Abnormal

Psychology
Abnormal behavior is one of the most difficult things to do. There are
as many interpretations of what may be considered abnormal and what
may not, as there are individuals. Although the different mental health
experts have not arrived at a consensus as to what constitutes abnormal
behavior.
Deviation from statistical norms defines abnormal behavior according
to what is uncommon in a given population. Those who may be
considered to possess a statistically uncommon trait and who behave
accordingly are often seen as being different.
Social norms determine what is considered abnormal social norms
pertain to behaviors and characteristics that are acknowledged by a
given society. Any behavior that defies these generally accepted
standards may be deemed abnormal.
Maladaptiveness of behavior is the third, and probably the most
important criterion in defining the abnormality of a certain behavior. It
may include uncontrollable behaviors that are considered ineffective,
unproductive, of unlawful.
Level of personal distress a person may feel about his/her thoughts
and actions. Many people diagnosed as mentally ill often feel very
miserable. They may feel anxious or depressed with themselves.
Normality is even more difficult to define, as it encompasses a wide
variety as well as different degrees of behavior.
 The Diagnostic and Statistical
Manual for Mental Disorders (DSM)
The Multi- Axial System

The Diagnostic and Statistical Manual for Mental Disorders

is the most widely used classification system for abnormal behavior. It
recommends a multi- axial assessment that covers several
dimensions. Realizing that the presenting problem may not reflect all
the integral information needed to summarize clinical information, this
diagnostic procedure is accomplished in order to capture the
complexity of each client. The five axes cover the following areas:
Axis I - This is where the main diagnostic category is coded. It includes
the main focus of attention and often covers the primary reason
behind why client was referred.
Axis II In some instances, more long- standing psychological
conditions need to be considered. Mental retardation and personality
disorders are coded in this axis.
Axis III This axis contains any existing physical disorders/ conditions
that may need medical attention.
Axis IV The personal difficulties and stressful events that precipitated
the current disorders are duly noted in this axis.
Axis V The global assessment of functioning is coded in this Axis. A
scale of 100 points is used to reflect the quality of the general
functioning of the individual in the past year.

The following 17 diagnostic categories:

1. Disorders usually first diagnosed in infancy, childhood, or
adolescence These disorders include mental retardation and delays
in the various aspects in which children and adolescents are expected
to develop.
2. Delirium, dementia, amnestic, and other cognitive disorders
They cover the permanent or temporary impairment of the functioning
of the brain as a result of aging, degenerative diseases of the nervous
system, or the ingestion of toxic substances.
3. Mental disorders due to a general medical condition The
presence of mental symptoms is assessed to be the direct
physiological consequence of a medical condition.
4. Substance related disorders These include disorders caused by
the excessive and/or habitual use of one or more psychoactive
substances that alter behavior, the side effects of a prescribed
medication, or exposure to a toxic substance.
5. Schizophrenia and other psychotic disorders These are
characterized by gross impairment of reality testing, marked
disturbances of thought and perception, and bizarre behavior.
6. Mood disorders These are disturbances of normal mood.

7. Anxiety disorders Feelings of anxiety are either the main

symptom or play a crucial role in disorders of this nature.
8. Somatoform disorders In this group of disorders, physical
symptoms have no biological basis.
9. Factitious disorders Feigning or intentionally producing physical
or psychological symptoms to appear sick without any apparent gain
to a manifestation of these disorders.
10. Dissociative disorders These disorders are marked by temporary
shifts in the functions of consciousness, memory, identity, or
perception of the environment due to emotional problems.
11. Sexual and gender identity disorders Distress in these
disorders is caused by problems with sexual identity, sexual
performance, or the direction of sexual arousal.
12. Eating disorders These disorders include self- induced starvation
and/or binge eating, usually accompanied by an inaccurate
perception of ones body image.
13. Sleep disorders These disorders are evinced in pervasive and extreme
problems in sleep patterns.
14. Impulse control disorders These disorders include the inability to control
anger and the desire to steal, gamble, set fire, or pull ones hair.
15. Adjustment disorders these disorders cover emotional and/or behavioral
difficulties due to an identifiable stressor.
16. Personality disorders Long-standing and rigid patterns of inner experience
and maladaptive behavior that constitute immature and inappropriate ways of
coping with stress or solving problems are manifestations of this type of
disorder.
17. Other conditions that may be the focus of clinical attention They
include problems and life events for which people may seek professional
assistance.

