Medicurio

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Lymphedema refers to swelling that generally occurs in one of your arms or legs. Sometimes both arms or both legs swell.

Lymphedema is most commonly caused by the removal of or damage to your lymph nodes as a part of cancer treatment. It results from a blockage in your lymphatic system, which is part of your immune system. The blockage prevents lymph fluid from draining well, and the fluid buildup leads to swelling.

While there is presently no cure for lymphedema, it can be managed with early diagnosis and diligent care of your affected limb.

Symptoms

Lymphedema signs and symptoms, which occur in your affected arm or leg, include:

• Swelling of part or all of your arm or leg, including fingers or toes
• A feeling of heaviness or tightness
• Restricted range of motion
• Aching or discomfort
• Recurring infections
• Hardening and thickening of the skin (fibrosis)

The swelling caused by lymphedema ranges from mild, hardly noticeable changes in the size of your arm or leg to extreme changes that make the limb hard to use. Lymphedema caused by cancer treatment may not occur until months or years after treatment.

When to see a doctor

Make an appointment with your doctor if you notice persistent swelling in your arm or leg.

If you already have the diagnosis of lymphedema of a limb, see your doctor if there is a sudden dramatic increase in the size of the involved limb, as it may suggest a new process is occurring.

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Causes

Your lymphatic system is crucial to keeping your body healthy. It circulates protein-rich lymph fluid throughout your body, collecting bacteria, viruses and waste.

products. Your lymphatic system carries this fluid and harmful substances through your lymph vessels, which lead to lymph nodes. The wastes are then filtered out by lymphocytes — infection-fighting cells that live in your lymph nodes — and ultimately flushed from your body.

Lymphedema occurs when your lymph vessels are unable to adequately drain lymph fluid, usually from an arm or leg. Lymphedema can be either primary or secondary. This means it can occur on its own (primary lymphedema), or it can be caused by another disease or condition (secondary lymphedema). Secondary lymphedema is far more common than primary lymphedema.

Causes of secondary lymphedema

Any condition or procedure that damages your lymph nodes or lymph vessels can cause lymphedema. Causes include:

• Surgery. Removal of or injury to lymph nodes and lymph vessels may result in lymphedema. For example, lymph nodes may be removed to check for spread of breast cancer, and lymph nodes may be injured in surgery that involves blood vessels in your limbs.
• Radiation treatment for cancer. Radiation can cause scarring and inflammation of your lymph nodes or lymph vessels.
• Cancer. If cancer cells block lymphatic vessels, lymphedema may result. For instance, a tumor growing near a lymph node or lymph vessel could enlarge enough to block the flow of the lymph fluid.
• Infection. An infection of the lymph nodes or parasites can restrict the flow of lymph fluid. Infection-related lymphedema is most common in tropical and subtropical regions and is more likely to occur in developing countries.

Causes of primary lymphedema

Primary lymphedema is a rare, inherited condition caused by problems with the development of lymph vessels in your body. Specific causes of primary lymphedema include:

• Milroy’s disease (congenital lymphedema). This disorder begins in infancy and causes lymph nodes to form abnormally.
• Meige’s disease (lymphedema praecox). This disorder often causes lymphedema around puberty or during pregnancy, though it can occur later, until age 35.
• Late-onset lymphedema (lymphedema tarda). This occurs rarely and usually begins after age 35.

Risk factors

Factors that may increase your risk of developing lymphedema after cancer, from cancer treatment or from other secondary causes include:

• Older age
• Excess weight or obesity
• Rheumatoid or psoriatic arthritis

Complications

Lymphedema in your arm or leg can lead to serious complications, such as:

• Infections. Possible infections that can result from lymphedema include a serious bacterial infection of the skin (cellulitis) and an infection of the lymph vessels (lymphangitis). The smallest injury to your arm or leg can be an entry point for infection.
• Lymphangiosarcoma. This rare form of soft tissue cancer can result from the most-severe cases of untreated lymphedema. Possible signs of lymphangiosarcoma include blue-red or purple marks on the skin.

Prevention

If you have had or you are going to have cancer surgery, ask your doctor whether your procedure will involve your lymph nodes or lymph vessels. Ask if your radiation treatment will be aimed at lymph nodes, so you’ll be aware of the possible risks.

To reduce your risk of lymphedema, try to:

• Protect your arm or leg. Avoid injury to your affected limb. Cuts, scrapes and burns can invite infection. Protect yourself from sharp objects. For example, shave with an electric razor, wear gloves when you garden or cook, and use a thimble when you sew. If possible, avoid medical procedures, such as blood draws and vaccinations, in your affected limb.
• Rest your arm or leg while recovering. After cancer treatment, exercise and stretching are encouraged. But avoid strenuous activity until you’ve recovered from surgery or radiation.
• Avoid heat on your arm or leg. Don’t apply ice or heat, such as with a heating pad, to your affected limb. Also, protect your affected limb from extreme cold.
• Elevate your arm or leg. Whenever possible, elevate your affected limb above the level of your heart.
• Avoid tight clothing. Avoid anything that could constrict your arm or leg, such as tightfitting clothing and, in the case of your arm, blood pressure cuffs. Ask that your blood pressure be taken in your other arm.
• Keep your arm or leg clean. Make skin and nail care high priorities. Inspect the skin on your arm or leg daily, watching for changes or breaks in your skin that could lead to infection. Don’t go barefoot.

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Chest trauma accounts for 25-50% of all trauma-related deaths in the world. Trauma to the chest can result in broken ribs, pulmonary injury, cardiac injury, and blood vessel damage. Stove-in chest is a complex type of flail chest injury. Flail chest describes damage to the chest due to significant blunt force trauma, such as in a car accident or act of violence. Stove-in chest is a rare type of trauma to the thorax that occurs most often in car accidents. Here are the facts about this serious injury.

Diagnosing Stove-In Chest

Victims of stove-in chest may visit the emergency department with severe chest pain and difficulty breathing, or dyspnea. Doctors may use tracheal intubation, mechanical ventilation, or chest tube insertion to enable breathing while assessing a chest injury. Diagnosing stove-in chest requires scans, x-rays, and radiographs. This type of chest injury occurs when a segment of the chest wall collapses.

Stove-in chest differs from typical flail chest in that the latter describes only blunt force trauma to the chest. Flail chest happens when part of the chest wall moves due to fractures of three or more ribs, posteriorly and anteriorly in each rib. There are several different types of flail chest injuries depending on the location of the fractures. Stove-in chest occurs when the wall of the chest collapses, due to three or more ribs breaking upon impact.

Flail chest and stove-in chest require significant force over a large area of the chest, such as the thorax, to cause multiple rib fractures at once. Striking the steering wheel in a car accident, for example, could cause flail chest or stove-in chest. In some cases, the force of impact of a seatbelt across the chest can cause impact injuries. These injuries are so dangerous because they can easily affect the heart and lungs, leading to pulmonary contusion, respiratory insufficiency, and death.

Prognosis and Treatments for Stove-In Chest Injuries

Stove-in chest has a high rate of immediate mortality, but there is a chance of recovery with proper medical treatment. If the patient does not die upon impact, doctors can confirm stove-in chest using x-rays.

The chest wall will show collapse due to abnormal motion in three or more ribs. Depending on the nature of the injury, doctors will choose the appropriate treatment method moving forward. Here are two examples:

• Vehicle accident – Blunt force trauma can break multiple adjacent ribs in several places, leading to a part of the chest wall moving independently. Patients with stove-in chest from car accidents typically require surgery to fix the fractures and physiotherapy reduce the risk of complications.
• Assault or act of violence – Gunshot wounds or stabbings can lead to penetration injuries, typically requiring surgery. Patients with penetrating chest trauma may deteriorate rapidly depending on the nature of the injury. However, they may also recover faster than patients with blunt chest injuries.

Doctors will also have to treat related injuries, such as those to the lung, airways, heart, blood vessels, and other structures within the torso. Complex flail chest and stove-in chest injuries require tailored medical treatment according to each individual patient. The risk of complications is too high for one type of treatment to work across the board. For example, in one fatal stove-in chest injury, failure to ventilate the patient early (the patient exhibited good gas exchange) may have contributed to the formation of the empyema, or pus buildup in the pleural space, that caused the patient’s death.

Stove-in chest is one of the most life-threatening injuries that can occur in an accident. If you or someone you loved suffered this type of injury, seek help from an experienced attorney. Someone may be liable to pay for your physical injuries, pain and suffering, and emotional distress.

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Gangrene is death of body tissue due to a lack of blood flow or a serious bacterial infection. Gangrene commonly affects the arms and legs, including the toes and fingers, but it can also occur in the muscles and in organs inside the body, such as the gallbladder.

Your risk of gangrene is higher if you have an underlying condition that can damage your blood vessels and affect blood flow, such as diabetes or hardened arteries (atherosclerosis).

