8.4 Somatic Symptom and Dissociative Disorders

Question 1

Somatic Symptoms

Answer 1

• Physical symptoms that suggest a medical disease but no known pathology behind it.
• Excessive focus on physical symptoms and distress that cause functional impairment
• Occur more frequently in young adults and adolescents

Causes..
- Illness anxiety disorder
- Conversion disorder (loss or change in body function)
- Factitious disorder
- Psychological factors

Question 2

Dissociative Disorders

Answer 2

• Disruption in integration between consciousness, memory, and identity.
• Occurs when anxiety becomes overwhelming
• Defense mechanisms that govern consciousness, identity, and memory break down.
• Onset occurs in childhood but symptoms may not be recognized until much later

Includes
- Depersonalization-derealization disorder
- Dissociative amnesia
- Dissociative identity disorder

Symptoms
- Depersonalization is common in younger adults during extreme stress
- Dissociative amnesia occurs in war or natural disasters. Difficult to diagnose in younger children due to easy confusion with inattention.

Question 3

Illness Anxiety Disorder (Somatic)

Answer 3

• Unrealistic interpretation of physical symptoms leading to fear of having a serious disease.
• No pathology behind it
• People with this disease is extremely conscious of bodily sensations.
• Aware of even the slightest changes in their body.
• Anxiety, depression, and obsessive-compulsive traits frequently accompany this disorder

Question 4

Factitious Disorder (Munchausen Syndrome)

Answer 4

• Pretend to be ill to receive emotional care and support
• They may exaggerate existing symptoms, or even inflict painful injuries on themselves.

Question 5

Conversion Disorder

Answer 5

• Loss/change in body function that is unexplained
• There is most likely something causing it but it is not obvious or identifiable

Examples
- Paralysis
- Aphonia (inability to produce voice)
- Seizures
- Difficulty swallowing
- Akinesia (absence of movement)
- Urinary retention
- Anosmia (inability to perceive smell)

Pseudocyesis
- False pregnancy (may be caused by strong desire to become pregnant)

Question 6

Dissociative Amnesia

Answer 6

Amnesia
- Permanent or Transient loss of memory

Dissociative Amnesia
- Inability to recall important personal information that cannot be explained by ordinary forgetfulness and not due to effects of medication or neurological issues.
- Usually follows severe psychosocial stress

Selective Amnesia
- Inability to remember certain incidents associated with traumatic events

Localized Amnesia
- Inability to recall all incidents associated with a traumatic event

Generalized Amnesia
- Inability to recall anything that has happened in the individuals entire lifetime (including personal identity)

Question 7

Dissociative Fugue

Answer 7

• There is sudden unexpected travel away from home with the inability to recall some of one’s past life.
• May sometimes assume a new identity

Question 8

Dissociative Identity Disorder

Answer 8

• Multiple personality disorder
• Existence of 2 or more personalities in a single individual.
• Only one personality is evident at any given moment and one is usually dominant.
• Most with this disorder are victims of childhood physical/sexual abuse.

Question 9

Depersonalization-De-realization Disorder

Answer 9

Temporary change in quality of self-awareness
- Feelings of unreality
- Changes in bodily image
- Feelings of detachment from the environment
- A sense of observing ones self from outside the body.

Depersonalization
- Disturbance in perception of ones self

Derealization
- Alteration in perception of external environment

• Can occur in different psychiatric disorders such as schizophrenia, depression, anxiety, NCD.

S/S
- Happen persistently
- Anxiety
- Fear of going insane
- Obsessive thought
- Somatic complaints
- Disturbances in subjective sense of time