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• Post-traumatic stress disorder (PTSD) is a result of some trauma experienced (natural disaster, war, violent crime) by the victim. Victims reexperience the traumatic event in nightmares about the event, or flashbacks in which the individual relives the event and behaves as if he/she is experiencing it at that moment. Victims may also experience reduced involvement with the external world, and general arousal characterized by hyperalertness, guilt, and difficulty concentrating.

The behavioral perspective says that anxiety responses are acquired through classical conditioning and maintained through operant conditioning. The cognitive perspective attributes anxiety disorders to misinterpretation of harmless situations as threatening, focusing excessive attention on perceived threats, and selectively recalling threatening information. The biological perspective attributes anxiety disorders at least partly to neurotransmitter imbalances. Generalized anxiety disorder, often treated with benzodiazepines (Valium, Xanax), is associated with too little availability of the inhibitory neurotransmitter GABA in some neural circuits, while obsessive-compulsive disorder and panic disorder, often treated with antidepressants (Prozac, Paxil, Zoloft), are associated with low levels of serotonin. The evolutionary perspective attributes the presence of anxiety to natural selection for enhanced vigilance that operates ineffectively in the absence of real threats.

Somatoform Disorders

Somatoform disorders are characterized by physical symptoms such as pain, paralysis, blindness, or deafness without any demonstrated physical cause. Somatoform disorders are different from psychosomatic disorders such as ulcers, tension headaches, and cardiovascular problems. Although the causes of both somatoform and psychosomatic disorders are psychological and the symptoms are physical, with somatoform disorders, no physical damage is done. Somatoform disorders include somatization disorder, conversion disorder, and hypochondriasis.

• Somatization disorder is characterized by recurrent complaints about usually vague and unverifiable medical conditions such as dizziness, heart palpitations, and nausea, which do not apparently result from any physical cause. To be classified as having a somatization disorder, an individual needs to have complained about, taken medicine for, changed lifestyle because of, or seen a physician regarding many different symptoms.

• Conversion disorder (known as hysteria in the Freudian era) is characterized by loss of some bodily function, such as becoming blind, deaf, or paralyzed, without physical damage to the affected organs or their neural connections. It is often marked by indifference and quick acceptance on the part of the patient. The symptoms usually last as long as anxiety is present.

• Suffering from hypochondriasis, a person unrealistically interprets physical signs—such as pains, lumps, and irritations—as evidence of serious diseases. The person consequently becomes anxious and upset about the symptoms. You probably know someone who thinks a headache is a sign that he/she is developing a brain tumor or that a bit of scar tissue is the beginning of cancer. Hypochondriasis differs from somatization in that those with hypochondriasis show excessive anxiety about only one or two symptoms and the implications they could have for potential future diseases.

Psychoanalyst Sigmund Freud’s explanation attributes somatoform disorders to bottled-up emotional energy that is transformed into physical symptoms. Behaviorists explain that operant responses are learned and maintained because they result in rewards. Cognitive behaviorists continue that the rewards enable individuals with somatoform disorders to avoid some unpleasant or threatening situation, provide an explanation or justification for failure, or attract concern, sympathy, and care. Social cognitive theorists think that individuals with somatoform