Neuroses disorders characterized by feelings of anxiety, conflicts, and

negative reactions, which are often not fully understood. Majority of people
suffering from certain neuroses are able to go to work and can establish as
well as maintain relationships with others.
Psychoses indicate a loss of ones contact with reality. Many people suffering
from a psychotic disorder have disordered thought patterns and disturbances
in emotionally. These may manifest themselves in false beliefs about the
person and the world around them (delusions), false sensory perceptions
(hallucinations), or thought and/or behavioral disorganization. Many
individuals are likewise disoriented with regard to time, place, and person.
 Pros and Cons of the DSM

The use of diagnostic manuals like the DSM-IV-TR (2000) can surely help ease
the communication of complex behaviors among mental health
professionals. At the same time, the categories employed help build an
understanding of the possible causes of the disorders and effective
treatment options. Some people have needlessly suffered from labels and
categories that do not reflect the individual nuance of their behaviors. The
fact that the DSM-IV-TR (2000) is American-made presents another serious
disadvantage for users of the manual here in the Philippines. While many of
the diagnostic categories listed are widely accepted, many aspects in the
Filipino culture need to be taken into consideration before a Filipino can be
so labeled. For instance, the phenomenon of sanib or sapi is a relatively
common form of dissociative disorder that is not found in the manual.
There are certain mental disorders that exist in certain cultures which do
not correspond to any DSM-IV-TR (2000) category.

Explaining Abnormal Behavior

Biological perspective - explains mental disorders in terms of disturbed

neuro-endocrine functions.
Psychoanalytic perspective emphasizes the importance of unconscious
conflicts and the maladaptive use of defense mechanisms.
Behavioral perspective focuses on abnormal behaviors as learned
experiences.
Cognitive perspective concerned with conscious mental processes that
cover the areas of motivation, emotions, and conflicts.
Biopsychosocial approach (Santrock, 2003) interactionist perspective of
understanding abnormal behavior.

The Psychological Disorders

The disorders discussed in this chapter include the following classifications:
disorders usually first diagnosed in infancy, childhood, or adolescence;
anxiety disorders; mood disorders; dissociative disorders; schizophrenia;
and personality disorders. In the section on the disorders usually first
diagnosed in infancy, childhood or adolescence, autism and the attention-
deficit/hyperactivity disorder are illustrated. Among anxiety disorders,
panic episode, specific phobia, and obsessive-compulsive disorder are
discussed. Major depressive disorder and manic episodes are classified
under the mood disorders. In the category encompassing dissociative
disorders, only dissociative identity is considered. A discussion of
schizophrenia as a general disorder follows. Finally, the cluster on
personality disorders, which includes antisocial, borderline, and passive-
aggressive personality disorders, is tackled. These are meant to
concretely illustrate the various disorders as seen in our society.
 Disorders Usually Diagnosed in Infancy,
Childhood, or Adolescence
Mental retardation This disorder is demonstrated by poor performance
in intelligence tests and by concurrent deficits in adaptive functioning(e.g.,
self-help skills, communication skills, social skills).
Learning disorders Disorders under this category are characterized by

significant lags (considering age and academic exposure) in learning the

three basic academic skills, namely, reading, writing, and mathematics.
Pervasive Development Disorders (PDD) These disorders are

characterized by severe and pervasive impairments in several areas of

development, including the areas of social interaction, communication, and
motor skills, where the presence of odd stereotyped behaviors is observed.
Attention-Deficit/Hyperactivity Disorder (AD/HD) This disorder is

