Somatoform and Dissociative Disorders: Understanding Symptoms and Treatment

1. Chapter 6 Somatoformand Dissociative Disorders

2. Somatoform and Dissociative Disorders • Considered by some to be the result of psychological process known as dissociation, in which different parts of an individual’s identity, memories, or consciousness become split off from one another.

3. Dissociative Experiences in the General Population

4. Somatoform Disorders • A group of disorders in which people experience significant physical symptoms for which there is no apparent organic cause • Symptoms are often inconsistent with possible physiological processes • Strong reason to believe that psychological factors are involved • People do not consciously produce or control the symptoms but truly experience the symptoms • Symptoms pass only when the psychological factors that led to the symptoms are resolved

5. Somatoform Disorders

6. Distinguishing Somatoform from Related Disorders • Psychosomatic Disorders • Malingering • Factitious Disorders • Factitious Disorders by Proxy

7. Somatoform Disorders

8. Conversion Disorder Symptoms Loss of functioning in some part of the body due to psychological rather than physiological causes—there may be indifference to the loss of functioning (la belle indifference) Etiology Often can occur after trauma or stress, perhaps because the individual cannot face memories or emotions associated with the trauma Treatment Psychoanalytic therapy focuses on helping the individual expression of emotions or memories. Behavioral therapy uses systematic desensitization and other techniques

9. Somatization & Pain Disorders Symptoms Somatization disorder involves a long history of multiple physical complaints for which people have sought treatment but for which there is no apparent organic cause. Pain disorder involves only the experience of chronic, unexplainable pain Etiology These disorders run in families, but it is not clear whether this is due to genetics or modeling. Different theories claim different origins for this disorder Treatment Psychoanalytic treatment involves helping people identify feelings and thoughts behind the symptoms and find more adaptive ways of coping

10. Hypochondriasis Symptoms Chronic worry that one has a serious medical disease despite evidence that one does not; frequent consultations with physicians over this worry Etiology A family history of depression or anxiety is common. These people may suffer from chronic distress and cope with this distress by exaggerating physical symptoms Treatment Same as somatization disorder, involving helping people identify feelings and thoughts behind the symptoms and find more adaptive ways of coping

11. Body Dysmorphic Disorder

12. Dissociative Disorders • Process in which different parts of an individual’s identity, memories, or consciousness become split off from one another. • Most people experience some form of dissociation— daydreaming is one example of dissociation. • When dissociation becomes chronic and a defining features of people’s lives, people may be diagnosed with a dissociative disorder.

13. Dissociative Disorders

14. Dissociative Identity Disorder Symptoms Presence of two or more separate personalities or identities in the same individual. These personalities may have different ways of speaking and relating to others and may even have different ages, genders, and physiological responses Etiology Alters may be created by people under conditions of extreme stress, often child abuse. Self-hypnosis may be involved. Some evidence it runs in families Treatment Long-term psychotherapy and use of hypnosis to discover functions of the personalities and to assist in “integration.” Antidepressants and antianxiety drugs may be used

15. Dissociative Fugue Symptoms Person suddenly moves away from home and assumes an entirely new identity, with no memory of previous identity Etiology Fugue states usually occur in response to some stressor, but because they are extremely rare, little is known about etiology Treatment Psychotherapy to help the person identify the stressors leading to the fugue state and learn better coping skills

16. Dissociative Amnesia Symptoms Loss of memory due to psychological rather than physiological causes. The memory loss is usually confined to personal information only Etiology Typically occurs following traumatic events. May involve motivated forgetting of events, poor storage of information during events due to overarousal, or avoidance of emotions experience during an event Treatment Help the individual remember traumatic events and accept them

17. Depersonalization Disorder • People with this disorder have frequent episodes in which they feel detached from their own mental processes or bodies, as if they are outside observers of themselves. • Occasional experiences of depersonalization are common, especially when people are sleep deprived. • Depersonalization disorder is only diagnosed when they are so frequent and distressing that they interfere with an individual’s ability to function.