Dissociative and Somatoform Disorders

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Dissociative and Somatoform Disorders
Dissociative disorders include Dissociative
Amnesia, Dissociative Fugue, Depersonalization
Disorder, Dissociative Identity
Disorder Somatoform disorders include Conversion
Disorder, Somatization Disorder, Pain
Disorder, Hypochondriasis, Body Dysmorphic
Disorder Factitious disorder
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Dissociative Disorders

• Disorders involve disruptions in the integration
  of memory, consciousness, or identity

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Dissociative Disorders

• Dissociative amnesia
• psychologically caused loss of memory
• Dissociative fugue
• flight from familiar surroundings accompanied by
  memory loss
• Depersonalization disorder
• the feeling of being detached from ones body
• Dissociative identity disorder
• multiple personalities in the same person

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DSM-IV Criteria for Dissociative Amnesia

• One or more episodes of inability to recall
  personal information usually a trauma too
  extensive for ordinary forgetfulness
• Disturbance does not occur during another
  disorder not directly related to substance
  abuse, brain injury, or general medical condition
• Symptoms cause clinically significant distress
  and impairment in social, occupational, other
  areas of functioning

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DSM-IV Criteria for Dissociative Fugue

• Predominant disturbance is sudden unexpected
  travel away from home or work inability to
  recall ones past
• Confusion about personal identity or assumption
  of a new identity
• Is not part of another dissociative disorder,
  substance abuse, or medical condition
• Causes significant distress, and impairment in
  functioning

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Treatment for Dissociative Amnesia and Fugue

• Psychologists view severe traumatic stress as the
  cause
• Psychoanalysts focus on uncovering repressed
  trauma
• Behaviorists focus on state-dependent learning
• Initial trauma will only be remembered under new
  forms of extreme stress ethically psychologists
  do not create situations to severely stress
  clients
• Treatment focuses on stress management and
  prevention of future episodes of amnesia or fugue

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Depersonalization Disorder

• Self becomes dissociated or separated from rest
  of personality
• Derealization feeling the world is not real, one
  is living in a dream

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DSM-IV Criteria for Depersonalization Disorder

• Persistent, recurring feeling detached from ones
  mental processes or body as if an observer
• During depersonalization, reality testing intact
• Causes significant distress and impairment in
  social, occupational, other functioning
• Depersonalization not related to another
  disorder, substance abuse, or medical condition

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DSM-IV Criteria for Dissociative Identity
Disorder

• Shares elements of the other dissociative
  disorders (amnesia, loss of time or unexpected
  travel, depersonalization, derealization)
• Symptoms appear more extreme

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DSM-IV Criteria for Dissociative Identity
Disorder

• Presence of two or more distinct identities or
  personality states
• At least two identities or personality states
  recurrently take control of behavior
• Inability to recall personal information too
  extensive for forgetfulness
• Disturbance not due to direct physiological
  effects, substance abuse, or general medical
  condition

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Dissociative Identity Disorder Facts

• Affects more women than men
• Runs in families
• Seems to be increasing
• Linked with childhood sexual abuse
• Prevalence is 3.3 percent in U.S.

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Dissociative Identity Disorder Treatment

• In the past, treatment involved picking one
  personality and focusing on it this did nothing
  to prevent new personalities from forming
• Now, treatment focuses on integrating/fusing
  personalities into one and teaching coping skills
  for dealing with stress or trauma
• Medications sometimes are used to treat comorbid
  anxiety or depression
• No controlled tx outcome studies exist

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Somatoform Disorders

• A category of psychological disorders
  characterized by unusual physical symptoms that
  occur in the absence of a known physical
  pathology

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Somatoform Disorders

• Conversion disorder
• physical symptoms usually confined to single
  organ/system and mimic symptoms of neurological
  condition
• Somatization disorder
• multiple, vague, physical complaints
• Hypochondriasis
• morbid preoccupation with imagined illness
• Pain disorder
• preoccupation with pain
• Body dysmorphic disorder
• obsessive concern with presumed defects in
  appearance

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DSM-IV Criteria for Hypochondriasis

• Preoccupation with fears of having disease,
  misinterpretation of bodily symptoms
• Preoccupation persists despite medical assurances
• Fears of disease not delusional, not restricted
  to concern about appearance
• Preoccupation causes distress, impairment in
  social, occupational, other functioning
• Duration is at least 6 months

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Hypochondriasis Treatment

• Patients rarely present for Mental Health
  treatment
• Explanations/Treatments vary with theory
• Psychoanalysts repressed conflict
• Family clinicians family dynamics
• Behaviorists reinforced learned behavior
• Cognitivists an attributional bias (attribute
  everyday experiences to serious illness)

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DSM-IV Criteria for Body Dysmorphic Disorder

• Preoccupation with imagined specific defects in
  appearance, excessiveness over slight anomaly
• Preoccupation causes distress and impairment in
  social, occupational, other functioning

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Body Dysmorphic Disorder Facts

• Usually starts during adolescence
• Females outnumber males 3 to 1
• More common among single and divorced adults
• Shares many characteristics with OCD

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Body Dysmorphic Disorder Treatment

• Difficult to treat because clients avoid
  confronting their anxiety
• Behavioral and Cognitive-behavioral therapy, and
  medication (SSRI antidepressant) have shown
  success.

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Factitious Disorder

• Psychological disorder whereby people feign
  illness to gain attention
• Munchausens syndrome

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DSM-IV Criteria for Factitious Disorder

• Intentional production or feigning of physical,
  psychological signs, symptoms
• Motivation is to assume sick role
• External incentives are absent