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DISSOCIATIVE DISORDERS DISSOCIATIVE DISORDERS Dissociative refers to the separation of certain personality components or mental processes from conscious thought. TYPES Dissociative Amnesia Sudden loss of a memory due to a traumatic event Dissociative Fugue Not only to people forget personal information, but they relocate and start a new life. Dissociative Identity Disorder This is not permanent and the fugue does end (multiple personalities)- usually result of child abuse Two or more personalities that come out at different times Depersonalization Disorder People with the feeling that they are on the outside of their body looking at themselves. EXPLANATIONS Psychoanalysts Dissociate in order to repress “Urges” Learning theorists People have learned not to think about disturbing events in order to avoid the feelings of guilt, shame or pain Cognitive/Biological Do not have a complete explanation for dissociative disorders TOP 5 SYPMTOMS OF DID De-realization Dissociation This is the most common symptom of DID. In an attempt to forget the traumatic past, the dissociative disorder patient may simply dissociate themselves from those unpleasant memories. They seem to completely forget about various special events in their lives such as their birthdays, weddings, or even birth of their children. Extreme cases may try to harm themselves by self mutilation to overcome their traumatic past. Feeling lost and lonely DID patients may refuse to recognize their own images in the mirror and feel as if they are two different people caught in a single body. There are instances of people with DID hearing imaginary voices in their head from someone who they don’t recognize. A continuous conflict in the mind about who they really are and what they want may be symptoms of this disorder. Often, individuals with multiple personality disorder find themselves doing things that they don’t recall later. They often get accused of lying as they seem to find themselves in places where they simply don’t remember to have traveled. Identity crisis Difficulties in expressing themselves Individuals suffering from this disorder usually don't share a good relationship with family due to their reluctance to express and share feelings. Presence of other similar mental disorders such as conversion disorder or post-traumatic stress disorder may also precipitate DID. CLOSER LOOK WITH CASE STUDIES Case Study 1 Case Study 2 Zelda is extremely concerned with cleanliness. In fact, before she retires at night, she goes through a cleaning ritual of her clothes and body that sometimes lasts for up to 2 hours. If she misses a step in the ritual or performs part of it imperfectly, she starts the ritual all over again. Monica is suffering from a form of amensia. She has deliberately left her home town moved to another city 350 miles away, and has assumed a new identity, a new job, and even new personality characteristics. Case Study 3 Alex periodically suffers from extremely high levels of anxiety but he cannot pinpoint the source or otherwise say why he is so anxious. He is terrified at times, his heart often races, he feels wobbly, and has difficulty concentrating. CONTINUED Case Study 4 Karen worries excessively about developing a rare disease. When she meets friends or writes letters to her relatives, she is constantly discussing how she feels and expresses concern that even the most minor irregularities in the functioning of her body are symptoms of underlying diseases. She spents a good deal of time consulting doctors for a second opinion. Case Study 5 Terry complains that he is experiencing recurrent episodes of lightheadedness, rapid breathing, and dizziness, especially as he attempts to leave his house. The symptoms have become so severe that, in fact, he is leaving his house less and less frequently. He now only goes the grocery store in the company of his sister. Once in the store, he checks immediately for the exits and windows ANSWERS Case Study 1: Obsessive-Compulsive Disorder Case Study 2:Psychogenic Fugue Case Study 3: Generalized Anxiety Disorder Case Study 4: Hypochondriasis Case Study 5: Phobic Disorder (In This Case, Agoraphobia) SOMATOFORM DISORDERS Psychological problems but with inexplicable physical pain. TYPES OF SOMATOFORM DISORDERS Conversion Disorder Hypochondriacs Chart on Page 422, put it in your notes CONVERSION DISORDER There are no standard tests to check for conversion disorder. The tests your doctor uses will depend on what kind of signs and symptoms you have. They may include: Simple bedside tests. Your doctor checks for normal reflexes to help rule out a physical cause for your signs and symptoms. These tests don't require any specialized equipment and are quick and painless. The exact tests your doctor does depends on your signs and symptoms. X-rays or other imaging tests. These tests may help your doctor confirm that your symptoms aren't caused by an injury or neurological or other physical conditions that might cause similar symptoms. An electroencephalogram (EEG) scan. Your doctor uses an EEG because it can help rule out a neurological cause of seizure symptoms. This test is a painless procedure to detect electrical activity in your brain. It's used to test for epilepsy and other brain disorders. CONVERSION DIAGNOSIS Diagnosis can be tricky because a doctor must rule out medical conditions with a physical cause. Conversion disorder can mimic a number of other health problems, including: Myasthenia gravis — a muscle weakness disorder Guillain-Barre syndrome — an uncommon disorder in which your body's immune system attacks your nerves Neurological disorders, such as multiple sclerosis, Parkinson's disease and epilepsy