Somatoform & Dissociative Disorders
Somatoform & Dissociative Disorders PSYC 270 Abnormal Psychology
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This 5 page Class Notes was uploaded by Summer Schnellbach on Friday February 19, 2016. The Class Notes belongs to PSYC 270 Abnormal Psychology at University of North Dakota taught by Rachel Kramer in Spring 2016. Since its upload, it has received 20 views. For similar materials see Abnormal Psychology in Psychlogy at University of North Dakota.
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Date Created: 02/19/16
Chapter 6: Somatoform & Dissociative Disorders Somatic Symptom Disorders o Unreasonable response to health concerns and symptoms Feel physical pain/symptoms Usually no medical explanation o Types of Disorders: Somatic symptom disorder Illness anxiety Conversion disorder Factitious disorder o "Briquet's Syndrome" = after French doctor o DSM-IV formerly said many different symptoms were needed to diagnose, but now (DSM-V) only requires 1 o NOT the same as illness anxiety: worry is more prominent than actual symptoms o Thinking about the symptoms excessively o *substantial impairment in social functioning o IF the symptoms are explainable, reaction is exaggerated o Rare disorder o Chronic o Affects mostly women who are unmarried and of low social economic status Illness Anxiety Disorder o Formerly called hypochondriasis o Severe anxiety thinking about getting a disease or having one o IF symptoms are truly present, they are mild o Seeking medical help does not change mindset o Comorbid with anxiety/mood disorders Culturally specific disorders: Koro, Dhat, Kyol Goeu o Koro: fear of genitals retracting into abdomen (Asian cultures) o Dhat: Idea that dizziness and fatigue are a result of semen loss (Indian cultures) o Kyol Goeu: fear that air ("wind") is not properly circulating in body (Cambodian Khmer peoples) Symptoms: dizzy, weak, tired, trembles Causes of Somatic Symptom Disorders o Constantly worrying about physical signs or feelings o Isolated bio or psych factors o Genetics o Learn from family members o Life stress o Illness in family during childhood o Receiving attention and sympathy when not getting it elsewhere SSD & Antisocial Personality Disorder o Comorbid Both begin early in life Both are hard to treat and last a lifetime Found more often in low social economic status regions Both are related to alcohol/drug abuse and personal issues o Disinhibition/Impulsivity o Dependence (SSD) vs. Aggression (APD) o APD more common in males, SSD more common in females Treatment for SSD o Benefit from education & a little reassurance o Cognitive behavioral therapy o DO NOT REWARD FOR SEEKING HELP o Antidepressants o Have physician ensure medical attention is not excessively pursued ("Gatekeeper") o Do not always give full attention to patient/family member Psych factors affecting medical condition: o Concentration problems = forget to take meds o Denies medical reassurance Conversion Disorder o "Functional Neurological Symptom Disorder o Impaired sensory/motor functioning that is not related to neural/medical problems or other disorder o Suggestive of neurological problem but no evidence o *must cause significant distress/impairment o Person might feel indifferent (la belle indifference) o NOT faking for attention (malingering) o Rare, chronic o Comorbid with anxiety/mood disorders o More common in females o Often seen in cultural/religious groups Causes of CD o Physical symptoms are revealed as a different way of the body expressing anxiety/unconscious conflict (Freud) o Freud believed that the Primary gain was the escape from conflict Secondary gain = attention or sympathy o It is common for a patient to take on symptoms that they are familiar with Treatment of Conversion Disorder o Process trauma instead of ignore o Remove secondary gains o Avoid giving attention to physical symptoms Factitious Disorder o Purposely faking o External gains are not obvious Possibly sympathy Not the same as malingering No concrete objective such as paid time off Factitious Disorder Imposed on Another o Munchausen Syndrome by proxy o Induce symptoms on someone else Parent inducing symptoms on child Parent gets attention Dissociative Disorders o Separations from reality o Altered identity, memories, consciousness o Depersonalization – out of body experiences o Derealization – life is all a dream o Ex: Sybil Types (DSM-V) o Depersonalization/Dissociative disorder o Dissociative Amnesia o Dissociative Trance Disorder o Dissociative Identity Disorder Depresonalization/Derealization o Out of body feeling o *interferes with life o Similar symptoms may appear in panic disorder or PTSD Symptoms might be in everyday life from lack of food or sleep, drugs/alcohol, emotions o Changes in cognitive behaviors o Hard time learning new info (easily distracted) o Less emotional responses o Dysregulated HPA axis o Chronic: trauma increases manifestation o No known treatments Dissociative Amnesia o Memory loss o Generalized vs. Localized/selective o Dissociative fugue Assume new identity when traveling (new place, new you) Not able to recall how you got to new place, or why o Appears and leaves rapidly o Mostly shown in adults o Trauma and stress can be triggers o Most do not need treatment Dissociative Trance o Vinvuso (Nigeria) o Phii Pob (Thailand) o Sudden change in personality as well as dissociative symptoms o "possession by a spirit" o Not a disorder unless it causes distress and impairment Dissociative Identity Disorder o "multiple personality disorder" o Average of 15 different "people" o Each "person" has new persona o Can quickly switch between personalities o Some patients are faking for attention, but not all Studies have shown altered brain activity between personalities o Sybil or The Three Faces of Eye Causes of DID o Severe trauma in childhood No support after occurrence o Opportunity to escape to traumatic impacts o Related to PTSD o Environmental risk Treatment o Try to find original identity o Rid of cues and triggers o Process trauma Hypnosis False Memories o Suggest false memories of being abused o Damaging to family and self o Well-trained therapists needed to not suggest false memories
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