phobia

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A phobia is an irrational fear of something that’s unlikely to cause harm. The word itself comes from the Greek word phobos, which means fear or horror.

Hydrophobia, for example, literally translates to fear of water.

When someone has a phobia, they experience intense fear of a certain object or situation. Phobias are different than regular fears because they cause significant distress, possibly interfering with life at home, work, or school.

People with phobias actively avoid the phobic object or situation, or endure it within intense fear or anxiety.

Phobias are a type of anxiety disorder. Anxiety disorders are very common. They’re estimated to affect more than 30 percent of U.S. adults at some time in their lives.

In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the American Psychiatric Association outlines several of the most common phobias.

Agoraphobia, a fear of places or situations that trigger fear or helplessness, is singled out as a particularly common fear with its own unique diagnosis. Social phobias, which are fears related to social situations, are also singled out with a unique diagnosis.

Specific phobias are a broad category of unique phobias related to specific objects and situations. Specific phobias affect an estimated 12.5 percent of American adults.

Phobias come in all shapes and sizes. Because there are an infinite number of objects and situations, the list of specific phobias is quite long.

According to the DSM, specific phobias typically fall within five general categories:

fears related to animals (spiders, dogs, insects)
fears related to the natural environment (heights, thunder, darkness)
fears related to blood, injury, or medical issues (injections, broken bones, falls)
fears related to specific situations (flying, riding an elevator, driving)
other (choking, loud noises, drowning)

These categories encompass an infinite number of specific objects and situations.

There’s no official list of phobias beyond what’s outlined in the DSM, so clinicians and researchers make up names for them as the need arises. This is typically done by combining a Greek (or sometimes Latin) prefix that describes the phobia with the -phobia suffix.

For example, a fear of water would be named by combining hydro (water) and phobia (fear).

There’s also such a thing as a fear of fears (phobophobia). This is actually more common than you might imagine.

People with anxiety disorders sometimes experience panic attacks when they’re in certain situations. These panic attacks can be so uncomfortable that people do everything they can to avoid them in the future.

For example, if you have a panic attack while sailing, you may fear sailing in the future, but you may also fear panic attacks or fear developing hydrophobia.

Personality disorders are a group of mental health conditions that are characterized by inflexible and unhealthy patterns of thinking, feeling, and behaving. These inner experiences and behaviors often differ from the expectations of the culture in which someone lives.

People with personality disorders usually have a hard time getting along with others and dealing with everyday problems in the ways that are expected by a cultural group. They commonly believe that their way of thinking and behaving is completely normal. However, they tend to have a view of the world that is quite different than others. As a result, they may find it difficult to participate in social, educational, and family activities. They also place blame on others for their challenges. These behaviors and attitudes often cause problems and limitations in relationships, social encounters, and work or school settings. They may also make people with personality disorders feel isolated, which can contribute to depression and anxiety.

The cause of personality disorders isn’t known. However, it is believed that they may be triggered by genetic and environmental influences, most prominently childhood trauma.

Personality disorders tend to emerge in the teenage years or early adulthood. The symptoms vary depending on the specific type of personality disorder. Treatment typically includes talk therapy and medication.

What Are the Different Types of Personality Disorders?

There are numerous different types of personality disorders. They are grouped into three clusters based on similar characteristics and symptoms. Some people may have signs and symptoms of multiple personality disorders.

Cluster A: Suspicious

Paranoid personality disorder: People with paranoid personality disorder are very distrustful of others and suspicious of their motives. They also tend to hold grudges.
Schizoid personality disorder: People with this type of disorder display little interest in forming personal relationships or partaking in social interactions. They usually don’t pick up on normal social cues, so they can seem emotionally cold.
Schizotypal personality disorder: In schizotypal personality disorder, people believe they can influence other people or events with their thoughts. They often misinterpret behaviors. This causes them to have inappropriate emotional responses. They may consistently avoid having intimate relationships.

Cluster B: Emotional and Impulsive

Antisocial personality disorder: People with antisocial personality disorder tend to manipulate or treat others harshly without expressing remorse for their actions. They may lie, steal, or abuse alcohol or drugs.
Borderline personality disorder: People with this type of disorder often feel empty and abandoned, regardless of family or community support. They may have difficulty dealing with stressful events. They may have episodes of paranoia. They also tend to engage in risky and impulsive behavior, such as unsafe sex, binge drinking, and gambling.
Histrionic personality disorder: In histrionic personality disorder, people frequently try to gain more attention by being overly dramatic or sexually provocative. They are easily influenced by other people and are extremely sensitive to criticism or disapproval.
Narcissistic personality disorder: People with narcissistic personality disorder believe that they are more important than others. They tend to exaggerate their achievements and may brag about their attractiveness or success. They have a deep need for admiration, but lack empathy for other people.

Cluster C: Anxious

Avoidant personality disorder: People with this type of disorder often experience feelings of inadequacy, inferiority or unattractiveness. They usually dwell on criticism from others and avoid participating in new activities or making new friends.
Dependent personality disorder: In dependent personality disorder, people heavily depend on other people to meet their emotional and physical needs. They usually avoid being alone. They regularly need reassurance when making decisions. They may also be likely to tolerate physical and verbal abuse.
Obsessive-compulsive personality disorder: People with obsessive-compulsive personality disorder have an overwhelming need for order. They strongly adhere to rules and regulations. They feel extremely uncomfortable when perfection isn’t achieved. They may even neglect personal relationships to focus on making a project perfect.

Common phobias list

Studying specific phobias is a complicated process. Most people don’t seek treatment for these conditions, so cases largely go unreported.

These phobias also vary based on cultural experiences, gender, and age.

A 1998 survey of more than 8,000 respondents published in the British Journal of Psychiatry Trusted Source found that some of the most common phobias include:

acrophobia, fear of heights
aerophobia, fear of flying
arachnophobia, fear of spiders
astraphobia, fear of thunder and lightning
autophobia, fear of being alone
claustrophobia, fear of confined or crowded spaces
hemophobia, fear of blood
hydrophobia, fear of water
ophidiophobia, fear of snakes
zoophobia, fear of animals

Unique phobias

Specific phobias tend to be incredibly specific. Some so much so that they may only affect a handful of people at a time.

These are difficult to identify because most people don’t report unusual fears to their doctors.

Examples of some of the more unusual phobias include:

alektorophobia, fear of chickens
onomatophobia, fear of names
pogonophobia, fear of beards
nephophobia, fear of clouds
cryophobia, fear of ice or cold

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The sum of all fears so far

A
Achluophobia	Fear of darkness
Acrophobia	Fear of heights
Aerophobia	Fear of flying
Algophobia	Fear of pain
Alektorophobia	Fear of chickens
Agoraphobia	Fear of public spaces or crowds
Aichmophobia	Fear of needles or pointed objects
Amaxophobia	Fear of riding in a car
Androphobia	Fear of men
Anginophobia	Fear of angina or choking
Anthophobia	Fear of flowers
Anthropophobia	Fear of people or society
Aphenphosmphobia	Fear of being touched
Arachnophobia	Fear of spiders
Arithmophobia	Fear of numbers
Astraphobia	Fear of thunder and lightning
Ataxophobia	Fear of disorder or untidiness
Atelophobia	Fear of imperfection
Atychiphobia	Fear of failure
Autophobia	Fear of being alone
B
Bacteriophobia	Fear of bacteria
Barophobia	Fear of gravity
Bathmophobia	Fear of stairs or steep slopes
Batrachophobia	Fear of amphibians
Belonephobia	Fear of pins and needles
Bibliophobia	Fear of books
Botanophobia	Fear of plants
C
Cacophobia	Fear of ugliness
Catagelophobia	Fear of being ridiculed
Catoptrophobia	Fear of mirrors
Chionophobia	Fear of snow
Chromophobia	Fear of colors
Chronomentrophobia	Fear of clocks
Claustrophobia	Fear of confined spaces
Coulrophobia	Fear of clowns
Cyberphobia	Fear of computers
Cynophobia	Fear of dogs
D
Dendrophobia	Fear of trees
Dentophobia	Fear of dentists
Domatophobia	Fear of houses
Dystychiphobia	Fear of accidents
E
Ecophobia	Fear of the home
Elurophobia	Fear of cats
Entomophobia	Fear of insects
Ephebiphobia	Fear of teenagers
Equinophobia	Fear of horses
F, G
Gamophobia	Fear of marriage
Genuphobia	Fear of knees
Glossophobia	Fear of speaking in public
Gynophobia	Fear of women
H
Heliophobia	Fear of the sun
Hemophobia	Fear of blood
Herpetophobia	Fear of reptiles
Hydrophobia	Fear of water
Hypochondria	Fear of illness
I-K
Iatrophobia	Fear of doctors
Insectophobia	Fear of insects
Koinoniphobia	Fear of rooms full of people
L
Leukophobia	Fear of the color white
Lilapsophobia	Fear of tornadoes and hurricanes
Lockiophobia	Fear of childbirth
M
Mageirocophobia	Fear of cooking
Megalophobia	Fear of large things
Melanophobia	Fear of the color black
Microphobia	Fear of small things
Mysophobia	Fear of dirt and germs
N
Necrophobia	Fear of death or dead things
Noctiphobia	Fear of the night
Nosocomephobia	Fear of hospitals
Nyctophobia	Fear of the dark
O
Obesophobia	Fear of gaining weight
Octophobia	Fear of the figure 8
Ombrophobia	Fear of rain
Ophidiophobia	Fear of snakes
Ornithophobia	Fear of birds
P
Papyrophobia	Fear of paper
Pathophobia	Fear of disease
Pedophobia	Fear of children
Philophobia	Fear of love
Phobophobia	Fear of phobias
Podophobia	Fear of feet
Pogonophobia	Fear of beards
Porphyrophobia	Fear of the color purple
Pteridophobia	Fear of ferns
Pteromerhanophobia	Fear of flying
Pyrophobia	Fear of fire
Q-S
Samhainophobia	Fear of Halloween
Scolionophobia	Fear of school
Selenophobia	Fear of the moon
Sociophobia	Fear of social evaluation
Somniphobia	Fear of sleep
T
Tachophobia	Fear of speed
Technophobia	Fear of technology
Tonitrophobia	Fear of thunder
Trypanophobia	Fear of needles or injections
U-Z
Venustraphobia	Fear of beautiful women
Verminophobia	Fear of germs
Wiccaphobia	Fear of witches and witchcraft
Xenophobia	Fear of strangers or foreigners
Zoophobia	Fear of animals

How Is a Personality Disorder Diagnosed?

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is a reference doctors and mental health professionals use to help diagnose mental health conditions. Each personality disorder has criteria that must be met for a diagnosis. A primary care or mental health provider will ask you questions based on these criteria to determine the type of personality disorder. In order for a diagnosis to be made, the behaviors and feelings must be consistent across many life circumstances. They should also cause significant distress and impairment in at least two of the following areas:

the way you perceive or interpret yourself and other people
the way you act when dealing with other people
the appropriateness of your emotional responses
how well you can control your impulses

In some cases, your primary care or mental health provider may perform blood tests to determine whether a medical problem is causing your symptoms. They may also order a screening test for alcohol and drugs.

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How Is a Personality Disorder Treated?

Treatment can vary depending on the type and severity of your personality disorder. It may include psychotherapy and medications.

Psychotherapy

Psychotherapy, or talk therapy, may help in managing personality disorders. During psychotherapy, you and a therapist can discuss your condition, as well as your feelings and thoughts. This can provide you with insight on how to manage your symptoms and behaviors that interfere with your daily life.

There are many different types of psychotherapy. Dialectical behavior therapy can include group and individual sessions where people learn how to tolerate stress and improve relationships. Cognitive behavioral therapy aims to teach people how to change negative thinking patterns so they can better cope with everyday challenges.

Medication

There aren’t any drugs approved for the treatment of personality disorders. However, certain types of prescription medications might be helpful in reducing various personality disorder symptoms:

antidepressants, which can help improve a depressed mood, anger, or impulsivity
mood stabilizers, which prevent mood swings and reduce irritability and aggression
antipsychotic medications, also known as neuroleptics, which may be beneficial for people who often lose touch with reality
anti-anxiety medications, which help relieve anxiety, agitation, and insomnia

What Is the Outlook for Someone with a Personality Disorder?

The most important aspect of treating a personality disorder is the recognition that the problem exists in the first place. People with these types of disorders believe that their personality traits are normal, so they can become quite upset when someone suggests that they may have a personality disorder.

If someone recognizes that they have a personality disorder and engages in treatment, they should see an improvement in their symptoms. It’s beneficial for friends or family members to be involved in their therapy sessions as well. It’s also important for someone with a personality disorder to avoid drinking alcohol and using illicit drugs. These substances can have a negative impact on emotions and interfere with treatment.

How to Help Someone with a Personality Disorder

If you are close to someone you suspect might have a personality disorder, you should encourage them to seek help. They may get angry or defensive, but it’s important to avoid arguing with them. Instead, focus on expressing your feelings and voicing your concerns about their behaviors.

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Personality disorders

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A personality disorder is a type of mental disorder in which you have a rigid and unhealthy pattern of thinking, functioning and behaving. A person with a personality disorder has trouble perceiving and relating to situations and people. This causes significant problems and limitations in relationships, social activities, work and school.

In some cases, you may not realize that you have a personality disorder because your way of thinking and behaving seems natural to you. And you may blame others for the challenges you face.

Personality disorders usually begin in the teenage years or early adulthood. There are many types of personality disorders. Some types may become less obvious throughout middle age.

The cause of personality disorders isn’t known. However, it is believed that they may be triggered by genetic and environmental influences, most prominently childhood trauma.

What Are the Different Types of Personality Disorders?

