somatoform and dissociative disorders. somatoform disorders physical ailment has no apparent medical...

Somatoform and Dissociative Disorders

Somatoform Disorders

• Physical ailment has no apparent medical cause…

• Do people purposely produce their symptoms?

• Hysterical and Preoccupation Somatoform Disorders

Hysterical Somatoform Disorders

• Suffer actual changes in their physical functioning

• Hard to distinguish• 3 disorders• Conversion,

somatization, & pain disorder associated with psychological factors

Conversion Disorder

• Psychological conflict or need is converted into…

• Symptoms seem…• Examples• DSM Checklist• Begin between late

childhood and young adulthood

• Suddenly, women• 5 of every 1,000 people

Somatization Disorder

• May have long-lasting physical ailments that have little or no organic basis

• Briquet’s Syndrome• Range of ailments…• Doctor to doctor• Runs in families• Begins between... And lasts…

Pain Disorder Associated with Psychological Factors

• Patients with a conversion of somatization disorder may also experience pain, but…

• Fairly common• More women than men• Often develops after an accident or during an

illness

Factitious Disorder

• People go to extremes to create appearance of illness

• Give themselves meds secretly

• Munchausen Syndrome• Munchausen Syndrome

by proxy

Preoccupation Somatoform Disorders• Misinterpret and overreact

to bodily symptoms• Hypochondriasis—• Begins at any age• DSM Checklist• Dysmorphophobia—• Focus on wrinkles,…• Bad odors…• Great lengths to hide

“defects”• Begin during adolescence

Causes of Somatoform Disorders

• May have been acquired earlier in life through conditioning or modeling

• So sensitive to and threatened by bodily cues that they come to over interpret them

• Brings rewards• Forms of communication

Somatoform Disorder Treatment

• Go to physician first• Typically receive kinds of treatments applied

to anxiety disorders

Dissociative Disorders

• Dissociative Disorders—

• Dissociative Amnesia—• Specific upsetting

events• 4 kinds-localized,

selective, generalized, continuous

• Localized is most common

• All deal with personal material

• Memory for abstract info remains

• Triggers?

Dissociative Fugue• Definition—• Can be brief• Extreme cases new

identity!• Follows a severely

stressful event• Affects personal memory• Tend to end

suddenly-”awaken”• Most regain all of

memories when over

Dissociative Identity Disorder (Multiple Personality)

• Definition—• Subpersonalities—• The host• Switching• Early adulthood diagnosis• Starts in childhood• 97% physically/sexually

abused• 100 observed in a case• Most have 2-3 at a time

How to explain it

• Repression of painful memories, thoughts or impulses

• Lifetime of repression• Bad thoughts, try to disown and assign them

to other personalities• Conditioning-bad event, get relief when minds

drift

Treatment

• Psychodynamic therapy• Hypnotic therapy• Drugs

• Multiple treatment difficult• Recognizing the disorder, recovering

memories, and integrating the subpersonalities