Hysteria | Description | Prevention | Causes and symptoms | Treatment
Definition
The term "hysteria" has been in use for over 2,000 years and its definition has becomebroader and more diffuse over time. In modern psychology and psychiatry, hysteria is a feature of hysterical disorders in which a patient experiences physical symptoms that have a psychological, rather than an organic, cause; and histrionic personality disorder characterized by excessive emotions, dramatics, and attention-seeking behavior.
Description
Hysterical disorders
Patients with hysterical disorders, such as conversion and somatization disorder experience physical symptoms that have no organic cause. Conversion disorder affects motor and sensory functions, while somatization affects the gastrointestinal, nervous, cardiopulmonary, or reproductive systems. These patients are not "faking" their ailments, as the symptoms are very real to them. Disorders with hysteric features typically begin in adolescence or early adulthood.
Histrionic personality disorder
Histrionic personality disorder has a prevalence of approximately 2-3% of the general population. It begins in early adulthood and has been diagnosed more frequently in women than in men. Histrionic personalities are typically self-centered and attention seeking. They operate on emotion, rather than fact or logic, and their conversation is full of generalizations and dramatic appeals. While the patient's enthusiasm, flirtatious behavior, and trusting nature may make them appear charming, their need for immediate gratification, mercurial displays of emotion, and constant demand for attention often alienates them from others.
Causes and symptoms
Hysterical disorders
Hysteria may be a defense mechanism to avoid painful emotions by unconsciously transferring this distress to the body. There may be a symbolic function for this, for example a rape victim may develop paralyzed legs. Symptoms may mimic a number of physical and neurological disorders which must be ruled out before a diagnosis of hysteria is made.
Histrionic personality disorder
According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV ), individuals with histrionic personality possess at least five of the following symptoms or personality features:
· a need to be the center of attention
· inappropriate, sexually seductive, or provocative behavior while interacting with others
· rapidly changing emotions and superficial expression of emotions
· vague and impressionistic speech (gives opinions without any supporting details)
· easily influenced by others
· believes relationships are more intimate than they are.
Diagnosis
Hysterical disorders frequently prove to be actual medical or neurological disorders, which makes it important to rule these disorders out before diagnosing a patient with hysterical disorders. In addition to a patient interview, several clinical inventories may be used to assess the patient for hysterical tendencies, such as the Minnesota Multiphasic Personality Inventory-2 (MMPI-2 ) or the Millon Clinical Multiaxial Inventory-III (MCMI-III). These tests may be administered in an outpatient or hospital setting by a psychiatrist or psychologist.
Treatment
Hysterical disorders
For people with hysterical disorders, a supportive healthcare environment is critical. Regular appointments with a physician who acknowledges the patient's physical discomfort are important. Psychotherapy may be attempted to help the patient gain insight into the cause of their distress.Use of behavioral therapy can help to avoid reinforcing symptoms.
Histrionic personality disorder
Psychotherapy is generally the treatment of choice for histrionic personality disorder. It focuses on supporting the patient and on helping develop the skills needed to create meaningful relationships with others.
Prognosis
Hysterical disorders
The outcome for hysterical disorders varies by type. Somatization is typically a lifelong disorder, while conversion disorder may last for months or years. Symptoms of hysterical disorders may suddenly disappear, only to reappear in another form later.
Histrionic personality disorder
Individuals with histrionic personality disorder may be at a higher risk for suicidal gestures, attempts, or threats in an effort to gain attention. Providing a supportive environment for patients with both hysterical disorders and histrionic personality disorder is key to helping these patients.
JEAN MARTIN CHARCOT (1825–1893)
Jean Martin Charcot was born to a carriage maker on November 29, 1825,in Paris, France. Charcot attended the University of Paris, earning his medical degree in 1853. In 1860, he accepted a position at the university as a professor of pathological anatomy until 1862, when he was named senior physician at the Salpêtrière, a hospital for the treatment of mental illness.
Charcot's research and work on psychoneuroses and hysterical disorders untimately helped to dispell the belief that hysteria was a disorder found only in women. Charcot also explored the possibility that physiological abnormalities of the nervous system played a part when behavioral problems were exhibited. He became known for his ability to diagnose and locate these abnormalities of the central nervous system. Finally, Charcot's most notable contribution to the field of psychiatry was his successful use of hypnotism in the diagnosis and treatment of hysteria. He found that, while hypnotized, the patient recalled details, which were not readily available to the individual in a conscious state. In addition, Charcot found that the therapist could more easily influence the hypnotized patient during therapy. In 1882, Charcot presented his research findings to the French Academy of Sciences with favorable results.
Charcot was a prolific writer and a talented artist. Between 1888 and 1894, his complete works were compiled into nine volumes. His most noted work Lectures on the Diseases of the Nervous Systemwas published in 1877. Charcot died on August 16, 1893.
KEY TERMS
Conversion disorder— A psychological disorder that alters motor or sensory functions. Paralysis, blindness, anesthesia (lack of feeling), coordination or balance problems, and seizures are all common symptoms of the disorder.
Somatization disorder— The appearance of physical symptoms in the gastrointestinal system,the nervous system, the cardiopulmonary system, or the reproductive system that have no organic cause.
Resources
ORGANIZATIONS
American Psychiatric Association. 1400 K Street NW, Washington DC 20005. (888) 357-7924. 〈http:// www.psych.org〉.
American Psychological Association (APA). 750 First St. NE, Washington, DC 20002-4242. (202) 336-5700. 〈ttp://www.apa.org〉.
National Alliance for the Mentally Ill (NAMI). Colonial Place Three, 2107 Wilson Blvd., Ste. 300, Arlington, VA 22201-3042. (800) 950-6264. 〈http://www.nami.org〉.