Cluster A: Suspicious

Paranoid personality disorder: People with paranoid personality disorder are very distrustful of others and suspicious of their motives. They also tend to hold grudges.
Schizoid personality disorder: People with this type of disorder display little interest in forming personal relationships or partaking in social interactions. They usually don’t pick up on normal social cues, so they can seem emotionally cold.
Schizotypal personality disorder: In schizotypal personality disorder, people believe they can influence other people or events with their thoughts. They often misinterpret behaviors. This causes them to have inappropriate emotional responses. They may consistently avoid having intimate relationships.

Cluster B: Emotional and Impulsive

Antisocial personality disorder: People with antisocial personality disorder tend to manipulate or treat others harshly without expressing remorse for their actions. They may lie, steal, or abuse alcohol or drugs.
Borderline personality disorder: People with this type of disorder often feel empty and abandoned, regardless of family or community support. They may have difficulty dealing with stressful events. They may have episodes of paranoia. They also tend to engage in risky and impulsive behavior, such as unsafe sex, binge drinking, and gambling.
Histrionic personality disorder: In histrionic personality disorder, people frequently try to gain more attention by being overly dramatic or sexually provocative. They are easily influenced by other people and are extremely sensitive to criticism or disapproval.
Narcissistic personality disorder: People with narcissistic personality disorder believe that they are more important than others. They tend to exaggerate their achievements and may brag about their attractiveness or success. They have a deep need for admiration, but lack empathy for other people.

Cluster C: Anxious

Avoidant personality disorder: People with this type of disorder often experience feelings of inadequacy, inferiority or unattractiveness. They usually dwell on criticism from others and avoid participating in new activities or making new friends.
Dependent personality disorder: In dependent personality disorder, people heavily depend on other people to meet their emotional and physical needs. They usually avoid being alone. They regularly need reassurance when making decisions. They may also be likely to tolerate physical and verbal abuse.
Obsessive-compulsive personality disorder: People with obsessive-compulsive personality disorder have an overwhelming need for order. They strongly adhere to rules and regulations. They feel extremely uncomfortable when perfection isn’t achieved. They may even neglect personal relationships to focus on making a project perfect.

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Causes

Personality is the combination of thoughts, emotions and behaviors that makes you unique. It’s the way you view, understand and relate to the outside world, as well as how you see yourself. Personality forms during childhood, shaped through an interaction of:

Your genes. Certain personality traits may be passed on to you by your parents through inherited genes. These traits are sometimes called your temperament.
Your environment. This involves the surroundings you grew up in, events that occurred, and relationships with family members and others.

Personality disorders are thought to be caused by a combination of these genetic and environmental influences. Your genes may make you vulnerable to developing a personality disorder, and a life situation may trigger the actual development.

Symptoms

Types of personality disorders are grouped into three clusters, based on similar characteristics and symptoms. Many people with one personality disorder also have signs and symptoms of at least one additional personality disorder. It’s not necessary to exhibit all the signs and symptoms listed for a disorder to be diagnosed.

Cluster A personality disorders

Cluster A personality disorders are characterized by odd, eccentric thinking or behavior. They include paranoid personality disorder, schizoid personality disorder and schizotypal personality disorder.

Paranoid personality disorder

Pervasive distrust and suspicion of others and their motives
Unjustified belief that others are trying to harm or deceive you
Unjustified suspicion of the loyalty or trustworthiness of others
Hesitancy to confide in others due to unreasonable fear that others will use the information against you
Perception of innocent remarks or nonthreatening situations as personal insults or attacks
Angry or hostile reaction to perceived slights or insults
Tendency to hold grudges
Unjustified, recurrent suspicion that spouse or sexual partner is unfaithful

Schizoid personality disorder

Lack of interest in social or personal relationships, preferring to be alone
Limited range of emotional expression
Inability to take pleasure in most activities
Inability to pick up normal social cues
Appearance of being cold or indifferent to others
Little or no interest in having sex with another person

Schizotypal personality disorder

Peculiar dress, thinking, beliefs, speech or behavior
Odd perceptual experiences, such as hearing a voice whisper your name
Flat emotions or inappropriate emotional responses
Social anxiety and a lack of or discomfort with close relationships
Indifferent, inappropriate or suspicious response to others
“Magical thinking” — believing you can influence people and events with your thoughts
Belief that certain casual incidents or events have hidden messages meant only for you

Cluster B personality disorders

Cluster B personality disorders are characterized by dramatic, overly emotional or unpredictable thinking or behavior. They include antisocial personality disorder, borderline personality disorder, histrionic personality disorder and narcissistic personality disorder.

Antisocial personality disorder

Disregard for others’ needs or feelings
Persistent lying, stealing, using aliases, conning others
Recurring problems with the law
Repeated violation of the rights of others
Aggressive, often violent behavior
Disregard for the safety of self or others
Impulsive behavior
Consistently irresponsible
Lack of remorse for behavior

Borderline personality disorder

Impulsive and risky behavior, such as having unsafe sex, gambling or binge eating
Unstable or fragile self-image
Unstable and intense relationships
Up and down moods, often as a reaction to interpersonal stress
Suicidal behavior or threats of self-injury
Intense fear of being alone or abandoned
Ongoing feelings of emptiness
Frequent, intense displays of anger
Stress-related paranoia that comes and goes

Histrionic personality disorder

Constantly seeking attention
Excessively emotional, dramatic or sexually provocative to gain attention
Speaks dramatically with strong opinions, but few facts or details to back them up
Easily influenced by others
Shallow, rapidly changing emotions
Excessive concern with physical appearance
Thinks relationships with others are closer than they really are

Narcissistic personality disorder

Belief that you’re special and more important than others
Fantasies about power, success and attractiveness
Failure to recognize others’ needs and feelings
Exaggeration of achievements or talents
Expectation of constant praise and admiration
Arrogance
Unreasonable expectations of favors and advantages, often taking advantage of others
Envy of others or belief that others envy you

Cluster C personality disorders

Cluster C personality disorders are characterized by anxious, fearful thinking or behavior. They include avoidant personality disorder, dependent personality disorder and obsessive-compulsive personality disorder.

Avoidant personality disorder

Too sensitive to criticism or rejection
Feeling inadequate, inferior or unattractive
Avoidance of work activities that require interpersonal contact
Socially inhibited, timid and isolated, avoiding new activities or meeting strangers
Extreme shyness in social situations and personal relationships
Fear of disapproval, embarrassment or ridicule

Dependent personality disorder

Excessive dependence on others and feeling the need to be taken care of
Submissive or clingy behavior toward others
Fear of having to provide self-care or fend for yourself if left alone
Lack of self-confidence, requiring excessive advice and reassurance from others to make even small decisions
Difficulty starting or doing projects on your own due to lack of self-confidence
Difficulty disagreeing with others, fearing disapproval
Tolerance of poor or abusive treatment, even when other options are available
Urgent need to start a new relationship when a close one has ended

Obsessive-compulsive personality disorder

Preoccupation with details, orderliness and rules
Extreme perfectionism, resulting in dysfunction and distress when perfection is not achieved, such as feeling unable to finish a project because you don’t meet your own strict standards
Desire to be in control of people, tasks and situations, and inability to delegate tasks
Neglect of friends and enjoyable activities because of excessive commitment to work or a project
Inability to discard broken or worthless objects
Rigid and stubborn
Inflexible about morality, ethics or values
Tight, miserly control over budgeting and spending money

Obsessive-compulsive personality disorder is not the same as obsessive-compulsive disorder, a type of anxiety disorder.

When to see a doctor

If you have any signs or symptoms of a personality disorder, see your doctor or other primary care professional or a mental health professional. Untreated, personality disorders can cause significant problems in your life that may get worse without treatment.

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How Is a Personality Disorder Diagnosed?

the way you perceive or interpret yourself and other people
the way you act when dealing with other people
the appropriateness of your emotional responses
how well you can control your impulses

Risk factors

Although the precise cause of personality disorders is not known, certain factors seem to increase the risk of developing or triggering personality disorders, including:

Family history of personality disorders or other mental illness
Abusive, unstable or chaotic family life during childhood
Being diagnosed with childhood conduct disorder
Variations in brain chemistry and structure

Complications

Personality disorders can significantly disrupt the lives of both the affected person and those who care about that person. Personality disorders may cause problems with relationships, work or school, and can lead to social isolation or alcohol or drug abuse.

How Is a Personality Disorder Treated?

Treatment can vary depending on the type and severity of your personality disorder. It may include psychotherapy and medications.

Psychotherapy

Online therapy options

Read our review of the best online therapy options to find the right fit for you.

Medication

There aren’t any drugs approved for the treatment of personality disorders. However, certain types of prescription medications might be helpful in reducing various personality disorder symptoms:

antidepressants, which can help improve a depressed mood, anger, or impulsivity
mood stabilizers, which prevent mood swings and reduce irritability and aggression
antipsychotic medications, also known as neuroleptics, which may be beneficial for people who often lose touch with reality
anti-anxiety medications, which help relieve anxiety, agitation, and insomnia

What Is the Outlook for Someone with a Personality Disorder?

How to Help Someone with a Personality Disorder

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AUTISM

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Autism spectrum disorder (ASD) is a broad term used to describe a group of neurodevelopmental disorders.

These disorders are characterized by problems with communication and social interaction. People with ASD often demonstrate restricted, repetitive, and stereotyped interests or patterns of behavior.

ASD is found in individuals around the world, regardless of race, culture, or economic background. According to the Centers for Disease Control and Prevention (CDC)Trusted Source, autism does occur more often in boys than in girls, with a 4 to 1 male-to-female ratio.

The CDC estimated in 2014 that nearly 1 in 59 children have been identified with ASD.

There are indications that instances of ASD are on the rise. Some attribute this increase to environmental factors. However, experts debate whether there’s an actual increase in cases or just more frequent diagnoses.

Autism spectrum disorder is a condition related to brain development that impacts how a person perceives and socializes with others, causing problems in social interaction and communication. The disorder also includes limited and repetitive patterns of behavior. The term “spectrum” in autism spectrum disorder refers to the wide range of symptoms and severity.

Autism spectrum disorder includes conditions that were previously considered separate — autism, Asperger’s syndrome, childhood disintegrative disorder and an unspecified form of pervasive developmental disorder. Some people still use the term “Asperger’s syndrome,” which is generally thought to be at the mild end of autism spectrum disorder.

Autism spectrum disorder begins in early childhood and eventually causes problems functioning in society — socially, in school and at work, for example. Often children show symptoms of autism within the first year. A small number of children appear to develop normally in the first year, and then go through a period of regression between 18 and 24 months of age when they develop autism symptoms.

While there is no cure for autism spectrum disorder, intensive, early treatment can make a big difference in the lives of many children.

What are the different types of autism?

The DSM (Diagnostic and Statistical Manual of Mental Disorders) is published by the American Psychiatric Association (APA) and is used by clinicians to diagnose a variety of psychiatric disorders.

The fifth and most recent edition of the DSM was released in 2013. The DSM-5 currently recognizes five different ASD subtypes, or specifiers. They are:

with or without accompanying intellectual impairment
with or without accompanying language impairment
associated with a known medical or genetic condition or environmental factor
associated with another neurodevelopmental, mental, or behavioral disorder
with catatonia

Someone can be diagnosed with one or more specifiers.

Prior to the DSM-5, people on the autism spectrum may have been diagnosed with one of the following disorders:

autistic disorder
Asperger’s syndrome
pervasive development disorder-not otherwise specified (PDD-NOS)
childhood disintegrative disorder

It’s important to note that a person who received one of these earlier diagnoses hasn’t lost their diagnosis and won’t need to be reevaluated.

According to the DSM-5, the broader diagnosis of ASD encompasses disorders such as Asperger’s syndrome.

What are the symptoms of autism?

Autism symptoms typically become clearly evident during early childhood, between 12 and 24 months of age. However, symptoms may also appear earlier or later.

Early symptoms may include a marked delay in language or social development.

The DSM-5 divides symptoms of autism into two categories: problems with communication and social interaction, and restricted or repetitive patterns of behavior or activities.

Problems with communication and social interaction include:

issues with communication, including difficulties sharing emotions, sharing interests, or maintaining a back-and-forth conversation
issues with nonverbal communication, such as trouble maintaining eye contact or reading body language
difficulties developing and maintaining relationships

Restricted or repetitive patterns of behavior or activities include:

repetitive movements, motions, or speech patterns
rigid adherence to specific routines or behaviors
an increase or decrease in sensitivity to specific sensory information from their surroundings, such as a negative reaction to a specific sound
fixated interests or preoccupations

Individuals are evaluated within each category and the severity of their symptoms is noted.

In order to receive an ASD diagnosis, a person must display all three symptoms in the first category and at least two symptoms in the second category.

What causes autism?

The exact cause of ASD is unknown. The most current research demonstrates that there’s no single cause.

Some of the suspected risk factors for autism include:

having an immediate family member with autism
genetic mutations
fragile X syndrome and other genetic disorders
being born to older parents
low birth weight
metabolic imbalances
exposure to heavy metals and environmental toxins
a history of viral infections
fetal exposure to the medications valproic acid (Depakene) or thalidomide (Thalomid)

According to the National Institute of Neurological Disorders and Stroke (NINDS), both genetics and environment may determine whether a person develops autism.

Multiple sources, old and new Trusted Source, have concluded that the disorder isn’t caused by vaccines, however.

A controversial 1998 study proposed a link between autism and the measles, mumps, and rubella (MMR) vaccine. However, that study has been debunked by other research and was eventually retracted in 2010

What tests are used to diagnose autism?

An ASD diagnosis involves several different screenings, genetic tests, and evaluations.

Developmental screenings

The American Academy of Pediatrics (AAP) recommends that all children undergo screening for ASD at the ages of 18 and 24 months.

Screening can help with early identification of children who could have ASD. These children may benefit from early diagnosis and intervention.

The Modified Checklist for Autism in Toddlers (M-CHAT) is a common screening tool used by many pediatric offices. This 23-question survey is filled out by parents. Pediatricians can then use the responses provided to identify children that may be at risk of having ASD.

It’s important to note that screening isn’t a diagnosis. Children who screen positively for ASD don’t necessarily have the disorder. Additionally, screenings sometimes don’t detect every child that has ASD.

Other screenings and tests

Your child’s physician may recommend a combination of tests for autism, including:

DNA testing for genetic diseases
behavioral evaluation
visual and audio tests to rule out any issues with vision and hearing that aren’t related to autism
occupational therapy screening
developmental questionnaires, such as the Autism Diagnostic Observation Schedule (ADOS)

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Diagnoses are typically made by a team of specialists. This team may include child psychologists, occupational therapists, or speech and language pathologists.

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How is autism treated?

There are no “cures” for autism, but therapies and other treatment considerations can help people feel better or alleviate their symptoms.

Many treatment approaches involve therapies such as:

behavioral therapy
play therapy
occupational therapy
physical therapy
speech therapy

Massages, weighted blankets and clothing, and meditation techniques may also induce relaxing effects. However, treatment results will vary.

Alternative treatments

Alternative treatments for managing autism may include:

high-dose vitamins
chelation therapy, which involves flushing metals from the body
hyperbaric oxygen therapy
melatonin to address sleep issues

Research on alternative treatments is mixed, and some of these treatments can be dangerous.

Before investing in any of them, parents and caregivers should weigh the research and financial costs against any possible benefits.

Can diet have an impact on autism?

There’s no specific diet designed for people with ASD. Nevertheless, some autism advocates are exploring dietary changes as a way to help minimize behavioral issues and increase overall quality of life.

A foundation of the autism diet is the avoidance of artificial additives. These include preservatives, colors, and sweeteners.

An autism diet may instead focus on whole foods, such as:

fresh fruits and vegetables
lean poultry
fish
unsaturated fats
lots of water

Some autism advocates also endorse a gluten-free diet. The protein gluten is found in wheat, barley, and other grains.

Those advocates believe that gluten creates inflammation and adverse bodily reactions in certain people with ASD. However, scientific research is inconclusive on the relationship between autism, gluten, and another protein known as casein.

Some studies, and anecdotal evidence, have suggested that diet can help improve symptoms of attention-deficit hyperactivity disorder (ADHD), a condition similar to autism. Find out more about the ADHD diet.

How does autism affect kids?

Children with autism may not reach the same developmental milestones as their peers, or they may demonstrate loss of social or language skills previously developed.

For instance, a 2 year old without autism may show interest in simple games of make-believe. A 4 year old without autism may enjoy engaging in activities with other children. A child with autism may have trouble interacting with others or dislike it altogether.

Children with autism may also engage in repetitive behaviors, have difficulty sleeping, or compulsively eat nonfood items. They may find it hard to thrive without a structured environment or consistent routine.

If your child has autism, you may have to work closely with their teachers to ensure they succeed in the classroom.

Many resources are available to help children with autism as well as their loved ones.

Local support groups can be found through the national nonprofit The Autism Society. The organization Autism Speaks also provides targeted toolkits intended for the parents, siblings, grandparents, and friends of children with autism.

Autism and exercise

Children with autism may find that certain exercises can play a role in alleviating frustrations and promoting overall well-being.

Any type of exercise that your child enjoys can be beneficial. Walking and simply having fun on the playground are both ideal.

Swimming and being in water can serve as both exercise and a sensory play activity. Sensory play activities can help people with autism who may have trouble processing signals from their senses.

Sometimes contact sports can be difficult for children with autism. You can instead encourage other forms of challenging yet strengthening exercises.

How does autism affect girls?

Because of its gender-specific prevalence, autism is often stereotyped as a boys’ disease. According to the trusted source ASDs are about 4 times more common in boys than in girls.

However, this doesn’t mean that autism doesn’t occur in girls. In fact, the CDC estimates that 0.66 percent, or around 1 in every 152 girls, have autism. Autism may even present differently in women.

In comparison to recent decades, autism is being tested earlier and more often now. This leads to higher reported rates in both boys and girls.

How does autism affect adults?

Families who have loved ones with ASD may worry about what life with autism looks like for an adult.

A minority of adults with ASD may go on to live or work independently. However, many adults with ASD require continued aid or intervention throughout their lives.

Introducing therapies and other treatments early in life can help lead to more independence and better quality of life.

Sometimes people who are on the spectrum aren’t diagnosed until much later in life. This is due, in part, to a previous lack of awareness among medical practitioners.

Seek help if you suspect you have adult autism. It’s not too late to be diagnosed.

Why is autism awareness important?

April is World Autism Month. It’s also been deemed National Autism Awareness Month in the United States. However, many advocates have rightly called for the need to increase awareness about ASDs year-round, and not just during 30 select days.

Autism awareness also requires empathy and an understanding that ASDs are different for everyone.

Certain treatments and therapies can work for some people but not others. Parents and caregivers can also have differing opinions on the best way to advocate for a child with autism.

Understanding autism and people who are on the spectrum starts with awareness, but it doesn’t end there.

Risk factors

The number of children diagnosed with autism spectrum disorder is rising. It’s not clear whether this is due to better detection and reporting or a real increase in the number of cases, or both.

Autism spectrum disorder affects children of all races and nationalities, but certain factors increase a child’s risk. These may include:

Your child’s sex. Boys are about four times more likely to develop autism spectrum disorder than girls are.
Family history. Families who have one child with autism spectrum disorder have an increased risk of having another child with the disorder. It’s also not uncommon for parents or relatives of a child with autism spectrum disorder to have minor problems with social or communication skills themselves or to engage in certain behaviors typical of the disorder.
Other disorders. Children with certain medical conditions have a higher than normal risk of autism spectrum disorder or autism-like symptoms. Examples include fragile X syndrome, an inherited disorder that causes intellectual problems; tuberous sclerosis, a condition in which benign tumors develop in the brain; and Rett syndrome, a genetic condition occurring almost exclusively in girls, which causes slowing of head growth, intellectual disability and loss of purposeful hand use.
Extremely preterm babies. Babies born before 26 weeks of gestation may have a greater risk of autism spectrum disorder.
Parents’ ages. There may be a connection between children born to older parents and autism spectrum disorder, but more research is necessary to establish this link.

Complications

Problems with social interactions, communication and behavior can lead to:

Problems in school and with successful learning
Employment problems
Inability to live independently
Social isolation
Stress within the family
Victimization and being bullied

Prevention

There’s no way to prevent autism spectrum disorder, but there are treatment options. Early diagnosis and intervention is most helpful and can improve behavior, skills and language development. However, intervention is helpful at any age. Though children usually don’t outgrow autism spectrum disorder symptoms, they may learn to function well.

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Drug and Alcohol dependence

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It is often difficult for people to recognise that they have become dependent on alcohol or other drugs. They may see it as a temporary situation because they are in physical pain or because they are dealing with a difficult situation such as grief, loss, anxiety or trauma.

Asking for help when you first suspect you have a problem is important so that you can get support to make changes. The earlier you reach out the better – but it’s never too late.

Signs of alcohol or other drug dependence

Some signs that you may have an alcohol or other drug problem are:

changed eating or sleeping habits
caring less about your appearance
spending more time with people who drink or use drugs to excess
missing appointments, classes or work commitments
losing interest in activities that you used to love
getting in trouble in school, at work or with the law
getting into more arguments with family and friends
friends or family asking you if you have a substance abuse problem
relying on drugs or alcohol to have fun or relax
having blackouts
drinking or using drugs when you are alone
keeping secrets from friends or family
finding you need more and more of the substance to get the same feeling.

Often it is family and friends who first recognise that a person they care about has an alcohol or drug problem. They may have noticed them acting differently – being withdrawn, always tired, increasingly hostile or easily upset. They may ask the person straight out if they have a problem.

If that happens to you, you might feel threatened or criticised. Try to remember that they’re trying to look out for your wellbeing. A positive first step would be to listen, reflect, and be honest with yourself about what they had to say.

Recognising an alcohol and drug problem

There is no particular type of person who becomes dependent on alcohol or other drugs. It can happen to anyone.

What starts as occasional use of a drug or one prescription of pain-relieving medication, for example, can get out of control as time passes – especially in times of pain or stress. You may find you need bigger doses to get the same feeling or to lessen the pain. Eventually, you may depend on the drug to feel good or to get through your day.

Other signs that you are becoming dependent on alcohol or other drugs include:

having intense urges for the substance – this could be once a day or several times a day
needing more of a substance to get the same effect
fixating about making sure you have a constant supply of the substance
spending money on the substance, even when you cannot afford it
cutting back on social or other activities
not meeting your work, family or study responsibilities
lying to people about your alcohol or drug use when they ask
doing things that are illegal so you can get the substance, such as stealing
taking risks such as driving when you are under the influence of the substance
trying but failing to stop using the substance
experiencing withdrawal symptoms when you try to stop taking the substance.

Reducing or stopping use of alcohol or other drugs

Cutting down on alcohol or other drugs is hard to do because repeated alcohol or drug use makes the body more dependent and changes the brain. Brain scans of people who are dependent on alcohol or other drugs often show changes in the areas of the brain that help you learn and remember and make decisions.

The best thing you can do is to talk to someone you trust so you do not have to deal with this challenge alone.

What is alcoholism, or alcohol use disorder?

Alcoholism has been known by a variety of terms, including alcohol abuse and alcohol dependence. Today, it’s referred to as alcohol use disorder.

It occurs when you drink so much that your body eventually becomes dependent on or addicted to alcohol. When this happens, alcohol becomes the most important thing in your life.

People with alcohol use disorder will continue to drink even when drinking causes negative consequences, like losing a job or destroying relationships with people they love. They may know that their alcohol use negatively affects their lives, but it’s often not enough to make them stop drinking.

Some people may drink alcohol to the point that it causes problems, but they’re not physically dependent on alcohol. This used to be referred to as alcohol abuse.

What causes it?

The cause of alcohol use disorder is still unknown. Alcohol use disorder develops when you drink so much that chemical changes in the brain occur. These changes increase the pleasurable feelings you get when you drink alcohol. This makes you want to drink more often, even if it causes harm.

Eventually, the pleasurable feelings associated with alcohol use go away and the person with alcohol use disorder will engage in drinking to prevent withdrawal symptoms. These withdrawal symptoms can be quite unpleasant and even dangerous.

Alcohol use disorder typically develops gradually over time. It’s also known to run in families.

What are the risk factors?

Although the exact cause of alcohol use disorder is unknown, there are certain factors that may increase your risk for developing this disease.

Known risk factors include having:

more than 15 drinks per week if you’re male
more than 12 drinks per week if you’re female
more than 5 drinks per day at least once a week (binge drinking)
a parent with alcohol use disorder
a mental health problem, such as depression, anxiety, or schizophrenia

You may also be at a greater risk for alcohol use disorder if you:

are a young adult experiencing peer pressure
have low self-esteem
experience a high level of stress
live in a family or culture where alcohol use is common and accepted
have a close relative with alcohol use disorder

What are the symptoms?

Symptoms of alcohol use disorder are based on the behaviors and physical outcomes that occur as a result of alcohol addiction.

People with alcohol use disorder may engage in the following behaviors:

drinking alone
drinking more to feel the effects of alcohol (having a high tolerance)
becoming violent or angry when asked about their drinking habits
not eating or eating poorly
neglecting personal hygiene
missing work or school because of drinking
being unable to control alcohol intake
making excuses to drink
continuing to drink even when legal, social, or economic problems develop
giving up important social, occupational, or recreational activities because of alcohol use

People with alcohol use disorder may also experience the following physical symptoms:

alcohol cravings
withdrawal symptoms when not drinking, including shaking, nausea, and vomiting
tremors (involuntary shaking) the morning after drinking
lapses in memory (blacking out) after a night of drinking
illnesses, such as alcoholic ketoacidosis (includes dehydration-type symptoms) or cirrhosis

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Self-testing: Do I misuse alcohol?

Sometimes it can be hard to draw the line between safe alcohol use and the misuse of alcohol. if you answer “yes” to some of the following questions:

Do you need to drink more in order to feel the effects of alcohol?
Do you feel guilty about drinking?
Do you become irritable or violent when you’re drinking?
Do you have problems at school or work because of drinking?
Do you think it might be better if you cut back on your drinking?

The National Council on Alcoholism and Drug Dependence and AlcoholScreening.org offer more comprehensive self-tests. These tests can help you assess whether you misuse alcohol.

Professional diagnosis

Your doctor or healthcare provider can diagnose alcohol use disorder. They’ll do a physical exam and ask you questions about your drinking habits.

Your doctor may ask if you:

drive when you’re drunk
have missed work or have lost a job as a result of your drinking
need more alcohol to feel “drunk” when you drink
have experienced blackouts as a result of your drinking
have tried to cut back on your drinking but couldn’t

Your doctor may also use a questionnaire that assesses alcohol use disorder to help diagnose your condition.

Typically, a diagnosis of alcohol use disorder doesn’t require any other type of diagnostic test. There’s a chance your doctor may order blood work to check your liver function if you show signs or symptoms of liver disease.

Alcohol use disorder can cause serious and lasting damage to your liver. Your liver is responsible for removing toxins from your blood. When you drink too much, your liver has a harder time filtering the alcohol and other toxins from your bloodstream. This can lead to liver disease and other complications.

How is it treated?

