Chapter 8: Dissociative Disorders and Somatoform Disorders
dissociative disorders
involve the sudden disruption in the continuity of consciousness, emotions, motivation, memory, and identity
explicit memory
involves conscious recall of experiences/facts
functional neurological disorder
sensory or motor function impaired with no known neurological cause; symptoms are often inconsistent
role played
DID can be
differs by clinician
DID diagnosis ____ (a few clinicians diagnose the majority of DID cases)
sociocognitive model
DID is a form of role play in suggestible individuals; occurs in response to prompting (via hypnosis) by therapists or media; no conscious deception
partial implicit memory deficits
DID patients show only ______ (alters "share" memories)
posttraumatic model
DID results from severe psychological and/or sexual abuse in childhood (92% surveyed reported abuse; also chronic over a long period of time)
dissociative fugue subtype
a type of dissociative amnesia in which the person "flees" - may assume a new identity in a new location, new job, personality characteristics, etc; more often of brief duration
Complex Somatic Symptom Disorder
at least one somatic symptom that is distressing; excessive thoughts related to this symptom; duration of at least 6 months; primarily related to PAIN
hippocrates
believed functional neurological disorder occurred in women due to a wandering uterus (hysteria)
freud
coined term conversion; believed anxiety and conflict converted into physical symptoms; anna o.
pain disorder or somatization
complex somatic symptom disorder is also called
rural, low SES, non western cultures
complex somatic symptom disorders are more common in
anxiety and depression
depersonalization and derealization disorder is often comorbid with
conversion disorder
functional neurological disorder was previously named
unusual sensory experiences; floating
depersonalization usually involves a lost sense of self, _______ such as deformed/enlarged feeling limbs/an off sounding voice, and feelings of detachment such as ____ or watching oneself
amnesia
dissociative ____ is not explained by substances or by other medical or psychological conditions
explicit memory
dissociative disorders show deficits in _____
schizophrenia
dissociative identity disorder has no relation to ____ (no thought disorders or behavioral disorganization)
ptsd, major depression, somatic symptoms
dissociative identity disorder is often comorbid with
tofranil
effective antidepressant given in low doses to treat complex somatic symptom disorders
somatic symptoms disorders
excessive concerns about physical symptoms or health, physical symptoms have no known physical cause
cognitive perspective on memory
extreme stress usually enhances rather than impairs memory
after therapy begins
for many with DID, symptoms emerge _____
other somatic symptom disorders, MDD, substance abuse
functional neurological disorder is often comorbid with
dissociative identity disorder
involves two or more distinct and fully developed personalities; each has unique modes of being, thinking, acting, memories, etc; primary alter may be unaware of existence of other alters
anosmia
loss of smell
facticious disorder
making yourself or someone else sick for no benefit other than attention; must rule this out before diagnosis of a somatic symptom disorder
dementia
memory fails slowly over time; not linked to stress; accompanied by other cognitive defects, such as the inability to learn new information
overcome repression; hypnosis
most treatment of DID involves integration and improvement of coping skills, but the psychodynamic approach includes ____ and the use of ____ through age regression, which can actually worsen symptoms
interference memory formation
not accessible to awareness later; we block the memory to protect ourselves
emotions
people experiencing derealization are unable to experience
depersonalization
persistent or recurrent experiences of detachment from one's mental processes or body, as though one is in a dream, despite intact reality testing
derealization
persistent or recurrent experiences of unreality of surroundings
illness anxiety disorder
preoccupation with and high level of anxiety about having or acquiring a serious disease; involves excessive behaviors/maladaptive avoidance; no more than mild somatic symptoms are present; lasts 6 months
Spanos
psychologist who put false memories into college student's heads
dissociation
some aspect of cognition or experience becomes inaccessible to consciousness; avoidance response
integration
the goal of treatment of dissociative identity disorder
dissociative amnesia
the inability to recall important personal information; usually about a traumatic experience, not ordinary forgetting or due to physical injury; may last hours or years but usually memory remits spontaneously
the psychodynamic perspective
the most popular paradigm from which to view dissociative disorders
dissociative identity disorder
the most severe of dissociative disorders; recovery may be less complete
life stress; women
the onset of functional neurological disorder is typically in adolescence following _____ and occurs more in ___
posttraumatic model and sociocognitive model
the two major theories of the etiology of dissociative identity disorder
no support
there is ____ for genetic influence on complex somatic symptom disorder
complex somatic symptom disorder, illness anxiety disorder, functional neurological syndrome
three major somatic symptom disorders
distinguish
to diagnose dissociative disorders, you must ____ it from other causes of memory loss
psychodynamic perspective on memory
traumatic events are repressed
bodily sensations; interpretation
two important cognitive variables involved with complex somatic symptom disorder include attention to ____ and ____ of those sensations
implicit memory
underlies behaviors based on experiences that cannot be consciously recalled; motor skills
malingering
when someone fakes symptoms to get out of something such as work, military, etc. ; must rule this out to diagnose a somatic symptom disorder
depersonalization derealization disorder
when the perception of the self is altered but symptoms are not explained by substances/another disorder; triggered by stress or a traumatic event, no disturbance in memory, no psychosis, chronic, onset in adolescence
aphonia
whispered speech
limits; reinforced
with complex somatic symptom disorder, sick role _____ healthy life alternatives and help seeking behaviors are ____ by attention or sympathy
childhood; women
with dissociative identity disorder, the typical onset is in ___ and it is more common in ___