Mood, Dissociative & Somatoform
Disorders
Learning Targets: To discuss mood, dissociative & somatoform disorders
Mood Disorders
● psychological disorders characterized by emotional extremes○ major depressive disorder, mania, bipolar disorder
Major Depressive Disorder
● Five or more symptoms present during the same 2-week period, different from previous functioning
● at least ONE has to be either depressed mood or loss of interest or pleasure
● symptoms cause significant distress or impairment of social, occupational or other important areas of function
7% of population impacted
Major Depressive Disorder
● Five or more symptoms present during the same 2-week period, different from previous functioning
● at least ONE has to be either depressed mood or loss of interest or pleasure
● symptoms cause significant distress or impairment of social, occupational or other important areas of function
7% of population impacted
Symptoms (5+ needed for dx)● depressed mood most of the
day, nearly every day (irritable in kids)
● markedly diminished interest or pleasure in all, or almost all activities, nearly every day
● significant weight loss when not dieting or weight gain, or decrease in appetite nearly every day
● insomnia or hypersomnia nearly every day
● Psychomotor agitation or retardation nearly every day
● fatigue or loss of energy nearly every day
● feelings of worthlessness or excessive or inappropriate guilt nearly every day
● diminished ability to think or concentrate, or indecisiveness
● recurrent thoughts of death, recurrent suicidal ideation without a plan, or attempt or a specific plan
Persistent Depressive Disorder
● formerly Dysthymia● lasts for 2+ years● some criteria for major depressive disorder
but could include○ low self-esteem○ feelings of hopelessness○ NO loss of pleasure
● impacts .5% of Americans
Bipolar Disorder
● formerly called “Manic Depression”● cycles of mania and depression● Bipolar I- intense manic phases, interferes
with functioning, depression isn’t as bad● Bipolar II- hypomanic episodes, do not
interfere with functioning, depression is worse
Mania• Euphoria• Lots of socialization/going out.• Spend a lot of money.• Impatient with people• Racing thoughts & ideas for business, travel, relationships, etc… • Very active – desire action• Talkative... Self-confident (don’t realize they’re sounding odd)• Delusions of grandeur – thinking they’re smarter, better, more athletic,
more beautiful than they are• Hyperactive... Tireless – can stay up for hours on end... Require little
sleep• Increased sex drive• Appetite increases greatly
Depression
• Depression in bipolar patients looks like major depressive disorder. • Extended period of time.
Where mood disorders come from
• Links to Serotonin, Norepinephrine, and Dopamine
• Irrational Thinking
• Learned Helplessness
• Optimistic Explanatory Style
• Pessimistic Explanatory Style
• Stressors in life
• Genes
Somatoform Characterized by physical symptoms that seem to suggest
a physical disorder, yet have no physical causes or
evidence suggests that the symptoms are linked to
psychological factors
1. Conversion Disorder
2. Illness Anxiety Disorder
● (formerly hypochondriasis)
3. Body Dysmorphic Disorder● now part of obsessive-compulsive related
Also includes:
Munchausen
Syndrome,
Munchausen by
proxy, and Ganser
Syndrome
Conversion Disorder A person experiences very specific physical symptoms for which no
physiological basis can be found
● one or more symptoms of altered voluntary movement or sensory
function
● causes distress and impairment and is unconscious
● Common symptoms are paralysis, blindness, deafness and difficulty
walking, slurred speech, tremors
○ can occur with or without an onset stressor
○ maladaptive personality traits are typically associated with this
disorder
Factitious Disorder
● person presents self as injured, ill or impaired● it is deceptive behavior that is evident even
without rewards present● falsifying medical or psychological signs
○ ganser syndrome
■ mostly mimic psychological disorders like schizophrenia
■ no financial gain, but just “need” to be seen as ill or injured
Illness Anxiety Disorder (hypochondriasis) ● Preoccupation with the idea that one has or might get a
serious disease, along with misinterpretation of bodily
systems or functions1. Physiological arousal (worried, anxious and often have sleep disturbances)
2. Bodily focus (close monitoring of bodily features & preoccupied with physical
complaints)
3. Behaviors designed to avoid or check for physical illness (avoids those who
have a disease and engages in repeated self-inspection or medical
consultation)
Body Dysmorphic Disorder● preoccupation with one or more perceived defects or
flaws in physical appearance that aren’t observable or are slight to others
● repetitive behaviors (mirror checking, excessive grooming, skin picking, reassurance seeking) or mental acts (comparing his/her appearance to others) in response to appearance concerns
● preoccupation causes significant distress or impairment
Dissociative Disorders
Conscious awareness becomes separated (dissociated) from previous memories, thoughts & feelings
Break in connection between reality & perception of reality.
DISSOCIATIVE (PSYCHOGENIC) FUGUE: Forgets his past & essentially creates a new history
NOT aware that he has had another past
Invented past is the only reality that he knows
Fugue also involves “fleeing” -> new location
DISSOCIATIVE (PSYCHOGENIC) AMNESIA: Forgets her past but realizes she has forgotten it
NO FORM of biological insult or injury to the brain
Amnesia must stem from a psychological cause
DISSOCIATIVE IDENTITY DISORDER (D.I.D.):**Previously known as - ‘multiple personality disorder’
Result of trauma: Personality is split into distinct & separate different personalities
Personalities are called forth under different circumstances & often one personality does not know about other personalities
Depersonalization/Derealization
● Depersonalization- experiences unreality, detachment, or being outside the body with regard to thoughts, feelings, sensations, body or actions
● Derealization- experiences of unreality or detachment with respect to surroundings (foggy state, dreamlike, lifeless, visually distorted)
DID - Dissociative Identity Disorder