Chapter 7 - Dissociative and Somatoform

Question 1

dissociative disorder

Answer 1

A disorder characterized by disruption, or dissociation, of identity, memory, or consciousness.

Question 2

dissociative identity disorder

Answer 2

A dissociative disorder in which a person has two or more distinct, or alter, personalities.

Question 3

Dissociative Identity Disorder:

Description

Answer 3

Emergence of two or more distinct personalities.

Question 4

Dissociative Identitiy Disorder:

Associated Features

Answer 4

• Alternates may vie for control
• May represent a psychological defense against severe childhood abuse or trauma

Question 5

Dissociative Amnesia:

Description

Answer 5

Inability to recall important personal material that cannot be accounted for by medical causes.

Question 6

Dissociative Amnesia:

Associated Features

Answer 6

• Information lost to memory is usually of traumatic or stressful experiences
• Subtypes include localized amnesia, selective amnesia, and generalized amnesia

Question 7

Dissociative Fugue:

Description

Answer 7

Amnesia “on the run;” the person travels to a new location and is unable to remember personal information or reports a past filled with false informaion not reconized as false.

Question 8

Dissociative Fugue:

Associated Features

Answer 8

• Person may be confused about his or her personal identity or assumes a new identity
• Person may start a new family or business.

Question 9

Depersonalization Disorder:

Description

Answer 9

Episodes of feeling detached from one’s self or one’s body or having a sense of unreality about one’s surroundings (derealization).

Question 10

Depersonalization Disorder:

Associated Features

Answer 10

• Person may feel as if he or she were living in a dream or acting like a robot.
• Episodes of depersonalization are persistent or recurrent and cause significant distress.

Question 11

Features of Dissociative Identity Disorder

(Formerly Multiple Personality Disorder)

Answer 11

1. At least two distinct personalities exist within the person, with each having a relatively enduring and distinct pattern of perceiving, thinking about, and relating to the environment and the self.
2. Two or more of these personalities repeatedly take complete control of the individual’s behaviour.
3. There is a failure to recall important personal information too substantial to be accounted for by ordinary forgetfulness.
4. The disorder cannot be accounted for by the effects of a psychoactive substance or general medical condition.

Question 12

dissociative amnesia

Answer 12

A dissociative disorder in which a person experiences memory loss without any identifiably organic cause.

Question 13

the five types of dissociative amnesia

Answer 13

1. Localized amnesia
2. Selective amnesia
3. Generalized amnesia
4. Continuous amnesia
5. Systematized amnesia

Question 14

the five types of dissociative amnesia:

localized amnesia

Answer 14

Most cases take the form of localized amnesia in which events occurring during a specific time period are lost to memory. For example, the person cannot recall events for a number of hours or days afer a stressful or traumatic incident, such as a battle or a car accident.

Question 15

the five types of dissociative amnesia:

selective amnesia

Answer 15

In selective amnesia, people forget only the disturbing particulars that take place during a certain period of time. Aperson may recall the period of life during which he conducted an extramarital affair, but not the guilt-arousing affair itself. A soldier may recall most of a battle, but not the death of his buddy.

Question 16

the five types of dissociative amnesia:

generalized amnesia

Answer 16

In generalized amnesia, people forget their entire lives—who they are, what they do, where they live, who they live with. This form of amnesia is very rare. People with generalized amnesia cannot recall personal information, but they tend to retain their habits, tastes, and skills. If you had generalized amnesia, you would still know how to read, although you would not recall your elementary school teachers; you would still prefer French fries to baked potatoes—or vice versa.

Question 17

the five types of dissociative amnesia:

continuous amnesia

Answer 17

In this form of amnesia, the person forgets everything that occurred from a particular point in time up to and including the present.

Question 18

the five types of dissociative amnesia:

systematized amnesia

Answer 18

In systematized amnesia, the memory loss is specific to a particular category of information, such as memory about one’s family or particular people in one’s life.

Question 19

dissociative fugue

Answer 19

A dissociative disorder in which one suddenly flees from one’s life situation, travels to a new location, assumes a new identity, and has amnesia for personal material.

Question 20

depersonalization

Answer 20

Feelings of unreality or detachment from one’s self or one’s body.

