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 ___