Chapter Ill

Disorders

This chapter presents the common disorders that are somehow associated with abnormal persons discussed under
chapter I of this text. Such abnormalities are: anxiety disorders, delusional disorders, mood disorders, personality
disorders, schizophrenia, sexual disorders, somatoform disorders and dissociative disorders. Furthermore, progress
check is provided at the end of this chapter.

Segment 1. Anxiety Disorder

Anxiety is a psychological disorder that involves excessive levels of negative emotions, such as nervousness,
tension, worry, fright, and anxiety. It is a generalized feeling of apprehension, fear, or tension that may be associated
with a particular object or situation or may be free-floating, not associated with anything specific. Anxiety can cause
such distress that it interferes with a person's ability to lead a normal life (Lahey, 2001).

What is the difference between Anxiety and Fear?

Anxiety is defined as an unpleasant emotional state for which the cause is either not readily identified or perceived to
be uncontrollable or unavoidable, whereas, fear is an emotional and physiological response to a recognized external
threat or a response to a real danger or threat.

What are the Symptoms of an Anxiety Disorder?

Symptoms vary depending on the type of anxiety disorder, but general symptoms include:

Feelings of panic, fear, and uneasiness

Uncontrollable, obsessive thoughts
Repeated thoughts or flashbacks of traumatic experiences Nightmares
Ritualistic behaviors, such as repeated hand washing Problems sleeping
Cold or sweaty hands and/or feet
Shortness of breath
Palpitations
An inability to be still and calm
Dry mouth
Numbness or tingling in the hands or feet
Nausea
Muscle tension
Dizziness

What are the Types of Anxiety Disorder?

There are several recognized types of anxiety disorders, including:

Generalized Anxiety Disorder - This disorder involves excessive, unrealistic worry and tension, even if there is little
or nothing to provoke the anxiety. Accordingly, symptoms include restlessness or feeling keyed up, difficulty
concentrating, irritability, muscle tension and jitteriness, deep disturbance, and unwanted, intrusive worries.

Obsessive-Compulsive Disorder (OCD) - People with OCD are plagued by constant thoughts or fears that cause
them to perform certain rituals or routines. The disturbing thoughts are called obsessions — are anxiety provoking
thoughts that will not go away (ex.: one may have repetitive thoughts of killing a child, of becoming contaminated by a
handshake, or of having unknowingly hurt someone in a traffic accident; and the rituals are called compulsions —
are irresistible urges to engage in behaviors (ex.: a person with an unreasonable fear of germs who constantly
washes his or her hands, compulsive counting, touching, and checking).
Panic Disorder - This disorder keeps recurring attacks to a person of intense fear or panic, often with feelings of
impending doom of death. People with this condition have feelings of terror that strike suddenly and repeatedly with
no warning. Other symptoms of a panic attack include sweating, chest pain, palpitations (irregular heartbeats), and a
feeling of choking, which may make the person feel like he or she is having a heart attack or "going crazy."

Post-Traumatic Stress Disorder (PTSD) - PTSD is a condition that can develop following a traumatic and/or
terrifying event, such as a sexual o physical assault, the unexpected death of a loved one, or a natural disaster.
People with PTSD often have lasting and frightening thought and memories of the event, and tend to be emotionally
numb.

The Vietnam War appears to have produced an unprecedented 500,000 veterans with at least mild problems of
PTSD (Santrock, 2003).

Specific Phobias - A Specific Phobia is an intense fear of a specific object or situation, such as snakes, heights, or
flying. Phobia is an exaggerated, unrealistic fear of a specific situation, activity, or object.

The level of fear usually is inappropriate to the situation and may cause the person to avoid common everyday
situations. Some specific phobias are:

Acrophobia -fear of heights

ailorophobia -fear of cats
amaxophobia -fear of vehicles or driving
anuptaphobia -fear of staying single
aquaphobia -fear of water or swimming
arachnophobia -fear of spiders
astraphobia -fear of storms, thunder and lightning
airophobia -fear of flying, airplanes
biblophobia -fear of books
blennophobia -fear of slime
bogyphobia -fear of demons
cathisophobia -fear of sitting down
cibophobia -fear of food
claustrophobia -fear of confinement
coitophobia -fear of sexual intercourse
cremnophobia -fear of precipices
cynophobia -fear of dogs
demophobia -fear of crowds
dromophobia – fear of crossing streets
ecophobia - fear of home
entomophobia - fear of insects
gamophobia -fear of marriage

Social Anxiety Disorder - This is also called social phobia. It involves overwhelming worry and self-consciousness
about everyday social situations. The worry often centers on a fear of being judged by others, or behaving in a way
that might cause embarrassment or lead to ridicule (Wade, 2004).

Three types of anxiety according to Freud

Reality Anxiety - Reality anxiety refers to fear of real dangers in the external world.
Neurotic Anxiety - Neurotic anxiety refers to fear that instincts will get out of control and cause the person to do
something for which he or she will be punished.

Moral Anxiety - Moral anxiety is the fear of the conscience. People with well-developed superegos tend to feel guilty
when they do something that is contrary to the moral code by which they have been raised (Hall and Lindzey, 1978).

Segment 2. Delusional Disorder: False Belief

Delusional disorder is sometimes referred to as paranoia; delusions are false, sometimes even preposterous,
beliefs that are not part of the person's culture. One might think he is Jesus Christ; another Napoleon (King, 2008).

Types of Delusional Disorder

Delusion may manifest itself as any of the following types:

I. Persecutory Type (Delusion of Persecution) - The person of this type believes that he or she is being threatened
or mistreated my others.