Treatments for gangrene include surgery to restore blood flow and remove dead tissue, antibiotics if there is an infection, and hyperbaric oxygen therapy. The earlier gangrene is identified and treated, the better your chances for recovery.

Gangrene is when part of your body tissue dies. This often occurs because the tissue is not getting enough blood from your circulatory system.

Gangrene usually affects your extremities — the areas farthest from your heart, such as your toes and fingers. However, it can affect other parts of your body as well. Gangrene can even affect your internal organs.

The condition typically starts in a specific body part, such as a leg, hand, or internal organ. Gangrene can spread through your body and cause you to go into shock if left untreated. Shock is a condition marked by a variety of symptoms including low blood pressure. Shock can be life-threatening and is considered a medical emergency.

Gangrene is a medical emergency that could lead to amputations or death. Recognizing and treating the condition as fast as possible will improve your outlook.

Types of gangrene

Dry gangrene

All of your organs (such as your liver, heart, and muscles) need oxygen to function properly and survive. The oxygen is carried to different parts of your body by your blood. Dry gangrene occurs when one of your body parts isn’t getting enough oxygen. Eventually, the body part will start to deteriorate and die. With dry gangrene, the skin is closed and there is no evidence of infection.

Wet gangrene

Wet gangrene happens when your body tissues become infected with some type of bacteria. The tissues react to the presence of the bacteria by growing moist and breaking down. This process causes the death of your tissues. It’s more of an emergency than dry gangrene because of the possibility of infection spreading to other parts of the body.

Gas gangrene

Bacteria called Clostridia cause gas gangrene. These bacteria create an infection that causes gas bubbles and toxins to develop inside the affected area. The resulting gases cause tissue death. This type of gangrene can be fatal, though it’s rare in the United States.

Internal gangrene. Gangrene that affects one or more of your organs, such as your intestines, gallbladder or appendix, is called internal gangrene. This type of gangrene occurs when blood flow to an internal organ is blocked — for example, when your intestines bulge through a weakened area of muscle in your stomach area (hernia) and become twisted.

Left untreated, internal gangrene can be deadly.Fournier’s gangrene. Fournier’s gangrene involves the genital organs. Men are more often affected, but women also can develop this type of gangrene. An infection in the genital area or urinary tract causes this type of gangrene. Meleney’s gangrene. This rare type of gangrene — also called progressive bacterial synergistic gangrene — is usually a complication of surgery. People with Meleney’s gangrene develop painful skin lesions one to two weeks after their operations.

Symptoms

When gangrene affects your skin, signs and symptoms may include:

• Skin discoloration — ranging from pale to blue, purple, black, bronze or red, depending on the type of gangrene you have
• Swelling
• Blisters
• Sudden, severe pain followed by a feeling of numbness
• A foul-smelling discharge leaking from a sore
• Thin, shiny skin, or skin without hair
• Skin that feels cool or cold to the touch

If you have a type of gangrene that affects tissues beneath the surface of your skin, such as gas gangrene or internal gangrene, you may also have a low-grade fever and generally feel unwell.

If the germs that caused the gangrene spread through your body, septic shock can occur. Signs and symptoms of septic shock include:

• Low blood pressure
• Fever, although some people may have a body temperature lower than the normal 98.6 F (37 C)
• Rapid heart rate
• Lightheadedness
• Shortness of breath
• Confusion

When to see a doctor

Gangrene is a serious condition and needs emergency treatment. Call your doctor right away if you have persistent, unexplained pain in any area of your body along with one or more of the following signs and symptoms:

• Persistent fever
• Skin changes — including discoloration, warmth, swelling, blisters or lesions — that won’t go away
• A foul-smelling discharge leaking from a sore
• Sudden pain at the site of a recent surgery or trauma
• Skin that’s pale, hard, cold and numb

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Causes

Causes of gangrene include:

• Lack of blood supply. Your blood provides oxygen and nutrients to your body. It also provides your immune system with antibodies to ward off infections. Without a proper blood supply, your cells can’t survive, and your tissue decays.
• Infection. An untreated bacterial infection can cause gangrene.
• Traumatic injury. Gunshot wounds or crushing injuries from car crashes can cause open wounds that let bacteria into the body. If the bacteria infect tissues and remain untreated, gangrene can occur.

Recognizing the signs of gangrene

External gangrene

Sometimes the first sign of dry gangrene is a reddish line that develops around the affected tissue. This line may later turn black.

Other signs that might indicate you have gangrene include:

• a wound that is red, sore, or swollen
• a wound that is filled with pus or gives off a bad smell
• an isolated area of your body feels cold
• lacking a sense of touch in an isolated area
• sores that keep coming back in the same place on your body
• part of your skin has turned an unusual color (greenish-black, red, blue, or bronze)

Internal gangrene

It’s also possible to experience internal gangrene, which affects your inner tissues or organs. In this case, you may not have any symptoms on your skin or limbs. However, you may have pain, an unexplained fever that lasts a long time, or low blood pressure. You may also experience confusion.

How is gangrene diagnosed?

Your doctor may suspect that you have gangrene based on your medical history and symptoms. They may also use a combination of additional diagnostic methods to determine your condition.

Lab analysis of tissue or fluid samples

A scraping of tissue from your affected body part may be examined with a microscope to look for dead cells.

Blood tests

An abnormally high white blood cell count can indicate a gangrenous infection.

Medical imaging

Some kinds of imaging are helpful in diagnosing the spread of gangrene in your internal tissues. These tests could include X-rays, MRI scans, or CT scans.

An anarteriogram test may be performed if doctors suspect that your gangrene is related to a circulatory problem. This test uses X-rays to monitor the flow of a special dye through your arteries, showing whether any arteries are blocked.

Risk factors

Several factors increase your risk of developing gangrene. These include:

• Diabetes. If you have diabetes, your body doesn’t produce enough of the hormone insulin (which helps your cells take up blood sugar) or is resistant to the effects of insulin. High blood sugar levels can eventually damage blood vessels, decreasing or interrupting blood flow to a part of your body.
• Blood vessel disease. Hardened and narrowed arteries (atherosclerosis) and blood clots also can block blood flow to an area of your body.
• Severe injury or surgery. Any process that causes trauma to your skin and underlying tissue, including an injury or frostbite, increases your risk of developing gangrene, especially if you have an underlying condition that affects blood flow to the injured area.
• Smoking. People who smoke have a higher risk of gangrene.
• Obesity. Obesity often accompanies diabetes and vascular disease, but the stress of extra weight alone can also compress arteries, leading to reduced blood flow and increasing your risk of infection and poor wound healing.
• Immunosuppression. If you have an infection with the human immunodeficiency virus (HIV) or if you’re undergoing chemotherapy or radiation therapy, your body’s ability to fight off an infection is impaired.
• Medications or drugs that are injected. In rare instances, certain medications and illegal drugs that are injected have been shown to cause infection with bacteria that cause gangrene.
• Complications of COVID-19. There have been a few reports of people getting dry gangrene in their fingers and toes after having COVID-19-related blood clotting problems (coagulopathy). More research is needed to confirm this association.

Complications

Gangrene can lead to serious complications if it’s not immediately treated. Bacteria can spread quickly to other tissues and organs. You may need to have a body part removed (amputated) to save your life.

Removal of infected tissue can lead to scarring or the need for reconstructive surgery.

Prevention

Here are a few suggestions to help you reduce your risk of developing gangrene:

• Care for your diabetes. If you have diabetes, make sure you examine your hands and feet daily for cuts, sores, and signs of infection, such as redness, swelling or drainage. Ask your doctor to examine your hands and feet at least once a year, and try to maintain control over your blood sugar levels.
• Lose weight. Excess pounds not only put you at risk of diabetes but also place pressure on your arteries, constricting blood flow and putting you at risk of infection and slow wound healing.
• Don’t use tobacco. The chronic use of tobacco products can damage your blood vessels.
• Help prevent infections. Wash any open wounds with a mild soap and water and try to keep them clean and dry until they heal.
• Watch out when the temperature drops. Frostbitten skin can lead to gangrene because frostbite reduces blood circulation in an affected area. If you notice that any area of your skin has become pale, hard, cold and numb after prolonged exposure to cold temperatures, call your doctor.

Gangrene treatment

Antibiotics

Your doctor may prescribe antibiotics if bacteria are present. These are typically given intravenously, or through a needle directly into the bloodstream.

Vascular surgery

For people with poor circulation that results in gangrene, vascular surgery (surgery on the arteries or veins) may be recommended in order to improve the flow of blood through the veins to body tissues.

Hyperbaric oxygen chamber

Placing a person with gas gangrene in a special oxygen-rich environment can slow the growth of bacteria. This allows the skin to begin healing. It also brings oxygen to the damaged tissue to promote healing.

