Transcript Abnormal Psych

Chapter 8
Somatoform and Dissociative
Disorders
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Somatoform Disorders

Somatoform and
Pain Disorders

Subjective experience of many physical
symptoms, with no organic causes

Psychosomatic
Disorders

Actual physical illness present and
psychological factors seem to be
contributing to the illness

Malingering

Deliberate faking of physical symptoms
to avoid an unpleasant situation, such
as military duty

Factitious Disorder

Deliberate faking of physical illness to
gain medical attention
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Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Somatoform Disorders
Conversion
disorder
Somatization
Pain
disorder
Disorder
Loss
of functioning in some part of the body for
psychological rather than physical reasons
History
of complaints about physical symptoms, affecting
many different areas of the body, for which medical attention
has been sought but no physical cause found
History
of complaints about pain, for which medical
attention has been sought but that appears to have no
physical cause
Hypochondriasis
Chronic
Body
Excessive
dysmorphic
disorder
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worry that one has a physical disease in the
absence of evidence that one does; frequently seek medical
attention
preoccupation with some part of the body the
person believes is defective
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
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
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Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
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
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Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
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
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Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
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.
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Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
Dissociative Disorders

Dissociative
Identity Disorder

There are separate, multiple personalities
in the same individual.

Dissociative
Fugue

The person moves away and assumes a
new identity, with amnesia for the previous
identity.

Dissociative
Amnesia

The person loses memory of important
personal facts, including personal identity,
for no apparent organic cause

Depersonalization
Disorder

Frequent episodes where individual feels
detached from his or her mental state or
body
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Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
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
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Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
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
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Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
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
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Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.
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
Chapter 8
Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved.