PSY 242 Chapter 8: Dissociative Disorders and Somatic Symptom Related Disorders

Medicine for Somatic Disorders

Antidepressants; Tofranil

Conversion Disorder

At least one sensory or motor function impairment, but no known neurological cause

Somatic Symptom Disorder

At least one somatic symptom that is distressing or disrupts daily life, excessive thoughts, feelings and behaviors related to somatic symptoms. Duration for at least six months.

Etiology of Somatic Disorder: Cognitive Behavior Factors

Attention to bodily sensation and interpretation of those sensations.

Etiology of DID: Post-traumatic Model

Children who are abused are at risk for developing dissociative symptoms. No prospective studies on it because its rare

Etiology of DID: Sociocognitive Model

DID is a form of role-playing in suggestible individual. Could be iatrogenic; occurs in response to prompting by a therapist

Treatment of DID

Empathetic and supportive therapist, integration of alters into one fully functioning individuals, improvement in social skills

Depersonalization

Experience of unreality, detachment being an outside observer of your thoughts, feelings and actions

Derealization

Experiences of unreality and detachment from your surroundings

Factitious Disorder (previous Muchausm)

Fabrication of physical or psychological symptom. Presenting themselves as ill to gain external rewards

Treatment of Somatic Disorder

Few controlled treatment outcome studies. Identify and change triggering emotions, change cognitions about symptom, replace sick role behaviors with more appropriate social interaction

Etiology of Conversion Disorder

Hippocrates believed it only occurred in women. Freud coined the term conversion; anxiety and conflict converted into physical symptoms. Anna O.

Dissociative Amnesia

Inability to recall important details of traumatic or stressful events. Inconsistent with normal forgetting. Disturbance not attributed to a neurological condition

Neurological factors in somatic disorders

Increased activity in anterior cingulate cortex, anterior insula and somata sensory cortex

Factitious Disorder (by Proxy)

Individual presents another individual (victim) to others as ill, impaired or injured

Psychodynamic approach to DID

Overcome regression, hypnosis (can result in false memories and make symptoms worse)

Illness Anxiety Disorder

Preoccupation with and high level of anxiety about having or acquiring a serious illness. Easily alarmed about personal health status. Excessive health-related behaviors or maladaptive avoidance. Occurs for at least 6 months

Depersonalization/Derealization Disorder

Presence of depersonalization and/or derealization, reality testing remains intact during these experiences and causes significant distress

Consequences of cognitive behavior factors of somatic disorders

Sick role limits healthy life alternative and help-seeking behaviors reinforcement by attention or sympathy

Dissociation

Sudden disruption in the continuity of conscious, memory, identity, emotions, perception, body representation, motor control, behavior and motivation. Some aspect of cognition or experience becomes inaccessible to consciousness.

Dissociative Identity Disorder

Two or more distinct and fully developed personality. Each identity has unique modes of being, thinking, feeling, acting, memory and relationships. Recurrent gaps in recall inconsistent with normal forgetting. Aware this change of alter is distressing