marked by lack of focus, excessive and inappropriate physical activity, and

poor impulse control.
Some familiarity with the normal course of child development is necessary.
For example, a child 3 years of age may not be diagnosed to have a learning
disorder, as children do not learn basic academic skills until they are of
school age, and understandably, have had some school exposure (about 7
to 8 years of age). Similarly, the same 3-year-old child cannot be given a
diagnosis of Attention-Deficit/Hyperactivity Disorder because children at
this age are often physically hyperactive
and cannot sustain attention. However, when this child turns 8 years old and
still behaves in the same inattentive and hyperactive-impulsive manner, a
diagnosis may be warranted. Although early descriptions of children
diagnosed with these disorders blamed the condition on the lack of parental
emotional responsiveness, parental rage and rejection, and parental
reinforcement of autistic symptoms, Sadock and Sadock (2003) clarified that
none of these claims have been adequately substantiated by studies.
Mental retardation, for instance, is known to be caused by some
chromosomal abnormalities (as is evident in Downs syndrome and the
Fragile X syndrome, for instance) and other genetic factors. Head trauma,
serious infections in the brain, and exposure to certain toxic substances can
likewise cause severe learning disabilities.

Pervasive Developmental Disorders (PDD)

A cluster of disorders characterized by severe and sustained delays
observed across the various areas in which children are expected to
develop. Primary among these areas are the following: social skills,
language development, and motor skills. These disorders are lifelong
conditions for which no known cure has yet been found. The most well-
known among these disorders is autism. Before the age of 3 years, children
may be diagnosed to have PDD. This disorder is often marked by delays in
social interaction, language as used communication, and the ability to
engage in symbolic or imaginative play. Children with PDD may exhibit a
limited amount of attachment to their primary caregiver.
They may also not exhibit the usual separation anxiety when left in an
unfamiliar surrounding with strangers. Due to their delayed social skills,
their language capacities often fail to reflect the social reciprocity of
conversations. It is common among young children with this disorder to be
mistaken as deaf, because they do not respond to calls and selectively
ignore certain sounds. When they learn to talk eventually, they may say
something totally different from what the other person is saying. Many of
those diagnosed with autistic disorder have repetitive and stereotyped
patterns of behavior and interests. They may be consumed by spinning
objects and may engage in hand flapping or twisting. They often have very
poor eye contact and prefer to play alone. They usually indulge in games
that have no apparent theme but are mere repetitions of patterns.
For example, a child with autism may arrange his toys in a line and be

totally absorbed with this pattern. He may ask repetitive questions that do
not seem relevant to a given situation. The way such a child plays with toys
ad objects likewise often reflects a rigid, monotonous, and repetitive style.
The child may also manifest an attachment to certain inanimate objects.
Many among these diagnosed with autism have cognitive limitations,
mental retardation is not a criterion for diagnosis. There are children with
autism who are referred to as high functioning. This term suggests that
although the child exhibits behavior patterns associated with autistic
disorder, he/she is able to meet the demands of regular schooling and other
demands of being more independent. A number of children and adults
diagnosed with autism exhibit exceptional skills in very specific areas.
These pockets of giftedness are called savant skills. Some children with this
condition are able to play the piano despite never having taken lessons.
Others are able to tell the day of the week, given any calendar date of any
year. These skills are often limited to certain areas only and hardly
generalize to other skills.