2. Grandiose Type (Delusion of Grandeur) - Victims of this disorder believe that they are extraordinarily important
people or are possessed with extraordinary power, knowledge or ability.

3. Jealous Type - This delusion centers on the suspected unfaithfulness of a spouse or sexual partner. This delusion
is more common than others.

4. Erotomanic Type - This is a type of delusional disorder where a person has an erotic delusion that he/she is loved
by another person, especially by someone famous or of higher status.

5. Somatic Type - The false belief focuses on a delusional physical abnormality or disorder. The somatic delusion
relates to the patient's body. No matter what the mirror says, a person suffering from this type of delusion believes
his/her body is under attack. The attack can be from bugs, or bad odors, or just the belief that there is something
terribly wrong with his/her body.

6. Guilt Delusion - This person believes he/she has done something terribly wrong. One extremely rare instance of
this disease is called folie å deux (Uriarte, 2009).

Segment 3. Mood Disorders

Mood Disorders are disorders characterized by extreme and unwanted disturbances in feeling or mood. These are
major disturbances in one's condition or emotion, such as depression and mania. It is otherwise known as affective
disorder (DSM-IV-TR, 2000).

What are the symptoms of a mood disorder? Depression symptoms include:

a. Sadness g. Dejection
b. Difficulty sleeping h. Exaggerated guilt
c. Fatigue i. Changes in appetite
d. Hopelessness j. Feelings of incompetence
e. Despair k. Loss of interest
f. Sense of inferiority l. Inability to function effectively

Types of Mood Disorder

1. Bipolar Disorder - In bipolar disorder, formerly known as manic- depression, there are swings in mood from
elation (extreme happiness) to depression (extreme sadness) with no discernable external cause.

Two Phases of Bipolar

Manic Phase - During the manic phase of this disorder, the patient may show excessive, unwarranted excitement or
silliness, carrying jokes too far. They may also show poor judgment and recklessness and may be argumentative.
Manic may speak rapidly, have unrealistic ideas, and jump from subject to subject. They may not be able to sleep or
sit still for very long.

Depressive Episode - The other side of the bipolar coin is the depressive episode. Bipolar depressed patients often
sleep more than usual and are lethargic. During bipolar depressive episodes, a patient may also show irritability and
withdrawal.

Accordingly (Wade, 2004), the depressed person speaks slowly and monotonously while the manic person speaks
rapidly, dramatically, often with many jokes and puns. The depressed person has low self-esteem while the manic
person has inflated self-esteem.

2. Depressive Disorder - Depressive disorder is when the person experiences extended, unexplainable periods of
sadness.

Three Types of Depressive Disorder

Major Depressive Disorder - A person suffering from major depressive disorder is in a depressed mood for most of
the day, nearly every day or has lost interest or pleasure in all, or almost all, activities, for a period of at least two
weeks (see other symptoms on Segment 3, Chapter Il).

Single Episode - Single episode depression is like major depression only it strikes in one dramatic episode.

Recurrent - Recurrent depression is an extended pattern of depressed episodes. Depressed episodes can include
any of the features of major depressive disorder (Santrock, 2003).

Segment 4. Personality Disorder

Personality disorders are chronic maladaptive cognitive-behavioral patterns that are thoroughly integrated into the
individual,s personality and that are troublesome to others or whose pleasure sources are either harmful or illegal
(Livesly, 2001)

Types of Personality Disorder: Cluster A, B & C

According to the Diagnostic and Statistical Manual (DSM-IV-TR, 2000), a reference used to clinically define mental
illnesses, there are ten different personality disorders categorized into three main groupings or clusters.

Cluster A: Odd or Eccentric Behaviors

Schizoid Personality Disorder (SPD) - Those with SPD may be perceived by others as somber, aloof and often are
referred to as "loners."
Manifestations:
Social isolation and a lack of desire for close personal relationships.
Prefers to be alone and seem withdrawn and emotionally detached.
Seem indifferent to praise or criticism from other people.
Paranoid Personality Disorder (PPD) - Although they. are prone to unjustified angry or aggressive outbursts when
they perceive others as disloyal or deceitful, those with PPD more often come across as emotionally "cold" or
excessively serious.
Manifestations:
They feel constant suspicion and distrust toward other people.
They believe that others are against them and constantly look for evidence to support their suspicions.
They are hostile toward others and react angrily to perceived insults.

Schizotypal Personality Disorder (SPD) –This disorder is characterized both by a need for isolation as well as odd,
outlandish, or paranoid beliefs. Some researchers suggest this disorder is less severe than schizophrenia.
Manifestations:
They engage in odd thinking, speech, and behavior.
They may ramble or use words and phrases in unusual ways.
They may believe they have magical control over others.
They feel very uncomfortable with close personal relationships and tend to be suspicion of others.

Cluster B: Dramatic, Emotional, or Erratic Behaviors

Antisocial Personality Disorder (APB) — APD is characterized by lack of empathy or conscience, a difficulty
controlling impulses and manipulative behaviors. Antisocial behavior in people less than 18 years old is called
conduct disorder.
Manifestations:
Act in a way that disregards the feelings and rights of other people.
Anti-social personalities often break the law.
Use or exploit other people for their own gain.
They may lie repeatedly, act impulsively, and get into physical fights.
They may mistreat their spouse, neglect or abuse their children and exploit their employees.
They may even kill other people.
People with this disorder are also sometimes called sociopaths or psychopaths.

