Dimensions of Psychotic and Other Problems of Thought and Affect
A third broad domain of correlated dimensions of frequently serious psychological problems is termed psychotic and related problems of thought and affect in this book, for want of a better term. The adjective “psychotic” refers to beliefs and experiences that essentially all members of a society consider to be baseless or false. Many of the dimensions of problems described in this domain involve psychotic beliefs (delusions), perceptual experiences (hallucinations), and other cognitive disturbances that can be said to put the person “out of touch with reality.” In addition, they often involve emotions and atypical energy levels that can be markedly inconsistent with the situation. Cognition, emotion, and energy levels that are not consistent with reality can sometimes take a very serious toll on people, but recent research strongly suggests that each of these problems lies on a continuum and can be viewed in dimensional terms. The Diagnostic and Statistical Manual of Mental Disorders categorical diagnoses that correspond to high levels of these problems include schizophrenia, schizotypal personality disorder, schizoid personality disorder, bipolar disorder, conversion disorders, and dissociative disorders (derealization and depersonalization). In addition, recent research suggests that obsessive and compulsive problems, compulsive rigidity, and some eating problems share features with this domain. Autistic spectrum problems are discussed in this chapter on the basis of limited current evidence regarding their best placement.