Attention-Deficit/Hyperactivity Disorder (AD/HD)

Characterized by these behavioral markers: lack of focus and attention
span, physical hyperactivity, and impulsiveness. Some children diagnosed
with this disorder may present primarily symptoms of being unable to focus
on a task on hand and flit from one activity to the next whereas others may
be diagnosed with primarily excessive physical or motor movements and
impulsive behaviors. Many of them also have symptoms of aggression and
defiance. All these symptoms/behaviors must be seen in the context of
childhood development and should manifest deviation from what may be
considered within the range of typical behaviors of children at certain ages.
They must persist for an extended period of time before a child turns 7
years of age. The main cause of AD/HD is not known. Although minimal
brain damage has long been suspected to be a possible cause of this
disorder, research has revealed inconsistent results. Many studies have
suggested biological antecedents to this disorder (Barkley, 2002; Melillo &
Letsman, 2004). There is some evidence linking the disorder to generic
factors, as there
appears to be a higher occurrence of the disorder among identical twins
than fraternal twins. Neurotransmitters such as dopamine and
norepinephrine have also been associated with AD/HD, as evidenced
by the effectiveness of certain psychoactive substances in the
treatment of certain symptoms associated with the disorder. Yet
another area in the study of the cause of AD/HD focuses on comparing
the blood flow and electrical activity on certain parts of the brain of
people with and without AD/HD. Researchers believe that an
interactive process of multiple factors may actually be involved. Many
factors affect the behaviors of children. Most of the causes of AD/HD
being explored are biological in nature, it is generally acknowledged
that stressful events in young childrens lives may initiate and
perpetuate symptoms of the disorder. Repetitive or significant family
disruptions and prolonged emotional deprivation are some of the
psychosocial factors that may contribute to behaviors linked to
AD/HD.
People with AD/HD
 Anxiety Disorders
All humans experience anxiety. This is an unpleasant emotion often
accompanied by autonomic responses or physiological reactions such
as perspiration, increased heart rate and higher blood pressure,
tightness in chest, and mild stomach discomfort. Anxiety is also often
accompanied by fear, an alerting signal of impending danger or threat
to oneself.
These are normal reactions in stressful situations:
1. Anxiety disorders a group of disorders characterized by persistent
experience of fear, apprehension, and distress. In an attempt to lessen the
overpowering anxiety, maladaptive behaviors often develop, such as the
avoidance of certain things, places, and situations. These attempts at coping
with the felt distress may cause a significant disruption of daily routines,
school or work productivity, and relationships.
Examples of these anxiety disorders:
. Psychoanalytic theories unconscious conflicts may be traced to early
childhood. Feelings of inadequacy and lack of control may have resulted from
a punitive disciplining strategy during toilet training.
. Behavioral theories focus on anxiety as a learned response to external
events, and invoke principles of associative learning to explain some phobias.
. Cognitive theories emphasize the way anxious people think about
potential dangers: their overestimation of the likelihood and degree of harm
makes them tense and physiologically prepared for danger.
. Biological theories focus on the interaction of a number of
neurotransmitters (including norepinephrine, serotonin, and gamma-
aminobutyric acid) that regulate feelings of anxiety. Biochemical abnormalities
and genetic evidence have likewise been identified in panic attacks and
obsessive-compulsive disorders.
. In the Philippines, particularly for the Tagalogs, anxiety disorders are often

referred to as nerbyos. It is commonly heard that someone ill at ease was

inatake ng nerbyos (having the case of the nerves).
2. Panic disorder characterized by recurrent and unexpected panic
attacks. According to the DSM-IV-TR (2000), a panic attack is marked by
discrete period in which there is the sudden onset of intense
apprehension fearfulness, or terror, often associated with feelings of
impending doom. These feelings are often accompanied by
palpitations, sweating, shortness of breath, and trembling. They may be
experienced with or without agoraphobia. Agoraphobia is the fear of
being in places where escape may be difficult or embarrassing, or where
help may be unavailable when an unexpected panic attack occurs.
People who experience panic attacks with agoraphobia will require the
constant company of someone, and will avoid being in a crowd of
people, in an elevator, and other similar situations.