People with this disorder are at high risk for premature and violent death, injury, imprisonment, loss of employment,
bankruptcy, alcoholism, drug dependence, and failed personal relationships.

Borderline Personality Disorder (BPD) - This mental illness interferes with an individual's ability to regulate
emotion. Borderlines are highly sensitive to rejection, and fear of abandonment may result in frantic efforts to avoid
being left alone, such as suicide threats and attempts.
Manifestations:
They have intense emotional instability, particularly in relationship with other.
They make frantic efforts to avoid real or imagined abandonment by others.
They may experience minor problems as major crises. d. They express their anger, frustration, and dismay
through suicidal gestures, self-mutilation, and other self-destructive acts.
They tend to have an unstable self-image or sense of self.

Borderline personalities are at high risk for developing depression, alcoholism, drug dependence, and bulimia;
dissociate disorder, and post-traumatic stress disorder. Furthermore, 10 percent of people with this disorder commit
suicide by the age of 30.

Narcissistic Personality Disorder (NPD) — NPD is characterized primarily by grandiosity, need for admiration, and
lack of empathy. Narcissistic tend to be extremely self-absorbed, intolerant of others' perspectives, insensitive to
others' needs and indifferent to the effect of their own egocentric behavior.
Manifestations:
They a grandiose sense of self-importance.
They seek excessive admiration from others and fantasize about unlimited success or power.
 They believe they are special, unique, or superior to others. However, they often have very fragile self-
esteem.

Histrionic Personality Disorder (HPD) - Individuals with this personality disorder exhibit a pervasive pattern of
excessive emotionality and attempt to get attention in unusual ways, such as bizarre appearance or speech.
Manifestations:
They strive to be the center of attention.
They act overly flirtatious or dress in ways that draw attention.
They may also talk in dramatic or theatrical style and display exaggerated emotional reactions.

Cluster C: Anxious, Fearful Behaviors

Avoidant Personality Disorder (APD) - Those with avoidant personalities are often hypersensitive to rejection and
unwilling to take social risks. Avoidant displays a high level of social discomfort, timidity, fear of criticism, avoidance
of activities that involve interpersonal contact.
Manifestations:
They possess intense, anxious shyness.
They are reluctant to interact with others unless they feel certain of being liked.
They fear being criticized and rejected.
They often view themselves as socially inept and inferior to others.

Dependent Personality Disorder (DPD) - People with dependent disorder typically exhibits a pattern of needy and
submissive behavior, and rely on others to make decisions for them.
Manifestations:
They have severe and disabling emotional dependency on others.
They have difficulty in making decisions without a great deal of advice and reassurance from other
They urgently seek out another relationship when a close relationship ends.
They feel uncomfortable by themselves.

Obsessive-Compulsive Personality Disorder (OCPD) - Individuals with OCPD, also called Anankastic Personality
Disorder, are so focused on order and perfection that their lack of flexibility interferes with productivity and efficiency.
They can also be workaholics, preferring the control of working alone, as they are afraid that work completed by
others will not be done correctly.
Manifestations:
a. They have a preoccupation with details, orderliness, perfection, and control.
b. They devote excessive amounts of time to work and productivity and fail to take time for leisure activities
and friendships.
c. They tend to be rigid, formal, stubborn, and serious.

This disorder differs from obsessive-compulsive disorder, which often includes more bizarre behavior and rituals
(Lahey, 2001 & Santrock, 2003).

Segment S. Schizophrenia

Schizophrenia is a group of disorders characterized by loss of contact with reality, marked disturbances of thought
and perception, and bizarre behavior. At some phase delusions or hallucinations almost always occur.

Emil Kraepelin first identified the illness in 1896 when he distinguished it from the mood disorders. He called it
dementia praecox, which means a premature deterioration of the brain. Emil's thoughts were later disputed by many
psychiatrists. One of these was Eugene Bleuler, an eminent Swiss psychiatrist, who in 1911 gave the term
"schizophrenia." He developed the word by combining two Greek words schizein meaning "to split" and phren
"mind." This emphasized a splitting apart of the patient's affective and cognitive functioning, which are heavily
affected by the disease. Also, schizophrenia came from the New Latin words schizo, meaning "split," and phrenia,
meaning "mind" (King, 2008).
Schizophrenic Hallucinations

Hallucinations can be broken down into the following categories:

1. Tactile (touch) People with Schizophrenia often have the sensation that there are things (like bugs or insects)
crawling across their skin.

2. Visual (sight) This kind of hallucination causes the person to see things that are not really there,

3. Auditory (hearing) This is the most common type of hallucination• People with auditory hallucinations hear voices
and sounds that others cannot hear.

4. olfactory (smell) - The person experiencing an olfactory hallucination smells things (usually foul s

5. command (hearing) - When a voice commands the person to do something he/she would not ordinarily do.

Characteristics of Schizophrenia

Disturbance of Thought and Attention - People suffering schizophrenia often cannot think logically and as the
result of this they cannot write a story, because every word they write down might make sense, but are meaningless
in relation to each other, and they cannot keep their attention to the writing. The principal disturbance in the
schizophrenic's thought processes is multiple delusions. This is divided into two subcategories:

a. Persecutory Delusion - the schizophrenic believes that he/she is being talked about, spied upon, or
his/her death being planned.

b. Delusions of Reference - the schizophrenic give personal importance to completely unrelated incidents,
objects, or people.

Disturbances of Perception - During acute schizophrenic episodes, people say that the world appears different to
them, their bodies appear longer, colors seem more intense and they cannot recognize themselves in a mirror.