Treatment for alcohol use disorder varies, but each method is meant to help you stop drinking altogether. This is called abstinence. Treatment may occur in stages and can include the following:

detoxification or withdrawal to rid your body of alcohol
rehabilitation to learn new coping skills and behaviors
counseling to address emotional problems that may cause you to drink
support groups, including 12-step programs such as Alcoholics Anonymous (AA)
medical treatment for health problems associated with alcohol use disorder
medications to help control addiction

There are a couple of different medications that may help with alcohol use disorder:

Naltrexone (ReVia) is used only after someone has detoxed from alcohol. This type of drug works by blocking certain receptors in the brain that are associated with the alcoholic “high.” This type of drug, in combination with counseling, may help decrease a person’s craving for alcohol.
Acamprosate is a medication that can help re-establish the brain’s original chemical state before alcohol dependence. This drug should also be combined with therapy.
Disulfiram (Antabuse) is a drug that causes physical discomfort (such as nausea, vomiting, and headaches) any time the person consumes alcohol.

You may need to seek treatment at an inpatient facility if your addiction to alcohol is severe. These facilities will provide you with 24-hour care as you withdraw from alcohol and recover from your addiction. Once you’re well enough to leave, you’ll need to continue to receive treatment on an outpatient basis.

What’s the outlook for a person with alcohol use disorder?

Recovering from alcohol use disorder is difficult. Your outlook will depend on your ability to stop drinking. Many people who seek treatment are able to overcome the addiction. A strong support system is helpful for making a complete recovery.

Your outlook will also depend on the health complications that have developed as a result of your drinking. Alcohol use disorder can severely damage your liver. It can also lead to other health complications, including:

bleeding in the gastrointestinal (GI) tract
damage to brain cells
cancer in the GI tract
dementia
depression
high blood pressure
pancreatitis (inflammation of the pancreas)
nerve damage
changes in mental status, including Wernicke-Korsakoff syndrome (a brain disease that causes symptoms such as confusion, vision changes, or memory loss)

How can you prevent alcohol use disorder?

You can prevent alcohol use disorder by limiting your alcohol intake. According to the National Institute on Alcohol Abuse and Alcoholism, women shouldn’t drink more than one drink per day, and men shouldn’t drink more than two drinks per day.

See your doctor if you begin to engage in behaviors that are signs of alcohol use disorder or if you think that you may have a problem with alcohol. You should also consider attending a local AA meeting or participating in a self-help program such as Women for Sobriety.

What is drug dependence?

Drug dependence occurs when you need one or more drugs to function. The American Psychiatric Association (APA) used to distinguish between dependence and abuse. Abuse was considered the mild or early phase of inappropriate drug use that led to dependence. People viewed dependence as a more severe problem than abuse.

The APA replaced “dependence” and “abuse” with “substance use disorder” in the 2013 edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This diagnosis focuses on the disorder involving the use of the substance.

Drug dependence vs. drug addiction

People sometimes use the terms “addiction” and “dependence” interchangeably. Dependence is not the same as addiction.

Addiction

Addiction can occur without being dependent on drugs.

Addiction may involve:

using drugs despite the consequences
being unable to stop using drugs
neglecting social and work obligations because of drug use

Dependence

It’s possible to be dependent on drugs without being addicted. Dependence can be a bodily response to a substance. This often occurs if you rely on medications to control a chronic medical condition. These conditions may include:

high blood pressure
diabetes
glaucoma

Dependence may involve:

some or all the symptoms of addiction
development of a high tolerance for the substance as your body adapts to the drug, leading to a desire for larger or more frequent doses
physical symptoms of withdrawal when you attempt to stop using the drug

How drug abuse can lead to dependence

The National Institute on Drug Abuse estimates 22.7 million Americans need help treating a drug or alcohol problem. In some cases, people may take a prescription medication for pain or another medical condition. This kind of use can sometimes develop into a substance use disorder.

The following are known triggers for substance use disorders:

having a family history of addiction
living in an environment where illegal drugs are often used and easy to access
having a history of anxiety
having a history of depression
having a history of other mental health conditions

Drug users typically pass through certain stages on the way to drug dependence. One way that healthcare providers describe these stages is with the Jellinek Curve. The curve tracks typical stages experienced through occasional use, dependence, disorder, and rehabilitation.

These stages include:

You use drugs for recreation. You take them infrequently and in social settings.
You start using drugs on a regular basis, often abandoning family and friends in favor of drug use. You become concerned about losing access to drugs.
You become addicted to drugs as you become more tolerant to their effects and preoccupied with getting them. You may abandon most or all your previous interests and relationships.
You become dependent on drugs and unable to live without them. Your physical and mental health deteriorates.

Recognizing the symptoms of drug dependence

You can often determine if an addiction has turned into dependence by looking at behavior. When a person addicted to drugs hasn’t had them for a period of time, this can cause a physical reaction. Physical symptoms of withdrawal occur when the body becomes stressed without the drug. These symptoms include:

anxiety
depression
muscle weakness
nightmares
body aches
sweating
nausea
vomiting

What drugs are most likely to cause dependency?

Treating drug dependence

When drug abuse escalates to dependence, treatment becomes complicated. You must stop using the drug, but doing so abruptly can cause physical symptoms. You may need the help of a healthcare provider to rid your body of the substance. This can be done on an inpatient or outpatient basis.

Substances that mimic the effects of illegal drugs may help reduce the symptoms of withdrawal during treatment. Detox programs use a combination of therapy and medical treatment to ease dependence and treat the disorder. Ongoing therapy sessions may be needed after you’re released from a treatment program.

Extreme cases of intoxication, withdrawal, or overdose may need emergency care before addiction and dependence can be treated.

Long-term outlook for people with drug dependence

If left untreated, dependence on illicit drugs can be dangerous. You may increase your drug use as your body adapts to the drugs. This can result in overdose or death.

Treatment can reverse dependence, but you must want to be treated. Sometimes, treatment is successful the first time, but relapse is common. Ongoing therapy and support groups can help you recover, stay on track, and address symptoms of relapse.

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Anxiety disorders

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Anxiety is your body’s natural response to stress. It’s a feeling of fear or apprehension about what’s to come. The first day of school, going to a job interview, or giving a speech may cause most people to feel fearful and nervous.

But if your feelings of anxiety are extreme, last for longer than six months, and are interfering with your life, you may have an anxiety disorder.

Experiencing occasional anxiety is a normal part of life. However, people with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks).

These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. You may avoid places or situations to prevent these feelings. Symptoms may start during childhood or the teen years and continue into adulthood.

Examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias and separation anxiety disorder. You can have more than one anxiety disorder. Sometimes anxiety results from a medical condition that needs treatment.

What are anxiety disorders?

It’s normal to feel anxious about moving to a new place, starting a new job, or taking a test. This type of anxiety is unpleasant, but it may motivate you to work harder and to do a better job. Ordinary anxiety is a feeling that comes and goes, but does not interfere with your everyday life.

In the case of an anxiety disorder, the feeling of fear may be with you all the time. It is intense and sometimes debilitating.

This type of anxiety may cause you to stop doing things you enjoy. In extreme cases, it may prevent you from entering an elevator, crossing the street, or even leaving your home. If left untreated, the anxiety will keep getting worse.

Anxiety disorders are the most common form of emotional disorder and can affect anyone at any age. According to the American Psychiatric Association, women are more likely than men to be diagnosed with an anxiety disorder.

Experiencing gastrointestinal (GI) problems
Having difficulty controlling worry
Having the urge to avoid things that trigger anxiety

Several types of anxiety disorders exist:

Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed.
Anxiety disorder due to a medical condition includes symptoms of intense anxiety or panic that are directly caused by a physical health problem.
Generalized anxiety disorder includes persistent and excessive anxiety and worry about activities or events — even ordinary, routine issues. The worry is out of proportion to the actual circumstance, is difficult to control and affects how you feel physically. It often occurs along with other anxiety disorders or depression.
Panic disorder involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart (heart palpitations). These panic attacks may lead to worrying about them happening again or avoiding situations in which they’ve occurred.
Selective mutism is a consistent failure of children to speak in certain situations, such as school, even when they can speak in other situations, such as at home with close family members. This can interfere with school, work and social functioning.
Separation anxiety disorder is a childhood disorder characterized by anxiety that’s excessive for the child’s developmental level and related to separation from parents or others who have parental roles.
Social anxiety disorder (social phobia) involves high levels of anxiety, fear and avoidance of social situations due to feelings of embarrassment, self-consciousness and concern about being judged or viewed negatively by others.
Specific phobias are characterized by major anxiety when you’re exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people.
Substance-induced anxiety disorder is characterized by symptoms of intense anxiety or panic that are a direct result of misusing drugs, taking medications, being exposed to a toxic substance or withdrawal from drugs.
Other specified anxiety disorder and unspecified anxiety disorder are terms for anxiety or phobias that don’t meet the exact criteria for any other anxiety disorders but are significant enough to be distressing and disruptive

When to see a doctor

See your doctor if:

You feel like you’re worrying too much and it’s interfering with your work, relationships or other parts of your life
Your fear, worry or anxiety is upsetting to you and difficult to control
You feel depressed, have trouble with alcohol or drug use, or have other mental health concerns along with anxiety
You think your anxiety could be linked to a physical health problem
You have suicidal thoughts or behaviors — if this is the case, seek emergency treatment immediately

Your worries may not go away on their own, and they may get worse over time if you don’t seek help. See your doctor or a mental health provider before your anxiety gets worse. It’s easier to treat if you get help early.

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Causes

Researchers are not sure of the exact cause of anxiety. But, it’s likely a combination of factors play a role. These include genetic and environmental factors, as well as brain chemistry.

In addition, researchers believe that the areas of the brain responsible for controlling fear may be impacted.

Current research of anxiety is taking a deeper look at the parts of the brain that are involved with anxiety.

The causes of anxiety disorders aren’t fully understood. Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to anxiety. Inherited traits also can be a factor.

Medical causes

For some people, anxiety may be linked to an underlying health issue. In some cases, anxiety signs and symptoms are the first indicators of a medical illness. If your doctor suspects your anxiety may have a medical cause, he or she may order tests to look for signs of a problem.

Examples of medical problems that can be linked to anxiety include:

Heart disease
Diabetes
Thyroid problems, such as hyperthyroidism
Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and asthma
Drug misuse or withdrawal
Withdrawal from alcohol, anti-anxiety medications (benzodiazepines) or other medications
Chronic pain or irritable bowel syndrome
Rare tumors that produce certain fight-or-flight hormones

Sometimes anxiety can be a side effect of certain medications.

It’s possible that your anxiety may be due to an underlying medical condition if:

You don’t have any blood relatives (such as a parent or sibling) with an anxiety disorder
You didn’t have an anxiety disorder as a child
You don’t avoid certain things or situations because of anxiety
You have a sudden occurrence of anxiety that seems unrelated to life events and you didn’t have a previous history of anxiety

Symptoms

Anxiety feels different depending on the person experiencing it. Feelings can range from butterflies in your stomach to a racing heart. You might feel out of control, like there’s a disconnect between your mind and body.

Other ways people experience anxiety include nightmares, panic attacks, and painful thoughts or memories that you can’t control. You may have a general feeling of fear and worry, or you may fear a specific place or event.

Symptoms of general anxiety include:

increased heart rate
rapid breathing
restlessness
trouble concentrating
difficulty falling asleep

Your anxiety symptoms might be totally different from someone else’s. That’s why it’s important to know all the ways anxiety can present itself.

Common anxiety signs and symptoms include:

Feeling nervous, restless or tense
Having a sense of impending danger, panic or doom
Having an increased heart rate
Breathing rapidly (hyperventilation)
Sweating
Trembling
Feeling weak or tired
Trouble concentrating or thinking about anything other than the present worry
Having trouble sleeping
Experiencing gastrointestinal (GI) problems
Having difficulty controlling worry
Having the urge to avoid things that trigger anxiety

What is an anxiety attack?

An anxiety attack is a feeling of overwhelming apprehension, worry, distress, or fear. For many people, an anxiety attack builds slowly. It may worsen as a stressful event approaches.

Anxiety attacks can vary greatly, and symptoms may differ among individuals. That’s because the many symptoms of anxiety don’t happen to everyone, and they can change over time.

Common symptoms of an anxiety attack include:

feeling faint or dizzy
shortness of breath
dry mouth
sweating
chills or hot flashes
apprehension and worry
restlessness
distress
fear
numbness or tingling

A panic attack and an anxiety attack share some common symptoms, but they’re not the same.

Risk factors

These factors may increase your risk of developing an anxiety disorder:

Trauma. Children who endured abuse or trauma or witnessed traumatic events are at higher risk of developing an anxiety disorder at some point in life. Adults who experience a traumatic event also can develop anxiety disorders.
Stress due to an illness. Having a health condition or serious illness can cause significant worry about issues such as your treatment and your future.
Stress buildup. A big event or a buildup of smaller stressful life situations may trigger excessive anxiety — for example, a death in the family, work stress or ongoing worry about finances.
Personality. People with certain personality types are more prone to anxiety disorders than others are.
Other mental health disorders. People with other mental health disorders, such as depression, often also have an anxiety disorder.
Having blood relatives with an anxiety disorder. Anxiety disorders can run in families.
Drugs or alcohol. Drug or alcohol use or misuse or withdrawal can cause or worsen anxiety.

