 304).  While studies have shown that identical twins are more likely to suffer from eating disorders such as anorexia and bulimia many individuals often develop an eating disorder while suffering from other disorders like depression and obsessive-compulsive disorders which both have genetic links.  Low levels of serotonin can contribute to an individual developing anorexia and bulimia because serotonin is a “neurotransmitter associated with appetite regulation, mood and anxiety disorders, impulse control problems, and obsessional thinking” (Hansell & Damour, 2008 p. 302).    
The cognitive functions of an individual suffering from an eating disorder become impaired because when the human body is in a state of hunger it affects the mind in a serious way.  When an individual is hungry they feel weak and have a difficult time concentrating so if they are suffering from an eating disorder such as anorexia or bulimia their main focus may be maintaining their weight as they are very concerned of how other’s see them. 
A sexual disorder is defined as “any such disorder that is caused at least in part by psychological factors.  Such a disorder characterized by a decrease or other disturbance of sexual desire is called a sexual dysfunction, and that characterized by unusual or bizarre sexual fantasies, urges, or practices is called paraphilia” ("Sexual disorder," 2012).  Sexual dysfunctions, paraphilia’s, and gender identity disorder are three types of sexual disorders identified in the DSM-IV-TR.  Hypoactive sexual desire and sexual aversion are sexual desire dysfunctions; Female arousal disorder and male erectile disorder are sexual arousal dysfunctions; premature ejaculation, male orgasmic disorder and female orgasmic disorder are orgasmic disorders; Vaginismus and dyspareunia are sexual pain disorders.
Sexual dysfunctions consist of an individual having difficulties in their sexual relationships.  Paraphilia’s consist of chaotic sexual relationships and abnormal sexual preferences, such as sexual stimuli involving “nonhuman objects (such as inanimate objects or animals), hostile rather than affectionate human relationships (such as sexual sadism), or non-consenting sexual relationships (for example, with children)” (Hansell & Damour, 2008 p. 379).
The biological components of sexual disorders consist of medical illness, not eating healthy, “temporal lobe epilepsy, brain tumors or injuries, and degenerative diseases” (Hansell & Damour, 2008 p. 393). There also have been studies that have shown that many women that were accused of committing sexual acts similar to paraphilia’s had a history of mental illness and physical abuse as a child as well as an adult.
Classical conditioning and social learning are the cognitive-behavioral components of paraphilia’s.  The cognitive-behavioral components of paraphilia’s are compared to those of phobias because the theories surrounding both consist of a “physical reaction (sexual arousal or fear) occurring in response to an inappropriate stimulus (something that would not normally arouse sexual excitement or fear)” (Hansell & Damour, 2008 p. 392).
Personality disorders are “characterized by extreme and rigid personality traits that cause impairment” (Hansell & Damour, 2008 p.410).  Individual’s suffering from personality disorders have personality traits that are socially unacceptable which makes it impossible for their behaviors to adapt to their current environment.  There are ten personality disorders listed in the DSM-IV-TR and are grouped into three clusters based on mutual characteristics.  Cluster A: personality disorders are bizarre and include paranoid, schizoid, and schizotypal; Cluster B: personality disorders are “dramatic, emotional or erratic and include antisocial, borderline, histrionic and narcissistic”; Cluster C: personality disorders traits are “anxious or fearful and include avoidant, dependent, and obsessive compulsive” (Hansell & Damour, 2008 p.412).
Biological components of personality disorders involve low levels of serotonin, which serotonin is associated with “mood and anxiety disorders, impulse control problems, and obsessional thinking” (Hansell & Damour, 2008 p. 302).  Another biological component of personality disorder involves “prenatal drug exposure which leads to negative social, psychological and academic outcomes” (Hansell & Damour, 2008 p. 423).
Cognitive-behavioral components of personality disorders “emphasizes that childhood experiences shape thought patterns (cognitive schemas), establish interpersonal strategies, and influence the patterns of perception and behavior that become personality traits” (Hansell & Damour, 2008 p. 414). Personality development is directly influenced by parents, caretakers and siblings and many personality disorders could possibly be developed from children mimicking behaviors that were either taught or observed.
I examined the case of Hilde because her story appeared common in many situations that many families are faced with on the regular.  Hilde was raised in a wealthy family where her mother showed her little attention and her father was not always available.  She was a very beautiful young lady so she was encouraged to use her looks to get her needs met socially.  That is a common characteristic that is seen in many young celebrities today.  Hilde displayed signs of histrionic personality disorder which “is characterized by a strong and constant need for attention and superficial emotions” (Hansell & Damour, 2008 p. 430).  Individuals that suffer from histrionic personality disorder are often desperately seeking attention in many different ways such as flirtation, “self-dramatization, or an attention-grabbing appearance”.  Individuals with disorder often stand out because they make sure that they are noticed by being seen or heard.   Hilde was very attractive in her younger age so she gained a lot of attention but as she got older her physical appearance began to change as she was not as attractive as she once was and did not receive the same attention as she did in her younger days.  Hilde’s husband came from a different background than her and he was attracted to her physically and sexually but as she got older he lost attraction and felt they were no longer compatible.  I can only imagine the devastation that Hilde must have felt as she learned that the characteristics that she once used to manipulate situations and people no longer worked and her marriage was now over.
 Histrionic personality disorder appears to be difficult to treat because of how self-absorbed the individual could be. The challenge comes from the environment the individual was exposed to at an early age for a long period of time such as Hilde.  Hilde was taught that her wealth and looks could get her anything that she wanted and for years it worked.  In my opinion she developed the idea that world revolved around her and her way was always right.  It seems like her husband dealt with it for years but as she got older and her appearance started to change, he lost interest.  I hear of these stories a lot in many situations, which makes me wonder how many people could be suffering from histrionic personality disorder without even knowing.
Abnormal Psychology. (2001). The Gale Encyclopedia, 1(2), , 1-2.
Hansell, J., & Damour, L. (2008). Abnormal psychology (2nd ed.). Hoboken, NJ: Wiley.
Meyer, R., Chapman, L. K., & Weaver, C. M. (2009). Case studies in abnormal behavior (8th ed.). Boston, MA: Pearson/Allyn & bacon.
National Institute of Mental Health. (2013). Eating Disorders. Retrieved from http://www.nimh.nih.gov/health/publications/eating-disorders/index.shtml
Sexual disorder. (2012). Mosby’s dictionary of medicine, nursing, & health professions. Retrieved from http://search.credoreference.com.ezproxy.apollolibrary.com/content/entry/ehsmosbymed/sexual_disorder/0
Tan, J. (2008). DSM-IV. Encyclopedia of obesity. doi:10.4135/9781412963862.n132

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