Disturbances of Affect - Schizophrenic persons fail to show 'normal' emotions. This symptom is easiest described
as an excessive lack of correlation between what an individual is saying and what emotion they are expressing (e.g.
recounting an experience of serious horror white chuckling or a patient may smile while talking over tragic events).

Withdrawal from Reality - During schizophrenic episodes, the individual becomes absorbed in his inner thoughts
and fantasies. The self-absorption may be so intense that the individual may not know the month or day or the place
where he is staying.

Delusions and Hallucinations - In most cases it is accompanied by delusions. Delusions are inflexible misleading
beliefs. They appear as a result of exaggerations or distortions of reasoning, as well as false interpretations of things
and events.

The most common are beliefs that other persons are trying to control his thoughts, he may become suspicious of
friends (paranoid), and this is the reason why Robert Kennedy was assassinated (Spoor, 1999).

Kinds of Schizophrenia

The following are the kinds of schizophrenia:

1. Paranoid Schizophrenia - If a person has paranoid schizophrenia, he or she:

Is very suspicious of others,

 Has great schemes of persecution at the root of the behavior,
Has hallucinations and delusions which are also the symptoms of this type of schizophrenia,
Displays the psychotic symptoms.

2. Residual Schizophrenia - Residual schizophrenia is usually:

Expressed through a person's having no motivation or interest in everyday life,

Advised when an individual has been through at least one episode of schizophrenia (6 months) but then
"recover."

3. Disorganized Schizophrenia (Hebephrenic Schizophrenia) - This schizophrenia is characterized by:

Person is incoherent verbally and to his/her feeling,

Expressing emotions that are not appropriate to the situation.

4. Catatonic Schizophrenia - A person diagnosed with catatonic schizophrenia is:

Extremely withdrawn, negative, isolated, and has obvious psychomotor disturbances,

The subject may be almost immobile or exhibit agitated purposeless movement,
Symptoms can include catatonic stupor and waxy flexibility.

5. Undifferentiated Schizophrenia - People with undifferentiated schizophrenia exhibit the symptoms of more than
one of the above mentioned types of schizophrenia, but without a clear predominance of a particular set of diagnostic
characteristics. This is used when the patient's symptoms clearly point to schizophrenia but are so clouded that
classification into the different types of schizophrenia is very difficult (Santrock, 2003).

How Schizophrenia develops?

Schizophrenia develops through any of the following causes:

Genetic Cause - A cause of schizophrenia usually lies in a person's having immediate relatives with a history of
schizophrenia or other psychiatric diseases (schizoaffective disorder, bipolar disorder, and depression). Some
researchers consider schizophrenia to be highly heritable (estimates are as high as 70%).

Environmental/Social Cause - There is considerable evidence indicating that stress may trigger episodes of
schizophrenia psychosis. For example, emotionally turbulent families and stressful life events have shown to be
some of the risk factors for the relapses or triggers of schizophrenia episodes.

The "social drift hypothesis" suggests that people affected by schizophrenia may be less able to hold steady,
demanding, or high-paying jobs. As a result, low income and problems increases stress levels and leave such people
susceptible to lapsing into a schizophrenic episode.

Prenatal Cause - Causal factors are thought to initially come together in early neurodevelopment to increase the risk
of later developing schizophrenia (Ex. prenatal exposure to infections). One curious finding is that people diagnosed
with schizophrenia are more likely to have been born in winter or spring, (at least in the northern hemisphere).

Substance Abuse Cause - In a recent study of people with schizophrenia and a substance abuse disorder, over a
ten year period, "substantial proportions were above cutoffs selected by dual diagnosis clients as indicators of
recovery." Example! Illegal drugs, tobacco and the like (Spoor, 1999).

However, Eugene Bleuler, one of the pioneers in the diagnosis and study of schizophrenia, divided the disorder into
two forms, they are:
Type l. Reactive or Acute Schizophrenia - Reactive schizophrenia is usually sudden and seems to be a reaction to
some life crisis. Reactive schizophrenia is a more treatable form of the illness than process or chronic schizophrenia.

Type ll. Process Schizophrenia/Chronic Schizophrenia - Process schizophrenia is also referred to as poor
premorbid schizophrenia, this type is characterized by lengthy periods of its development with a gradual deterioration
and exclusively negative symptoms. It doesn't seem to be related to any major life change or negative event. Usually
this type of schizophrenia is associated with "loners" who are rejected by society, tend not to develop social skills and
don't excel out of high school (Carlson, 1990).

Segment 6. Sexual Disorders

Sexual dysfunctions are disorders related to a particular phase of the sexual response cycle. Sexual disorders
include problems of sexual identity, sexual performance, and sexual aim.

Major Categories of Sexual Disorder

l. Sexual dysfunctions,
ll. Paraphilia, and
Ill. Gender identity disorders.

Category l. Sexual Dysfunction

Sexual dysfunction is a persistent or recurrent problem that causes marked distress and interpersonal difficulty and
that may involve any or some combination of the following:
a. sexual arousal or the pleasure associated with sex, or
b. orgasm.

It is a disturbance in any phase of the Human Sexual Response cycle (Lahey, 2001).

What is the Human Sexual Response Cycle?

The Human Sexual Response Cycle is a four-stage model of physiological responses during sexual stimulation. The
term was coined by William H. Masters and Virginia E. Johnson in their 1966 book Human sexual Response. The
cycle is:

Excitement Phase - It is also known as the arousal phase or initial excitement phase. It is the first stage of the
human sexual response cycle. It occurs as the result of any erotic physical or mental stimulation, such as kissing,
petting, or viewing erotic images that lead to sexual arousal. It is characterized by an erection in males and a swelling
of the clitoris and vaginal lubrication in females.