Complications

Having an anxiety disorder does more than make you worry. It can also lead to, or worsen, other mental and physical conditions, such as:

Depression (which often occurs with an anxiety disorder) or other mental health disorders
Substance misuse
Trouble sleeping (insomnia)
Digestive or bowel problems
Headaches and chronic pain
Social isolation
Problems functioning at school or work
Poor quality of life
Suicide

Prevention

There’s no way to predict for certain what will cause someone to develop an anxiety disorder, but you can take steps to reduce the impact of symptoms if you’re anxious:

Get help early. Anxiety, like many other mental health conditions, can be harder to treat if you wait.
Stay active. Participate in activities that you enjoy and that make you feel good about yourself. Enjoy social interaction and caring relationships, which can lessen your worries.
Avoid alcohol or drug use. Alcohol and drug use can cause or worsen anxiety. If you’re addicted to any of these substances, quitting can make you anxious. If you can’t quit on your own, see your doctor or find a support group to help you.

Are there tests that diagnose anxiety?

A single test can’t diagnose anxiety. Instead, an anxiety diagnosis requires a lengthy process of physical examinations, mental health evaluations, and psychological questionnaires.

Some doctors may conduct a physical exam, including blood or urine tests to rule out underlying medical conditions that could contribute to symptoms you’re experiencing.

Several anxiety tests and scales are also used to help your doctor assess the level of anxiety you’re experiencing.

What are treatments for anxiety?

Once you’ve been diagnosed with anxiety, you can to explore treatment options with your doctor. For some people, medical treatment isn’t necessary. Lifestyle changes may be enough to cope with the symptoms.

In moderate or severe cases, however, treatment can help you overcome the symptoms and lead a more manageable day-to-day life.

Treatment for anxiety falls into two categories: psychotherapy and medication. Meeting with a therapist or psychologist can help you learn tools to use and strategies to cope with anxiety when it occurs.

Medications typically used to treat anxiety include antidepressants and sedatives. They work to balance brain chemistry, prevent episodes of anxiety, and ward off the most severe symptoms of the disorder.Treatments for anxiety disorder include:

Medication. Several types of drugs are used to treat anxiety disorders. Talk to your doctor or psychiatrist about the pros and cons of each medicine to decide which one is best for you.

Antidepressants. Modern antidepressants (SSRIs and SNRIs) are typically the first drugs prescribed to someone with an anxiety disorder. Examples of SSRIs are escitalopram (Lexapro) and fluoxetine (Prozac). SNRIs include duloxetine (Cymbalta)and venlafaxine (Effexor).
Bupropion. This is another type of antidepressant commonly used to treat chronic anxiety. It works differently than SSRIs and SNRIs.
Other antidepressants. These include tricyclics and monoamine oxidase inhibitors (MAOIs). They are less commonly used because side effects, like drops in blood pressure, dry mouth, blurry vision, and urinary retention, can be unpleasant or unsafe for some people.
Benzodiazepines. Your doctor may prescribe one of these drugs if you’re having persistent panicky feelings or anxiety. They help lower anxiety. Examples are alprazolam (Xanax) and clonazepam (Klonopin). They work quickly, but you can become dependent on them. Usually, they’re meant to be an add-on to your anxiety disorder treatment and you shouldn’t take them for a long time.
Beta-blockers. This type of high blood pressure drug can help you feel better if you’re having physical symptoms of anxiety, such as a racing heart, trembling, or shaking. A beta-blocker may help you relax during an acute anxiety attack.
Anticonvulsants. Used to prevent seizures in people with epilepsy, these drugs also can relieve certain anxiety disorder symptoms.
Antipsychotics. Low doses of these drugs can be added to help make other treatments work better.
Buspirone (BuSpar). This anti-anxiety drug is sometimes used to treat chronic anxiety. You’ll need to take it for a few weeks before seeing full symptom relief.

Psychotherapy: This is a type of counseling that helps you learn how your emotions affect your behaviors. It’s sometimes called talk therapy. A trained mental health specialist listens and talks to you about your thoughts and feelings and suggests ways to understand and manage them and your anxiety disorder.

Cognitive behavioral therapy (CBT): This common type of psychotherapy teaches you how to turn negative, or panic-causing, thoughts and behaviors into positive ones. You’ll learn ways to carefully approach and manage fearful or worrisome situations without anxiety. Some places offer family CBT sessions.

What natural remedies are used for anxiety?

Lifestyle changes can be an effective way to relive some of the stress and anxiety you may cope with every day. Most of the natural “remedies” consist of caring for your body, participating in healthy activities, and eliminating unhealthy ones.

These include:

getting enough sleep
meditating
staying active and exercising
eating a healthy diet
staying active and working out
avoiding alcohol
avoiding caffeine
quitting smoking cigarettes

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Psychiatric disorders of childhood and adolescence

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Although it is sometimes assumed that childhood and adolescence are times of carefree bliss, as many as 20% of children and adolescents have a diagnosable mental disorder that causes impairment. With increasing age, more children develop one or more disorders. All told, about 27.9% of US adolescents aged 13 to 17 are reported to meet criteria for 2 or more disorders. Recent studies that follow children from birth to adulthood indicate that most adult mental health disorders begin in early childhood and adolescence. Genes associated with mental health disorders have been reported to show high expression throughout the lifespan, beginning in the 2nd trimester and impacting neurodevelopmental processes, which may explain the early ages of onset. Most of these disorders may be viewed as exaggerations or distortions of normal behaviors and emotions.

Like adults, children and adolescents vary in temperament. Some are shy and reticent; others are socially exuberant. Some are methodical and cautious; others are impulsive and careless. Whether a child is behaving like a typical child or has a disorder is determined by the presence of impairment and the degree of distress related to the symptoms. For example, a 12-year-old girl may be frightened by the prospect of delivering a book report in front of her class. This fear would be viewed as social anxiety disorder only if her fears were severe enough to cause significant distress and avoidance.

There is much overlap between the symptoms of many disorders and the challenging behaviors and emotions of normal children. Thus, many strategies useful for managing behavioral problems in children can also be used in children who have mental disorders. Furthermore, appropriate management of childhood behavioral problems may decrease the risk of temperamentally vulnerable children developing a full-blown disorder. Also, effective treatment of some disorders (eg, anxiety) during childhood may decrease the risk of mood disorders later in life.

The most common mental disorders of childhood and adolescence fall into the following categories:

Anxiety disorders
Stress-related disorders
Mood disorders
Obsessive-compulsive disorder
Disruptive behavioral disorders (eg, attention-deficit/hyperactivity disorder [ADHD], conduct disorder, and oppositional defiant disorder)

Schizophrenia and related psychotic disorders are much less common.

Pediatric catatonia is more common than childhood schizophrenia. It may represent a psychiatric disorder but often occurs in medical conditions (eg, infections, metabolic disorders, autoimmune conditions) and is not detected by pediatricians.

However, more often than not, children and adolescents have symptoms and problems that cut across diagnostic boundaries. For example, > 25% of children with ADHD also have an anxiety disorder, and 25% meet the criteria for a mood disorder.

Sign of Mental Illness in Children

Nightmares

Nightmares are dreams that are threatening and scary. Nearly everyone has had a nightmare from time to time. For trauma survivors, though, nightmares are a common problem. Along with flashbacks and unwanted memories, nightmares are one of the ways in which a trauma survivor may relive the trauma for months or years after the event.

What are symptoms and signs of mental illness in children?

Children with mental illness may experience the classic symptoms of their particular disorder but may exhibit other symptoms as well, including

poor school performance;
persistent boredom;
frequent complaints of physical symptoms, such as headaches and stomachaches;
sleep and/or appetite problems like sleeping too much or too little, nightmares, or sleepwalking;
behaviors returning to those of a younger age (regressing), like bedwetting, throwing tantrums, or becoming clingy;
noncompliant or aggressive behaviors; and
more risk-taking behaviors and/or showing less concern for their own safety.

Examples of risk-taking behaviors include running into the street, climbing too high, engaging in physical altercations, or playing with unsafe items.

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What are causes and risk factors for mental illness in children?

As is the case with most mental health disorders at any age, such disorders in children do not have one single definitive cause. Rather, people with these illnesses tend to have a number of biological, psychological, and environmental risk factors that contribute to their development. Biologically, mental illnesses tend to be associated with abnormal levels of neurotransmitters, like serotonin or dopamine in the brain, a decrease in the size of some areas of the brain, as well as increased activity in other areas of the brain. Physicians are more likely to diagnose girls with mood disorders like depression and anxiety compared to boys, while disorders like attention deficit hyperactivity disorder and autism spectrum disorders are more often assigned to boys. Gender differences in mental illness are the result of, among other things, a combination of biological differences based on gender, as well as the differences in how girls are encouraged to interpret their environment and respond to it compared to boys. There is thought to be at least a partially genetic contribution to the fact that children and adolescents with a mentally ill parent are up to four times more likely to develop such an illness themselves. Teens who develop a mental disorder are also more prone to having had other biological challenges, like low birth weight, trouble sleeping, and having a mother younger than 18 years old at the time of their birth.

Psychological risk factors for mental illness in children include low self-esteem, poor body image, a tendency to be highly self-critical, and feeling helpless when dealing with negative events. Teen mental disorders are somewhat associated with the stress of body changes, including the fluctuating hormones of puberty, as well as teen ambivalence toward increased independence, and with changes in their relationships with parents, peers, and others. Teenagers who suffer from conduct disorder, attention deficit hyperactivity disorder (ADHD), clinical anxiety, or who have cognitive and learning problems, as well as trouble relating to others are at higher risk of also developing a mental disorder.

Childhood mental illness may be a reaction to environmental stresses, including trauma like being the victim of verbal, physical, or sexual abuse, the death of a loved one, school problems, or being the victim of bullying or peer pressure. Gay teens are at higher risk for developing mental disorders like depression, thought to be because of the bullying by peers and potential rejection by family members. Children in military families are at risk for experiencing depression as well.

The aforementioned environmental risk factors tend to predispose individuals to childhood mental illness. Other risk factors tend to predispose people to developing a mental disorder at any age. Such nonspecific risk factors include a history of poverty, exposure to violence, having an antisocial peer group, or being socially isolated, abuse victimization, parental conflict, and family dissolution. Children who have low physical activity, poor academic performance, or lose a relationship are at higher risk for mental illness as well.

How do health care professionals diagnose mental illness in children?

Many health care professionals may help make the diagnosis of a mental illness in children, including licensed mental health therapists, pediatricians or other primary care providers, emergency physicians, psychiatrists, psychologists, psychiatric nurses, physician assistants, and social workers. One of these professionals will likely conduct an extensive medical interview and physical examination or refer the child for those assessments as part of establishing the diagnosis.

Childhood mental illnesses may be associated with a number of other medical conditions or can be a side effect of various medications. For this reason, health care professionals perform routine laboratory tests during the initial evaluation to rule out other causes of symptoms. Occasionally, it may be necessary to get an X-ray, scan, or other imaging study. As part of this examination, a health care provider may ask the child and his or her parents a series of questions from a standardized questionnaire or self-test to help further assess symptoms. The use of screening tools is particularly important for detecting early signs of mental illness in infants and toddlers, due to their being largely preverbal in their communication.

RESPONSE OF WHO

Childhood and adolescence are critical stages of life for mental health. This is a time when rapid growth and development take place in the brain. Children and adolescents acquire cognitive and social-emotional skills that shape their future mental health and are important for assuming adult roles in society.

The quality of the environment where children and adolescents grow up shapes their well-being and development. Early negative experiences in homes, schools, or digital spaces, such as exposure to violence, the mental illness of a parent or other caregiver, bullying and poverty, increase the risk of mental illness.

Mental health conditions, such as childhood epilepsy, developmental disabilities, depression, anxiety and behavioural disorders, are major causes of illness and disability among young people. Worldwide, 10-20% of children and adolescents experience mental health conditions, but the majority of them do not seek help or receive care. Half of all mental health conditions start by 14 years of age. Suicide is the third leading cause of death in 15-19 year-olds. The consequences of not addressing mental health and psychosocial development for children and adolescents extend to adulthood and limit opportunities for leading fulfilling lives.

WHO supports Member States in the development and implementation of multisectoral, evidence-informed and human-rights-based strategies for the promotion of mental health, prevention of mental health conditions and provision of mental health care for children, adolescents and their families.

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Psychological testing

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Psychological tests are written, visual, or verbal evaluations administered to assess the cognitive and emotional functioning of children and adults.

Purpose

Psychological tests are used to assess a variety of mental abilities and attributes, including achievement and ability, personality, and neurological functioning.

For children, academic achievement, ability, and intelligence tests may be used as tools in school placement, in determining the presence of a learning disability or a developmental delay , in identifying giftedness, or in tracking intellectual development. Intelligence testing may also be used with teens and young adults to determine vocational ability (e.g., in career counseling).

Personality tests are administered for a wide variety of reasons, from diagnosing psychopathology (e.g., personality disorder, depressive disorder) to screening job candidates. They may be used in an educational setting to determine personality strengths and weaknesses.

Types of Psychological Testing

Psychological testing — also called psychological assessment — is the foundation of how psychologists better understand a person and their behavior. It is a process of problem solving for many professionals — to try and determine the core components of a person’s psychological or mental health problems, personality, IQ, or some other component. It is also a process that helps identifies not just weaknesses of a person, but also their strengths.

Psychological testing measures an individual’s performance at a specific point in time — right now. Psychologists talk about a person’s “present functioning” in terms of their test data. Therefore psychological tests can’t predict future or innate potential.

Psychological testing is not a single test or even a single type of test. It encompasses a whole body of dozens of research-backed tests and procedures of assessing specific aspects of a person’s psychological makeup. Some tests are used to determine IQ, others are used for personality, and still others for something else. Since so many different tests are available, it’s important to note that not all of them share the same research evidence for their use — some tests have a strong evidence base while others do not.