Specific Phobia
. A person suffers from a specific phobia when a marked and present
fear is experienced when exposed to a known object or situation. These
limited and identifiable objects or situations vary from person to person,
and may include the following: flying, seeing an animal or insect, seeing
blood, etc. When exposed to the feared object or situation, the person
suffering from the phobia may exhibit symptoms of a panic attack. The
person often has insight on the irrationality of the fear, but reactions are
too persistent and too severe to simply brush aside. A person will
typically avoid the feared situation using every
means possible. As the mere anticipation of the anxiety can cause
distress, the avoidance strategies involved may often interfere with
everyday routines.
 Obsessive-Compulsive Disorder (OCD)
Obsessive-compulsive disorder is an anxiety disorder in which
the mind is flooded with persistent and uncontrollable thoughts
and the individual is compelled to repeat certain acts again and
again, causing significant distress and interference with everyday
functioning (Davison & Neale, 2001). Obsessions are persistent
thoughts and impulses perceived to be disruptive and anxiety-
provoking and to be beyond what may be considered everyday
worries. Compulsions are repetitive behaviors or mental acts
performed according to rigid rules and rituals, and usually
designed to alleviate specific obsessive thoughts.
Examples of compulsions are repetitive checking if the door has
been locked, the excessive washing of hands, and counting cracks
in the street. The obsessions and compulsions of people suffering
from OCD consume a significant amount of their time. They may
interfere with regular daily routines and cause the person to be
less effective in other areas of functioning, including work and
relationships. Individuals with OCD recognized that their
obsessions and compulsions are excessive. Despite this insight,
however, they have great difficulty correcting their behavior.
 Post-Traumatic Stress Disorder (PTSD)
One of the grave effects of acute stress that result from natural
calamities(e.g., earthquakes, volcanic eruptions, typhoons, and
flooding), war, severe abuse(e.g., physical or sexual assault), and
accidents(e.g., plane crashes and automobile accidents) is severe
anxiety immediately after and long past the actual incident. This
pervading lack of feelings of safety is called post-traumatic stress
disorder (PTSD). Symptoms are characterized by nightmares when
asleep or during flashbacks of the incident while awake. A general
feeling of numbness and finding difficulty in experiencing everyday
joys may likewise be observed. An underlying sense of hypervigilance
and being easily startled are constantly experienced. Not all people
who experience the same stressful event will develop PTSD. Many
factors are involved in PTSDs incidence among individuals. Ones
ability to cope with stressors in life in general and the availability of
an external support system(e.g., friends and family) are two factors
that have been known to affect its onset.

Mood Disorders
Mood disorders include depressive disorders and bipolar
disorders(when there are periods of mania).
Depressive disorders characterized by sadness, loss of gratification in
life, negative thoughts, and the lack of motivation.
Bipolar disorders distinguished by alternate bouts of depression and
mania. Characterized by physical hyperactivity and an exceptional feeling
of euphoria, mania may often make a person do extraordinary feats
because energy does not seem to run out.
It is often in depressive states when people carry out plans to commit

suicide or harbor the desire to do so. Helplessness, loneliness, problems,

and difficulties are some of the reasons why many people consider this
option. While some people commit suicide do so because they find their
emotional distress intolerable and unsolvable, others may attempt suicide
merely to get attention. Whereas the former intend to end their miseries by
ending their lives altogether, the latter resort to suicide to impress others
with the seriousness of their problems. In a book entitled I Dont Want to
Talk About It, Real (1997) shared that men may display depression
differently from women. He relates this tendency to the cultural
expectation that depression is a womans illness because emotions are
usually considered part of the womans domain, whereas men are expected
to be stoically strong in the face of pain and other negative feelings. Men
tend to mask their depression with other forms of behavior, such as
physical illness, alcohol and drug abuse, domestic violence, intimacy
failures, self-sabotage in careers. He strongly advocates that the present
culture accept the fact that men do got depressed, for the men to be able
to obtain proper treatment for it.
The psychoanalytic perspective interprets depression as a reaction to
loss, whatever the nature of this loss may be. It may also be seen as a
kind of anger directed toward the self, when there appears to be
nobody else to blame but oneself. The behavioral perspective sees
depression as a reaction to the lack of positive reinforcements and/or
the proliferation of negative experiences in ones life. Cognitive
theorists insist that depression is not due to what people do, but to
how they view themselves and the world around them. One such
theory was developed by Beck (1979) who views depression as a
cognitive triad of negative thoughts about the self, present
experiences, and the future. Mood disorders are greatly influenced by
genetic predisposition.