Plateau Phase - It is the period of sexual excitement prior to orgasm. The plateau phase is the second phase of the
sexual cycle, after the excitement phase with the following manifestations such as: further increases in circulation
and heart rate occur in both sexes, sexual pleasure increases with increased stimulation, muscle tension increases
further, for those who never achieve orgasm; this is the peak of sexual excitement. Both men and women may also
begin to vocalize involuntarily at this stage. Prolonged time in the plateau phase without progression to the orgasmic
phase may result in frustration if continued for too long.

Orgasmic Phase - Orgasm is the conclusion of the plateau phase of the sexual response cycle, and is experienced
by both males and females. It is accompanied by quick cycles of muscle contraction in the lower pelvic muscles,
which surround both the anus and the primary sexual organs; women also experience uterine and vaginal
contractions; Orgasms are Often associated with other involuntary actions, including vocalizations and muscular
spasms in other areas of the body, and a generally euphoric Sensation; in men, orgasm is usually associated with
ejaculation. Each ejection is associated with a wave of sexual pleasure, especially in the Penis and loins; the first and
second convulsions are usually the most intense in sensation, and produce the greatest quantity of semen.
Thereafter, each contraction is associated with a diminishing volume of semen and a milder wave of pleasure.
Orgasms in females may also play a significant role in fertilization. The muscular spasms are theorized to aid in the
locomotion of sperm u the vaginal walls into the uterus.

Resolution Phase (Refractory Period) - The resolution phase occur: after orgasm and allows the muscles to relax,
blood pressure to drop the body to slow down from its excited state. Men and women may not experience a
refractory period, and further stimulation may cause a return to the plateau stage.

This allows the possibility of multiple orgasms in both sexes. However, typically men enter this refractory period and
some may find continued stimulation to be painful after the orgasmic phase. Women may not have a similar
refractory period and may be able to repeat the cycle almost immediately (Uriarte, 2009).

Types of Sexual Dysfunction

Dysfunctions of Sexual Desire (occurs during the Excitement Phase):

Hypoactive Sexual Desire Disorder - It is marked by lack or no sexual drive or interest in sexual activity. It is
characterized by a persistent, upsetting loss of sexual desire.

Sexual Aversion Disorder - It is characterized by a desire to avoid genital contact with a sexual partner. It refers to
persistent feelings of fear, anxiety, or disgust about engaging in sex.

Dysfunctions of Sexual Arousal (occurs during the Arousal/PIateaU Phase):

Male Erectile Disorder — It refers to the inability to maintain or achieve an erection (previously called as
impotence).

Female Sexual Arousal Disorder — It refers to none responsiveness to erotic stimulation both physically and
emotionally (previously called as frigidity).

Dysfunctions of Orgasm (occurs during the Orgasmic Phase):

Premature Ejaculation - It is the unsatisfactory brief period between the beginning or sexual stimulation and the
occurrence of ejaculation.

Male Orgasmic Disorder - It refers to the inability to ejaculate during sexual intercourse.

Female Orgasmic Disorder - It refers to the difficulty in achieving orgasm, either manually or during sexual
intercourse.

Sexual Pain Disorders:

I. Vaginismus - It is the involuntary muscle spasm at the entrance to the vagina that prevents penetration and sexual
intercourse.

2. Dyspareunia - It refers to painful coitus that may have either an organic or psychological basis.

Hyper Sexuality:

Nymphomania (or furor uterinus) - A female psychological disorder characterized by an overactive libido and an
obsession with sex (etymology of the word is nymph).

Satyriasis - In males the disorder is called satyriasis and the etymology is satyr (At Health, Inc., 1996-2013).
Category ll. Paraphilias

Paraphilia (in Greek 'para' = over and 'philia' = friendship) is a rare mental health disorder term recently used to
indicate sexual arousal in response to sexual objects or situations that are not part of societal normative
arousal/activity patterns, or which may interfere with the capacity for reciprocal affectionate sexual activity.

The disorder is characterized by a 6-month period of recurrent, intense, sexually arousing fantasies or sexual urges
involving a specific act, depending on the paraphilia.

Common forms of paraphilia are:

a. Exhibitionism - This is also known as flashing, is behavior by a that involves the exposure of private parts of
his/her body to person in a situation when they would not normally be exposed figure 2).

When the term is used to refer to the psychological compulsion for such exposure, it may be called apodysophilia or
a Lady Godiva syndrome.

Types of Exposure

Various types of behavior classified as exhibitionism includes:

Flashing - It is the display of bare breasts and/or buttocks by woman with an up-and-down lifting of the shirt and/or
bra or a person exposing and/or stroking his or her genitals.

Mooning - Refers to the display of the bare buttocks while bending down by the pulling-down of trousers and
underwear. This act is more often done for the sake of humor and/or mockery than for sexual excitement.

Anasyrma - Lifting up of the skirt when not wearing underwear, to expose genitals.

Martymachlia - Is a paraphilia which involves sexual attraction to having others watch the execution of a sexual act.

b. Fetishism - People with a fetish experience sexual urges and behavior which are associated with non-living
objects. For example, the object of the fetish could be an article of female clothing, like female underwear. Usually
the fetish begins in adolescence and tends to be quite chronic into adult life. Sexual fetishism, first described as such
by Sigmund Freud.

