1. PHOBIA
Understanding phobias according to the psikopatolog is as disturbing rejection, mediated fear not proportional to the danger which is contained by a particular object or situation you are recognized by patients as being without merit. In other words, a phobia is the fear of a situation or object that is clear (from outside the individual), which does no harm at the time of the incident.
Based on the DSM-IV-TR symptoms of phobias are (1) The fear of excessive, unreasonable, and settled that is triggered by the object or situation, (2) exposure to the triggering cause intense anxiety, (3) The person is aware of his fears are not realistic; ( 4) The object or situation is avoided or faced with intense anxiety.
Some of the most recognized term is claustrophobic, that fear of enclosed spaces. Agoraphobia is the fear of public places. Acrophobia, a fear of heights. Animal phobias are fears in certain animal species. Blood phobia is the fear of blood.
Many of certain patients who do not make them enough urgency to seek treatment. For example, if someone who has a huge fear of snakes, he lived in metropolitan areas, little chance he had direct contact with the feared object, so do not believe there is something wrong with her. In most cases, phobias are faced by women compared with men. Phobia itself is divided into two kinds of categories such as specific phobia and social phobia.
Specific Phobias
Specific phobia is an unreasonable fear caused by the presence or anticipation of a specific object or situation. More summarily phobia is caused by a specific object or situation. DSM-IV-TR divides phobias based on the source of his fear: blood, injury, and injections, the situation (such as airplanes, elevators, enclosed spaces), animals and natural environment (such as altitude, water)
Social Phobia
Social phobia is irrational fear settled and commonly associated with the presence of others. individuals who experience social phobia typically avoid situations that make him feel evaluated, experiencing anxiety or inappropriate behavior.
Fear is indicated by excessive sweating or blushing is visible impact. Talking or doing something in public, eating in public places, use public toilets, or almost any other activity carried out there where others can cause extreme concern in patients with social phobia.
People who suffer from social phobia many who have professions or jobs far below their abilities or intelligence because of their extreme social sensitivity natural. Better to do low-paying jobs from the every day dealing with other people in the higher job.
Phobia Patient Handling
In the treatment of patients with phobias, the person can not heal itself, so must be supported by competent therapists in their field. There are so many therapies that can be done. Here are some therapeutic approaches that can be done. Psychoanalytical approach in two ways namely (1) disclosure of repressed anxiety, (2) Settlement of conflict of childhood. Behavioral approaches are (1) Systematic desensitization, namely individuals who suffer from phobias to imagine a series of increasingly frightening situation while he is in a relaxed condition, (2) Flooding, which is a therapeutic technique in which clients were exposed to the source of a phobia in full intensity, (3) Modeling, is another technique that uses exposure to the feared situations. Cognitive Approach Elimination irational belief that, by eliminating the irrational thinking. Biological approach is by using drugs such as sedative, transquilizer, and anxyolitic
2. MENTAL RETARDATION
Mental retardation is an axis II disorder, is defined in the DSM IV TR as: (1) intellectual function below the average together with, (2) Lack of adaptive behavior, and (3) Happen before the age of 18 years. Criterion of mental retardation in the DSM IV TR are as follows:
(1) intellectual function is significantly below the average, an IQ of less than 70; (2) Lack of adaptive social function in at least the following two areas: communication, self care, family life, interpersonal skills, use of community resources, capabilities to make his own decisions, functional academic skills, recreation, employment, health and safety; (3) Happen before the age of 18 years.
The first component in the definition of DSM requires intelligence assessment. The determination must be based on a variety of IQ tests given to a person by a professional who is competent and well trained.
The next component is an adaptive function, namely referring to the mastery of skills in childhood, such as using the toilet, dressing, understanding the concept of time and money, was able to use the equipment, shop, travel by public transport and developing social responsiveness. A teenager, for example, is expected to be able to apply academic skills, reasoning and assessment in daily life and participate in various group activities. An adult is expected to support themselves and holding of social responsibility.
The last component in the definition of mental retardation is a disorder occurs before the age of 18 years, to prevent weakness classify intelligence and adaptive behavior caused by injury or illness that occurs at a later date resulting in mental retardation. Children who are experiencing severe hendaya often diagnosed in infancy. Even so, most children who have mental retardation are not identified so until they start school.
These children showed no signs of physiological, neurological, or physical problem appears clear and the surface only after they showed an inability to experience life the same as children their own age at school.
Classification of Mental Retardation
Classification criteria of mental retardation can not just use a benchmark of intelligence, because some people who fall into groups of mild mental retardation has no interference with the adaptive function that can not be classified in mental retardation disorders. The classification based on intelligence can be used if the patient susceptible to interference on adaptive function. Here's a summary of the characteristics of people who fall into each level of mental retardation.
Mild mental retardation
Between IQ 50-55 to 70. They can not always be distinguished from normal children before starting school. At the end of their teens they usually can learn academic skills more or less the same as level 6. They can work as adults, jobs that do not require complicated skills and they can have a child.
Mental retardation was
Between IQ 35-40 to 50-55. People who experience mental retardation were able to have weakness of physical and neurological dysfunction that inhibit the normal motor skills, such as holding and coloring within the lines, and gross motor skills, such as running and climbing. They were able, with much guidance and training, traveling alone in the local area who are not foreign to them. Many are living in institutional shelters, but most lived with family or dependent houses along the supervised.
Severe mental retardation
Between IQ 20-25 to 35-40. They often have physical abnormalities at birth and limitations in sensory motor control. Most lived in institutions and shelters need help super vision continuously. Adults who have severe mental retardation can behave in a friendly, but usually only briefly able to communicate in a very concrete level. They can do little activities independently and often looks listless because of severe damage to their brains makes them relatively passive and their living conditions had only a modest stimulation. They are capable of doing a very simple with constant supervision.
Severe mental retardation
IQ below 25. Those in this group require total supervision and often must be nurtured throughout their lives. Most experienced severe physical abnormalities and neurological damage and can not walk alone anywhere. Death rates in childhood in people who experience severe mental retardation is very high.
3. TRAUMA
Trauma,have you hear it? Then how to overcome and eliminate the trauma? At the present time, many of news contains about crime, robbery, murder, rape, and others. Of course very disturbing, not to mention the conflicts and bombings in various places.
Maybe the next day word was replaced by another. But one thing is overlooked, namely the effect of the incident. So what's the effect, that effect is a form of trauma. In the area displaced by the conflict for example, does not mean that children or women were evacuated and then the problem is completed. Instead of a possible problem is starting.
When talking about violence and trauma, there is a term known as Post Traumatic Stress Disorder, or PTSD (post traumatic stress disorder). Which stress disorder arising from traumatic events associated with the extraordinary. For example, seeing people killed, brutally tortured, victims of accidents, natural disasters, and others.
PTSD is a severe psychiatric disorder, since patients usually experience mental disorders that interfere with life. In general, PTSD symptoms are divided into three types, namely:
1. Reexperiencing.
Patients such as re-experience the traumatic event has ever experienced. Usually this condition will arise when the patient is dreaming or seeing a similar atmosphere with their traumatic experience. Patients may behave surprisingly, suddenly scream, cry, or run scared.
Other phenomena may also appear as afraid to sleep because if she slept so traumatic event recurring. For example, rape or murder incident that took place in front of the eye.
2.Hyperarousal.
A state of alert overload, such as jumpy, tense, suspicious faces something of symptoms, things that fall he considered as the fall of a bomb, and sleep often wake-up
3. Avoidance.
Someone will always avoid situations that remind him of the traumatic event. Had it happened during a crowded atmosphere, he'll avoid the mall or market. Vice versa, if he experienced on his own time, then he will avoid quiet areas.
If PSTD is taken care not carefully , it can affects one's personality (personality changes). Like the paranoid (suspicious) for example. This difficulty is seldom conciousness patients come to the experts. Moreover, the stigma that circulate the community that the psychiatrist is identical with the mentally ill or crazy.
Then how do we overcome and eliminate the problem of trauma? Various models have been developed to overcome the psychotherapy of PTSD, such as behavioral therapy, desensitization, hypnotherapy, all quite effective origin of the patient also received support from the community and also the people closest society.
Need to be distinguished, whether a person has lead to PTSD or still PTS (post traumatic sympton). If it still will not PTS to cause severe disruption, may still be handled by a trained psychologist. What should be done is PTS not to be PTSD
4. DID
Dissociative identity disorder is a psychiatric diagnosis that describes a condition in which a person displays multiple distinct identities or personalities (known as alter egos or alters), each with its own pattern of perceiving and interacting with the environment. In the International Statistical Classification of Diseases and Related Health Problems the name for this diagnosis is multiple personality disorder. In both systems of terminology, the diagnosis requires that at least two personalities routinely take control of the individual's behavior with an associated memory loss that goes beyond normal forgetfulness; in addition, symptoms cannot be the temporary effects of drug use or a general medical condition.
There is a great deal of controversy surrounding the topic. There are many commonly disputed points about DID. These viewpoints critical of DID can be quite varied, with some taking the position that DID does not actually exist as a valid medical diagnosis, and others who think that DID may exist but is either always or usually an adverse side effect of therapy. DID diagnoses appear to be almost entirely confined to the North American continent; reports from other continents are at significantly lower rates.
Individuals diagnosed with DID demonstrate a variety of symptoms with wide fluctuations across time; functioning can vary from severe impairment in daily functioning to normal or high abilities. Symptoms can include :
* Multiple mannerisms, attitudes and beliefs that are not similar to each other
* Unexplainable headaches and other body pains
* Distortion or loss of subjective time
* Comorbidity
* Depersonalization
* Derealization
* Severe memory loss
* Depression
* Flashbacks of abuse or trauma
* Unexplainable phobias
* Sudden anger without a justified cause
* Lack of intimacy and personal connections
* Frequent panic/anxiety attacks
* Auditory hallucinations of alternate personalities (though these hallucinations typically possess a quality that makes them distinct from psychotic disorders or schizophrenia)
Patients may experience an extremely broad array of other symptoms that resemble epilepsy, schizophrenia, anxiety disorders, mood disorders, post traumatic stress disorder, personality disorders, and eating disorders.
Treatment of DID may attempt to reconnect the identities of disparate alters into a single functioning identity. In addition or instead, treatment may focus on symptoms, to relieve the distressing aspects of the condition and ensure the safety of the individual. Treatment methods may include psychotherapy and medications for comorbid disorders.Some behavior therapists initially use behavioral treatments such as only responding to a single identity, and using more traditional therapy once a consistent response is established.It has been stated that treatment recommendations that follow from models that do not believe in the traumatic origins of DID might be harmful due to the fact that they ignore the posttraumatic symptomatology of people with DID.
Tidak ada komentar:
Posting Komentar