Tissue debridement

In serious gangrene cases, the dead tissue or body part may need to be removed. This process is called debridement. Debridement can be done with surgical tools or with chemicals. The goal of this type of surgery is to remove the affected areas to prevent the spread of infection and rid the body of the dead tissue.

One alternative form of debridement, known as maggot debridement, uses fly larvae to eat away bacteria and dead tissue. Though rare, this practice can still be used by physicians in the United States and abroad.

Doctors are sometimes able to restore the flow of oxygen to the affected area. Skin grafts can repair any damaged tissue. This procedure uses a piece of your healthy skin from elsewhere on the body to cover the damaged area.

Amputation

For severe cases, amputation of a limb, finger, or toe could be necessary to save your life. People who must have part of an arm or leg amputated due to gangrene may be fitted with a prosthesis, or artificial limb, to replace the missing body part.

What is the long-term outlook for gangrene?

Gangrene can sometimes be treated without serious complications, especially if it is caught early. However, it can lead to amputation in some serious cases, particularly if it’s not treated quickly.

Gangrene can even be fatal for some individuals. This is rare, but it can occur if:

• you have other serious medical issues that complicate your treatment
• the gangrenous area covers a large part of your body
• treatment is not provided quickly enough

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5 Important Concepts in Social Psychology

Social psychology is a branch of psychology concerned with how social influences affect how people think, feel, and act. The way we perceive ourselves in relation to the rest of the world plays an important role in our choices, behaviors, and beliefs. Conversely, the opinions of others also impact our behavior and the way we view ourselves.

Understanding social psychology can be useful for many reasons. First, we can better understand how groups impact our choices and actions. There are some basic aspects of social behavior that play a large role in our actions and how we see ourselves.

Social Behavior Is Goal-Oriented

Our interactions serve goals or fulfill needs. Some common goals or needs include the need for social ties, the desire to understand ourselves and others, the wish to gain or maintain status or protection, and the need to attract companions.

The way people behave is often driven by the desire to fulfill these needs.1 People seek friends and romantic partners, strive to gain social status, and attempt to understand the motivations that guide other people’s behaviors.

Situations Help Determine Outcome

In many instances, people behave very differently depending upon the situation. To fully understand why people do the things they do, it is essential to look at individual characteristics, the situation and its context, and the interactions among all these variables.

For example, someone who is normally quiet and reserved might become much more outgoing when placed in some type of leadership role. Another example is how people sometimes behave differently in groups than they would if they were by themselves. Environmental and situational variables play an important role and have a strong influence on our behavior.

Social psychology allows us to gain a greater appreciation for how our social perceptions affect our interactions with other people.

Social Situations Form Self-Concept

Our social interactions help form our self-concept and our perceptions. One method of forming self-concept is through the reflected appraisal process,2 in which we imagine how other people see us. Another method is through the social comparison process, whereby we consider how we compare to other people in our peer group.

Sometimes we engage in upward social comparison where we rate ourselves against people who are better off than us in some way. In other instances, we might engage in downward social comparison where we contrast our own abilities to those of others who are less capable.

We Analyze the Behavior of Others

One common phenomenon is the expectation confirmation, where we tend to ignore unexpected attributes and look for evidence that confirms our preexisting beliefs about others.4 This helps simplify our worldview, but it also skews our perception and can contribute to stereotyping.

If you expect people to behave in a certain way, you might look for examples that confirm your belief while at the same time ignoring evidence that conflicts with your existing opinions.

We Believe Behavior Reflects Personality

Another influence on our perceptions of other people can be explained by the theory of correspondent inferences.5 This occurs when we infer that the actions and behaviors of others correspond to their intentions and personalities. For example, if we see a woman helping an elderly person cross the street, we might assume that she is kind-hearted. While behavior can be informative, it can also be misleading.

If we have limited interaction with someone, the behavior we see may be atypical or caused by the specific situation rather than by the person’s overriding dispositional characteristics. In the previous example, the woman might only be helping the elderly person because she has been employed to do so instead of out of the kindness of her heart.

What is the Importance of Social Psychology in Society?

 The importance of social psychology is shown in all the interactive aspects of the individual’s social life and all the environments in which he coexists, which can affect the individual’s interactions and personality.
As social psychology studies the behavior of individuals and groups, everyone who deals with and communicates with different community groups needs this science; to understand and guide individuals and to study various responses within the community.
For example, the teacher needs in his class to analyze the students’ personalities and their interdependence and understand the relationships between them, and strategies that fit the patterns and mechanisms to convince them for a particular idea, in addition to the partnership among themselves and cooperation and competition and behaviors based on their presence within the group.
Social psychology also requires social specialists to understand the philosophy of society, the secrets of its composition, the relative appearance, and absence of phenomena, and link to societal behaviors.
The individual in his daily life is able to explain his behavior and self-behavior around him properly, understanding the interaction and harmony that takes place between the individual among others.
Thus the understanding of social and cultural being, which in turn determines the expected behavioral patterns in different social attitudes, in addition to this science, gives the individual the ability to differentiate between people, the possibility of accepting a certain category and move away from another category.
The importance of social psychology was highlighted directly in daily life situations, in addition to its great importance in the field of life of the international community and the world and social issues experienced by people from situations of war, slavery, freedom, and security.  These are separated as follows:

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What is the Importance of Social Psychology in Society?

 The importance of social psychology is shown in all the interactive aspects of the individual’s social life and all the environments in which he coexists, which can affect the individual’s interactions and personality.
As social psychology studies the behavior of individuals and groups, everyone who deals with and communicates with different community groups needs this science; to understand and guide individuals and to study various responses within the community.
For example, the teacher needs in his class to analyze the students’ personalities and their interdependence and understand the relationships between them, and strategies that fit the patterns and mechanisms to convince them for a particular idea, in addition to the partnership among themselves and cooperation and competition and behaviors based on their presence within the group.
Social psychology also requires social specialists to understand the philosophy of society, the secrets of its composition, the relative appearance, and absence of phenomena, and link to societal behaviors.
The individual in his daily life is able to explain his behavior and self-behavior around him properly, understanding the interaction and harmony that takes place between the individual among others.
Thus the understanding of social and cultural being, which in turn determines the expected behavioral patterns in different social attitudes, in addition to this science, gives the individual the ability to differentiate between people, the possibility of accepting a certain category and move away from another category.
The importance of social psychology was highlighted directly in daily life situations, in addition to its great importance in the field of life of the international community and the world and social issues experienced by people from situations of war, slavery, freedom, and security.  These are separated as follows:

Practical importance

All people who engage in groups and individuals need to study the principles of social psychology continuously in order to understand and guide social behaviors. The importance of these groups is as follows:
Teacher: The teacher in the classroom needs to understand the social-behavioral characteristics of the students as a micro-social environment based on the relationships and interactions among their members, as well as the importance of identifying the steps of socialization that are manifested in the behavioral interaction among individuals such as competition, cooperation, learning, and collective thinking.
Social Specialist: The importance of social psychology to social specialists in understanding and studying social organization and its orientation towards social cohesion, trends, intolerance, and leadership.
Businessmen: Social psychology helps to understand the nature of the laws of human relations that exist between categories of workers in a given domain, and the important relationship between the level of moral spirit and mental health and the level of production and achievement.
Normal Human: The study of social psychology in everyday life helps to achieve as much as possible the individual’s understanding of his own behavior and the external behavior of other individuals, thus understanding the dynamics of interaction and communication with others, as well as the cultural and social backgrounds in which patterns and behaviors are determined. Good judgment in using the proper way to deal with others, either by accepting and sacrificing in some situations or with distaste and dislike in other situations.

Global importance

Since the first emergence of social psychology, it deals with future issues by warning against crises and inevitable problems, optimism about the sound construction of this future, and providing suggestions and predictive and remedial plans for economic and political problems such as the problems of war and aggression and its consequences and global financial crises. Global Inclusiveness seeks to create a society of excellence in which the opportunities available to individuals in all fields are equal to all members of society.
It also has an important role in spreading the highest human ideals among individuals within one society in the effective study of psycho-social phenomena, research, and experimental study. The following points can be summarized as follows:
Warning of future problems: It is possible to warn against future problems and crises by predicting initial signs and symptoms that may indicate the possibility of a particular problem in a given area and warning people without intervening in the course of events. However, it is possible to direct social activity in light of current events.
Building the future: Human scientists emphasize that a person can change the course of his life by directing his activities appropriately with achieving his goals and solving problems. Just as human beings used biological sciences to raise the level of health efficiency, it is possible to use social psychology to seek social justice and the future.
Addressing political and economic problems: These problems arise as a result of the imbalance in the distribution of tasks, work, resources, and efforts in appropriate activities.
This results from ignorance of the understanding of the social characteristics of man, which is the subject of psychological and social research, which in turn creates the basic laws and principles of social life together.