Psychological assessment is something that’s typically done in a formal manner only by a licensed psychologist (the actual testing may sometimes be administered by a psychology intern or trainee studying to become a psychologist). Depending upon what kind of testing is being done, it can last anywhere from 1 1/2 hours to a full day. Testing is usually done in a psychologist’s office and consists largely of paper-and-pencil tests (nowadays often administered on a computer for ease-of-use).

Psychological testing is divided into four primary types:

Clinical Interview
Assessment of Intellectual Functioning (IQ)
Personality Assessment
Behavioral Assessment

In addition to these primary types of psychological assessment, other kinds of psychological tests are available for specific areas, such as aptitude or achievement in school, career or work counseling, management skills, and career planning.

The Clinical Interview

The clinical interview is a core component of any psychological testing. Some people know the clinical interview as an “intake interview”, “admission interview” or “diagnostic interview” (although technically these are often very different things). Clinical interviews typically last from 1 to 2 hours in length, and occur most often in a clinician’s office. Many types of mental health professionals can conduct a clinical interview — psychologists, psychiatrists, clinical social workers, psychiatric nurses, amongst others.

The clinical interview is an opportunity for the professional to gather important background and family data about the person. Think of it as an information-gathering session for the professional’s benefit (but ultimately for your benefit). You may have to recall or review a lot of your life and personal history with the professional, who will often ask specific questions about various stages in your life.

Some components of the clinical interview have now become computerized, meaning you will answer a series of questions on a computer in the clinician’s office instead of talking directly to a person. This is most often done for basic demographic information, but can also include structured diagnostic interview questions to help the clinicians formulate an initial diagnostic impression.

Before any formal psychological testing is done, a clinical interview is nearly always conducted (even if the person has already gone through one with a different professional). Psychologists conducting the testing will often want to form their own clinical impressions, which can be best done through a direct interview with the person.

Assessment of Intellectual Functioning (IQ)

Your IQ — intellectual quotient — is a theoretical construct of a measure of general intelligence. It’s important to note that IQ tests do not measure actual intelligence — they measure what we believe might be important components of intelligence.

There are two primary measures used to test a person’s intellectual functions — intelligence tests and neuropsychological assessment. Intelligence tests are the more common type administered and include the Stanford-Binet and the Wechsler scales. Neuropsychological assessment — which can take up to 2 days to administer — is a far more extensive form of assessment. It is focused not just on testing for intelligence, but also on determining all of the cognitive strengths and deficits of the person. Neuropsychological assessment is most usually done with people who have suffered some sort of brain damage, dysfunction or some kind of organic brain problem, just as having a brain hemorrhage.

The most commonly administered IQ test is called the Wechsler Adult Intelligence Scale—Fourth Edition (WAIS-IV). It generally takes anywhere from an hour to an hour and a half to administer, and is appropriate for any individual aged 16 or older to take. (Children can be administered an IQ test especially designed for them called the Wechsler Intelligence Scale for Children – Fourth Edition, or the WISC-IV.)

The WAIS-IV is divided into four major scales to arrive at what’s called a “full scale IQ.” Each scale is further divided into a number of mandatory and optional (also called supplemental) subtests. The mandatory subtests are necessary to arrive at a person’s full scale IQ. The supplemental subtests provide additional, valuable information about a person’s cognitive abilities.

Verbal Comprehension Scale

Similarities
Vocabulary
Information
Supplemental Subtest: Comprehension

Perceptual Reasoning Scale

Block Design
Matrix Reasoning
Visual Puzzles
Supplemental Subtests: Picture Completion; Figure Weights (16-69) only

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Working Memory Scale

Digit Span
Arithmetic
Supplemental Subtest: Letter-Number Sequencing (16-69 only)

Processing Speed Scale

Symbol Search
Coding
Supplemental Subtest: Cancellation (16-69 only)

As you can surmise from the names of some of the scales of the test, measuring IQ isn’t just answering questions about information or vocabulary. Because some of the subtests require physical manipulation of objects, the Wechsler is tapping into many different components of a person’s brain and thought processes (including the creative). For this reason and others, online IQ tests are not equivalent to real IQ tests given by a psychologist.

Personality Assessment

Personality assessment is designed to help a professional better understand an individual’s personality. Personality is a complex combination of factors that has been developed over a person’s entire childhood and young adulthood. There are genetic, environmental and social components to personality — our personalities are not shaped by one single influence. Therefore tests that measure personality take into account this complexity and rich texture.

There are two primary types of personality tests — objective, by far the most commonly used today, and projective. Objective tests include things like the Minnesota Multiphasic Personality Inventory (MMPI-2), the 16PF, and the Millon Clinical Multiaxial Inventory-III (MCMI-III). Projective tests include the Rorschach Inkblot Test, the Thematic Apperception Test (TAT), and the Draw-a-Person test.

Objective Tests

The most common objective personality test is the MMPI-2, a 567 true/false test that is a good measure of dysfunction within personality. It is less useful as a measure of healthy or positive personality traits, because its design was based on helping a professional to find a psychiatric diagnostic label that best suited an individual. Originally developed in the 1940s, it was significantly revised in 1989 (and had another minor revision in 2001).

The MMPI-2 measures personality traits such as paranoia, hypomania, social introversion, masculinity/femininity, and psychopathology, among others. It does this by connecting an individual’s responses to dozens of questions scattered throughout the test that are positively or negatively correlated with a particular personality trait. Because the questions are not always obviously related to the trait to which they are correlated, it is difficult to “fake” this test. The MMPI-2 is most often self-administered on a computer in a clinician’s office.

The Millon (MCMI-III) is specifically used to arrive at a DSM-IV personality disorder diagnosis. Because it takes only about a third of the time to take as the MMPI-2, it is often preferred when a simple assessment of an individual’s personality disorder is needed.

Because the MMPI-2 is not an ideal measure for people with healthy personalities, other measures, such as the 16PF may be more appropriate. The 16PF measures 16 basic personality traits and can help a person better understand where their personality falls amongst those traits:

Warmth (Reserved vs. Warm; Factor A)
Reasoning (Concrete vs. Abstract; Factor B)
Emotional Stability (Reactive vs. Emotionally Stable; Factor C)
Dominance (Deferential vs. Dominant; Factor E)
Liveliness (Serious vs. Lively; Factor F)
Rule-Consciousness (Expedient vs. Rule-Conscious; Factor G)
Social Boldness (Shy vs. Socially Bold; Factor H)
Sensitivity (Utilitarian vs. Sensitive; Factor I)
Vigilance (Trusting vs. Vigilant; Factor L)
Abstractedness (Grounded vs. Abstracted; Factor M)
Privateness (Forthright vs. Private; Factor N)
Apprehension (Self-Assured vs. Apprehensive; Factor O)
Openness to Change (Traditional vs. Open to Change; Factor Q1)
Self-Reliance (Group-Oriented vs. Self-Reliant; Factor Q2)
Perfectionism (Tolerates Disorder vs. Perfectionistic; Factor Q3)
Tension (Relaxed vs. Tense; Factor Q4)

This type of assessment might be administered so that a person can better understand themselves, and it can also help a professional better understand what type of approach or strategy to employ in treatment to best help the person.

Projective Tests

The most famous projective test is the Rorschach Inkblot Test. The test is composed 5 black and white inkblot cards and 5 colored inkblot cards that an individual is shown and then asked to tell the professional what they see. The most popular scoring system for the Rorschach is the Exner system, developed in the 1970s. Responses are scored based the location described in the inkblot, and its determinants — the things in the blot that prompted the person’s response. So yes, for the Rorschach there are answers that are “more right” than others.

The Thematic Apperception Test (TAT) is comprised of 31 cards that depict people in a variety of situations. A few contain only objects and one card is completely blank. Often only a small subset of the cards is given (such as 10 or 20). The person viewing the card is asked to make up a story about what they see. The TAT is not often formally scored; instead it’s a test designed to try and distinguish recurring themes in the person’s life. The pictures themselves have no inherent or “correct” story; therefore anything a person says about the picture may be an unconscious reflection into the person’s life or inner turmoil.

Behavioral Assessment

Behavioral assessment is the process of observing or measuring a person’s actual behavior to try and better understand the behavior and the thoughts behind it, and determine possible reinforcing components or triggers for the behavior. Through the process of behavioral assessment, a person — and/or a professional — can track behaviors and help change them.

After a clinical interview, the core of behavioral assessment is naturalistic observation — that is, observing the person in a natural setting and taking notes (much like an anthropologist). This can be done at home (think “Super Nanny” when Nanny spends the first day simply observing the current family patterns of behavior), at school, at work, or in a hospital or inpatient setting. Target negative and positive behaviors are observed, as well as their respective reinforcements. Then the therapist has a good idea of what needs to change in order to obtain new, healthier behaviors.

Self-monitoring is also a component of behavioral assessment. For instance, when a person is asked to keep a mood journal and track their moods over the course of a week or month, that’s a form of self-monitoring.

Inventories and checklists, popular nowadays online in the form of quizzes, can also be a form of behavioral assessment. For instance, the Beck Depression Inventory is a popular depression behavioral assessment.

Psychological assessment encompasses a wide variety of types of tests, procedures and techniques used to help a psychologist better understand a person. Once psychological testing has been completed, the professional typically requires a few weeks to compile the data, interpret it, and write up a personalized assessment report for the individual.

Such reports are usually lengthy and try to tie together the findings from all the various tests administered (if more than one test was administered). Findings that are outliers — e.g., only one test suggests something is significant but it is not backup by other tests — may be noted, but aren’t as significant as thematic findings that run through all the tests. The point of the test report is to summarize the findings in plain English, identify strengths and weaknesses, and help shed light on a person to help them better understand themselves.

The old saying, “Know thyself” comes to mind. When used responsibly in a clinical or school setting, psychological testing has been shown to help individuals better “know thyself” in ways that simply talking to a person might never discover.

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Aetiology of Psychiatric disorders

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Mental illness, also called mental health disorders, refers to a wide range of mental health conditions — disorders that affect your mood, thinking and behavior. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors.

Many people have mental health concerns from time to time. But a mental health concern becomes a mental illness when ongoing signs and symptoms cause frequent stress and affect your ability to function.

A mental illness can make you miserable and can cause problems in your daily life, such as at school or work or in relationships. In most cases, symptoms can be managed with a combination of medications and talk therapy (psychotherapy).

Symptoms

Signs and symptoms of mental illness can vary, depending on the disorder, circumstances and other factors. Mental illness symptoms can affect emotions, thoughts and behaviors.

Examples of signs and symptoms include:

Feeling sad or down
Confused thinking or reduced ability to concentrate
Excessive fears or worries, or extreme feelings of guilt
Extreme mood changes of highs and lows
Withdrawal from friends and activities
Significant tiredness, low energy or problems sleeping
Detachment from reality (delusions), paranoia or hallucinations
Inability to cope with daily problems or stress
Trouble understanding and relating to situations and to people
Problems with alcohol or drug use
Major changes in eating habits
Sex drive changes
Excessive anger, hostility or violence
Suicidal thinking

Sometimes symptoms of a mental health disorder appear as physical problems, such as stomach pain, back pain, headaches, or other unexplained aches and pains.

When to see a doctor

If you have any signs or symptoms of a mental illness, see your primary care provider or a mental health professional. Most mental illnesses don’t improve on their own, and if untreated, a mental illness may get worse over time and cause serious problems.

If you have suicidal thoughts

Suicidal thoughts and behavior are common with some mental illnesses. If you think you may hurt yourself or attempt suicide, get help right away:

Call your local emergency number immediately.
Call your mental health specialist.
Call a suicide hotline number.
Seek help from your primary care provider.
Reach out to a close friend or loved one.
Contact a minister, spiritual leader or someone else in your faith community.

Suicidal thinking doesn’t get better on its own — so get help.

Helping a loved one

If your loved one shows signs of mental illness, have an open and honest discussion with him or her about your concerns. You may not be able to force someone to get professional care, but you can offer encouragement and support. You can also help your loved one find a qualified mental health professional and make an appointment. You may even be able to go along to the appointment.

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Causes

Mental illnesses, in general, are thought to be caused by a variety of genetic and environmental factors:

Inherited traits. Mental illness is more common in people whose blood relatives also have a mental illness. Certain genes may increase your risk of developing a mental illness, and your life situation may trigger it.
Environmental exposures before birth. Exposure to environmental stressors, inflammatory conditions, toxins, alcohol or drugs while in the womb can sometimes be linked to mental illness.
Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that carry signals to other parts of your brain and body. When the neural networks involving these chemicals are impaired, the function of nerve receptors and nerve systems change, leading to depression and other emotional disorders.

What Biological Factors Are Involved in Mental Illness?

Some mental illnesses have been linked to abnormal functioning of nerve cell circuits or pathways that connect particular brain regions. Nerve cells within these brain circuits communicate through chemicals called neurotransmitters. “Tweaking” these chemicals — through medicines, psychotherapy or other medical procedures — can help brain circuits run more efficiently. In addition, defects in or injury to certain areas of the brain have also been linked to some mental conditions.

Other biological factors that may be involved in the development of mental illness include:

Genetics (heredity): Mental illnesses sometimes run in families, suggesting that people who have a family member with a mental illness may be somewhat more likely to develop one themselves. Susceptibility is passed on in families through genes. Experts believe many mental illnesses are linked to abnormalities in many genes rather than just one or a few and that how these genes interact with the environment is unique for every person (even identical twins). That is why a person inherits a susceptibility to a mental illness and doesn’t necessarily develop the illness. Mental illness itself occurs from the interaction of multiple genes and other factors — such as stress, abuse, or a traumatic event — which can influence, or trigger, an illness in a person who has an inherited susceptibility to it.
Infections: Certain infections have been linked to brain damage and the development of mental illness or the worsening of its symptoms. For example, a condition known as pediatric autoimmune neuropsychiatric disorder (PANDAS) associated with the Streptococcus bacteria has been linked to the development of obsessive-compulsive disorder and other mental illnesses in children.
Brain defects or injury: Defects in or injury to certain areas of the brain have also been linked to some mental illnesses.
Prenatal damage: Some evidence suggests that a disruption of early fetal brain development or trauma that occurs at the time of birth — for example, loss of oxygen to the brain — may be a factor in the development of certain conditions, such as autism spectrum disorder.
Substance abuse: Long-term substance abuse, in particular, has been linked to anxiety, depression, and paranoia.
Other factors: Poor nutrition and exposure to toxins, such as lead, may play a role in the development of mental illnesses.