Types of Fetishism

Sexual Transvestic Fetishism (Transvestism). Like most paraphilias, transvestic fetishism begins in adolescence,
usually around the onset of puberty. Most practitioners are male who are aroused by wearing, fondling, or seeing
female clothing. Lingerie (bras, panties, girdles, corsets, and slips), stockings, shoes or boots may all be the
fetishistic object.

Foot Fetishism - It is a pronounced fetishistic sexual interest in human feet. It is also one of the most common
fetishistic interests among humans. A foot fetishist can be sexually aroused by viewing, handling, licking, tickling,
sniffing or kissing the feet and toes of another person, or by having another person doing the same to his/her own
feet.

Tickling Fetishism - A sexual fetish related to gaining a specific sexual thrill from either tickling a sex partner or
being subjected to tickling themselves, usually to the point of helpless laughter. Often this involves some form of
restraint to prevent escape and/or accidentally hurting the tickler.
Wet and Messy Fetish (WAM) - A form of sexual fetishism that has a person getting aroused by substances applied
on the body like mud, shaving foam, custard pudding, chocolate sauce, etc. It could also involve wet clothes, or any
combination of the above.

Four (4) Major Categories of WAM

4. 1. Messy - The applying of largely opaque substances not usually used in this fashion. This includes food, shaving
cream and mud. A major subdivision of food play involves striking people with cream pies much like in silent comedy
films. This category also includes wrestling in mud oil or gelatin.

4. 2. Wet - The major varieties are of images of people in completely soaked clothing, usually involving full clothing
ensembles.

4. 3. Quicksand - Images of people sinking in quicksand. In drawn images, the stage where female characters sink
up to their chests and their breasts are up in response is a favorite.

4.4. Underwater - Also called Aquaphilia. It involves images of people swimming or posing underwater. Some
subsets of this category are underwater fashion (models posing underwater, often while fully clothed), scuba, rubber
(people in skin-tight rubber wetsuits), simulated drowning, and underwater sex.

5. Pygmalionism - It is a sexual deviation whereby a person has sexual desire for statues.

6. Incendiarism - It is a sexual deviation whereby a person derives sexual pleasure from setting fire.

c. Frotteurism (Frottage) - Frotteurism is the act of obtaining sexual arousal and gratification by rubbing one's
genitals against others in public places or crowds or sexual urges are related to the touching or rubbing of their body
against a non-consenting, unfamiliar woman.

d. Pedophilia - Pedophilia is used to refer to child sexual abuse which comes from the Greek word (paidophilia)
(pais), "child" and (philia), "friendship. It is also called "pedophilic behavior".

e. Masochism - Sexual masochism involves acts in which a person derives sexual excitement from being humiliated,
beaten, bound, or otherwise abused.

f. Sadism - Sadism is the act attaining sexual pleasure or gratification by the infliction of pain and suffering upon
another person. The word is derived from the name of the Marquis de Sade, a prolific French writer of sadistic
novels.

g. Voyeurism (peeping tom) - Voyeurism came from the French voyeur meaning, "One who looks". This is the act
of reaching sexual pleasure or gratification by watching or observing the subject from a distance, or by stealth to
observe the subject with the use of peep-holes, two-way mirrors, hidden cameras, secret photography and other
devices and strategies (see figure 3).

h. Scatologia - It is also called Coprolalia, deviant sexual practice in which sexual pleasure is obtained through the
compulsive use of obscene language. The affected person commonly satisfies his desires through obscene
telephone calls (Telephone Scatologia), usually to strangers. Related terms are copropraxia, performing obscene or
forbidden gestures, and coprographia, making obscene writings or drawings.

i. Necrophilia - Necrophilia is also called thanatophilia and necrolagnia, is the sexual attraction to corpses. 'The word
is artificially derived from Ancient Greek (nekros; "corpse," or "dead") and (philia; "friendship").

j. Coprophilia - Coprophilia (from Greek k6pros—excrement and filia— liking, fondness), also called scatophilia or
scat, is the paraphilia involving sexual pleasure from feces.
k. Zoophilia - Zoophilia is the practice of sex between humans and animals (also known as bestiality/bestosexual). It
came from the Greek (z6i0n, "animal") and (philia, "friendship" or "love"), also known as ZOOsexuality. A person who
practices zoophilia is known as a zoophile.

l. Urophilia (Urolagnia) - A paraphilia of the fetishistic/talismanic type in which sexuoerotic arousal and facilitation or
attainment of orgasm is responsive to, and being urinated upon and/or swallowing urine (Greek ouron, urine + -
philial.

m. Gerontophilia (Sexual preference for the elderly) - Gerontophilia describes a specific sexual inclination
towards the elderly and may at times explain the sadistic attacks made upon them.

n. Mysophilia - Mysophilia is obtaining sexual arousal and gratification by filth or a filthy surrounding. Put simply, this
is getting horny from smelling, chewing•or rubbing against dirty underwear (Greek, mysos, uncleanness + -philia).

o. Hypoxyphilia - Hypoxyphilia is the desire to achieve an altered state of consciousness as an enhancement to the
experience of orgasm.

In this disorder, the individual may use a drug such as nitrous oxide to produce hypoxia, or a "high" due to a lack of
oxygen to the brain. Autoerotic asphyxiation is also associated with hypoxic states, but it is classified as a form of
sexual masochism.

Category Ill. Gender Identity Disorder (Transsexualism)

Gender identity disorder exists when a person experiences confusion, vagueness or conflict in his/her feelings about
his/her own sexual identity. It is condition in which the individual feels trapped in a body of the wrong sex. A person
who is anatomically male feels that he is actually a woman who somehow was given the wrong body is an example

Category of Sexual Abnormalities

A. Sexual Abnormalities as to the Choice of Sexual Partner:

1. Heterosexual - This refers to a sexual desire towards the opposite sex. This is a normal sexual behavior, socially
and medically acceptable.