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Cognitive development is the construction of thought processes, including remembering, problem solving, and decision-making, from childhood through adolescence to adulthood.

It was once believed that infants lacked the ability to think or form complex ideas and remained without cognition until they learned language. It is now known that babies are aware of their surroundings and interested in exploration from the time they are born. From birth, babies begin to actively learn. They gather, sort, and process information from around them, using the data to develop perception and thinking skills.

Cognitive development refers to how a person perceives, thinks, and gains understanding of his or her world through the interaction of genetic and learned factors. Among the areas of cognitive development are information processing, intelligence , reasoning, language development , and memory.

The 4 Stages of Cognitive Development

Jean Piaget’s theory of cognitive development suggests that children move through four different stages of mental development. His theory focuses not only on understanding how children acquire knowledge, but also on understanding the nature of intelligence.1 Piaget’s stages are:

• Sensorimotor stage: birth to 2 years
• Preoperational stage: ages 2 to 7
• Concrete operational stage: ages 7 to 11
• Formal operational stage: ages 12 and up

Piaget believed that children take an active role in the learning process, acting much like little scientists as they perform experiments, make observations, and learn about the world. As kids interact with the world around them, they continually add new knowledge, build upon existing knowledge, and adapt previously held ideas to accommodate new information.

How Piaget Developed the Theory

Piaget was born in Switzerland in the late 1800s and was a precocious student, publishing his first scientific paper when he was just 11 years old. His early exposure to the intellectual development of children came when he worked as an assistant to Alfred Binet and Theodore Simon as they worked to standardize their famous IQ test.

Much of Piaget’s interest in the cognitive development of children was inspired by his observations of his own nephew and daughter. These observations reinforced his budding hypothesis that children’s minds were not merely smaller versions of adult minds.

Up until this point in history, children were largely treated simply as smaller versions of adults. Piaget was one of the first to identify that the way that children think is different from the way adults think.

Instead, he proposed, intelligence is something that grows and develops through a series of stages. Older children do not just think more quickly than younger children, he suggested. Instead, there are both qualitative and quantitative differences between the thinking of young children versus older children.

Based on his observations, he concluded that children were not less intelligent than adults, they simply think differently. Albert Einstein called Piaget’s discovery “so simple only a genius could have thought of it.”

Piaget’s stage theory describes the cognitive development of children. Cognitive development involves changes in cognitive process and abilities.2 In Piaget’s view, early cognitive development involves processes based upon actions and later progresses to changes in mental operations.

The Stages

Through his observations of his children, Piaget developed a stage theory of intellectual development that included four distinct stages:

The Sensorimotor Stage

Ages: Birth to 2 Years

Major Characteristics and Developmental Changes:

• The infant knows the world through their movements and sensations
• Children learn about the world through basic actions such as sucking, grasping, looking, and listening
• Infants learn that things continue to exist even though they cannot be seen (object permanence)
• They are separate beings from the people and objects around them
• They realize that their actions can cause things to happen in the world around them

During this earliest stage of cognitive development, infants and toddlers acquire knowledge through sensory experiences and manipulating objects. A child’s entire experience at the earliest period of this stage occurs through basic reflexes, senses, and motor responses.

It is during the sensorimotor stage that children go through a period of dramatic growth and learning. As kids interact with their environment, they are continually making new discoveries about how the world works.

The cognitive development that occurs during this period takes place over a relatively short period of time and involves a great deal of growth. Children not only learn how to perform physical actions such as crawling and walking; they also learn a great deal about language from the people with whom they interact. Piaget also broke this stage down into a number of different substages. It is during the final part of the sensorimotor stage that early representational thought emerges.

Piaget believed that developing object permanence or object constancy, the understanding that objects continue to exist even when they cannot be seen, was an important element at this point of development.

By learning that objects are separate and distinct entities and that they have an existence of their own outside of individual perception, children are then able to begin to attach names and words to objects. The Sensorimotor Stage of Cognitive Development

The Preoperational Stage

Ages: 2 to 7 Years

Major Characteristics and Developmental Changes:

• Children begin to think symbolically and learn to use words and pictures to represent objects.
• Children at this stage tend to be egocentric and struggle to see things from the perspective of others.
• While they are getting better with language and thinking, they still tend to think about things in very concrete terms.

The foundations of language development may have been laid during the previous stage, but it is the emergence of language that is one of the major hallmarks of the preoperational stage of development.3

Children become much more skilled at pretend play during this stage of development, yet continue to think very concretely about the world around them. 

At this stage, kids learn through pretend play but still struggle with logic and taking the point of view of other people. They also often struggle with understanding the idea of constancy.
For example, a researcher might take a lump of clay, divide it into two equal pieces, and then give a child the choice between two pieces of clay to play with. One piece of clay is rolled into a compact ball while the other is smashed into a flat pancake shape. Since the flat shape looks larger, the preoperational child will likely choose that piece even though the two pieces are exactly the same size. Preoperational Stage of Cognitive Development in Young Children

The Concrete Operational Stage

Ages: 7 to 11 Years

Major Characteristics and Developmental Changes

• During this stage, children begin to thinking logically about concrete events
• They begin to understand the concept of conservation; that the amount of liquid in a short, wide cup is equal to that in a tall, skinny glass, for example
• Their thinking becomes more logical and organized, but still very concrete
• Children begin using inductive logic, or reasoning from specific information to a general principle

While children are still very concrete and literal in their thinking at this point in development, they become much more adept at using logic.2 The egocentrism of the previous stage begins to disappear as kids become better at thinking about how other people might view a situation.

While thinking becomes much more logical during the concrete operational state, it can also be very rigid. Kids at this point in development tend to struggle with abstract and hypothetical concepts.

During this stage, children also become less egocentric and begin to think about how other people might think and feel. Kids in the concrete operational stage also begin to understand that their thoughts are unique to them and that not everyone else necessarily shares their thoughts, feelings, and opinions. The Concrete Operational Stage in Cognitive Development

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The Formal Operational Stage

Ages: 12 and Up

Major Characteristics and Developmental Changes:

• At this stage, the adolescent or young adult begins to think abstractly and reason about hypothetical problems
• Abstract thought emerges
• Teens begin to think more about moral, philosophical, ethical, social, and political issues that require theoretical and abstract reasoning
• Begin to use deductive logic, or reasoning from a general principle to specific information

The final stage of Piaget’s theory involves an increase in logic, the ability to use deductive reasoning, and an understanding of abstract ideas.3 At this point, people become capable of seeing multiple potential solutions to problems and think more scientifically about the world around them.

The ability to thinking about abstract ideas and situations is the key hallmark of the formal operational stage of cognitive development. The ability to systematically plan for the future and reason about hypothetical situations are also critical abilities that emerge during this stage. 

It is important to note that Piaget did not view children’s intellectual development as a quantitative process; that is, kids do not just add more information and knowledge to their existing knowledge as they get older. Instead, Piaget suggested that there is a qualitative change in how children think as they gradually process through these four stages.4 A child at age 7 doesn’t just have more information about the world than he did at age 2; there is a fundamental change in how he thinks about the world. Formal Operational Stage of Cognitive Development

Important Concepts

To better understand some of the things that happen during cognitive development, it is important first to examine a few of the important ideas and concepts introduced by Piaget.

The following are some of the factors that influence how children learn and grow:

Schemas

A schema describes both the mental and physical actions involved in understanding and knowing. Schemas are categories of knowledge that help us to interpret and understand the world.

In Piaget’s view, a schema includes both a category of knowledge and the process of obtaining that knowledge.3 As experiences happen, this new information is used to modify, add to, or change previously existing schemas.

For example, a child may have a schema about a type of animal, such as a dog. If the child’s sole experience has been with small dogs, a child might believe that all dogs are small, furry, and have four legs. Suppose then that the child encounters an enormous dog. The child will take in this new information, modifying the previously existing schema to include these new observations.

Assimilation

The process of taking in new information into our already existing schemas is known as assimilation. The process is somewhat subjective because we tend to modify experiences and information slightly to fit in with our preexisting beliefs. In the example above, seeing a dog and labeling it “dog” is a case of assimilating the animal into the child’s dog schema. Assimilation and Jean Piaget’s Adaptation Process

Accommodation

Another part of adaptation involves changing or altering our existing schemas in light of new information, a process known as accommodation. Accommodation involves modifying existing schemas, or ideas, as a result of new information or new experiences.5 New schemas may also be developed during this process.

Equilibration

Piaget believed that all children try to strike a balance between assimilation and accommodation, which is achieved through a mechanism Piaget called equilibration. As children progress through the stages of cognitive development, it is important to maintain a balance between applying previous knowledge (assimilation) and changing behavior to account for new knowledge (accommodation). Equilibration helps explain how children can move from one stage of thought to the next.