Major Depressive Disorder

Major depressive disorder may be diagnosed when sad feelings
and a general loss of interest or pleasure is experienced for a period
of at least 2 weeks. In children and adolescents, these feelings may
also manifest through irritability. Many people who become depressed
experience concomitant weight loss and disturbance in sleeping
patterns (i.e., too much or too little). They become lethargic and have
very little energy for anything. A diminished sense of worth and guilt
may likewise be present.
 Bipolar Disorder
Bipolar disorder characterized by extreme fluctuations of mood.
People who suffer from this disorder alternate between unusually high
highs and severely low lows, forming a cycle. When they are feeling
high (manic), they feel invulnerable, even invincible. In these euphoric
moments, they are full of energy and are convinced that they can do
the most ambitious feats with little prior experience. As they fall from
their highs, the unbearable despair and pain (depression) that ensues
consumes them.
 Dissociative Identity Disorder
Dissociative identity disorder (DID), formerly known as multiple
personality disorder, is characterized by the presence of two or more distinct
identities or personality states in a person. These identities have their own
patterns of thinking, behaving, and relating to others, their own individual
perceptions of reality and self. A personality or two dominate the persons
behaviors. These identities are also sometimes called alters (Hales & Hales,
1995), and may have a name or may be labeled according to their main trait.
For example, a woman with DID may have four personalities: the Judge who
metes out punishment, the Little Girl who keeps crying, Mr. Macho who is stoic
when in pain, and the Flirt who goes out on sexual adventures with strangers.
Another feature of this disorder is that the person is unable to remember
pertinent information about herself, notwithstanding the fact that this
information is too massive to be explained by simple forgetfulness. Did is
more prevalent among woman than men, with women averaging 15 identities
as compared to the eight identities of men. The cause of DID is really
unknown, a great majority of those suffering from it have been noted to
experience a chronic traumatic event such as physical or sexual abuse during
their childhood. No firm biological evidence has been established for DID, a
high preponderance of abnormal brain activity, as measured through the
electroencephalogram (EEG), has been reported. When people talk about
mental illness in everyday conversation, the terms split personalities and
schizophrenia are often associated. The two terms are actually distinct
diagnostic labels that connote very different symptoms.
Painting of Mukti Alamsyah
 Schizophrenia
Schizophrenia characterized by disturbances in the form of thought
(disorganized and often irrelevant speech), in the content of thought
(presence of delusions and lack of insight), and in affective response
(flattening of feelings). Disorganized thinking is often observed through the
invention of new words (neologisms) or mixed-up sentences of incoherent
words.
For example, a person suffering from schizophrenia may be heard mumbling
to himself/herself: The world is endless in the sense of lightness with me in
the middle of it all. Other symptoms of schizophrenia also include
perceptual disturbances (such as hallucinations, which may take on any of
the following forms: auditory-hearing voices that are not present; or
olfactory-smelling objectively absent odors), inappropriate affect (intense
fear or anger for no apparent reason), bizzare motor activity, loss of speech,
withdrawal from reality, and impaired functioning. People with schizophrenia
are often observed to have difficulty relating with other people
appropriately, and their normal everyday functioning is usually severely
deteriorated. Other biological causes that have also been studied include
irregularities of neuro-chemicals (particularly dopamine) and differences in
brain structure (decreased limbic system size and larger cerebral ventricles)
between those who have been diagnosed with schizophrenia and those who
have not. The relative success of drug treatment in those diagnosed with
schizophrenia contributes to the recognition of its biological basis. There is
reason to believe that schizophrenia has strong
biological causes, certain social and psychological factors cannot be
overlooked. In studies around the world, especially in industrialized
countries, there seems to be a relatively more frequent occurrence of
schizophrenia among people in the lower socio-economic classes than
in any other groups. This may be due to the tendency of those with
such illness to move into or to fail from rising from a low socio-
economic group. The stresses of being poor may contribute to the
development of the illness.
For example, a person diagnosed with schizophrenia who may have

delusions of grandeur may be reacting to an injured self-concept.

