Anxiety, Mood/Affective, Dissociative, and Somatoform Matrix
By Mary R. Torczon
PSY/410 Dr. Jones
July 25th, 2011

Anxiety, Mood/Affective, Dissociative, and Somatoform Matrix
A disorder is a disruptive condition or combinations of symptoms that an individual experiences that may debilitate to his or her daily lives. Some disorders are more complex than others such as hypochondriasis, and post-traumatic stress disorder. Anxiety, mood, dissociative, and somatoform disorders make the ability for normal daily functioning impossible. This paper will analyze the disorders of anxiety, mood/affective, dissociative, and somatoform disorders in reference to the biological, emotional, cognitive, and behavioral components of each disorder category.
Anxiety Disorders
Anxiety disorders, which are many of the most severe mental disorders, stem from phobias or fears. All people experience some form of generalized anxiety or worry from time to time. Categories of anxiety disorders are general anxiety disorder (GAD), panic disorder, phobias, obsessive-compulsive disorder (OCD), and post-traumatic disorder (PTSD). Inappropriate anxiety causes the heart to race, breathing becomes rapid, and muscles tense for no reason (AllPsych, 2004). The symptoms, such as excessive worry and fear, become a disorder when they become part of normal daily life. Cognitively, individuals may fixate on perceived dangers and threats. They may over exaggerate the severity of undesirable situations, and underestimate the ability to cope with dangers and threats (Hansell & Damour, 2008).
When an individual suffers from a phobia, the fear and worry induces biological effects such as sweating, and rapid heart rate when introduced with a specific object or situation. Post-traumatic stress disorder (PTSD) manifestations are similar to a phobia, originating from excessive worry or fear, but different in that the fear ties to a situation or event. Luckily medications such as Valium and Xanax treat anxiety disorders. Antidepressants such as Zoloft also treat panic attacks, form of excessive anxiety. To treat OCD and PTSD, selective serotonin reuptake inhibitors (SSRIs) such as Celexa and Lexapro ease symptoms and generally have fewer side effects than other anti-depressants (Mayo Clinic, 2011).
Mood/Affective disorders
Mood/Affective disorders, characterized by long periods of severe depression with manic episodes of elevated, expansive, or irritable mood, last at least a week. These disorders also impair social and professional functioning (Hansell & Damour, 2008). Suicidal thoughts, insomnia, increased self-consciousness, extreme guilt, fatalism, and poor social skills all fall under the behavioral category of mood/affective disorders. Schizophrenic diagnosis also falls within this axis. Practitioners and researchers have criticized this category, arguing that depression is part of a normal life, and that the criterion of the DSM-IV facilitates false diagnosis of mood disorder when the behaviors are transitive and appropriate (Fawcett, 2009).
Dissociative disorders
Dissociative disorders are repressive disorders caused by traumatic experiences (Hansell & Damour, 2008). Categories of this disorder are dissociative amnesia, depersonalization disorder, dissociative fugue, and dissociative identity disorder (Hansell & Demour, 2008). Dissociative disorders affect the cognitive process in that the human memory will build mental blocks to protect an individual from a traumatic experience. One may even create a new identity to escape his or her past. Behaviors of this disorder include detachment from society, social awkwardness, and a dazed state of mind. Biologically, a medically induced dissociative state involves an alteration in the hippocampus, amygdale, and thalamus (Hansell & Damour, 2008). Presently, there are no medications that specifically treat the full magnitude of dissociative disorders. However, acute symptoms are treated. Since clinicians started to treat patients with dissociative disorders, they have emphasized the “need to first stabilize them and only then gradually approach the dissociative parts of the personality, including the traumatic memories” (Bremner & Marmar, p. 257-258).
Somatoform disorders
Somatoform disorders are medically or physiologically based, but they are psychosocial factors and mimic medical disorders (Comer, 2006). Categorized somatoform disorders are conversion disorder, somatization disorder, and pain disorder, hypochondriasis, and body dysmorphic disorder. Behaviors of this disorder include an individual preoccupied with physical concerns, but appearing normal. Biologically, this disorder causes enough stress potentially to impair or debilitate oneself. Similar to dissociative disorder, somatoform disorders are treated by medicating the symptoms only. Sometimes antidepressants and antianxiety medications help, but only with the symptoms. Intense talk therapies to uncover the nature of the individual’s emotional distress will guide practitioners to understand the individual’s psychological distress expressed as a physical symptom (Hansell & Damour, 2008). DSM-IV TR
Through the use of the DSM-IV TR, the multiaxial diagnosis manual, clinicians determine whether the client’s manifestations and problem behaviors explained through hidden factors. The DSM-IV TR provides definitions, symptoms, and characterizes mental disorders (Hsuing, 2008). Examples of such factors include personality disorders and mental retardation. As in the case of many disorders, the multiaxial diagnostic system helps clarify a diagnosis, but many diagnoses require multiaxial definitions.
According to Dr. Russ Dewey, creator of Psych Web, the DSM-IV TR is considered the “bible” of psychiatric diagnoses. The manual’s five axes are: Axis 1- Clinical disorder or other conditions that need immediate clinical attention.
Axis 2- Personality disorders/Mental retardation
Axis 3- General medical conditions. Ex. diabetes, heart disease.
Axis 4- Psychosocial and environmental problems. Ex. abuse, poverty, dysfunctional families.
Axis 5- Global Assessment of Functioning Scale. Full rating of one’s ability to cope with a normal life.
Problems in translation between what a client says and what is his or her behavior may manufacture very different diagnoses. Moreover, some abnormal behaviors may be complex, and therefore fit the diagnoses in the different categories. Additionally, these behaviors and manifestations may be adaptive in nature, and as a result should not lead to a mental disorder diagnosis. Therefore, clinicians must consider the multiaxial definition of each disorder before diagnosing.

References
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http://www.dr-bob.org/tips/dsm4a.html

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