Cognitive development
Age	Activity
One month	Watches person when spoken to.
Two months	Smiles at familiar person talking. Begins to follow moving person with eyes.
Four months	Shows interest in bottle, breast, familiar toy, or new surroundings.
Five months	Smiles at own image in mirror. Looks for fallen objects.
Six months	May stick out tongue in imitation. Laughs at peekaboo game. Vocalizes at mirror image. May act shy around strangers.
Seven months	Responds to own name. Tries to establish contact with a person by cough or other noise.
Eight months	Reaches for toys out of reach. Responds to “no.”
Nine months	Shows likes and dislikes. May try to prevent face-washing or other activity that is disliked. Shows excitement and interest in foods or toys that are well-liked.
Ten months	Starts to understand some words. Waves bye-bye. Holds out arm or leg for dressing.
Eleven months	Repeats performance that is laughed at. Likes repetitive play. Shows interest in books.
Twelve months	May understand some “where is…?” questions. May kiss on request.
Fifteen months	Asks for objects by pointing. Starting to feed self. Negativism begins.
Eighteen months	Points to familiar objects when asked “where is…?” Mimics familiar adult activities. Know some body parts. Obeys two or three simple orders.
Two years	Names a few familiar objects. Draws with crayons. Obeys found simple orders. Participates in parallel play.
Two-and-a-half years	Names several common objects. Begins to take interest in sex organs. Gives full names. Helps to put things away. Peak of negativism.
Three years	Constantly asks questions. May count to 10. Begins to draw specific objects. Dresses and undresses doll. Participates in cooperative play. Talks about things that have happened.
Four years	May make up silly words and stories. Beginning to draw pictures that represent familiar things. Pretends to read and write. May recognize a few common words, such as own name.
Five years	Can recognize and reproduce many shapes, letters, and numbers. Tells long stories. Begins to understand the difference between real events and make-believe ones. Asks meaning of words
SOURCE : Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, 5th ed . and Child Development Institute, http://www.childdevelopmentinfo.com.

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Dissociative disorders are mental disorders that involve experiencing a disconnection and lack of continuity between thoughts, memories, surroundings, actions and identity. People with dissociative disorders escape reality in ways that are involuntary and unhealthy and cause problems with functioning in everyday life.

Dissociative disorders usually develop as a reaction to trauma and help keep difficult memories at bay. Symptoms — ranging from amnesia to alternate identities — depend in part on the type of dissociative disorder you have. Times of stress can temporarily worsen symptoms, making them more obvious.

Treatment for dissociative disorders may include talk therapy (psychotherapy) and medication. Although treating dissociative disorders can be difficult, many people learn new ways of coping and lead healthy, productive lives.

Causes

Dissociative disorders usually develop as a way to cope with trauma. The disorders most often form in children subjected to long-term physical, sexual or emotional abuse or, less often, a home environment that’s frightening or highly unpredictable. The stress of war or natural disasters also can bring on dissociative disorders.

Personal identity is still forming during childhood. So a child is more able than an adult to step outside of himself or herself and observe trauma as though it’s happening to a different person. A child who learns to dissociate in order to endure a traumatic experience may use this coping mechanism in response to stressful situations throughout life.

Symptoms

Signs and symptoms depend on the type of dissociative disorders you have, but may include:

• Memory loss (amnesia) of certain time periods, events, people and personal information
• A sense of being detached from yourself and your emotions
• A perception of the people and things around you as distorted and unreal
• A blurred sense of identity
• Significant stress or problems in your relationships, work or other important areas of your life
• Inability to cope well with emotional or professional stress
• Mental health problems, such as depression, anxiety, and suicidal thoughts and behaviors

There are three major dissociative disorders defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association:

• Dissociative amnesia. The main symptom is memory loss that’s more severe than normal forgetfulness and that can’t be explained by a medical condition. You can’t recall information about yourself or events and people in your life, especially from a traumatic time. Dissociative amnesia can be specific to events in a certain time, such as intense combat, or more rarely, can involve complete loss of memory about yourself. It may sometimes involve travel or confused wandering away from your life (dissociative fugue). An episode of amnesia usually occurs suddenly and may last minutes, hours, or rarely, months or years.
• Dissociative identity disorder. Formerly known as multiple personality disorder, this disorder is characterized by “switching” to alternate identities. You may feel the presence of two or more people talking or living inside your head, and you may feel as though you’re possessed by other identities. Each identity may have a unique name, personal history and characteristics, including obvious differences in voice, gender, mannerisms and even such physical qualities as the need for eyeglasses. There also are differences in how familiar each identity is with the others. People with dissociative identity disorder typically also have dissociative amnesia and often have dissociative fugue.
• Depersonalization-derealization disorder. This involves an ongoing or episodic sense of detachment or being outside yourself — observing your actions, feelings, thoughts and self from a distance as though watching a movie (depersonalization). Other people and things around you may feel detached and foggy or dreamlike, time may be slowed down or sped up, and the world may seem unreal (derealization). You may experience depersonalization, derealization or both. Symptoms, which can be profoundly distressing, may last only a few moments or come and go over many years.

When to see a doctor

Some people with dissociative disorders present in a crisis with traumatic flashbacks that are overwhelming or associated with unsafe behavior. People with these symptoms should be seen in an emergency room.

If you or a loved one has less urgent symptoms that may indicate a dissociative disorder, call your doctor.

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Suicidal thoughts or behavior

If you have thoughts of hurting yourself or someone else, call 911 or your local emergency number immediately, go to an emergency room, or confide in a trusted relative or friend. Or call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) to reach a trained counselor.

Risk factors

People who experience long-term physical, sexual or emotional abuse during childhood are at greatest risk of developing dissociative disorders.

Children and adults who experience other traumatic events, such as war, natural disasters, kidnapping, torture, or extended, traumatic, early-life medical procedures, also may develop these conditions.

Complications

People with dissociative disorders are at increased risk of complications and associated disorders, such as:

• Self-harm or mutilation
• Suicidal thoughts and behavior
• Sexual dysfunction
• Alcoholism and drug use disorders
• Depression and anxiety disorders
• Post-traumatic stress disorder
• Personality disorders
• Sleep disorders, including nightmares, insomnia and sleepwalking
• Eating disorders
• Physical symptoms such as lightheadedness or non-epileptic seizures
• Major difficulties in personal relationships and at work

Prevention

Children who are physically, emotionally or sexually abused are at increased risk of developing mental health disorders, such as dissociative disorders. If stress or other personal issues are affecting the way you treat your child, seek help.

• Talk to a trusted person such as a friend, your doctor or a leader in your faith community.
• Ask for help locating resources such as parenting support groups and family therapists.
• Look for churches and community education programs that offer parenting classes that also may help you learn a healthier parenting style.

If your child has been abused or has experienced another traumatic event, see a doctor immediately. Your doctor can refer you to a mental health professional who can help your child recover and adopt healthy coping skills.

Diagnosis of Dissociation

Your doctor will give you a physical exam and ask about any past physical or mental health issues. You should let them know if you take illicit drugs or any medication. They may check a sample of your blood or run other tests to rule out an illness or other medical condition as the cause of your dissociation. They may also order an electroencephalogram (EEG), a painless test that measures brain waves, to rule out certain types of seizure disorders that can sometimes cause dissociation.

Your doctor may then refer you to a mental health specialist. You might see a psychiatrist, psychologist, or psychiatric social worker. They will want to know about any severely troubling events you’ve had in the past.

They may give you other tests, including:

• Dissociative Experiences Scale (DES)
• Structured Clinical Interview for Dissociation

Treatment for Dissociation

There is no specific drug to treat dissociation, but it’s possible to get better with a mix of medication and counseling. Your doctor will tailor your care based on how severe your symptoms are and their cause.

Your treatment may include:

Psychotherapy. This kind of treatment may help you find the cause of your dissociation. But the goal is to help you manage or get rid of your symptoms.

Types of psychotherapy may include:

• Cognitive behavioral therapy. It’s designed to help you see and change negative thoughts and behaviors.
• Hypnotherapy. You may find it easier to explore and process your memories when you are in a relaxed state. You should only do this with a professional certified in hypnosis who is trained in dissociative disorders and PTSD.
• Phasic trauma treatment. This treatment aims to help you stop suicidal thoughts or self-destructive behavior first. Then your psychotherapist will slowly help you process any traumatic memories and re-integrate your identities, if necessary.
• Family treatment. You may find it helpful to get support from a spouse, partner, or other loved one.
• Dialectical behavioral therapy. It may help you learn skills to control your emotions and stop harmful behavior. This is a common treatment for borderline personality disorder.
• Eye movement desensitization and reprocessing. It uses techniques from cognitive behavioral therapy along with visual exercises to help you work through memories of severely troubling events. It may help stop your nightmares, flashbacks, or other PTSD symptoms.

