Eating, Substance Abuse, Sex/Gender/Sexual, Impulse-Control, and Personality Disorder

Normal behavior is accepted world-wide, but when people show abnormal behavior, it is accepted by the few that may understand why this is their behavior. Abnormal behavior that disrupts an individual’s life on a daily basis can be caused by several disorders. These disorders can very complex at times and some are more devastating to the mind and body than others. In this paper, the biological, emotional, cognitive, and behavioral components of eating, substance abuse, sex/gender/sexual, impulse-control, and personality disorders will be analyzed.
Biological
Eating Disorder Genetics and abnormalities in hormones, neurotransmitters, and brain structures are focused on to explain how eating disorders are developed. Studies have shown that identical twins are more likely to have anorexia and bulimia than fraternal twins. However, other studies show that eating disorder symptoms can be greatly influenced by nongenetic factors, such as obsessive-compulsive anxiety disorder and depression. Eating disorders are seen as an extension of obsessive-compulsive anxiety disorder by some clinicians because people may develop the compulsive need for dieting, exercising, or purging as a result of obsessional thoughts about being overweight (Hansell & Damour, 2008). As for hormonal abnormalities, two hormones (leptin and ghrelin) have been the main focus in recent research. Leptin is a hormone that suppresses appetite and ghrelin is a hormone that stimulates hunger. Lower than normal levels of leptin have been found in people suffering from bulimia, as well as ghrelin levels not dropping off after a meal. People with anorexia have abnormally high levels of ghrelin, but drop back down to normal levels when they gain weight which makes it unable to confirm that ghrelin abnormalities cause anorexia. Also, endorphins may cause anorexics and bulimics to want to behave this way because endorphins are secreted as a response. This then may reinforce eating disorder behavior (Hansell & Damour, 2008). Low levels of neurotransmitters, such as serotonin may be associated with anorexia and bulimia. Serotonin is associated with appetite regulation, mood and anxiety disorders, impulse control problems, and obsessional thinking. It is still undetermined though if low levels of serotonin result in eating disorders or cause them. There have been numerous studies done, all having different results. Some have found that serotonin levels go back to normal found once the eating disorder ends; other studies have found that serotonin abnormalities continue after recovery. So whether or not serotonin causes or is a result of eating disorders is still trying to be figured out (Hansell & Damour, 2008). It has been found that abnormalities in brain structures can either cause eating disorders or be a result from them. Some studies show that the abnormalities disappear when their weight is back to normal, but then there is evidence of the abnormalities continuing after recovery and the total volume of gray and white matter is less in adolescents who suffered from malnourishment (Hansell & Damour, 2008).
Substance Abuse When taking drugs, the dopamine transmitter system is affected and they activate the “reward pathway” which releases dopamine into the brain. Once stimulated, surges of pleasure run through the brain and body which reinforce the use of substances. The amygdala and hippocampus create lasting memories of the pleasuring feelings and can easily be activated by environmental reminders. Normal dopamine and glutamate control can be interrupted with persistent use of drugs and pathways that used to produce pleasure may not work the same way; this then creates a risk for developing an addictive cycle of craving drugs, especially during stressful times (Hansell & Damour, 2008).
Genetics may also play a role in contributing to the misuse of substances. In terms of alcoholism, studies show that alcoholism is in the genes, but shared environments can also justify why alcoholism can run in the family. Many studies on identical twins, fraternal twins, and adoption have been done to provide evidence on alcoholism in relation to family. In one Swedish study, researchers found that identical twins were at 58% and fraternal twins at 28% for becoming alcoholic when alcoholism runs in the family (Hansell & Damour, 2008).
Sexual Dysfunction and Deviance Injuries and illnesses that have a disinhibiting effect on behavior have been linked to paraphilias. Brain tumors, temporal lobe epilepsy, and degenerative diseases have been associated to paraphilias. It has also been found that women who have been accused of committing sexual offenses were also victims of childhood physical and sexual abuse, current physical abuse, or mental retardation (Hansell & Damour, 2008).
Personality disorder Temperament, which are the innate behavioral tendencies that are present at birth, have been researched and have been found that some personality disorders can happen from an interaction between genetically based temperament and certain environmental influences (Hansell & Damour, 2008).
Emotional
Eating Disorder In Hilde Bruch’s book, “The Golden Cage: The Enigma of Anorexia Nervosa”, she describes how patients with anorexia are very focused on the needs and desires of other people that they are no longer aware of what they want. He or she constantly fights to meet their parent’s expectations and feeling as though “perfection” is what they really want from him or her, which is how anorexia may be developed. There is observed evidence that supports Bruch’s claim that eating disorders happen more often in families that are into appearances and high achievements. Other studies have looked into the connection between the attitude of parents toward weight and appearance and eating disorders in young girls. Another study has shown that daughters are at a higher risk of developing an eating disorder if their parents were preoccupied with attractiveness and physical appearance. It has also been found that eating disorders are driven by complicated and mostly unconscious feelings. Sexual trauma has been linked to eating disorders later in life and in order to reclaim control over her body by eliminating her menstrual cycle and curvy characteristics that women have. Bulimics on the other hand unconsciously reenact their sexual trauma by overwhelming herself with food and then reversing the trauma by purging (Hansell & Damour, 2008).
Substance Abuse Substance misuse is viewed as a symptom due to other forces and issues inside the patient. Earlier, clinicians believed that the addict was fixated on the oral phase of life, seeking out comfort, dependency, nurture, and pleasure. As the psychodynamic theory continued to be developed, addiction was linked to the development of the ego and superego, object relations, attachment problems, and self-esteem. More recently, substance misuse is seen as a way to avoid painful emotions that are not easily tolerated. Denial and feeling as though the addict is in control are also a big part of developing and maintaining addictions. If they do not think it is a problem and believe that they can stop doing it at any point, then it is not an addiction (Hansell & Damour, 2008).
Sexual Dysfunction and Deviance Paraphilias were first thought to be direct expressions during adulthood that are fixations of sexual interests from developmental phases in childhood. They then changed paraphilias to be a certain defense mechanism that is responding to a core emotional conflict. Modern day explanations still put emphasis on defense mechanisms being the reason for paraphilias. Robert Stoller revised Freud’s theories on defense mechanisms and claimed that men suffering from paraphilias had one thing from childhood in common- humiliation that had a profound effect on them that threatened how masculine they felt. Reasons for this include sexual abuse and emotionally traumatic events. They suffer from unconscious motives where they humiliate others to get revenge for their past childhood humiliations (Hansell & Damour, 2008).
Personality disorder Maladaptive defense mechanisms and problematic childhood relationships are the main focus of personality disorders. Someone suffering from paranoid personality disorder has a distorted view on how people will treat them because they anticipate criticism or being hurt by them. They believe that other people are focused on them and their weaknesses, making them seem inferior, yet self-centered at the same time, according to clinicians (Hansell & Damour, 2008).
Cognitive
Eating Disorder Eating disorders, such as anorexia and bulimia, result from both dysfunctional thoughts and repeated experiences that reinforced eating disorder behaviors. The mind of a bulimic or an anorexic is in black and white when it comes to their thoughts on food or weight. Food is either bad or good, and they do not look at the nutritional value of foods where something that has fat in it would be bad to them, but really it is essential for healthy physical functioning (Hansell & Damour, 2008).
Substance Abuse Substance users have certain expectations on how the substance will make them feel and those expectations are what entice them to use the drug. People with substance abuse issues may also have thoughts about negative social evaluation, which makes abstaining even harder. Modeling can also have a profound effect because it can cause dysfunctional cognition where a child not only follows what they see, but thinks that it is alright to do because a parent is doing it too (Hansell & Damour, 2008).
Sexual Dysfunction and Deviance Classical conditioning explains the cognitive view on paraphilias. A physical reaction, such as sexual arousal, occurs in response to inappropriate stimuli, such as children, animals, or inanimate objects. Classical conditioning describes how these two things result in accidental, automatic learning. When a neutral stimulus is present and becomes associated with an emotional reflex, they can create a strong connection in the mind (Hansell & Damour, 2008).
Personality disorder People suffering from personality disorders force firm preexisting beliefs on most situations, tend not to question what they already believe, and carry on with their actions to their beliefs, even though they can be self-defeating. Personality disorders usually develop because of early life experiences. Interpersonal behavioral strategies are shaped and perceptions and interpretations are influenced by these childhood experiences. People with personality disorders also hold specific interpersonal beliefs, act in accordance with their beliefs so people will respond accordingly, and perceive their responses as proof of what they believe (Hansell & Damour, 2008).
Behavioral
Eating Disorder As stated above, cognitive and behavioral aspects work together in eating disorders. Cognitive processes activate behavioral responses, such as excessive dieting, binge eating, and purging, which then steer toward emotional reactions. These emotional reactions can then reintroduce cognitive distortions and behavioral disruptions (Hansell & Damour, 2008).
Substance Abuse Operant conditioning, classical conditioning, and social learning are important in describing and treating the misuse of substances. Operant conditioning explains substance abuse in that it can be highly reinforced both positively and negatively. The reason for continuous use of substances is to continue to have that positive reinforcement. Classical conditioning explains it as learned behavior that is a result from automatic mental association. Cravings can be brought on by associated places, people, and things. Social learning can have a strong influence in drug abuse. When family members are seen doing drugs or drinking alcohol, it trickles down to the children, resulting in the possibility of them following their parents footsteps. Peers and the media also contribute to the social learning about drugs and have much power behind their messages (Hansell & Damour, 2008).
Sexual Dysfunction and Deviance Social learning is also a big part of developing paraphilias; they are observed by watching others. When children see others behaving in sexually deviant ways, lack social and cognitive skills in relation to sexually inappropriate manners, and receive rewards for inappropriate sexual behavior, they are more likely to develop paraphilic behaviors (Hansell & Damour, 2008).
Personality disorder People suffering from personality disorders force firm preexisting beliefs on most situations, tend not to question what they already believe, and carry on with their actions to their beliefs, even though they can be self-defeating. Personality disorders usually develop because of early life experiences. Interpersonal behavioral strategies are shaped and perceptions and interpretations are influenced by these childhood experiences. People with personality disorders also hold specific interpersonal beliefs, act in accordance with their beliefs so people will respond accordingly, and perceive their responses as proof of what they believe (Hansell & Damour, 2008).
Conclusion
These disorders can have a very negative affect on an individual. They can disrupt people through their behavior, thoughts, and emotions. For that person suffering from their disorder though, they may not view it as abnormal, but to them it is normal because they have always behaved, felt or thought this way. It is important to learn about these types of disorders so they can be looked at without feeling like they are doing something wrong.

References
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Arlington, VA: APA.
Hansell, J., & Damour, L. (2008). Abnormal psychology (2nd ed.). Hoboken, NJ: Wiley.

Attachment
Matrix Week 3 DSM IV-TR Category Definition
(American Psychiatric Association, 2000)
Classification
(American Psychiatric Association, 2000) Eating Disorders characterized by severe disturbances in eating behavior Anorexia Nervosa- the individual refuses to maintain a minimally normal body weight, is intensely afraid of gaining weight, and exhibits a significant disturbance in the perception of the shape or size of his or her body
Bulimia Nervosa- the individual binge eats and prevents weight gain via inappropriate compensatory methods; self-evaluation is influenced by their body shape and weight Personality Disorders an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment. Cluster A- a pattern of pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent
Cluster B¬- a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood
Cluster C- a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation that begins by early adulthood and is present in a variety of contexts
Substance Abuse This term encompasses both dependence on and abuse of drugs usually taken voluntarily for the purpose of their effect on the central nervous system or to prevent or reduce withdrawal symptoms Substance Misuse-the continued use despite negative consequences, compulsive use, and loss of control of use of a substance
Substance Abuse- a maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to repeated use of substance

Sexual Disorders Characterized by disturbance in sexual desire and in the psychophysiological changes that characterize the sexual response cycle and cause marked distress and interpersonal difficulty.

Paraphilias- characterized by recurrent, intense sexual urges, fantasies, or behaviors that involve unusual objects, activities, or situations and cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
Gender Identity disorder- characterized by strong and persistent cross-gender identification accompanied by persistent discomfort with one’s assigned sex