2. Homosexual - This refers to a relationship or having a sexual desire towards member(s) of his/her own gender.
The term homosexual can be applied to either a man or woman, but female homosexuals are usually called lesbians.

Kinds of Homosexual

a. Overt - Persons who are conscious of their homosexual cravings, and who make no attempts to disguise
their intention. They make advances towards members of their own gender.

b. Latent - Persons who may or may not be aware of the tendency in that direction but are inclined to
repress the urge to give way to their homosexual yearning.

3. Infantosexual - This refers to a sexual desire towards an immature person such as pedophilia.

4. Bestosexual - This refers to a sexual gratification towards animals. This is similar to bestiality and zoophilia.

5. Autosexual (Self Gratification or Masturbation) - It is a form of "selfabuse" or "solitary vice" carried without the
cooperation of another person or the induction of a state of erection of the genital organs and the achievement of
orgasm by manual or mechanical stimulation.

Types of Masturbation
5. 1. Conscious Type - The person deliberately resorts to some mechanical means of producing sexual excitement
with or without orgasm.

Ways of Masturbation:

a. ln Male:

a. 1. By manual manipulation to the point of emission.

a.2. Ejaculation produced by rubbing his sex organ against some part of the female body without the use of
the hand (frottage).

b. ln Female:

b. 1. Manual manipulation of clitoris.

b. 2. Introduction of penis-substitute.

5.2. Unconscious Type - The release of sexual tension may come about via the mechanism of nocturnal stimulation
with or without emission, which may also be as "masturbation equivalent.

6. Gerontophilia - This refers to a sexual desire with elder person.

7. Necrophilia - This refers to a sexual perversion characterized by erotic desire or actual sexual intercourse with a
corpse.

8. Incest - This refers to sexual relations between persons who, by reason of blood relationship cannot legally marry.

B. Sexual Abnormalities as to Instinctual Strength of Sexual Urge:

1. Over Sex:

a. Satyriasis - This refers to an excessive sexual desire of men to intercourse.

b. Nymphomania - This refers to the strong sexual feeling of women. They are commonly called "hot" or "fighter".
Both satyriasis and nymphomania are general expression Of compulsive neurosis.

2. Under Sex:

a. Sexual Anesthesia - This refers to the absence of sexual desire or arousal during sexual act in women.

b. Dyspareunia - It refers to the painful sexual act in women.

c. Vaginismus - It refers to the painful spasm of the vagina during sexual act.

C. Sexual Abnormalities as to Mode of Sexual Ex ression or Wa of Sexual Satisfaction:

1.. Oralism - This refers to the use of the mouth as a way of sexual gratification. This includes any of the following:

a. Fellatio (Irrumation) - The female agent receives the penis of a man into her mouth and by friction with
the lips and tongue coupled with the act sucking the sexual organ.

b. Cunnilingus - The sexual gratification is attained by licking or sucking the external female genitalia.
 c. Anilism (Anilingus) - It is a form of sexual perversion wherein a person derives excitement by licking the
anus of another person of either sex.

2. Sado-masochism (Algolagnia) - This refers to a painful or cruel act as a factor for gratification. The example of
this is flagellation, it is a sexual deviation associated specifically with the act of whipping or being whipped.

a. Sadism (Active Algolagnia) - This refers to a form of sexual Perversion in which the infliction of pain on
another is necessary or sometimes the sole factor in sexual enjoyment.

b. Masochism (Passive Algolagnia) - This refers to the attainment of Pain and humiliation from the
opposite sex as the primary factor for sexual gratification.

3. Fetishism - It is a form of sexual perversion wherein the real fantasized presence of an object or bodily part is
necessary for sexual stimulation and/or gratification (see examples above).

D. Sexual Abnormalities as to the Part of the Body:

1. Sodomy - This refers to a sexual act through anus of another human being.

2. Uranism - This refers to the attainment of sexual gratification by fingering, fondling with the breast, licking parts of
the body, etc.

3. Frottage (Frotteurism) - It is a form of sexual gratification characterized by the compulsive desire of a person to
rub his sex organ against some parts of the body of another.

4. Partialism - It is a form of sexual deviation wherein a person has special affinity to certain parts of the female
body. Sexual libido may develop in the breast, buttock, foot, legs, etc. of women.

E. Sexual Abnormalities as to Visual Stimulus:

1. Voyeurism - It is a form of sexual perversion characterized by a compulsion to peep to see persons undress or
perform other personal activities. The offender is sometimes called "Peeping Tom". Usually, after peeping, the
person masturbates in excess.

2. Mixoscopia (Scoptophilia) - It refers to a perversion wherein sexual pleasure is attained by watching couple
undress or during their sex intimacies.

F. Sexual Abnormalities as to Number of Sex Partner:

1. Triolism (from French word, trios which means three - It is a form of sexual perversion in which three persons
are participating in the sexual orgies. The combination may consist of two men and a woman or two women and a
man.
Troilist (a person) becomes aroused and gratified by the "sharing".
2. Pluralism - It is a form of sexual deviation in which a group of person 2 pluralism sexual orgies. Two or more
couples may perform participates in the sexual act in a room and they may even agree to exchange partners for
"variety sake" during "sexual festival"

G. sexual Abnormalities as to Sexual Reversal:

1. Transvestism - (Sexo-esthetic Inversion, Psychical Hermaphroditism, or Metamorphosis Sexualis Paranoica) - I

male individual derives pleasure from wearing the female apparel. This condition is found sometimes in females who
desire to dress themselves in male attire. A female transvestite may imagine that she possesses a penis.
2. Transexualism - The dominant desire in some person to identify themselves with the opposite sex as completely
as possible to discard forever their anatomical sex refers to Transexualism.