Add-on medication. Your doctor may give you antidepressants, a mood stabilizer, or other drugs to help with anxiety or sleep problems. If you have schizophrenia, you may need an antipsychotic.

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Conversion disorder is a broad term for when mental or emotional distress causes physical symptoms without the existence of an actual physical condition.

When you have conversion disorder, you’re not able to control your physical response. This response usually involves either your senses or your motor control. In other words, you experience a traumatic or stressful event, and your body responds with tremors, paralysis of an arm or leg, or something similar. There isn’t an underlying physical condition, like an injury, causing the tremors or paralysis. Instead, the physical condition is caused by the stress or emotional trauma.

Functional neurologic disorders — a newer and broader term that includes what some people call conversion disorder — feature nervous system (neurological) symptoms that can’t be explained by a neurological disease or other medical condition. However, the symptoms are real and cause significant distress or problems functioning.

Signs and symptoms vary, depending on the type of functional neurologic disorder, and may include specific patterns. Typically these disorders affect your movement or your senses, such as the ability to walk, swallow, see or hear. Symptoms can vary in severity and may come and go or be persistent. However, you can’t intentionally produce or control your symptoms.

The cause of functional neurologic disorders is unknown. The condition may be triggered by a neurological disorder or by a reaction to stress or psychological or physical trauma, but that’s not always the case. Functional neurologic disorders are related to how the brain functions, rather than damage to the brain’s structure (such as from a stroke, multiple sclerosis, infection or injury).

Early diagnosis and treatment, especially education about the condition, can help with recovery.

Causes

Conversion disorder is normally caused by some sort of extreme stress, emotional trauma, or depression. It’s your body’s response to something you perceive as a threat.

The physical symptoms may come about as a way to try and resolve or relieve whatever is causing the extreme mental stress. For example, a police officer or soldier who experiences mental trauma from the thought of shooting and possibly killing someone may have paralysis in their hands. The physical symptoms create a way to avoid whatever is causing the stress.

The exact cause of functional neurologic disorders is unknown. Theories regarding what happens in the brain to result in symptoms are complex and involve multiple mechanisms that may differ, depending on the type of functional neurologic disorder.

Basically, parts of the brain that control the functioning of your muscles and senses may be involved, even though no disease or abnormality exists.

Symptoms of functional neurologic disorders may appear suddenly after a stressful event, or with emotional or physical trauma. Other triggers may include changes or disruptions in how the brain functions at the structural, cellular or metabolic level. But the trigger for symptoms can’t always be identified.

Symptoms

Symptoms of functional neurologic disorders may vary, depending on the type of functional neurologic disorder, and they’re significant enough to cause impairment and warrant medical evaluation. Symptoms can affect body movement and function and the senses.

Signs and symptoms that affect body movement and function may include:

• Weakness or paralysis
• Abnormal movement, such as tremors or difficulty walking
• Loss of balance
• Difficulty swallowing or feeling “a lump in the throat”
• Seizures or episodes of shaking and apparent loss of consciousness (nonepileptic seizures)
• Episodes of unresponsiveness

Signs and symptoms that affect the senses may include:

• Numbness or loss of the touch sensation
• Speech problems, such as inability to speak or slurred speech
• Vision problems, such as double vision or blindness
• Hearing problems or deafness

When to see a doctor

Seek medical attention for signs and symptoms listed above. If the underlying cause is a neurological disease or another medical condition, quick diagnosis and treatment may be important. If the diagnosis is a functional neurologic disorder, treatment may improve the symptoms and help prevent future problems.

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Diagnosis

The diagnosis of conversion disorder comes from meeting certain criteria given by the Diagnostic and Statistical Manual of Mental Disorders. Some of these criteria include:

• symptoms of movement in your body or sensory symptoms that can’t be controlled
• symptoms that happen after or in relation to a stressful event or emotional trauma
• symptoms that can’t be explained medically or physically
• symptoms that negatively affect your daily life

There aren’t specific tests that diagnose conversion disorder. The tests that are performed are primarily to rule out any medical conditions that may be causing your symptoms. The types of tests your doctor may perform during diagnosis depend on the type of symptoms you’re having. Some tests may include:

• CT scan, X-rays, or other imaging to rule out possible injuries and neurological conditions
• electroencephalogram for seizure symptoms to rule out neurological causes
• routine tests such as checking your blood pressure and reflexes

Conversion disorder can have similar symptoms to a number of other medical conditions. Therefore, it’s important for your doctor to rule out other possible causes before coming to a diagnosis of conversion disorder.

Risk factors

Factors that may increase your risk of functional neurologic disorders include:

• Having a neurological disease or disorder, such as epilepsy, migraines or a movement disorder
• Recent significant stress or emotional or physical trauma
• Having a mental health condition, such as a mood or anxiety disorder, dissociative disorder or certain personality disorders
• Having a family member with a functional neurologic disorder
• Possibly, having a history of physical or sexual abuse or neglect in childhood

Women may be more likely than men to develop functional neurologic disorders.

Complications

Some symptoms of functional neurologic disorders, particularly if not treated, can result in substantial disability and poor quality of life, similar to that caused by medical conditions or disease.

Prevention

The primary method of preventing conversion disorder is to find ways to relieve stress and to avoid emotional trauma when possible. Some preventive measures may include:

• getting treatment for any mental or emotional disorder you may have, including depression
• maintaining a good work and life balance
• creating and maintaining positive relationships
• having a secure and calm family atmosphere

You may be unable to control some of these areas. However, if you work toward controlling the areas you can, you may be able to better manage those you can’t. Any reduction in stress and emotional trauma can be effective in helping to prevent conversion disorder.

Conversion Disorder Treatment

Simply knowing that you don’t have a serious physical condition might be enough to stop the symptoms. But getting help from your doctor early on can make you feel better.

They’ll probably recommend psychotherapy treatments, including:

• Occupational or physical therapy
• Counseling
• Hypnosis
• Antidepressants or antipsychotic drugs

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Illness anxiety disorder (IAD), formerly known as hypochondriasis, is a condition marked by an excessive fear of having a serious medical condition despite having few or no symptoms. People who have IAD often go to doctors about symptoms they believe are linked to a medical problem or may believe that mild symptoms are more serious than they really are.

While there may not be a medical illness present, the concerns that people with IAD have are very real, and the anxiety they feel can cause serious disruptions in normal daily functioning.

Illness anxiety disorder, sometimes called hypochondriasis or health anxiety, is worrying excessively that you are or may become seriously ill. You may have no physical symptoms. Or you may believe that normal body sensations or minor symptoms are signs of severe illness, even though a thorough medical exam doesn’t reveal a serious medical condition.

You may experience extreme anxiety that body sensations, such as muscle twitching or fatigue, are associated with a specific, serious illness. This excessive anxiety — rather than the physical symptom itself — results in severe distress that can disrupt your life.

Illness anxiety disorder is a long-term condition that can fluctuate in severity. It may increase with age or during times of stress. But psychological counseling (psychotherapy) and sometimes medication can help ease your worries.

Hypochondriasis

Hypochondriasis, or hypochondria, was eliminated in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).12 Hypochondria was eliminated from the DSM-5 because the term has negative connotations and is stigmatizing.

Instead, most people who would have previously been diagnosed with hypochondriasis now receive a diagnosis of illness anxiety disorder or somatic symptom disorder. However, there are some who feel that hypochondriasis should be reclassified as a phobia since it represents a specific fear.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, no longer includes hypochondriasis — also called hypochondria — as a diagnosis. Instead, people previously diagnosed with hypochondriasis may be diagnosed as having illness anxiety disorder, in which the focus of the fear and worry is on uncomfortable or unusual physical sensations being an indication of a serious medical condition.

On the other hand, somatic symptom disorder ― a related disorder ― involves focusing on the disabling nature of physical symptoms, such as pain or dizziness, without the worry that these symptoms represent a specific illness.

Symptoms

Symptoms of illness anxiety disorder center primarily on a preoccupation with the possibility of being ill, often based on normal body functions or mild physical complaints. Common symptoms include:

• Avoiding people or places out of a fear of contracting an illness
• Constantly searching the internet for information about symptoms and health conditions
• Constantly talking to others about health problems
• Distress that is significant enough to impair normal daily functioning
• Fear that physical sensations are caused by a serious medical disease
• Feeling nervous and obsessed with frequently checking health status
• Heightened awareness of minor bodily symptoms such as headaches, joint pain, or sweating
• Making doctor’s appointments to check up on mild symptoms or normal body functions
• Significant distress over the possibility of being sick

Causes

The exact cause of illness anxiety disorder isn’t clear, but these factors may play a role:

• Beliefs. You may have a difficult time tolerating uncertainty over uncomfortable or unusual body sensations. This could lead you to misinterpret that all body sensations are serious, so you search for evidence to confirm that you have a serious disease.
• Family. You may be more likely to have health anxiety if you had parents who worried too much about their own health or your health.
• Past experience. You may have had experience with serious illness in childhood, so physical sensations may be frightening to you.