Question 21

derealization

Answer 21

A sense of unreality about the outside world.

Question 22

depersonalization disorder

Answer 22

A dissociative disorder characerized by persistent or recurrent episodes of depersonalization.

Question 23

Diagnostic Features of Depersonalization Disorder

Answer 23

1. Rucurrent or persistent experiences of depersonalization, which are characterized by feelings of detachment from one’s mental processes or body, as if one were an outside observer of oneself. The experience may have a dreamlike quality.
2. The individual is able to maintain reality testing (i.e., distinguish reality from unreality) during the depersonalization state.
3. The depersonalization experience causes significant personal distress or impairment in one or more important areas of functioning, such as social or occupational functioning.
4. Depersonalization experiences cannot be attributed to other disorders or to the direct effects of drugs, alcohol, or medical conditions.

Question 24

somatoform disorders

Answer 24

Disorders characterized by complaints of physical problems or symptoms that cannot be explained by physical causes.

Question 25

malingering

Answer 25

Faking illness in order to avoid work or duty.

Question 26

factitious disorder

Answer 26

A disorder characterized by intentional fabrication of psychological or physical symptoms for no apparent gain.

Question 27

Münchausen syndrome

Answer 27

A type of factitious disorder characterized by the fabrication of medical symptoms.

Question 28

Conversion Disorder:

Description

Answer 28

Change in, or loss of, a physical function without medical cause.

Question 29

Conversion Disorder:

Associated Features

Answer 29

• Emerges in context of conflicts or stressful experiences, which lends credence to its physical origins.
• May be associated with la belle indifférence (indifference to symptoms).

Question 30

Hypochondriasis:

Description

Answer 30

Preoccupation with the belief that one is seriously ill.

Question 31

Hypochondriasis:

Associated Features

Answer 31

• Fear despite medical reassurance
• Tendency to interpret physical sensations or minor aches and pains as signs of serious illness.

Question 32

Somatization Disorder:

Description

Answer 32

Recurrent, multiple complaints about symptoms that have no clear organic basis.

Question 33

Somatization Disorder:

Associated Features

Answer 33

• Symptoms may prompt frequent medical visits or cause significant impairment of functioning.

Question 34

Body Dysmorphic Disorder:

Description

Answer 34

Preoccupation with an imagined or exaggerated physical defect.

Question 35

Body Dysmorphic Disorder:

Associated Features

Answer 35

• Person may believe that others think less of him or her as a person because of the perceived defect.
• Person may engage in compulsive behaviours, such as excessive grooming, that aim to correct the perceived defect.

Question 36

Pain Disorder:

Description

Answer 36

Persistent physical pain believed to be associated with psychological factors.

Question 37

Pain Disorder:

Associated Features

Answer 37

• Pain severe and persistent enough to interfere with daily functioning; medical conditions and psychological factors may play important roles in accounting for the pain.

Question 38

Diagnostic Features of Conversion Disorder

Answer 38

1. At least one symptom or deficit involving voluntary motor or sensory functions that suggests the presence of a physical disorder.
2. Psychological factors are judged to be associated with the disorder because the onset or exacerbation of hte physical symptoms is linked to the occurence of psychosocial stressors or conflict situations.
3. The person does not purposefully produce or fake the physical symptom.
4. The symptom cannot be explained as a cultural ritual or response pattern, nor can it be explained by any known physical disorder on the basis of appropriate testing.
5. The symptom causes significant emotional deistress, impirment in one or more important areas of functioning, such as social or occupational functioning, or is sufficient to warrant medical attention.
6. The symptom is not restricted to complaints of pain or problems in sexual functioning, nor can it be accounted for by another mental disorder.

Question 39

conversion disorder

Answer 39

A somatoform disorder characterized by loss or impairment of physical function in the absence of any apparent organic cause.

Question 40

hypochondriasis

Answer 40

A somatoform disorder characterized by misinterpretation of physical symptoms as signs of underlying serious disease.