Stroke Lupus Spinal cord injury HIV/AIDS WARNING SIGNS OF HYPOCONDIRACS The person has a history of going to many doctors. He or she might even "shop around" for a doctor who will agree that he or she has a serious illness. The person recently experienced a loss or stressful event. The person is overly concerned about a specific organ or body system, such as the heart or the digestive system. The person’s symptoms or area of concern might shift or change. A doctor’s reassurance does not calm the person’s fears. They believe the doctor is wrong or made a mistake. The person might have had a serious illness as a child. The person’s concern about illness interferes with his or her work, family, and social life. The person might suffer from anxiety, nervousness, and/or depression CAUSES OF HYPOCONDRIACS A history of physical or sexual abuse A poor ability to express emotions A parent or close relative with the disorder — Children might learn this behavior if a parent is overly concerned about disease and/or overreacts to even minor illnesses. An inherited susceptibility for the disorder MOOD DISORDERS MOOD DISORDERS All mood disorders are characterizes into 2 categories Depression Bipolar Disorders DEPRESSION By far the most common of all psychological disorders Depressed mood (feelings of sadness or being blue) Lack of interest (in activities that you previously enjoyed) Feelings of worthlessness Poor concentration Thoughts of death As many as 15% of severely depressed people commit suicide. BIPOLAR DISORDER Used to be called manic depression Periods of extreme excitement---mania’s Can quickly change to feelings of depression In severe cases individuals may have delusions or hallucinations, hearing voices etc. SYMPTOMS OF BIPOLAR DISORDER Euphoria Inflated self-esteem Poor judgment Rapid speech Racing thoughts Aggressive behavior Agitation or irritation Increased physical activity Risky behavior Spending sprees or unwise financial choices Increased drive to perform or achieve goals Increased sex drive Decreased need for sleep Easily distracted Careless or dangerous use of drugs or alcohol Frequent absences from work or school Delusions or a break from reality (psychosis) Poor performance at work or school Sadness Hopelessness Suicidal thoughts or behavior Anxiety Guilt Sleep problems Low appetite or increased appetite Fatigue Loss of interest in activities once considered enjoyable Problems concentrating Irritability Chronic pain without a known cause Frequent absences from work or school Poor performance at work or school DIFFERENT PRESPECTIVES Outline page 424 and 425 to find the similarities and differences in psychological and biological views of depression and bipolar disorder WHAT DOES THIS PICTURE MAKE YOU FEEL? SCHIZOPHRENIA SCHIZOPHRENIA Usually considered the most serious of psychological disorders. Usually appears in young adults and progresses gradually Many different kinds of symptoms’’ Delusions. These beliefs are not based in reality and usually involve misinterpretation of perception or experience. They are the most common of schizophrenic symptoms. Hallucinations. These usually involve seeing or hearing things that don't exist, although hallucinations can be in any of the senses. Hearing voices is the most common hallucination among people with schizophrenia. Thought disorder. Difficulty speaking and organizing thoughts may result in stopping speech midsentence or putting together meaningless words, sometimes known as word salad. Disorganized behavior. This may show in a number of ways, ranging from childlike silliness to unpredictable agitation. NEGATIVE SYMPTOMS Negative symptoms refer to a diminishment or absence of characteristics of normal function. They may appear with or without positive symptoms. Loss of interest in everyday activities Appearing to lack emotion Reduced ability to plan or carry out activities Neglect of personal hygiene Social withdrawal Loss of motivation COGNITIVE SYMPTOMS Cognitive symptoms involve problems with thought processes. These symptoms may be the most disabling in schizophrenia because they interfere with the ability to perform routine daily tasks. A person with schizophrenia may be born with these symptoms. Problems with making sense of information Difficulty paying attention Memory problems TEENAGER SYMPTOMS Schizophrenia symptoms in teenagers are similar to those in adults, but the condition may be more difficult to recognize in this age group. This may be in part because some of the early symptoms in teenagers are common during teen years Withdrawal from friends and family A drop in performance at school Trouble sleeping Irritability Compared with schizophrenia symptoms in adults, teens may be: Less likely to have delusions More likely to have visual hallucinations TYPES OF SCHIZOPHRENIA Paranoid Schizophrenia Delusions and Hallucinations centered around a single theme May be convinced that people are after them (paranoid) Disorganized Schizophrenia People who are incoherent in speech and thought as well as disorganized in their behavior Delusions and hallucinations are brief and not connected Normally either emotionless or show inappropriate emotions Catatonic Schizophrenia Disturbance of movement, usually slow movements then move to agitation. CATATONIC SCHIZOPHRENIA CONTINUTED Individuals may hold strange or uncomfortable positions for hours at a time. PERSONALITY DISORDERS PERSONALITY DISORDERS These are not Psychological disorders They are patterns of inflexible traits that disrupt social life or work and distress the affected individual Major components of an individuals personality Antisocial disorder. is one common type of personality TYPES OF PERSONALITY DISORDERS Paranoid Schiziod Antisocial Avoidant