Chapter 6 - Dissociative and Somatic Symptom and Related Disorders

Question 1

Dissociative Disorders

Answer 1

Severe maladaptive disruptions/alterations of identity, memory, and consciousness

Cannot control

Dissociation – lack of normal integration of psychological functioning
Can be adaptive (Daydreaming, state of flow)

Question 2

Dissociative Amnesia

Answer 2

Inability to recall important personal information

Following traumatic event
Usually remits spontaneously within few days – sometimes more chronic

Dissociative fugue – person with memory loss travels/wanders
Can adopt new identity/occupation
When memory recovered, no memory of events

Question 3

Memory Loss Patterns

Answer 3

Localized amnesia – failure to recall information from specific time period

Selective amnesia – parts of trauma forgotten

Generalized amnesia – forget all past personal information

Continuous amnesia – forget specific date until present

Systemized amnesia – forget certain categories of information (people, places)

Question 4

Depersonalization/Derealization Disorder

Answer 4

Depersonalization – unreality/detachment from self

Derealization – detachment from one’s surroundings

Typically begins adolescence (chronic)
Associated with reduced emotional reactivity

Question 5

Dissociative Identity Disorder

Answer 5

Presence of 2+ personality states – “host” and “alters”

Switching – changing from one personality to another
Gaps in memory

Question 6

Etiology of Dissociative Disorders

Answer 6

Trauma model
Diathesis-stress formulation
Severe childhood trauma – dissociation = defense mechanism
Attachment theory

Socio-cognitive model
Role playing
Iatrogenic condition – caused by therapist during course of therapy

Question 7

Treatment of Dissociative Disorders

Answer 7

Psychotherapy
          Establish safe environment
          Develop coping skills
          Remember trauma
          Accept past, integration of personalities

Hypnosis

Medication
Truth serum – causes drowsiness
Recall forgotten memories
Identify alters

Transcranial magnetic stimulation – helpful for depersonalization/derealization disorder

Question 8

Conversion Disorder

Answer 8

Loss of functioning in part of body without underlying medical explanation

Can be diagnosed with medical testing
Symptoms inconsistent with known physiological mechanisms
Glove anesthesia – loss of sensations through hand

La belle indifference – lack of concern about one’s symptoms

Question 9

Somatic Symptom Disorder

Answer 9

Multiple, recurrent somatic symptoms exaggerated by individual

Personal identity wrapped in physical illness
Anxiety about health/symptoms

Excessive sensitivity to minor bodily symptoms
Similar to panic disorder

Predominant pain – if pain persists beyond time, psychological factors considered

Question 10

Illness and Anxiety Disorder

Answer 10

Preoccupied with fear of having serious medical disease
Despite medical examinations revealing nothing wrong

Becomes part of self-identity

Question 11

Factitious Disorder

Answer 11

Deliberate faking of illness/injury to get medical attention
Fake symptoms

Motivation to gain sympathy, care, and attention

Imposed on another – falsifying illness in another person (ex. child)

Question 12

Etiology of Somatic Symptoms Disorder

Answer 12

Groups of disorders

Psychoanalytic explanations – conversion of anxiety associated with somatic symptoms

Chronic stress perceived as illness

Substantial amount of time monitoring body
Distort bodily sensations

Negative affectivity/emotion regulation – hypnosis

Early experiences and social learning (trauma, reinforcement)

Question 13

Treatment of Somatic Symptom Disorders

Answer 13

Medication

Psychotherapy