What Psychological Factors Contribute to Mental Illness?

Psychological factors that may contribute to mental illness include:

Severe psychological trauma suffered as a child, such as emotional, physical, or sexual abuse
An important early loss, such as the loss of a parent
Neglect
Poor ability to relate to others

What Environmental Factors Contribute to Mental Illness?

Certain stressors can trigger an illness in a person who is susceptible to mental illness. These stressors include:

Death or divorce
A dysfunctional family life
Feelings of inadequacy, low self-esteem, anxiety, anger, or loneliness
Changing jobs or schools
Social or cultural expectations (For example, a society that associates beauty with thinness can be a factor in the development of eating disorders.)
Substance abuse by the person or the person’s parents

Risk factors

Certain factors may increase your risk of developing a mental illness, including:

A history of mental illness in a blood relative, such as a parent or sibling
Stressful life situations, such as financial problems, a loved one’s death or a divorce
An ongoing (chronic) medical condition, such as diabetes
Brain damage as a result of a serious injury (traumatic brain injury), such as a violent blow to the head
Traumatic experiences, such as military combat or assault
Use of alcohol or recreational drugs
A childhood history of abuse or neglect
Few friends or few healthy relationships
A previous mental illness

Mental illness is common. About 1 in 5 adults has a mental illness in any given year. Mental illness can begin at any age, from childhood through later adult years, but most cases begin earlier in life.

The effects of mental illness can be temporary or long lasting. You also can have more than one mental health disorder at the same time. For example, you may have depression and a substance use disorder.

Complications

Mental illness is a leading cause of disability. Untreated mental illness can cause severe emotional, behavioral and physical health problems. Complications sometimes linked to mental illness include:

Unhappiness and decreased enjoyment of life
Family conflicts
Relationship difficulties
Social isolation
Problems with tobacco, alcohol and other drugs
Missed work or school, or other problems related to work or school
Legal and financial problems
Poverty and homelessness
Self-harm and harm to others, including suicide or homicide
Weakened immune system, so your body has a hard time resisting infections
Heart disease and other medical conditions

Prevention

There’s no sure way to prevent mental illness. However, if you have a mental illness, taking steps to control stress, to increase your resilience and to boost low self-esteem may help keep your symptoms under control. Follow these steps:

Pay attention to warning signs. Work with your doctor or therapist to learn what might trigger your symptoms. Make a plan so that you know what to do if symptoms return. Contact your doctor or therapist if you notice any changes in symptoms or how you feel. Consider involving family members or friends to watch for warning signs.
Get routine medical care. Don’t neglect checkups or skip visits to your primary care provider, especially if you aren’t feeling well. You may have a new health problem that needs to be treated, or you may be experiencing side effects of medication.
Get help when you need it. Mental health conditions can be harder to treat if you wait until symptoms get bad. Long-term maintenance treatment also may help prevent a relapse of symptoms.
Take good care of yourself. Sufficient sleep, healthy eating and regular physical activity are important. Try to maintain a regular schedule. Talk to your primary care provider if you have trouble sleeping or if you have questions about diet and physical activity.

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Group Dynamics and Inter-group relations & Consequences of belonging

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performance,
decision making,
cooperation
conflict

Every organization is a group unto itself. A group refers to two or more people who share a common meaning and evaluation of themselves and come together to achieve common goals. In other words, a group is a collection of people who interact with one another; accept rights and obligations as members and who share a common identity.

What is Group Dynamics?

Group dynamics deals with the attitudes and behavioral patterns of a group. Group dynamics concern how groups are formed, what is their structure and which processes are followed in their functioning. Thus, it is concerned with the interactions and forces operating between groups.

Group dynamics is relevant to groups of all kinds – both formal and informal. If the UPA government has set up Group of Ministers for every governance issue, the Supreme Court of India has 27 Group of Judges committees overseeing all manner of non-judicial work in the apex court. In an organizational setting, the term groups are a very common and the study of groups and group dynamics is an important area of study.

Characteristics of a Group:

Regardless of the size or the purpose, every group has similar characteristics:

(a) 2 or more persons (if it is one person, it is not a group)

(b) Formal social structure (the rules of the game are defined)

(d) Common goals (the destiny is the same and emotionally connected)

(e) Face-to-face interaction (they will talk with each other)

(f) Interdependence (each one is complimentary to the other)

(g) Self-definition as group members (what one is who belongs to the group)

(h) Recognition by others (yes, you belong to the group).

Process/Stages of Group Development/Evolution:

Group Development is a dynamic process. How do groups evolve? There is a process of five stages through which groups pass through. The process includes the five stages: forming, storming, forming, performing, and adjourning.

Forming:

The first stage in the life of a group is concerned with forming a group. This stage is characterized by members seeking either a work assignment (in a formal group) or other benefit, like status, affiliation, power, etc. (in an informal group). Members at this stage either engage in busy type of activity or show apathy.

Storming:

The next stage in this group is marked by the formation of dyads and triads. Members seek out familiar or similar individuals and begin a deeper sharing of self. Continued attention to the subgroup creates a differentiation in the group and tensions across the dyads / triads may appear. Pairing is a common phenomenon. There will be conflict about controlling the group.

Norming:

The third stage of group development is marked by a more serious concern about task performance. The dyads/triads begin to open up and seek out other members in the group. Efforts are made to establish various norms for task performance.

Members begin to take greater responsibility for their own group and relationship while the authority figure becomes relaxed. Once this stage is complete, a clear picture will emerge about hierarchy of leadership. The norming stage is over with the solidification of the group structure and a sense of group identity and camaraderie.

Performing:

This is a stage of a fully functional group where members see themselves as a group and get involved in the task. Each person makes a contribution and the authority figure is also seen as a part of the group. Group norms are followed and collective pressure is exerted to ensure the Process of Group effectiveness of the group.

The group may redefine its goals Development in the light of information from the outside environment and show an autonomous will to pursue those goals. The long-term viability of the group is established and nurtured.

Adjourning:

In the case of temporary groups, like project team, task force, or any other such group, which have a limited task at hand, also have a fifth stage, This is known as adjourning.

The group decides to disband. Some members may feel happy over the performance, and some may be unhappy over the stoppage of meeting with group members. Adjourning may also be referred to as mourning, i.e. mourning the adjournment of the group.

The readers must note that the four stages of group development mentioned above for permanent groups are merely suggestive. In reality, several stages may go on simultaneously.

Types of Groups:

One way to classify the groups is by way of formality – formal and informal. While formal groups are established by an organization to achieve its goals, informal groups merge spontaneously. Formal groups may take the form of command groups, task groups, and functional groups.

1. Command Groups:

Command groups are specified by the organizational chart and often consist of a supervisor and the subordinates that report to that supervisor. An example of a command group is a market research firm CEO and the research associates under him.

2. Task Groups:

Task groups consist of people who work together to achieve a common task. Members are brought together to accomplish a narrow range of goals within a specified time period. Task groups are also commonly referred to as task forces. The organization appoints members and assigns the goals and tasks to be accomplished.

Examples of assigned tasks are the development of a new product, the improvement of a production process, or designing the syllabus under semester system.

Other common task groups are ad hoc committees, project groups, and standing committees. Ad hoc committees are temporary groups created to resolve a specific complaint or develop a process are normally disbanded after the group completes the assigned task.

3. Functional Groups:

A functional group is created by the organization to accomplish specific goals within an unspecified time frame. Functional groups remain in existence after achievement of current goals and objectives. Examples of functional groups would be a marketing department, a customer service department, or an accounting department.

In contrast to formal groups, informal groups are formed naturally and in response to the common interests and shared values of individuals. They are created for purposes other than the accomplishment of organizational goals and do not have a specified time frame. Informal groups are not appointed by the organization and members can invite others to join from time to time.

Informal groups can have a strong influence in organizations that can either be positive or negative. For example, employees who form an informal group can either discuss how to improve a production process or how to create shortcuts that jeopardize quality. Informal groups can take the form of interest groups, friendship groups, or reference groups.

i. Interest Group:

Interest groups usually continue over time and may last longer than general informal groups. Members of interest groups may not be part of the same organizational department but they are bound together by some other common interest.

The goals and objectives of group interests are specific to each group and may not be related to organizational goals and objectives. An example of an interest group would be students who come together to form a study group for a specific class.

ii. Friendship Groups:

Friendship groups are formed by members who enjoy similar social activities, political beliefs, religious values, or other common bonds. Members enjoy each other’s company and often meet after work to participate in these activities. For example, a group of employees who form a friendship group may have a yoga group, a Rajasthani association in Delhi, or a kitty party lunch once a month.

iii. Reference Groups:

A reference group is a type of group that people use to evaluate themselves. The main objectives of reference groups are to seek social validation and social comparison. Social validation allows individuals to justify their attitudes and values while social comparison helps individuals evaluate their own actions by comparing themselves to others. Reference groups have a strong influence on members’ behavior. Such groups are formed voluntarily. Family, friends, and religious affiliations are strong reference groups for most individuals.

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Factors Affecting Group Behaviour:

The success or failure of a group depends upon so many factors. Group member resources, structure (group size, group roles, group norms, and group cohesiveness), group processes (the communication, group decision making processes, power dynamics, conflicting interactions, etc.) and group tasks (complexity and interdependence).

1. Group Member Resources:

The members’ knowledge, abilities, skills; and personality characteristics (sociability, self- reliance, and independence) are the resources the group members bring in with them. The success depends upon these resources as useful to the task.

2. Group Structure:

Group Size:

Group size can vary from 2 people to a very large number of people. Small groups of two to ten are thought to be more effective because each member has ample opportunity to take part and engage actively in the group. Large groups may waste time by deciding on processes and trying to decide who should participate next.

Evidence supports the notion that as the size of the group increases, satisfaction increases up to a certain point. Increasing the size of a group beyond 10-12 members’ results in decreased satisfaction. It is increasingly difficult for members of large groups to identify with one another and experience cohesion.

Group Roles:

In formal groups, roles are always predetermined and assigned to members. Each role shall have specific responsibilities and duties. There are, however, emergent roles that develop naturally to meet the needs of the groups.

These emergent roles will often substitute the assigned roles as individuals begin to express themselves and become more assertive. Group roles can then be classified into work roles, maintenance roles, and blocking roles.

Work roles are task-oriented activities that involve accomplishing the group’s goals. They involve a variety of specific roles such as initiator, informer, clarifier, summarizer, and reality tester.

Maintenance roles are social-emotional activities that help members maintain their involvement in the group and raise their personal commitment to the group. The maintenance roles are harmonizer, gatekeeper, consensus tester, encourager, and compromiser.

Blocking roles are activities that disrupt the group. Blockers will stubbornly resist the group’s ideas, disagree with group members for personal reasons, and will have hidden agendas. They may take the form of dominating discussions, verbally attacking other group members, and distracting the group with trivial information or unnecessary humour.

Often times the blocking behaviour may not be intended as negative. Sometimes a member may share a joke in order to break the tension, or may question a decision in order to force group members to rethink the issue. The blocking roles are aggressor, blocker, dominator, comedian, and avoidance behaviour.

Role conflicts arise when there is ambiguity (confusion about delegation and no specific job descriptions) between the sent role and the received role which leads to frustration and dissatisfaction, ultimately leading to turnover; inconsistency between the perceived role and role behaviour (conflict between work roles and family roles); and conflicting demands from different sources while performing the task.

Group Norms:

Norms define the acceptable standard or boundaries of acceptable and unacceptable behaviour, shared by group members. They are typically created in order to facilitate group survival, make behaviour more predictable, avoid embarrassing situations, and express the values of the group.

Each group will create its own norms that might determine from the work performance to dress to making comments in a meeting. Groups exert pressure on members to force them to conform to the group’s standards and at times not to perform at higher levels. The norms often reflect the level of commitment, motivation, and performance of the group.

The majority of the group must agree that the norms are appropriate in order for the behaviour to be accepted. There must also be a shared understanding that the group supports the norms. It should be noted, however, that members might violate group norms from time to time.

If the majority of members do not adhere to the norms, then they will eventually change and will no longer serve as a standard for evaluating behaviour. Group members who do not conform to the norms will be punished by being excluded, ignored, or asked to leave the group.

Group Cohesiveness:

Cohesiveness refers to the bonding of group members or unity, feelings of attraction for each other and desire to remain part of the group. Many factors influence the amount of group cohesiveness – agreement on group goals, frequency of interaction, personal attractiveness, inter-group competition, favourable evaluation, etc.

The more difficult it is to obtain group membership the more cohesive the group will be. Groups also tend to become cohesive when they are in intense competition with other groups or face a serious external threat to survival. Smaller groups and those who spend considerable time together also tend to be more cohesive.

Cohesiveness in work groups has many positive effects, including worker satisfaction, low turnover and absenteeism, and higher productivity. However, highly cohesive groups may be detrimental to organizational performance if their goals are misaligned with organizational goals.

Highly cohesive groups may also be more vulnerable to groupthink. Groupthink occurs when members of a group exert pressure on each other to come to a consensus in decision making. Groupthink results in careless judgments, unrealistic appraisals of alternative courses of action, and a lack of reality testing.