The exact causes of illness anxiety disorder are not known, but there are a number of contributing factors that may play a role in the development of this condition. Some of these factors may include:1

• A history of illness during childhood
• Having another mental health condition such as anxiety, obsessive-compulsive disorder, or major depressive disorder
• A history of trauma, abuse, or neglect during childhood
• The presence of a serious symptom that poses a health threat
• Stress
• Feeling uncomfortable when experiencing normal body sensations

Some research also suggests that people may have a higher risk of developing IAD if they spend a great deal of time on the internet reviewing the symptoms of different health conditions.4

Illness anxiety disorder frequently overlaps with other anxiety disorders.3 People who have IAD may also have co-occurring conditions such as specific phobias, generalized anxiety disorder, and/or panic disorder with agoraphobia, among other conditions.

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Types

There are two types of illness anxiety disorder: care-seeking and care-avoidant.

Care-Seeking Type

Some people with illness anxiety disorder react with a need for constant reassurance. They may visit the doctor regularly despite tests showing that everything is normal. They may also frequently complain of their symptoms to friends and family members.

Care-Avoidant Type

Others with IAD react in the opposite extreme. They may avoid visiting the doctor for fear of learning bad news. They may be reluctant to share their fears with loved ones, either because they are afraid of having their fears confirmed or because they believe that they will not be taken seriously.

Risk factors

Illness anxiety disorder usually begins in early or middle adulthood and may get worse with age. Often for older individuals, health-related anxiety may focus on the fear of losing their memory.

Risk factors for illness anxiety disorder may include:

• A time of major life stress
• Threat of a serious illness that turns out not to be serious
• History of abuse as a child
• A serious childhood illness or a parent with a serious illness
• Personality traits, such as having a tendency toward being a worrier
• Excessive health-related internet use

Complications

Illness anxiety disorder may be associated with:

• Relationship or family problems because excessive worrying can frustrate others
• Work-related performance problems or excessive absences
• Problems functioning in daily life, possibly even resulting in disability
• Financial problems due to excessive health care visits and medical bills
• Having another mental health disorder, such as somatic symptom disorder, other anxiety disorders, depression or a personality disorder

Prevention

Little is known about how to prevent illness anxiety disorder, but these suggestions may help.

• If you have problems with anxiety, seek professional advice as soon as possible to help stop symptoms from getting worse and impairing your quality of life.
• Learn to recognize when you’re stressed and how this affects your body — and regularly practice stress management and relaxation techniques.
• Stick with your treatment plan to help prevent relapses or worsening of symptoms.

Treatment

Research has shown that there are treatments that can be effective for illness anxiety disorder.3 Treatment often depends on the nature and severity of the condition, as well as any co-occurring mental health conditions.

Psychotherapy

There are different types of psychotherapy that can be useful for treating illness anxiety. Cognitive behavioral therapy (CBT) has become a popular option for treating IAD. This type of therapy helps people learn to manage the anxiety that they feel towards their physical symptoms. In turn, this can help the symptoms themselves diminish.

Medications

In addition to therapy, medication may be prescribed. Selective serotonin reuptake inhibitors (SSRIs) are a type of medication that can help to treat illness anxiety disorder.5 These drugs are generally known as antidepressants and work by affecting the levels of serotonin in the brain. Examples include Zoloft (sertraline), Paxil (paroxetine) and Prozac (fluoxetine).

Coping

In addition to professional treatment for the condition, there are a number of self-help strategies that people might find helpful for reducing feelings of illness anxiety disorder:

• Manage stress levels. Because stress can contribute to illness anxiety, finding ways to relieve stress may be helpful. Deep breathing, visualization, and progressive muscle relaxation are just a few techniques that you may find helpful for relieving stress.
• Practice mindfulness. Mindfulness is a technique that involves focusing on your body in the present moment. It may help you better understand the normal sensations that you feel each day so that they feel more normal and less like potential health problems.
• Avoid unhelpful information. Constantly reading frightening articles online about health conditions can heighten your anxieties. When you do seek information, look for sources that are trustworthy and reassuring, but avoid constantly reading about health conditions or illnesses.

Physical Therapy Management (current best evidence)

Current evidence on Physical Therapy Management of hypochondriasis is limited.  Due to the psychological nature of the disease there are often no physical symptoms that would benefit from physical therapy.  If a patient is not improving with traditional therapeutic intervention, objective findings do not match the patient’s complaints, and the patient fits the diagnostic criteria for hypochondriasis a referral to their primary care physician would be appropriate.

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Obsessive-compulsive disorder (OCD) features a pattern of unwanted thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). These obsessions and compulsions interfere with daily activities and cause significant distress.

You may try to ignore or stop your obsessions, but that only increases your distress and anxiety. Ultimately, you feel driven to perform compulsive acts to try to ease your stress. Despite efforts to ignore or get rid of bothersome thoughts or urges, they keep coming back. This leads to more ritualistic behavior — the vicious cycle of OCD.

OCD often centers around certain themes — for example, an excessive fear of getting contaminated by germs. To ease your contamination fears, you may compulsively wash your hands until they’re sore and chapped.

If you have OCD, you may be ashamed and embarrassed about the condition, but treatment can be effective.

Obsessive-compulsive disorder (OCD) is a chronic mental health condition characterized by obsessions which lead to compulsive behaviors.

People often double check to make sure they’ve locked the front door or always wear their lucky socks on game days — simple rituals or habits that make them feel more secure.

OCD goes beyond double checking something or practicing a game day ritual. Someone diagnosed with OCD feels compelled to act out certain rituals repeatedly, even if they don’t want to — and even if it complicates their life unnecessarily.

What is OCD?

Obsessive-compulsive disorder (OCD) is characterized by repetitive, unwanted thoughts (obsessions) and irrational, excessive urges to do certain actions (compulsions).

Although people with OCD may know that their thoughts and behaviors don’t make logical sense, they’re often unable to stop them.

Causes

The exact cause of OCD is unknown, but researchers believe that certain areas of the brain may not respond normally to serotonin, a chemical that some nerve cells use to communicate with each other.

Genetics are thought to contribute to OCD, as well.

If you, your parent, or a sibling have OCD, there’s about a 25 percent chance that another immediate family member will have it.

The cause of obsessive-compulsive disorder isn’t fully understood. Main theories include:

• Biology. OCD may be a result of changes in your body’s own natural chemistry or brain functions.
• Genetics. OCD may have a genetic component, but specific genes have yet to be identified.
• Learning. Obsessive fears and compulsive behaviors can be learned from watching family members or gradually learned over time.

Symptoms

Obsessive-compulsive disorder usually includes both obsessions and compulsions. But it’s also possible to have only obsession symptoms or only compulsion symptoms. You may or may not realize that your obsessions and compulsions are excessive or unreasonable, but they take up a great deal of time and interfere with your daily routine and social, school or work functioning.

Obsession symptoms

OCD obsessions are repeated, persistent and unwanted thoughts, urges or images that are intrusive and cause distress or anxiety. You might try to ignore them or get rid of them by performing a compulsive behavior or ritual. These obsessions typically intrude when you’re trying to think of or do other things.

Obsessions often have themes to them, such as:

• Fear of contamination or dirt
• Doubting and having difficulty tolerating uncertainty
• Needing things orderly and symmetrical
• Aggressive or horrific thoughts about losing control and harming yourself or others
• Unwanted thoughts, including aggression, or sexual or religious subjects

Examples of obsession signs and symptoms include:

• Fear of being contaminated by touching objects others have touched
• Doubts that you’ve locked the door or turned off the stove
• Intense stress when objects aren’t orderly or facing a certain way
• Images of driving your car into a crowd of people
• Thoughts about shouting obscenities or acting inappropriately in public
• Unpleasant sexual images
• Avoidance of situations that can trigger obsessions, such as shaking hands

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Compulsion symptoms

OCD compulsions are repetitive behaviors that you feel driven to perform. These repetitive behaviors or mental acts are meant to reduce anxiety related to your obsessions or prevent something bad from happening. However, engaging in the compulsions brings no pleasure and may offer only a temporary relief from anxiety.

You may make up rules or rituals to follow that help control your anxiety when you’re having obsessive thoughts. These compulsions are excessive and often are not realistically related to the problem they’re intended to fix.

