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