Somatoform Disorders & Dissociative Disorders Kimberley Clow [email protected]
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Transcript of Somatoform Disorders & Dissociative Disorders Kimberley Clow [email protected]
Somatoform Disorders &Dissociative Disorders
Kimberley Clow
[email protected]://instruct.uwo.ca/psychology/155b/
Outline
Somatoform Disorders Somatization Disorder Pain Disorder Hypochondriasis Conversion Disorder Body Dysmorphic Disorder
Dissociative Disorders Dissociative Amnesia Dissociative Fugue Depersonalization Disorder Dissociative Identity Disorder
Somatoform Disorders
Bodily symptoms that suggest a physical defect or dysfunctionBUT no physiological basis can be
foundEmotions Physical Symptoms
Different fromMalingeringFactitious Disorder
Somatization Disorder
Causes & Treatment
Contributors Behaviour rewarded Excessive illness growing up Association with Antisocial Personality
Disorder Runs in families
Treatment Focus on stress Reduce help-seeking behaviour Eliminate reinforcers
Pain Disorder
Predominant complain is pain and psychological factors have an important role in the onset, severity, exacerbation, or maintenance of the pain
Types Acute Chronic
Causes Psychodynamic Behavioural
Hypochondriasis
Causes & Treatment
Conversion Disorder
Motor or sensory symptoms suggesting a neurological impairment when there is none
Conversion refers to unconscious conflicts being converted into physical symptoms Discharging anxiety without
experiencing it
Freud
Causes & Treatment
ContributorsTriggered by a stressful
/ traumatic event Primary & Secondary
Gain
TreatmentNeed to address initial
stressful eventRemove reinforcersGlove Anesthesia
Body Dysmorphic Disorder
Dysfunctional preoccupation about imagined physical defects Ideas of reference Successive changes
& surgeries With insight Without insight
Delusional Disorder
0
10
20
30
40
50
60
70
%
Hair
Nose
Skin
Eyes
Stomach
Breasts
Penis
Causes & Treatment
Contributors Societal beauty images High comorbidity with OCD
Treatment Drugs
Same ones for OCD Behavioural Therapy
Exposure and Response Prevention
Same therapy as for OCD
General Considerations
Psychodynamic Neurosis
Primary gain Secondary gain
Behavioural Sick role Modeling
Stress & Trauma High incidences
of child abuse History of illness
Cognitive Faulty
interpretations Biological
History of illness Sensitivity to
bodily sensations Cultural Factors
More prevalent in cultures that stigmatize mental disorders
Dissociative Disorders
Disruptions of consciousness, memory, and identityMissing time
No memory for a period Weren’t conscious when it happened
Don’t know who you are Lost memories Don’t identify with self Multiple identities
Don’t feel real
Dissociative Experiences Scale
1. Able to ignore pain2. Missing part of a conversation3. Usually difficult things can be done with
ease and spontaneity4. Not sure whether you have done
something or only thought about it5. Absorption in TV program or movie6. Remembering past so vividly you seem to
be reliving it7. Staring into space8. Talking out loud to yourself when alone9. Finding evidence of having done things you
can’t remember doing
10. Not sure if remembered event happened or was a dream
11. Being approached by people you doesn’t know who call you by a different name
12. Feeling as though you were two different people
13. So involved in fantasy that it seems real14. Driving a car and realizing you don’t remember
part of the trip15. Not remembering important events in your life16. Being in a familiar place but finding it
unfamiliar17. Being accused of lying when you are telling the
truth18. Finding notes or drawings that you must have
done but don’t remember doing
19. Seeing yourself as if looking at another
person20. Hearing voices inside your head21. Not recognizing friends or family members22. Other people and objects do not seem real23. Looking at the world through a fog24. Finding unfamiliar things among your
belongings25. Feeling as though your body is not your
own26. Finding yourself in a place but unaware of
how you got there27. Finding yourself dressed in clothes that you
don’t remember putting on28. Not recognizing your own reflection in a
mirror
Dissociative Amnesia
Person is unable to recall important personal information Usually related to a
traumatic or stressful event
Variations Generalized Localized Selective
24
Dissociative Fugue
Person suddenly leaves home and work and assumes a new identity Usually triggered by
stress or trauma
Depersonalization Disorder
Person’s perception or experience of the self is disconcertingly and disruptively altered Frequent episodes Reality does remain
intact during episodes No amnesia or new
identities
Causes & Treatment
Dissociative Identity Disorder (DID)
Causes & Treatment
Is DID A Real Disorder?
Yes It IsMany symptoms
of PTSD are similar to those of DID
Alters show several physiological and / or behavioural differences
No It Isn’tThe use of hypnosis
may be a source of therapist contamination
Physiological changes are also seen in subjects asked to fake DID