PS 280- (5) Somatic Symptoms & Dissociative Disorder

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Dissociative Disorders are:

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Dissociative ( Identity, somatic, indentification ) Disorder (DID): DSM-5:
-at least ( 2, 3, 5, 4, 1 ) distinct personalities exist within the person
-2 or mot of these personalities repeatedly take control of individuals behaviour

-failure to recall important personal information too substantial to be accounted for forgetness
-not due to psychoactive substance or general medical condition

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vs :
-host need not be aware of alters

-each personality (alter) may be distinct & have different behaviours
-Average # of alters = (some cases 100+)
-transition from one alter to another is called a ; trigger = stress (cue from environment)

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Symptoms of DID:
-Another person existing inside- ❌
-Voices talking- ❌
-Amnesia for childhood- ❌
-Referring to self as "we" or "us"- ❌
-Blank spells- 68%
-being told of unremembered events- 63%
-feelings of unreality- 57%
-strangers know the patient- 44%
-noticing that objects are missing- 42%
-coming out of a blank spell in a strange place- 36%
-objects are present that cannot be accounted for- 31%
-different handwriting styles - 28%

90%

80%

70%

87%

85%

84%

83%

82%

74%

75%

73%

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Etiology (causation) of DID:

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Dissociative Amnesia is the inability to recall important personal information

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Dissociative Amnesia:
-real & complete memory loss- in the absence of ( physical, mental, emotional ) or medical cause
-often only ( personal, important, group ) info lost
-( Sudden, planned, recurring ) onset, usually in response to traumatic or stressful experience
-different from (VS) real brain injury & amnesia

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Types of Dissociative Amnesia:
1. Amnesia: fail to remember info during a specific time period (most common)
2. Amnesia: only parts of the trauma are recalled
3. Amnesia: forget info from a specific date until present time
4. Amnesia: only certain categories of info are forgotten
5. Amnesia: forget entire life

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Dissociative Amnesia with or without (specifier) Dissociative Fugue:

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De( personalization, realization, personalized ) Disorder: feeling of being detached from oneself

De( realization, Personalization, reality ) Disorder: feeling of being detached from one's surroundings

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Depersonalization Disorder:
-feel as though one is in a dream, outside of one's body
- onset
-"no impairment in memory or identity confusion"

For diagnosis:
-experiences are persistent or
-marked distress

Etiology:
-note: abuse, trauma, war ( mechanism)

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Psychodynamic Theory:

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Learning & Cognitive Theories:

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Diathesis-Stress Model:

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Treatment:
Dissociative Identity Disorder (DID)
-difficult to treat

treatment involves:
-: safely relive traumatic experiences & make them conscious
-: e.g. anti-anxiety & anti-depressants

Depersonalization Disorder:
treatment involves:
-medications: s- deal with anxiety & depression

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(1&2 important)
1. ( Somatic, Autonic, Automatic ) Symptom Disorder:
characterized by: distress about having physical symptoms for which there is ( no, is, is many ) physical cause
-high levels of anxiety about health or symptoms
-feeling this way for ( >6, <6, equal ) months

2. ( Illness, disease, personalized disease ) Anxiety Disorder:
-excessive concern about serious illness
-longstanding (( 6+, -6, 7 or more )months) fears of having a serious illness, despite assurance that these fears are groundless
-misinterprets ( minor, major, no ) bodily symptoms as evidence of a serious disease

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3. ( Conversion, connection, communication ) Disorder:
-loss or impairment of physical function but ( no, a lot, significant ) physical cause: formerly hysteria
-motor or sensory functioning

symptoms are usually fascinating:
-motor deficits
-conversion stocking or glove anesthesia
Note- symptoms often ( do not, do ) match the medical conditions they suggest

4. ( Factitious, facts, forming conclusion ) Disorder:
distinguished from:
( Malingering, lingering, malnutrition ): purposefully adopts the sick role and complains of symptoms to achieve a particular end (e.g. getting out of a midterm)

Factitious Disorder: psychological disorder characterized by the intentional fabrication of or physical symptoms for no apparent gain
*Most common form= ( munchausen, memory, memory loss ) Syndrome

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❌ of Factitious Disorder:
❌ Theory:
-emotions converted into physical symptoms
-symptoms may be functional (e.g. paralysis of arm)

❌ Theories:
-reinforcing properties of the sick role
-relief of responsibility
-attention, empathy

❌ Mechanisms (re attention to somatic events):
-interpretation of the meaning & significance of these events (e.g. catastrophizing)
-uncontrollable preoccupation with somatic experiences

❌ Experiences:
-personal experience with personal illness
-socialization & prior experience with illness

❌
behavioural approach: reward attempts to assume responsibility & remove sources of reinforcement (stress management)

Cognitive Restructuring: avoid catastrophizing
Antidepressants: SSRIs for hypochondrias

Etiology

beginning

Psychodynamic

psychological

psychoanalytic

Learning

behavioural

experiences

Cognitive

Controlling

Formative

Treatment:

Psychology

PS 280- (5) Somatic Symptoms & Dissociative Disorder

Dissociative Disorders are:

vs : -host need not be aware of alters -each personality (alter) may be distinct & have different behaviours -Average # of alters = (some cases 100+) -transition from one alter to another is called a ; trigger = stress (cue from environment)

Etiology (causation) of DID:

Dissociative Amnesia is the inability to recall important personal information

Dissociative Amnesia with or without (specifier) Dissociative Fugue:

Depersonalization realization personalized( personalization, realization, personalized ) Disorder: feeling of being detached from oneself Derealization Personalization reality( realization, Personalization, reality ) Disorder: feeling of being detached from one's surroundings

Depersonalization Disorder: -feel as though one is in a dream, outside of one's body - onset -"no impairment in memory or identity confusion" For diagnosis: -experiences are persistent or -marked distress Etiology: -note: abuse, trauma, war ( mechanism)

Psychodynamic Theory:

Learning & Cognitive Theories:

Diathesis-Stress Model:

Treatment: Dissociative Identity Disorder (DID) -difficult to treat treatment involves: -: safely relive traumatic experiences & make them conscious -: e.g. anti-anxiety & anti-depressants Depersonalization Disorder: treatment involves: -medications: s- deal with anxiety & depression

vs :
-host need not be aware of alters

-each personality (alter) may be distinct & have different behaviours
-Average # of alters = (some cases 100+)
-transition from one alter to another is called a ; trigger = stress (cue from environment)

De( personalization, realization, personalized ) Disorder: feeling of being detached from oneself

De( realization, Personalization, reality ) Disorder: feeling of being detached from one's surroundings

Depersonalization Disorder:
-feel as though one is in a dream, outside of one's body
- onset
-"no impairment in memory or identity confusion"

For diagnosis:
-experiences are persistent or
-marked distress

Etiology:
-note: abuse, trauma, war ( mechanism)

Treatment:
Dissociative Identity Disorder (DID)
-difficult to treat

treatment involves:
-: safely relive traumatic experiences & make them conscious
-: e.g. anti-anxiety & anti-depressants

Depersonalization Disorder:
treatment involves:
-medications: s- deal with anxiety & depression