3. Intersexuality - It is a genetic defect wherein an individual show intermingling, in varying degrees, of the
characteristics of both sexes including physical form, reproductive organs, and sexual behavior.

Classification of Intersexuality:

a. Gonadal Agenesis - The sex organs (testes or ovaries) have never developed.
b. Gonadal Dysgenesis - The external sexual structures are present but at puberty the testes or the ovaries fail to
develop.
c. True Hermaphroditism - A state of bisexuality, having both ovaries and testicles. The nuclear sex is usually
female. The character may be neutral or whichever is dominant.
d. Pseudohermaphrodite - The sex organ is anatomically of one sex but the sex character is that of the opposite
sex.

Segment 7. Somatoform Disorders

Somatoform Disorder is a mental disorder characterized by physical symptoms that mimic physical disease or injury
for which there is no identifiable physical cause. The symptoms that result from a somatoform disorder are due to
mental factors. In people who have somatoform disorder, medical test results are either People normal who or don't
have explain the person's symptoms this disorder may undergo several medical evaluations and tests to be sure that
they do not have an illness related to a physical cause or central lesion. Patients with this disorder often become very
worried about their health because the doctors are unable to find a cause for their health problems.

Six (6) Major Types of Somatoform Disorder

1. Conversion Disorder (Hysteria) - This is a condition where a patient displays neurological symptoms such as
numbness, paralysis, or fits, even though no neurological explanation is found and it is determined that the symptoms
are due to the patient's psychological response to stress.

Symptoms are grouped as follows:

a. Sensory Symptoms - These include anesthesia, excessive sensitivity to strong stimulation (hyper anesthesia),
loss of sense of pain (analgesia), and unusual symptoms such as tingling or crawling sensations.

b. Motor Symptoms - In motor symptoms, any of the body's muscle groups may be involved: arms, legs, vocal
chords. Included are tremors, tics (involuntary twitches), and disorganized mobility or paralysis.

c. Visceral Symptoms - Examples includes trouble swallowing frequent belching, spells of coughing or vomiting, all
carried to an uncommon extreme, In both sensory and motor symptoms, the areas affected may not correspond at all
to the nerve distribution in the area."

2. Hypochondriasis - It is a somatoform disorder in which persons are preoccupied with their health and are
convinced that they have some serious disorder despite reassurance from doctors to the contrary.

3. Somatization Disorder - Also Briquet's disorder or, in antiquity, hysteria is a psychiatric diagnosis applied to
patients who chronically and persistently complain of varied physical symptoms that have no identifiable physical
origin.

4. Pain Disorder - It is when a patient experiences chronic pain in one or more areas, and is thought to be caused by
psychological stress. The pain is often so severe that it disables the patient from proper functioning. It can last as
short as a few days, to as long as many years.
5. Body Dysmorphic Disorder (BDD) It is previously known as Dysmorphophobia and sometimes referred to as
body dysmorphia or dysmorphic syndrome. It is a (psychological) somatoform disorder in which the affected person
is excessively concerned about and preoccupied by a perceived defect in his or her physical features (body image).

6. Undifferentiated Somatoform Disorder - Only one unexplained symptom is required for at least 6 months.
Included among these disorders are false pregnancy, psychogenic urinary retention, and mass psychogenic illness
(so-called mass hysteria) (Spoor, 1999).

Segment 8. Dissociative Disorders

Dissociative disorders are disorders in which, under stress, one loses the integration of consciousness, identity, and
memories of important personal events. These include four recognized varieties:

1. Psychogenic Amnesia - It is also known as Dissociative Amnesia is the temporary or permanent loss of a part or
all of the memory. When this is due to extreme psychosocial stress, it is labeled psychogenic amnesia. This stress is
most often associated with catastrophic events.

Four Sub-categories of Psychogenic Amnesia

Localized Amnesia- This is most often an outcome of a particular event. The disease renders the afflicted unable to
recall the details of a usually traumatic event, such as a violent incestuous rape. This is undoubtedly the most
common type of amnesia.

Selective Amnesia - As its name implies, this is similar to localized amnesia except that the memory retained is very
selective. Often a person can remember certain general occurrences of the traumatic situation, but not the specific
parts which make it so.

c & d. Generalized and Continuous Amnesia - These less common forms of amnesia exists when a person either
forgets the details of his/her entire lifetime, or as in the case of continuous amnesia, he/she can't recall the details
prior to a certain point in time, including the present.

2. Psychogenic Fugue - It is also known as Dissociative Fugue. Psychogenic fugue is simply the addition to
generalized amnesia of a flight from family, problem, or location. In highly uncommon cases, the person may create
an entirely new life (fugue means "flight")

3. Multiple Personality Disorder - It is also known as Dissociative Identity Disorder. It is defined as the occurrence
of two or more personalities within the same individual, each of which during sometime in the person's life is able to
take control. This is not often a mentally healthy thing when the personalities vie for control.

4. Depersonalization Disorder - This is the continued presence of feelings that the person is not himself/herself or
that he/she can't control his/her own actions. This is labeled as disorder when it is recurrent and impairs social and
occupational function (Santrock, 2000 & King, 2008).