Download Dissociative Disorders

Dissociative Disorders
Persistent,
maladaptive
disruptions in
memory,
consciousness, or
identity
Dissociative Identity
Disorder
 A.
presence of two or more distinct
identities or personality states
 B.
at least two of these identities
recurrently take control
 C.
inability to recall important
personal information
Possible Causes:
 Biological
 Severe
vulnerability
abuse/trauma history
 Suggestibility
Treatment:
 identify
cues or triggers that provoke
memories or dissociation
 try
to help person integrate personalities
 hypnosis
sometimes used
 antidepressants
may be helpful
Depersonalization
Disorder
 depersonalization
disorder: severe
feelings of unreality - dominates the
person’s life
 depersonalization
 derealization
Depersonalization Disorder:
Causes
 Causes
 Cognitive
deficits
Attention
Short-term memory
Spatial reasoning
Easily distracted
 Decreased
emotional response
Dissociative Amnesia:
 generalized
amnesia: can’t remember
anything- even identity
 localized
or selective amnesia: failure to recall
specific events (often traumatic)
 dissociative
flight
 dissociative
fugue: memory loss combined with
trance disorder: dissociative
phenomena that appears as a trance or
“possession”
Somatic Symptom and
Related Disorders
Historical Roots
 hysteria:


“wandering uterus”
physical symptoms without a known cause
term dates back to Hippocrates and Egyptians
 neurosis:
emotional distress due to underlying
unconscious conflicts, anxiety, and implementation
of defense mechanisms
Illness Anxiety Disorder
 Preoccupation
with fears of having a serious
disease based on a misinterpretation of bodily
symptoms

Persists despite appropriate medical evaluation
and reassurance

Causes distress or impairment in
functioning

Disturbance lasts at least 6 months
Cultural Variations
 Africa

Sensation of something crawling in one’s head
 India


and Pakistan
Sensation of burning in hands or feet
dhat – concern about losing semen accompanied
by feelings of weakness and exhaustion
 China,

East Asia
koro – sudden intense anxiety that one’s genitals
will recede into one’s body and possibly cause
death
Somatic Symptom Disorder
A
disorder in which persons become
excessively distressed, concerned, and
anxious about the bodily symptoms that
they are experiencing.
 Their
lives are greatly and
disproportionately disrupted by the
symptoms.
Somatic Symptom Disorder
and Antisocial Personality
Disorder
 Run
in the same families
 Gender
differences
 Common
features
Conversion Disorder
•
Presence of one or more symptoms or deficits that
affect voluntary or sensory functioning
• paralysis
• blindness
• difficulty speaking
• loss of sense of touch
Causes of Somatic Symptom
and Related Disorders
 Cognitive
behavioral view
 Psychodynamic
view
 Tends
to run in families (genetic and environmental
contributions)
 Often
develops in context of stressful life event
 Reviewed
Treatment
(Kroenke, 2007)
34 randomized controlled studies of
treatment of somotaform disorders (3,922
patients)
 Concluded
that the most effective treatment
for somatoform disorders was cognitivebehavioral therapy (CBT).
 some
evidence that antidepressants and a
consultation letter to primary care physician
can help.
Factitious Disorder
A
disorder in which an individual feigns or
induces physical symptoms, typically for the
purpose of assuming the role of a sick person.
 Different
from Malingering
 Specifiers
of imposed on self vs. imposed on
another (formerly factitious disorder by proxy)
 http://abcnews.go.com/Health/arizona-mother-
accused-poisoning-baby-munchausen-syndromeproxy/story?id=13308998