Because of the distorted thought patterns of people suffering from
schizophrenia, the incidence of their successfully committing suicide is
high. Studies show that they are more likely to hurt themselves than
other people.
The Scream by Edward
Munch
 Personality Disorders
Personality disorders long-standing, culturally maladaptive
behaviors that constitute immature patterns of coping with stress or
solving problems. Personality disorders develop over the years, from
childhood through adolescence and adulthood. Only adults are
diagnosed with these disorders. The rigidity and immaturity with
which a person employs a pattern of coping are hallmarks of these
disorders. Their behavioral symptoms are difficult to isolate and study
scientifically. People suffering from a personality disorder may not see
the necessity of changing their ways and may stick to their
maladaptive responses despite feedback from others. Substantial
evidence supporting biological factors as possible causes of these
disorders has emerged. Twin studies have revealed similar interests
and basic temperaments among monozygotic twins, whether reared
together or apart. In other studies, people diagnosed with the three
different clusters of personality disorders were found to be more likely
related to people diagnosed with other similar mental disorders. Other
biological factors explored include hormones that regulate impulse
control, as well as neurotransmitters responsible for aggressive
behaviors.
Only three personality disorders will be discussed, namely, antisocial,
borderline, and passive-aggressive personality disorders.

Antisocial Personal Disorder People diagnosed with this disorder tend

to possess little sense of responsibility, morality, and concern for others.
They are often interested only in their own gains and lack a guiding
conscience. Seldom, if ever, do they feel remorse for offenses they have
committed against others. They are impulsive thrill seekers, often
disregarding their own safety, let alone other peoples security. There is
some evidence that points to genetic factors as leading to antisocial
behavior mostly related to low levels of arousability and impulsiveness. As
a result, an inherent tendency to interpret vague social cues as prompting
aggression may ensue.
Borderline Personality Disorder marked by psychological instability
and fear of abandonment. Persons suffering from this personality disorder
often have unstable moods, self-concepts, and interpersonal relationships.
These individuals are also prone to transient episodes where they feel
unreal, lose track of time, and forget who they are. People who suffer from
this disorder may have a fleeting concept of themselves. One minute, they
may feel good about themselves; the next, they may debase themselves.
They are irritable and prone to temper tantrums for no apparent reason.
They may engage in self-injurious behavior, which may lead to successful
suicide. They view people in characteristic instability, thereby leading them
to appraise one person
ideally one minute, and to attest to the exact opposite the next. They are
unable to maintain stable and meaningful relationship with other people.
The present understanding of the cause of this personality disorder is unclear.
An increased prevalence of certain mental disorders has been found among
first-degree relative of those diagnosed with this disorder in the US. The
fact that a good number of those diagnosed with this disorder had histories
of physical or sexual abuse further supports this cognitive-behavioral view.
Passive-Aggressive Personality Disorder defined as a pattern of

negativistic attitude and passive resistance to perform adequately.

