Saturday, May 26, 2012

Eating and Weight, Substance Use, Sex, Gender, and Sexual, and Personality Disorders Matrix

Eating, Weight, and Eating Disorders:  Eating disorders are characterized by a refusal to maintain a normal body weight, and may include binge eating and starvation as compensatory measures to maintain control or to avoid weight gain.  It usually involves an obscured and inaccurate body image which, consequently, influences self-evaluation (Hansell & Damour, 2008).


Anorexia Nervosa

This disorder is characterized by a refusal to maintain a reasonable body weight.  It involves an intense fear of gaining weight or becoming fat, even if the individual is underweight.  Individuals have an extremely distorted image of their body and this image has an inappropriately weighted influence on self-evaluation.  Typically they lose their ability to recognize their seriously low body weight.  In women, it is common to have amenorrhea, a condition in which women's menstrual cycle ceases (Hansell & Damour, 2008).   In reverse anorexia in men, they have an altered perception and view themselves as small and weak despite large size and excessive muscle development.

Bulimia Nervosa
(Purging Type and Non-purging Type)

This disorder is characterized by cyclical episodes of uncontrolled binge eating followed by self-induced vomiting, misuse of laxatives or diuretics, fasting, or excessive exercise to prevent weight gain.  The binge eating and purging or other inappropriate compensatory behavior occurs at least twice a week for 3 months.  Body weight and shape become all encompassing concerns (Hansell & Damour, 2008).  Purging type bulimia is characterized by binge eating and then vomiting or using laxatives to avoid weight gain, whereas the non-purging type is characterized by binging and then fasting or using excessive exercise to avoid weight gain from (Krieg, Lauer, and Pirke, 1989)

Eating disorder not otherwise specified

This classification is for disordered eating behaviors that do not meet enough of the criteria for anorexia or bulimia. This classification could include people who are overly concerned about weight and body shape, although maintain normal weight or people who chew and spit out a large amount of their food so they won't gain weight.

Substance Use Disorders:  Substance use disorders are based on negative and erroneous relationships between a user and a drug, and demonstrates patterns of compulsive use, demonstrates no control over continued use, and continued use despite harmful and negative consequences (Hansell & Damour, 2008).


Substance Abuse

Substance abuse is characterized by the use of a substance that causes negative consequences for the user, although the user continues despite such consequences.  Other characterizations include compulsive use and a loss of control over the use of the substance as when the user uses more of the substance in larger amounts or more frequently than planned (Hansell & Damour, 2008).  To determine substance abuse the relationship between the user and the drug must be assessed.  If the relationship appears maladaptive, if it harms the user, and interferes with daily functioning, it is likely substance abuse.

Substance Dependence

Substance dependence is a more severe diagnosis and is commonly referred to addiction.  It involves negative consequences and compulsive use of the substance, loss of control over its use, and, in some cases, physical or psychological dependence.  Substance dependence is often compulsive, out of control, and has negative consequences for the user that includes physical dependence on the substance (Hansell & Damour, 2008).   Attributed at least in part to the user's biological predisposition, two defining symptoms are tolerance and withdrawal (Goldstein & Volkow, 1989). 

Sex, Gender, and the Sexual Disorders:   These disorders are concerned with the functionality or lack thereof the sex act and its bizarre deviations, and gender identity.  These disorders are persistent, and impair normal functioning (Hansell & Damour, 2008).


Sexual Dysfunctions

The sexual dysfunctions are recurrent and distressing problems that cause impairment to normal functionin in desire, arousal, and orgasm during normal sexual experience.  Sexual dysfunctions are divided into sexual desire disorders, sexual arousal disorders, and orgasmic disorders (Hansell & Damour, 2008).


Paraphilias are more severe disorders than the sexual dysfunctions, which involve deviant and bizarre  sexual relationships and preferences.  The most common paraphilias are voyeurism, exhibitionism, fetishism, pedophilia, frotteurism, sexual masochism, and sexual sadism (Hansell & Damour, 2008)

Gender Identity Disorder

Gender identity disorder involves an intense discomfort or dislike toward one's biological sex often accompanied by the desire to change one's sex.  There is usually a strong and persistent identification with the opposite gender.  People with this disorder feel as if they can neither relate to the body they inhabit nor the roles typical to their gender.  Significant distress and disruption of normal functioning is common in this disorder (Hansell & Damour, 2008).

Personality Disorders:  Disorders that are characterized by extreme and rigid personality traits that cause impairment and usually involve extreme versions of common personality traits (Hansell & Damour, 2008).


Cluster A:
Paranoid, schizoid, and schizotypal personality disorders


People with schizoid personality disorder have eccentric behaviors, distorted perceptions and thought processes, and tend to be distant, detached, and indifferent to social relationships.  (Hansell & Damour, 2008; The Cleveland Clinic Foundation, 2009).

Paranoid personality disorder Personality traits involving extreme distrust and suspiciousness. . (Hansell & Damour, 2008).

Cluster B:
Antisocial, borderline, histrionic, and narcissistic personality disorders.


Antisocial personality disorder involves total disregard for others and an inclination toward violating the rights of others (Hansell & Damour, 2008).

Borderline personality disorder characteristically involves a definitive instability in interpersonal relationships, emotions, impulsivity, self-image, and self-destructive behavior (Hansell & Damour, 2008).

Histrionic personality disorder involves the use of excessive and superficial emotions and any behavior that will draw attention (Hansell & Damour, 2008).

Narcissistic personality disorder is characterized by an extremely inflated sense of self, self-preoccupation, self importance, and a need for admiration, and lack of empathy (Hansell & Damour, 2008).

Cluster C:
Avoidant, dependent, and obsessive-compulsive
personality disorders.


Avoidant personality disorder involves social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.

Dependent personality disorder characteristically involves submissive and clinging behavior related to an excessive need to be cared for by others (Hansell & Damour, 2008).

Obsessive-compulsive personality disorder involves the preoccupation with rules, orderliness, perfectionism, and control at the expense of spontaneity, flexibility, and enjoyment (Hansell & Damour, 2008).

Goldstein, R. Z., & Volkow, N. D. (2002). Drug Addiction and Its Underlying Neurobiological Basis: Neuroimaging Evidence for    the involvement of the frontal cortex. The American Journal of Psychiatry, 159(10), 1642-1652
Hansell, J., & Damour, L. (2008). Abnormal psychology. Hoboken, NJ: Wiley.
Krieg, J., Lauer, C., & Pirke, K. (1989). Structural brain abnormalities in patients with bulimia nervosa. Psychiatry Research, 27(1), 39-48. doi: 10.1016/0165-1781(89)90007-3
The Cleveland Clinic Foundation. (2009). Schizoid personality disorder. Cleveland Clinic. Retrieved May 18, 2011, from

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