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DISSOCIATIVE AND SOMATIC SYMPTOM DISORDERS CHAPTER 9 Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. DISSOCIATIVE DISORDERS Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. FORMS OF DISSOCIATIVE DISORDERS • Dissociative identity disorder: • Formerly called multiple personality disorder • An individual develops more than one self or personality Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. DISSOCIATIVE AMNESIA • An inability to remember important personal details and experiences that is associated with traumatic or very stressful events. • This amnesia can be diagnosed with a specifier of dissociative fugue: • During which they travel or wander without knowing their identity. Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. DEPERSONALIZATION/ DEREALIZATION DISORDER • A dissociative disorder in which the individual experiences recurrent and persistent episodes of depersonalization, derealization, or both: • Depersonalization is the condition in which people feel they are detached from their own body. • Derealization is a condition in which people feel a sense of unreality or detachment from their surroundings Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. TREATMENT OF DISSOCIATIVE DISORDERS • Goal • Integrate alters • Methods • Hypnotherapy • Cognitive behavioral techniques • Treatment of dissociative disorders oft en involves not only these disorders themselves, but also associated disorders of mood, anxiety, and posttraumatic stress. Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. ITEMS FROM THE SCID-D-R Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. THE BIOPSYCHOSOCIAL PERSPECTIVE • Distinctions between real and fake psychological symptoms • Cognitive-behavioral explanations • How stress affects physical functioning Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. SOMATIC SYMPTOM AND RELATED DISORDERS Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. SOMATOFORM DISORDERS • Somatic symptoms involving physical problems and/or concerns about medical symptoms. • The term “somatic” comes from the Greek word “soma,” meaning body. Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. SOMATIC SYMPTOM DISORDER • Somatic Symptom Disorder involves physical symptoms that may or may not be accountable by a medical condition. • They also have maladaptive thoughts, feelings, and behaviors. • People with this disorder think to a disproportionate degree about the seriousness of their symptoms. • They feel extremely anxious about them, and spend a great deal of time and energy to the symptoms or their concerns about their health. Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. ILLNESS ANXIETY DISORDER • Illness Anxiety Disorder is a somatic symptom disorder characterized by the misinterpretation of normal bodily functions as signs of serious illness. • People with this disorder fear or mistakenly believe that normal bodily reactions represent the symptoms of a serious illness. • Formerly called Hypocondriasis. Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. CONVERSION DISORDER (FUNCTIONAL NEUROLOGICAL SYMPTOM DISORDER) • A somatic symptom disorder involving the translation of unacceptable drives or troubling conflicts into physical symptoms. • Clients with conversion disorder show a wide range of physical ailments: • • • • • • • Pseudoseizures Disorders of movement Paralysis Weakness Disturbances of speech Blindness and other sensory disorders Cognitive impairment Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. CONDITIONS RELATED TO SOMATIC SYMPTOM DISORDERS • Factitious disorder imposed on self, people fake symptoms or disorders, not for the purpose of any particular external gain but because of an inner need to maintain a sick role. • The individual may also feign the illness of someone else in cases of factitious disorder imposed on another (or Munchausen’s syndrome by proxy) • Malingering is the fabrication of physical or psychological symptoms for some ulterior motive. • No longer a diagnosis in the DSM Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. THEORIES AND TREATMENT OF SOMATIC SYMPTOM AND RELATED DISORDERS • • • • Cognitive behavioral therapy Hypnotherapy Medication Interpersonal therapy Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. PSYCHOLOGICAL FACTORS AFFECTING OTHER MEDICAL CONDITIONS Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. PSYCHOLOGICAL FACTORS AFFECTING MEDICAL CONDITIONS • Disorder in which clients have a medical disease or symptom that appears to be exacerbated by psychological or behavioral factors. • Depression, stress, denial of a diagnosis, or engaging in poor or even dangerous health related behaviors Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. PSYCHOLOGICAL FACTORS AFFECTING OTHER MEDICAL CONDITIONS Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. STRESS AND COPING • Stress • Coping strategies for stress • Problem-focused • Emotion-focused • Emotional expression • Personality style • Type A behavior pattern • Type D personality Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. APPLICATIONS TO BEHAVIORAL MEDICINE • Behavioral medicine: An interdisciplinary approach to medical conditions affected by psychological factors that is rooted in learning theory • Psychoeducation Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. • For more information on material covered in this chapter, visit our Web site: • http://www.mhhe.com/whitbourne7eupdate Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education.