Anxiety, Somatoform and Dissociative Disorders

Anxiety, Somatoform and Dissociative Disorders
Quips and Quotes
Worry a little bit every day and in a lifetime you will
lose a couple of years. If something is wrong, fix it if
you can. But train yourself not to worry. Worry never
fixes anything.
Mary Hemingway
In this lesson we address three major aspects of
dysfunctional behaviour: anxiety disorders, somatoform
disorders, and dissociative disorders.
Lesson Objectives
What does it mean to be anxious?
What are the types of anxiety disorders?
What are somatoform disorders?
What are dissociative disorders?
Jigsaw: Anxiety, somatoform and dissociative disorders
o Assign a particular disorder to a small group of students who would then
prepare a short presentation on the topic.
Research/Discussion: Phobias and fears
o Research the myriad number of phobias.
o How is a phobia different from a fear?
o Are all phobias irrational?
o What is the relationship between superstition and phobias?
Discussion: Obsession and compulsion
o What are the differences between obsessive/compulsive behaviours,
habits and routine behaviours?
o Using the movie, As Good As It Gets, highlight the obsessive compulsive
behaviours demonstrated by Jack Nicholson’s character. Be aware that
there are several segments that may be inappropriate for adolescents.
Teachers should use discretion in selecting those scenes that are
appropriate and applicable to obsessive/compulsive behaviours.
Research: Anxiety disorders
Design and conduct an investigation into the following:
 Anxiety: What situations cause students to be extremely anxious?
 Phobias: What are they afraid of?
o Are there gender differences in the research results?
o Are there age differences in the research results?
Jigsaw: Theoretical perspectives on anxiety, somatoform and dissociative
o Assign one of the six theoretical perspectives to each small group of
students. Based on their theoretical perspective, how would the groups
explain anxiety, somatoform and dissociative disorders? What treatments
and therapies would they recommend based on their interpretation of the
causes of, or reasons for, anxiety, somatoform and dissociative
Making Connections
Refer to Topic 2.6, Personality for additional information.
Refer to Topic 3.4, Self-understanding for additional information.
Refer to Topic 4.6.1, Mood Disorders for additional information.
Movie: As Good As It Gets
Lesson 4.6.2: Teacher Information
What does it mean to be anxious?
Anxiety is customarily considered a generalized feeling of fear and apprehension that may be related to a particular event or object
and is often accompanied by increased physiological arousal. Anxiety is a key symptom of maladjustmentnot necessarily the cause of
maladjustment (Lefton et al., 2000, p. 496).
What are the types of anxiety disorders?
The person with a panic disorder is afflicted by frequent and over-whelming attacks of anxiety. The anxiety at first is not
really connected to anything specific; it is a physical occurrence. Soon, however, the panic begins to become associated with
more and more objects, events and people.
Phobic disorders involve an unreasonable, excessive and irrational fear of, and consequent attempt to avoid, specific objects or
situations. Mild phobic disorders occur in about 7.5 percent of the population. They are, in fact, relatively common in welladjusted people. Severe, disabling phobias occur in less than 0.05 percent of the population, typically in patients with other
disorders. Phobias occur most frequently between the ages of 30 and 60 and occur about equally in men and women.
An obsession refers to an endless preoccupation with some type of urge or thought. A compulsion is a symbolic, ritualized
behaviour that a person must act out repeatedly. The two words, obsessive-compulsive are generally used together. Most
compulsive people are obsessed with their compulsion (McMahon and Romano, 1998, p. 512).
An obsessive-compulsive disorder is an anxiety disorder characterized by persistent and uncontrollable thoughts and irrational
beliefs (obsessions) that cause performance of intrusive and inappropriate compulsive rituals that interfere with daily life. The
unwanted thoughts, urges and actions of people with obsessive-compulsive disorders focus on maintaining order and
control. About two percent of the population suffer from obsessive-compulsive disorders. Of those with the disorder, about 20
percent have only obsessions or compulsions; about 80 percent have both.
The term post-traumatic stress disorder is used to describe an anxiety disorder occurring in response to an extreme
psychological or physical trauma outside the range of normal human experience. As well as war, such traumas include a
physical threat to one's self or family, witnessing other people's deaths, and being involved in a natural or human-made
disaster. PTSD may occur immediately following a traumatic experience or weeks, months and even years later. As well as
tiredness, apathy, depression, social withdrawal and nightmares, veterans from the Vietnam war reported flashbacks of events
they had witnessed or participated in. Victims of PTSD also report higher use of alcohol, drugs or violence to try to curb the
disturbing symptoms (Gross and McIlveen, 1998, p. 604-611).
What are somatoform disorders?
In somatoform disorders, psychological issues are expressed in bodily symptoms, but there is no actual problem. There are
two major types:
o Conversion disorder, or “hysterical paralysis”, reflects a serious psychological trauma that is unconsciously
transformed into a symbolic physical dysfunction.
o Hypochondriacs see disastrous in a minor physical complaint (McMahon and Romano, 1998, p. 517).
What are dissociative disorders?
Dissociative disorders are characterized by a sudden but temporary alteration in consciousness, identity, sensory/motor behaviour or
memory. Although relatively rare, these disorders are quite noticeable and sharply delineated:
Dissociative amnesia is characterized by the sudden and extensive inability to recall important personal information, usually
information of a traumatic or stressful nature. The condition, which is relatively rare, occurs most often during wars or natural
Dissociative identity disorder, or multiple personality disorder, is characterized by the existence within an individual of two or
more distinct personalities, each of which is dominant at particular times and directs the individual’s behaviour at those
times. Each personality has unique traits and different memories and behavioural patterns. Each personality is often unaware
of any other one, but when time passes cannot account for it. The switch from one personality to another usually is brought on
by stress (Lefton et al., 2000, p. 537).
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