What is Delusional disorder?

Delusions are irrational beliefs, held with a high level of conviction, that are highly resistant to change even when the delusional person is exposed to forms of proof that contradict the belief. Non-bizarre delusions are considered to be plausible; that is, there is a possibility that what the person believes to be true could actually occur a small proportion of the time. Conversely, bizarre delusions focus on matters that would be impossible in reality. For example, a non-bizarre delusion might be the belief that one’s activities are constantly under observation by federal law enforcement or intelligence agencies, which actually does occur for a small number of people. By contrast, a man who believes he is pregnant with German Shepherd puppies holds a belief that could never come to pass in reality. Also, for beliefs to be considered delusional, the content or themes of the beliefs must be uncommon in the person’s culture or religion. Generally, in delusional disorder, these mistaken beliefs are organized into a consistent world-view that is logical other than being based on an improbable foundation.

Unlike most other psychotic disorders, the person with delusional disorder typically does not appear obviously odd, strange or peculiar during periods of active illness. Yet the person might make unusual choices in day-to-day life because of the delusional beliefs. Expanding on the previous example, people who believe they are under government observation might seem typical in most ways but could refuse to have a telephone or use credit cards in order to make it harder for “those Federal agents” to monitor purchases and conversations. Most mental health professionals would concur that until the person with delusional disorder discusses the areas of life affected by the delusions, it would be difficult to distinguish the sufferer from members of the general public who are not psychiatrically disturbed. Another distinction of delusional disorder compared with other psychotic disorders is that hallucinations are either absent or occur infrequently.

The person with delusional disorder may or may not come to the attention of mental health providers. Typically, while delusional disorder sufferers may be distressed about the delusional “reality,” they may not have the insight to see that anything is wrong with the way they are thinking or functioning. Regarding the earlier example, those suffering delusion might state that the only thing wrong or upsetting in their lives is that the government is spying, and if the surveillance would cease, so would the problems. Similarly, the people suffering the disorder attribute any obstacles or problems in functioning to the delusional reality, separating it from their internal control. Furthermore, whether unable to get a good job or maintain a romantic relationship, the difficulties would be blamed on “government interference” rather than on their own failures or omissions. Unless the form of the delusions causes illegal behavior, somehow affects an ability to work, or otherwise deal with daily activities, the delusional disorder sufferer may adapt well enough to navigate life without coming to clinical attention. When people with delusional disorder decide to seek mental health care, the motivation for getting treatment is usually to decrease the negative emotions of depression, fearfulness, rage, or constant worry caused by living under the cloud of delusional beliefs, not to change the unusual thoughts themselves.

What causes delusional disorder?

Because clear identification of delusional disorder has traditionally been challenging, scientists have conducted far less research relating to the disorder than studies for schizophrenia or mood disorders. Still, some theories of causation have developed, which fall into several categories.

GENETIC OR BIOLOGICAL – Close relatives of persons with delusional disorder have increased rates of delusional disorder and paranoid personality traits. They do not have higher rates of schizophrenia, schizoaffective disorder or mood disorder compared to relatives of non-delusional persons. Increased incidence of these psychiatric disorders in individuals closely genetically related to persons with delusional disorder suggest that there is a genetic component to the disorder.

DYSFUNCTIONAL COGNITIVE PROCESSING – An elaborate term for thinking is “cognitive processing.” Delusions may arise from distorted ways people have of explaining life to themselves. The most prominent cognitive problems involve the manner in which delusion sufferers develop conclusions both about other people, and about causation of unusual perceptions or negative events. Studies examining how people with delusions develop theories about reality show that the subjects have ideas which which they tend to reach an inference based on less information than most people use. This “jumping to conclusions” bias can lead to delusional interpretations of ordinary events.

MOTIVATED OR DEFENSIVE DELUSIONS – Some predisposed persons might suffer the onset of an ongoing delusional disorder when coping with life and maintaining high self-esteem becomes a significant challenge. In order to preserve a positive view of oneself, a person views others as the cause of personal difficulties that may occur. This can then become an ingrained pattern of thought.

Who is effected?

The base rate of delusional disorder in adults is unclear. The prevalence is estimated at 0.025-0.03%, lower than the rates for schizophrenia (1%). Delusional disorder may account for 1–2% of admissions to inpatient psychiatric hospitals. Age at onset ranges from 18–90 years, with a mean age of 40 years. More females than males (overall) suffer from delusional disorder, especially the late onset form that is observed in the elderly.

What is avoidant personaility disorder?

People who are diagnosed with avoidant personality disorder desire to be in relationships with others but lack the skills and confidence that are necessary in social interactions. In order to protect themselves from anticipated criticism or ridicule, they withdraw from other people. This avoidance of interaction tends to isolate them from meaningful relationships, and serves to reinforce their nervousness and awkwardness in social situations.

Avoidant personality disorder is one of several personality disorders listed in the newest edition of  the DSM-IV-TR .

What are the symptoms?