Evidence suggests that groups typically outperform individuals when the tasks involved require a variety of skills, experience, and decision making. Groups are often more flexible and can quickly assemble, achieve goals, and disband or move on to another set of objectives.

Many organizations have found that groups have many motivational aspects as well. Group members are more likely to participate in decision-making and problem-solving activities leading to empowerment and increased productivity. Groups complete most of the work in an organization; thus, the effectiveness of the organization is limited by the effectiveness of its groups.

3. Group Processes:

Decision-making by a group is superior, because group generates more information and knowledge, generates diverse alternatives, increases acceptance of a solution, and increases legitimacy. But it is also true, that decision making is like ‘munde munde matirbhinna’.

Decisions take longer time, minority is dominated, pressure is applied to conform to group decisions, and none is responsible for the decisions. Group processes also include communication, conflict management, and leadership that we shall discuss in details in the chapters to follow hereafter.

Intergroup Relationships

Intergroup relations (relationships between different groups of people) range along a spectrum between tolerance and intolerance. The most tolerant form of intergroup relations is pluralism, in which no distinction is made between minority and majority groups, but instead there’s equal standing. At the other end of the continuum are amalgamation, expulsion, and even genocide—stark examples of intolerant intergroup relations.

Genocide

Genocide, the deliberate annihilation of a targeted (usually subordinate) group, is the most toxic intergroup relationship. Historically, we can see that genocide has included both the intent to exterminate a group and the function of exterminating of a group, intentional or not.

Possibly the most well-known case of genocide is Hitler’s attempt to exterminate the Jewish people in the first part of the twentieth century. Also known as the Holocaust, the explicit goal of Hitler’s “Final Solution” was the eradication of European Jewry, as well as the decimation of other minority groups such as Catholics, people with disabilities, and homosexuals. With forced emigration, concentration camps, and mass executions in gas chambers, Hitler’s Nazi regime was responsible for the deaths of 12 million people, 6 million of whom were Jewish. Hitler’s intent was clear, and the high Jewish death toll certainly indicates that Hitler and his regime committed genocide. But how do we understand genocide that is not so overt and deliberate?

genocide is not a just a historical concept; it is practiced today. Recently, ethnic and geographic conflicts in the Darfur region of Sudan have led to hundreds of thousands of deaths. As part of an ongoing land conflict, the Sudanese government and their state-sponsored Janjaweed militia have led a campaign of killing, forced displacement, and systematic rape of Darfuri people. Although a treaty was signed in 2011, the peace is fragile.

Segregation

Segregation refers to the physical separation of two groups, particularly in residence, but also in workplace and social functions. It is important to distinguish between de jure segregation (segregation that is enforced by law) and de facto segregation (segregation that occurs without laws but because of other factors). A stark example of de jure segregation is the apartheid movement of South Africa, which existed from 1948 to 1994. Under apartheid, black South Africans were stripped of their civil rights and forcibly relocated to areas that segregated them physically from their white compatriots. Only after decades of degradation, violent uprisings, and international advocacy was apartheid finally abolished.

Pluralism

Pluralism is represented by the ideal of the United States as a “salad bowl”: a great mixture of different cultures where each culture retains its own identity and yet adds to the flavor of the whole. True pluralism is characterized by mutual respect on the part of all cultures, both dominant and subordinate, creating a multicultural environment of acceptance. In reality, true pluralism is a difficult goal to reach. In the United States, the mutual respect required by pluralism is often missing, and the nation’s past pluralist model of a melting pot posits a society where cultural differences aren’t embraced as much as erased.

Assimilation

Assimilation describes the process by which a minority individual or group gives up its own identity by taking on the characteristics of the dominant culture. In the United States, which has a history of welcoming and absorbing immigrants from different lands, assimilation has been a function of immigration.

Amalgamation

Amalgamation is the process by which a minority group and a majority group combine to form a new group. Amalgamation creates the classic “melting pot” analogy; unlike the “salad bowl,” in which each culture retains its individuality, the “melting pot” ideal sees the combination of cultures that results in a new culture entirely.

What Is a Sense of Belonging?

The need to belong, also known as belongingness, refers to a human emotional need to affiliate with and be accepted by members of a group. This may include the need to belong to a peer group at school, to be accepted by co-workers, to be part of an athletic team, or to be part of a religious group.

A sense of belonging involves more than simply being acquainted with other people. It is centered on gaining acceptance, attention, and support from members of the group as well as providing the same attention to other members.

The need to belong to a group also can lead to changes in behaviors, beliefs, and attitudes as people strive to conform to the standards and norms of the group.

In social psychology, the need to belong is an intrinsic motivation to affiliate with others and be socially accepted.1 This need plays a role in a number of social phenomena such as self-presentation and social comparison.

Sense of Belonging in Action

What inspires people to seek out specific groups? In many cases, the need to belong to certain social groups results from sharing some point of commonality. For example, teens who share the same taste in clothing, music, and other interests might seek each other out to form friendships. Other factors that can lead individuals to seek out groups include:

Pop culture interests
Religious beliefs
Shared goals
Socioeconomic status

People often present themselves in a particular way in order to belong to a specific social group. For example, a new member of a high school sports team might adopt the dress and mannerisms of the other members of the team in order to fit in with the rest of the group.

People also spend a great deal of time comparing themselves to other members of the group in order to determine how well they fit in. This social comparison might lead an individual to adopt some of the same behaviors and attitudes of the most prominent members of the group in order to conform and gain greater acceptance.

Effect of Belongingness

Our need to belong is what drives us to seek out stable, long-lasting relationships with other people.2 It also motivates us to participate in social activities such as clubs, sports teams, religious groups, and community organizations.

In Abraham Maslow’s hierarchy of needs, belongingness is part of one of his major needs that motivate human behavior. The hierarchy is usually portrayed as a pyramid, with more basic needs at the base and more complex needs near the peak. The need for love and belonging lie at the center of the pyramid as part of the social needs.3

By belonging to a group, we feel as if we are a part of something bigger and more important than ourselves.

While Maslow suggested that these needs were less important than the physiological and safety needs, he believed that the need for belonging helped people to experience companionship and acceptance through family, friends, and other relationships.

A 2020 study in college students found a positive link between a sense of belonging and greater happiness and overall well-being, as well as an overall reduction in the mental health outcomes including:4

Anxiety
Depression
Hopelessness
Loneliness
Social anxiety
Suicidal thoughts5

Increase Your Sense of Belonging

There are steps you (or a loved one who is struggling) can take to increase sense of belonging.

Make an effort. Creating a sense of belonging takes effort, to put yourself out there, seek out activities and groups of people with whom you have common interests, and engage with others.
Be patient. It might take time to gain acceptance, attention, and support from members of the group.
Practice acceptance. Focus on the similarities, not the differences, that connect you to others, and remain open to new ways of thinking.

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Aggression

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In psychology, the term aggression refers to a range of behaviors that can result in both physical and psychological harm to yourself, others, or objects in the environment. This type of behavior centers on harming another person either physically or mentally. It can be a sign of an underlying mental health disorder, a substance use disorder, or a medical disorder.

Aggressive behavior can cause physical or emotional harm to others. It may range from verbal abuse to physical abuse. It can also involve harming personal property.

Aggressive behavior violates social boundaries. It can lead to breakdowns in your relationships. It can be obvious or secretive. Occasional aggressive outbursts are common and even normal in the right circumstances. However, you should speak to your doctor if you experience aggressive behavior frequently or in patterns.

When you engage in aggressive behavior, you may feel irritable and restless. You may feel impulsive. You may find it hard to control your behavior. You might not know which behaviors are socially appropriate. In other cases, you might act aggressively on purpose. For example, you may use aggressive behavior to get revenge or provoke someone. You may also direct aggressive behavior towards yourself.

It’s important to understand the causes of your aggressive behavior. This can help you address it.

What Causes Aggressive Behavior?

Many things can shape your behavior. These can include your:

physical health
mental health
family structure
relationships with others
work or school environment
societal or socioeconomic factors
individual traits
life experiences

As an adult, you might act aggressively in response to negative experiences. For example, you might get aggressive when you feel frustrated. Your aggressive behavior may also be linked to depression, anxiety, PTSD, or other mental health conditions.

Health Causes of Aggressive Behavior

Many mental health conditions can contribute to aggressive behavior. For example, these conditions include:

autism spectrum disorder
attention deficit hyperactivity disorder (ADHD)
bipolar disorder
schizophrenia
conduct disorder
intermittent explosive disorder
post-traumatic stress disorder (PTSD)

Brain damage can also limit your ability to control aggression. You may experience brain damage as the result of:

stroke
head injury
certain infections
certain illnesses

Different health conditions contribute to aggression in different ways. For example, if you have autism or bipolar disorder, you might act aggressively when you feel frustrated or unable to speak about your feelings. If you have conduct disorder, you will act aggressively on purpose.

Forms of Aggression

Aggression can take a variety of forms, including:

Physical
Verbal
Mental
Emotional

While we often think of aggression as purely in physical forms such as hitting or pushing, psychological aggression can also be very damaging. Intimidating or verbally berating another person, for example, are examples of verbal, mental, and emotional aggression. How to Identify Emotional Abuse

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Purposes of Aggression

Aggression can serve a number of different purposes, including:

To express anger or hostility
To assert dominance
To intimidate or threaten
To achieve a goal
To express possession
A response to fear
A reaction to pain
To compete with others

Types of Aggression

Psychologists distinguish between two different types of aggression:

Impulsive Aggression: Also known as affective aggression, impulsive aggression is characterized by strong emotions, usually anger. This form of aggression is not planned and often takes place in the heat of the moment. When another car cuts you off in traffic and you begin yelling and berating the other driver, you’re experiencing impulsive aggression. Research suggests that impulsive aggression, especially when it’s caused by anger, triggers the acute threat response system in the brain, involving the amygdala, hypothalamus, and periaqueductal gray (PAG).
Instrumental Aggression: Also known as predatory aggression, instrumental aggression is marked by behaviors that are intended to achieve a larger goal. Instrumental aggression is often carefully planned and usually exists as a means to an end. Hurting another person in a robbery or car-jacking is an example of this type of aggression. The aggressor’s goal is to obtain money or a vehicle, and harming another individual is the means to achieve that aim.

Factors That Can Influence Aggression

A number of different factors can influence the expression of aggression, including:

Biological Factors: Men are more likely than women to engage in physical aggression. While researchers have found that women are less likely to engage in physical aggression, they also suggest that women do use non-physical forms, such as verbal aggression, relational aggression, and social rejection.
Environmental Factors: How you were raised may play a role. People who grow up witnessing more forms of aggression are more likely to believe that such violence and hostility are socially acceptable. Bandura’s famous Bobo doll experiment demonstrated that observation can also play a role in how aggression is learned. Children who watched a video clip where an adult model behaved aggressively toward a Bobo doll were more likely to imitate those actions when given the opportunity.
Physical Factors: Epilepsy, dementia, psychosis, alcohol abuse, drug use, and brain injuries or abnormalities can also influence aggression.

Causes in Children

Aggression in children can be caused by several factors. These can include:

poor relationship skills
underlying health conditions
stress or frustration

Your child might imitate aggressive or violent behavior that they see in their daily life. They may receive attention for it from family members, teachers, or peers. You can accidentally encourage it by ignoring or rewarding their aggressive behavior.

Sometimes, children lash out due to fear or suspicion. This is more common if your child has schizophrenia, paranoia, or other forms of psychoses. If they have bipolar disorder, they might act aggressively during the manic phase of their condition. If they have depression, they might act aggressively when they feel irritated.

Your child might also act aggressively when they have trouble coping with their emotions. They might find it especially hard to deal with frustration. This is common in children who have autism spectrum disorder or cognitive impairments. If they become frustrated, they may be unable to fix or describe the situation causing their frustration. This can lead them to act out.

Children with ADHD or other disruptive disorders may show a lack of attention or understanding. They may also appear impulsive. In some cases, these behaviors may be considered aggressive. This is especially true in situations when their behaviors are socially unacceptable.

Causes in Teens

Aggressive behavior in teenagers is common. For example, many teens act rudely or get into arguments sometimes. However, your teen might have a problem with aggressive behavior if they regularly:

yell during arguments
get into fights
bully others

In some cases, they may act aggressively in response to:

stress
peer pressure
substance abuse
unhealthy relationships with family members or others

Puberty can also be a stressful time for many teens. If they don’t understand or know how to cope with changes during puberty, your teen may act aggressively. If they have a mental health condition, it can also contribute to aggressive behavior.

How Is Aggressive Behavior Treated?

To work through aggressive behavior, you need to identify its underlying causes.

It may help to talk to someone about experiences that make you feel aggressive. In some cases, you can learn how to avoid frustrating situations by making changes to your lifestyle or career. You can also develop strategies for coping with frustrating situations. For example, you can learn how to communicate more openly and honestly, without becoming aggressive.

Your doctor may recommend psychotherapy to help treat aggressive behavior. For example, cognitive behavioral therapy (CBT) can help you learn how to control your behavior. It can help you develop coping mechanisms. It can also help you understand the consequences of your actions. Talk therapy is another option. It can help you understand the causes of your aggression. It can also help you work through negative feelings.

In some cases, your doctor may prescribe medications to treat your aggressive behavior. For example, they may prescribe antiepileptic drugs (AEDs), such as phenytoin and carbamazepine. If you have schizophrenia, Alzheimer’s, or bipolar disorder, they may prescribe mood stabilizers. They may also encourage you to take omega-3 fatty acid supplements.

Your treatment plan will vary, depending on the underlying causes of your aggressive behavior. Speak with your doctor to learn more about your condition and treatment options.

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