As with obsessions, compulsions typically have themes, such as:

• Washing and cleaning
• Checking
• Counting
• Orderliness
• Following a strict routine
• Demanding reassurance

Examples of compulsion signs and symptoms include:

• Hand-washing until your skin becomes raw
• Checking doors repeatedly to make sure they’re locked
• Checking the stove repeatedly to make sure it’s off
• Counting in certain patterns
• Silently repeating a prayer, word or phrase
• Arranging your canned goods to face the same way

Severity varies

OCD usually begins in the teen or young adult years, but it can start in childhood. Symptoms usually begin gradually and tend to vary in severity throughout life. The types of obsessions and compulsions you experience can also change over time. Symptoms generally worsen when you experience greater stress. OCD, usually considered a lifelong disorder, can have mild to moderate symptoms or be so severe and time-consuming that it becomes disabling.

When to see a doctor

There’s a difference between being a perfectionist — someone who requires flawless results or performance, for example — and having OCD. OCD thoughts aren’t simply excessive worries about real problems in your life or liking to have things clean or arranged in a specific way.

If your obsessions and compulsions are affecting your quality of life, see your doctor or mental health professional.

Compulsions

These are repetitive acts that temporarily relieve the stress and anxiety brought on by an obsession. Often, people who have compulsions believe these rituals will prevent something bad from happening.

Types of OCD

There are several different types of obsessions and compulsions. The most well known include:

• obsessions that involve fear of contamination (germs) with related compulsions of cleaning and washing
• obsessions related to symmetry or perfectionism with related compulsions of ordering or redoing

According to Dr. Jill Stoddard, author of “Be Mighty: A Woman’s Guide to Liberation from Anxiety, Worry, and Stress Using Mindfulness and Acceptance,” other obsessions include:

• intrusive and unwanted sexual thoughts
• fear of harming oneself or someone else
• fear of acting impulsively (like blurting out a curse word during a moment of silence). These involve compulsions like checking, counting, praying, and repeating, and can also involve avoidance (different from compulsions) like avoiding sharp objects.

OCD in children

OCD usually develops in children within two age ranges: middle childhood (8–12 years) and between late adolescence and emerging adulthood (18–25 years), says Dr. Steve Mazza, a clinical postdoctoral fellow at the Columbia University Clinic for Anxiety and Related Disorders.

“Girls tend to develop OCD at an older age than boys,” says Mazza. “Although there is a higher rate of OCD in boys than girls during childhood, there are equal rates of OCD between adult men and women.”

OCPD vs OCD

While the names are similar, obsessive-compulsive personality disorder (OCPD) and OCD are very different conditions.

OCD typically involves obsessions that are followed by compulsive behaviors. OCPD describes a set of personality traits that can often interfere with a person’s relationships.

OCPD is characterized by an extreme need for orderliness, perfection, and control, including within interpersonal relationships, says Mazza. Whereas OCD is usually confined to a set of obsessive thoughts and related compulsions.

“People [who have] OCD are more likely to seek help because they are distressed or disturbed by the symptoms,” he says. “People with OCPD may not see their characterological rigidity and need for perfection as problematic, despite its destructive effects on their relationships and well-being.”

OCD diagnosis

OCD is diagnosed by a mental health professional using a semi-structured interview process, according to Mazza.

One of the most widely used instruments is the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), which assesses for a variety of the most common obsessions and compulsions, as well as the degree to which OCD symptoms cause a person distress and interfere with their functioning.

Risk factors

Factors that may increase the risk of developing or triggering obsessive-compulsive disorder include:

• Family history. Having parents or other family members with the disorder can increase your risk of developing OCD.
• Stressful life events. If you’ve experienced traumatic or stressful events, your risk may increase. This reaction may, for some reason, trigger the intrusive thoughts, rituals and emotional distress characteristic of OCD.
• Other mental health disorders. OCD may be related to other mental health disorders, such as anxiety disorders, depression, substance abuse or tic disorders.

Complications

Problems resulting from obsessive-compulsive disorder may include, among others:

• Excessive time spent engaging in ritualistic behaviors
• Health issues, such as contact dermatitis from frequent hand-washing
• Difficulty attending work, school or social activities
• Troubled relationships
• Overall poor quality of life
• Suicidal thoughts and behavior

Prevention

There’s no sure way to prevent obsessive-compulsive disorder. However, getting treatment as soon as possible may help prevent OCD from worsening and disrupting activities and your daily routine.

Treatment

A typical treatment plan for OCD will usually include both psychotherapy and medications. Combining both treatments is usually the most effective.

Medication

Antidepressants are prescribed to help lessen symptoms of OCD.

A selective serotonin reuptake inhibitor (SSRI) is an antidepressant that’s used to reduce obsessive behaviors and compulsions.

Therapy

Talk therapy with a mental health professional can help to provide you with tools that allow changes in thought and behavior patterns.

Cognitive behavior therapy (CBT) and exposure and response therapy are types of talk therapy that are effective for many people.

Exposure and response prevention (ERP) is aimed at allowing a person with OCD to deal with the anxiety associated with obsessive thoughts in other ways, rather than engaging in the compulsive behavior.

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A mood disorder, also referred to as an affective disorder, is a condition that severely impacts mood and its related functions. Mood disorder is a broad term that’s used to include all the different types of depressive and bipolar disorders, both of which affect mood. If you have symptoms of a mood disorder, your moods may range from extremely low (depressed) to extremely high or irritable (manic).

Types of Mood Disorders

With the update of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) in 2013, mood disorders are now separated into two groups: bipolar disorder and related disorders and depressive disorders. In general, the main types of mood disorders include:

• Major depressive disorder: This is what we often hear referred to as major depression or clinical depression. It involves periods of extreme sadness, hopelessness, or emptiness accompanied by a variety of physical, cognitive, and emotional symptoms.
• Bipolar I disorder: This disorder was formerly called “manic depression,” Mania is characterized by euphoric and/or irritable moods and increased energy or activity. During manic episodes, people with bipolar I also regularly engage in activities that can result in painful consequences for themselves and/or others.
• Bipolar II disorder: To be diagnosed with bipolar II, a person must have had at least one episode of current or past hypomania (a less severe form of mania), and at least one episode of current or past major depression, but no history of any manic episodes. The criteria for episodes of mania, hypomania, and major depression remain the same.
• Cyclothymic disorder:Diagnosis requires a minimum two-year history of many episodes of not-quite hypomania and not-quite major depression.
• Other: There are other categories of mood disorders that include substance/medication and medically induced mood disorders. There are also “other specified” and “unspecified” mood disorders that don’t exactly meet criteria for the other mood disorders.

New Mood Disorders

There are three new depressive disorders included in the DSM-V.

• Disruptive mood dysregulation disorder: This depressive disorder was added to the DSM-Vfor children up to 18 years of age who exhibit persistent irritability and anger and frequent episodes of extreme temper outbursts without any significant provocation.
• Persistent depressive disorder: This diagnosis is meant to include both chronic major depressive disorder that has lasted for two or more years and what was previously known as dysthymic disorder or dysthymia, a lower grade form of depression.
• Premenstrual dysphoric disorder: This diagnosis is based on the presence of one or more specific symptoms in the week before the onset of menstruation, followed by the resolution of these symptoms after onset. The symptoms include mood swings, irritability or anger, depressed mood or hopelessness, and anxiety or tension, as well as one or more of an additional seven symptoms, for a total of at least five symptoms.

Causes

No one knows the exact causes of mood disorders, but a variety of factors seem to contribute to them and they tend to run in families. Chemical imbalances in the brain are the most likely cause. Stressful life events like death, divorce, or trauma can also trigger depression, especially if someone has already had it before or there’s a genetic component.

Symptoms of Mood Disorders

Mood disorders can lead to difficulty in keeping up with the daily tasks and demands of life. Some people, especially children, may have physical symptoms of depression, like unexplained headaches or stomachaches. Because there are various types of mood disorders, they can have very different effects on quality of life. In general, symptoms may include:

• Loss of interest in activities one once enjoyed
• Eating more or less than usual
• Difficulty sleeping or sleeping more than usual
• Fatigue
• Crying
• Anxiety
• Feeling “flat,” having no energy to care
• Feeling isolated, sad, hopeless, and worthless
• Difficulty concentrating
• Problems making decisions
• Feelings of guilt
• Irritability
• Thoughts of dying and/or suicide

With mood disorders, these symptoms are ongoing and eventually start to affect daily life in a negative way. They’re not the sporadic thoughts and feelings that everyone has on occasion.

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Diagnosis

Mood disorders should be properly evaluated and treated by a mental health professional, such as a psychiatrist. If any of the symptoms above have been interfering with your life, particularly if you are having suicidal thoughts, you should seek help immediately.

Your doctor will be able to diagnose you by performing a physical exam and lab tests to rule out any physical reasons for your symptoms along with a psychiatric evaluation.

Treatment

Millions of people experience mood disorders and are successfully treated, helping them live a better quality of life. Treatments for mood disorders can include psychotherapy, also known as talk therapy, as well as medications to help regulate chemical imbalances in the brain. A combination of psychotherapy and medication is often the best course of action.

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