It is characterized by marked avoidance of both social situations and close interpersonal relationships due to an excessive fear of rejection by others. Persons with this disorder exhibit feelings of inadequacy, low self-esteem, and mistrust toward others. These people tend to be very cautious when they speak, and they convey a general impression of awkwardness in their manner. Most are highly self-conscious and self-critical about their problems relating to others.

What are the causes?

The cause of avoidant personality disorder is not clearly defined, and may be influenced by a combination of social, genetic, and biological factors. Avoidant personality traits typically appear in childhood, with signs of excessive shyness and fear when the child confronts new people and situations. These characteristics are also developmentally appropriate emotions for children, however, and do not necessarily mean that a pattern of avoidant personality disorder will continue into adulthood. When shyness, unfounded fear of rejection, hypersensitivity to criticism, and a pattern of social avoidance persist and intensify through adolescence and young adulthood, a diagnosis of avoidant personality disorder is often indicated.

Many persons diagnosed with avoidant personality disorder have had painful early experiences of chronic parental criticism and rejection. The need to bond with the rejecting parents makes the avoidant person hungry for relationships but their longing gradually develops into a defensive shell of self-protection against repeated parental criticisms. Ridicule or rejection by peers further reinforces the young person’s pattern of social withdrawal and contributes to their fear of social contact.

What is a sleep terror?

What is phonological disorder?

Phonological disorder occurs when a child does not develop the ability to produce some or all sounds necessary for speech that are normally used at his or her age.

Phonological disorder is sometimes referred to as articulation disorder, developmental articulation disorder, or speech sound production disorder. If there is no known cause, it is sometimes called “developmental phonological disorder.” If the cause is known to be of neurological origin, the names “dysarthria” or “dyspraxia” are often used. Phonological disorder is characterized by a child’s inability to create speech at a level expected of his or her age group because of an inability to form the necessary sounds.

There are many different levels of severity of phonological disorder. These range from speech that is completely incomprehensible, even to a child’s immediate family members, to speech that can be understood by everyone but in which some sounds are slightly mispronounced. Treatment for phonological disorder is important not only for the child’s development to be able to form speech sounds, but for other reasons, as well. Children who have problems creating speech sounds may have academic problems in subject areas such as spelling or reading. Also, children who sound different than their peers may find themselves frustrated and ridiculed, and may become less willing to participate in play or classroom activities.

What causes phonological disorder?

Phonological disorder is often divided into three categories, based on the cause of the disorder. One cause is structural problems, or abnormalities in the areas necessary for speech sound production, such as the tongue or the roof of the mouth. These abnormalities make it difficult for children to produce certain sounds, and in some cases make it impossible for a child to produce the sounds at all. The structural problem causing the phonological disorder generally needs to be treated before the child goes into language therapy. This therapy is especially useful, because, in many of these cases, correction of the structural problem results in correction of the speech sound problem.

The second category of phonological disorder is problems caused by neurological problems or abnormalities. This category includes problems with the muscles of the mouth that do not allow the child sufficient fine motor control over the muscles to produce all speech sounds. The third category of phonological disorder is phonological disorder of an unknown cause. This is sometimes called “developmental phonological disorder.” Although the cause is not known, there is much speculation. Possible causes include slight brain abnormalities, causes rooted in the child’s environment, and immature development of the neurological system. As of 2002, there is research pointing to all of these factors, but no definitive cause has been found.

What are the symptoms?

The symptoms of phonological disorder differ significantly depending on the age of the child. It is often difficult to detect this disorder, as the child with phonological disorder develops speech sounds more slowly than his or her peers; generally, however, he or she develops them in the same sequence. Therefore, speech that may be normal for a four-year-old child may be a sign of phonological disorder in a six-year-old.

Nearly all children develop speech sounds in the same sequence. The consonant sounds are grouped into three main groups of eight sounds each: the early eight, the middle eight, and the late eight. The early eight include consonant sounds such as “m,” “b,”, and “p.” The middle eight include sounds such as “t,” “g”, and “chi,” and the late eight include more complicated sounds such as “sh,” “th,” “z,” and “zh.” Many children do not normally finish mastering the late eight until they are seven or eight years old. As children normally develop speech sound skills, there are some very common mistakes that are made. These include the omission of sounds, (i.e., frequently at the end of words), the distortion of sounds, or the substitution of one sound for another. Often the substitution is of a sound that the child can more easily produce for one that he or she cannot.

What is pain disorder?

Pain disorder is one of several somatoform disorders described in the revised, fourth edition of the  DSM-IV-TR. The term “somatoform” means that symptoms are physical but are not entirely understood as a consequence of a general medical condition or as a direct effects of a substance, such as a drug. Pain disorder is classified as a mental disorder because psychological factors play an important role in the onset, severity, worsening, or maintenance of pain.

What is pyromania?

Pyromania is defined as a pattern of deliberate setting of fires for pleasure or satisfaction derived from the relief of tension experienced before the fire-setting. The name of the disorder comes from two Greek words that mean “fire” and “loss of reason” or “madness.” The clinician’s handbook, the Diagnostic and Statistical Manual of Mental Disorders , also known as the DSM, classifies pyromania as a disorder of impulse control, meaning that a person diagnosed with pyromania fails to resist the impulsive desire to set fires—as opposed to the organized planning of an arsonist or terrorist.