Intentional inefficiency, particularly at work, is demonstrated through
procrastination, stubbornness, and forgetfulness. Persons said to be
passive-aggressive usually refuse to confront their adversary. They are not
very good in dealing with authority figures and often vacillate between
hostile defiance and guilt. They characteristically engage in vengeful acts
on their foes by simply doing nothing (passive resistance). They may be
observed to constantly complain about the demands of other people on
them and feel unrecognized for their achievements. They are often envious
and resentful of other peoples successes. Filipinos tend to engage in
behaviors that may be considered indicative of this pattern, given the
nonconfrontational aspects of the culture. People who suffer from this
disorder may have had punitive and hostile parents who discouraged them
from openly expressing themselves.
 Suicide
Suicide the act of hurting oneself with the desire to take ones own life,
whether successfully or not, has always remained a morbid fascination
among us. The possibility of suicide is a reality to anyone, whether rich or
poor, educated or uneducated, young or old, famous or ordinary. An interview
with Lynn Crisanta Panganiban, MD , Chairperson of the National Poison
Control and Information Service of the Philippine General Hospital, revealed
that in the past few years, there has been an apparent increase in the
number of suicide attempts among individuals aged 10 to 35 years old
(personal communication, 8 December 2003). She also shared that the
substances most commonly ingested are those found in ones home:
paracetamol, bleaching agents, pesticides, prescription drugs, rat killers,
malathion, and muriatic acid. She observed that the one attempting suicide
usually takes these chemicals while locked in a room. Suicide is also
attempted through hanging, shooting oneself with a gun, or carbon monoxide
poisoning. Dr. Panganiban added that attempts are frequently consummated
right after a fight with a family member, such as ones parents: or with a
significant other, such as ones boyfriend or girlfriend. In their book, Treating
Suicide Behavior, Rudd, Joiner, and Rajab (2001) mentioned that while
stressful events in ones life, such as the loss of a job, financial status,
relationships, sense of identity, and physical or cognitive ability may trigger
a suicide attempt, certain cognitive beliefs may actually underlie these
stressors that influence one to go into a suicidal mode. They cited Becks
studies (1996, as cited in Rudd et al., 2001), stating that a person
who commits suicide may have a pervasive sense of hopelessness, as
distinguished by having a sense of helplessness (e.g., I cant do
anything about my problems), feeling unlovable (e.g., I dont deserve
to live. Im worthless), and poor distress tolerance (I cant stand
feeling this way anymore). A suicide attempter may lack effective
problem solving skills and may, instead, have a poor grasp of the
following skills: conflict resolution, regulation of emotions, anger
management, and impulse control. The suicide attempter may also
have self-perception problems. Rudd et al. (2001) added that although
people may attempt to commit suicide, not all intend to die. At times,
the attempt is undertaken merely to hurt someone back, to gain
attention, or release tension. These possibilities show that the decision
to commit suicide may be an impulsive thought. Statistics in the United
States show that suicide among adolescents has quadrupled since
1950. The number of suicide attempts among girls is thrice the number
among boys, whereas the number of completed suicides is five times
higher among boys than girls. While the ordinary man on the street
may think that one who commits suicide is crazy, usually, those who do
attempt suicide are diagnosed to have mood disorders, especially
depression and borderline personality disorder where suicidal ideation,
suicide attempts, or self-injurious behaviors are among the symptoms.
Those suffering from schizophrenia and those diagnosed to suffer from
substance abuse have likewise been known to attempt suicide.
The studies cited earlier will demystify suicide and show that people who
attempt it are not crazy people, but are people who need help. Much
can be done when one is privy to anothers previous attempt or
intention to commit suicide. In their book, Helping Your Depressed
Teenager, Oster and Montgomery (1995) suggested that when a
peer or classmate threatens to commit suicide, talking to him or her
about it may be crucial. One may fear that talking about the suicide
attempt may encourage the teenager to think about it more, when
actually, talking about it communicates a message of hope and
caring, which inhibits such thoughts. When a person is found to have
attempted suicide, immediate medical attention must be
accompanied by consultations with either a psychiatrist or a
psychologist. Sessions with a mental health professional may need to
be sustained to obtain a comprehensive history and evaluation of the
one who attempted suicide. Suicide is not a disorder in itself but its
inclusion in the chapter was deemed important as many of those who
seriously contemplate or attempt suicide may be suffering from a
mental disorder.