What are Pervasive developmental disorders?

Pervasive developmental disorders are a group of conditions originating in childhood that involve serious impairment in several areas, including physical, behavioral, cognitive, social, and language development.

What is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is a developmental disorder characterized by distractibility, hyperactivity, impulsive behaviors, and the inability to remain focused on tasks or activities.

What is autism?

The term “autism” refers to a cluster of conditions appearing early in childhood. All involve severe impairments in social interaction, communication, imaginative abilities, and rigid, repetitive behaviors.

Each child diagnosed with an autistic disorder differs from every other, and so general descriptions of autistic behavior and characteristics do not apply equally to every child. Still, the common impairments in social interaction, communication and imagination, and rigid, repetitive behaviors make it possible to recognize children with these disorders, as they differ markedly from healthy children in many ways.

Many parents of autistic children sense that something is not quite right even when their children are infants. The infants may have feeding problems, dislike being changed or bathed, or fuss over any change in routine. They may hold their bodies rigid, making it difficult for parents to cuddle them. Or, they may fail to anticipate being lifted, lying passively while the parent reaches for them, rather than holding their arms up in return. Most parents of autistic children become aware of the strangeness of these and other behaviors only gradually.

Impairments in social interaction are usually among the earliest symptoms to develop. The most common social impairment is a kind of indifference to other people, or aloofness, even towards parents and close care-givers. The baby may fail to respond to his or her name being called and may show very little facial expression unless extremely angry, upset, or happy. Babies with autism may resist being touched, and appear to be lost in their own world, far from human interaction. Between seven and 10 months of age, most infants often resist being separated from a parent or well-known caregiver, but these infants may show no disturbance when picked up by a stranger.

Other children with autism may be very passive, although less resistant to efforts by others to interact. However, they do not initiate social interaction themselves. Still others may attempt to engage with adults and peers, but in ways that strike others as inappropriate, or odd.

In adolescence and adulthood, some of the higher-functioning individuals with autistic disorders may appear overly formal and polite. They may react with little spontaneity, as if social interaction doesn’t come naturally or easily to them, and so they are trying to follow a pre-determined set of rules.

Learning disorders, or learning disabilities, are disorders that cause problems in speaking, listening, reading, writing, or mathematical ability. It is estimated that 5% to 20% of school-age children suffer from learning disabilities. Often, learning disabilities appear together with other disorders, such as ADHD. Learning disabilities are also associated with certain conditions occurring during fetal development or birth, including maternal use of alcohol, drugs, and tobacco; exposure to infection; injury during birth; low birth weight; and sensory deprivation.
Aside from underachievement, other warning signs that a person may have a learning disability include overall lack of organization, forgetfulness, and taking unusually long amounts of time to complete assignments. In the classroom, the child’s teacher may observe one or more of the following characteristics: difficulty paying attention, unusual sloppiness and disorganization, social withdrawal, difficulty working independently, and trouble switching from one activity to another. In addition to the preceding signs, which relate directly to school and schoolwork, certain general behavioral and emotional features often accompany learning disabilities. These include impulsiveness, restlessness, distractibility, poor physical coordination, low tolerance for frustration, low self-esteem, daydreaming, inattentiveness, and anger or sadness

What are the types of learning disorders?

Learning disabilities are associated with brain dysfunctions that affect a number of basic skills. Perhaps the most fundamental is sensory-perceptual ability—the capacity to take in and process information through the senses. Difficulties involving vision, hearing, and touch will have an adverse effect on learning. Although learning is usually considered a mental rather than a physical pursuit, it involves motor skills, and it can also be impaired by problems with motor development. Other basic skills fundamental to learning include memory, attention, and language abilities.
The three most common academic skill areas affected by learning disabilities are reading, writing, and arithmetic. Some sources estimate that between 60% and 80% of children diagnosed with learning disabilities have reading as their only or main problem area. Learning disabilities involving reading have traditionally been known as dyslexia; sometimes refered to as reading disorder . A wide array of problems is associated with dyslexia, including difficulty identifying groups of letters, problems relating letters to sounds, reversals and other errors involving letter position, chaotic spelling, trouble with syllabication (breaking words into syllables), failure to recognize words, hesitant oral reading, and word-by-word rather than contextual reading.
Writing disabilities, known as dysgraphia or disorder of written expression, include problems with letter formation and writing layout on the page, repetitions and omissions, punctuation and capitalization errors, “mirror writing” (writing right to left), and a variety of spelling problems. Children with dysgraphia typically labor at written work much longer than their classmates, only to produce large, uneven writing that would be appropriate for a much younger child.
Learning abilities involving math skills, generally referred to as dyscalcula (or dyscalculia) or mathematics disorder , usually become apparent later than reading and writing problems—often at about the age of eight. Children with dyscalcula may have trouble counting, reading and writing numbers, understanding basic math concepts, mastering calculations, and measuring. This type of disability may also involve problems with nonverbal learning, including spatial organization.