Question 41

Diagnostic Features of Hypochondriasis

Answer 41

1. The person is preoccupied with a fear of having a serious illness or with the belief that he or she has a serious illness. the person interprets bodily sensations or physical signs as evidence of physical illness.
2. Fears of physical illness, or beliefs of having a physical illness persist, despite medical reassurances.
3. The preoccupations are not of a delusional intensity (the person recognizes the possibility that these fears and beliefs may be exaggerated or unfounded) and are not restricted to concerns about appearance.
4. The preoccupations cause significant emotional distress or interfere with one or more important areas of functioning, such as social or occupational functioning.
5. The disturbance has persisted for 6 months or longer.
6. The preoccupations do not occur exclusively within the context of another mental disorder.

Question 42

body dysmorphic disorder (BDD)

Answer 42

A somatoform disorder characterized by preoccupation with an imagined or exaggerated physical defect in appearance.

Question 43

pain disorder

Answer 43

A somatoform disorder in chich psychological factors are presumed to play a significant role in the development, severity, or course of chronic pain.

Question 44

somatization disorder

(formerly known as Briquet’s syndrome)

Answer 44

A somatoform disorder characterized by repeated multiple complaints that cannot be explained by physical causes.

Question 45

koro syndrome

Answer 45

A culture-bound disorder, found primarily in China, in which people fear that their genitals are shrinking and retracting into their bodies.

Question 46

dhat syndrome

Answer 46

A culture-bound disorder, found primarily among Asian Indian males, characterized by excessive fears over the loss of seminal fluid (semen).

Question 47

What are dissociative disorders?

Answer 47

Dissociative disorders involve changes or disturbances in identity, memory, or consciousness that affect the ability to maintian an integrated sense of self. Thus, the symptoms are theorized to reflect psychological rather than organic factors.

Question 48

What is dissociative identity disorder?

Answer 48

In dissasociative identity disorder, two or more distinct personalities, each possessing well-defined traits and memories, exist within the person and repeatedly take control of the person’s behaviour.

Question 49

What is dissociative amnesia?

Answer 49

In dissociative amnesia, the person experiences a loss of memory for personal information that cannot be counted for by organic causes.

Question 50

What is dissociative fugue?

Answer 50

In dissociative fugue, the person suddenly travels away from home or the workplace, shows a loss of memory for his or her personal past, and experiences identity confusion or takes on a new identity.

Question 51

What is depersonalization disorder?

Answer 51

In derpersonalization disorder, the person experiences persistent or recurrent episodes of depersonalization or derealization of sufficient severity to cause significant distress or impairment of functioning.

Question 52

How do theorists explain the development of dissociative disorders?

Answer 52

Psychodynamic theorists view dissociative disorders as a form of psycholgical defense by whic hthe ego defends itself against troubling memories and unacceptable impulses by blotting them out of consciousness. There is increasing documetnation of a link between dissociative disorders and early childhood trauma, which lends support to the view that dissociation may serve to protect the self from troubling memories. To learning and cognitive theorists, dissociative experiences involve ways of learning not to htink about certain troubling behaviours or thoughts that might lead to feelings of guilt or shame. Relief from anxiety negatively reinforces this pattern of dissociation. Some social-cognitive theorists suggest that multiple personality may represent a form of roleplaying behaviour.

Question 53

How is dissociative identity disorder treated?

Answer 53

The major form of treatment is psycotherapy aimed at achieving a reintegration of the personality by focusing on helping people with dissociative identity disorder uncover and integrate painful experiences from childhood.

Question 54

What are somatoform disorders?

Answer 54

In somatoform disorders, there are physical complaints that cannot be accounted for by organic causes. Thus the symptoms are theorized to reflect psychological, rather than organic, factors. Three major types of somatoform disorders are conversion disorder, hypochondriasis, and somatization disorder.

Question 55

What is Münchausen syndrome?

Answer 55

Münchausen syndrome is a type of factitious disorder and is characterized by the deliberate fabrication of physical symptoms for not apparent reason, other than to assume a patient role.

Question 56

What is conversion disorder?

Answer 56

In confersion disorder, symptoms or deficits in voluntary motor or sensory functions occur that suggest an underlying physical disorder, but not apparent medical basis for the condition can be found to account for the condition.

Question 57

What is hypochondriasis?

Answer 57

Hypochondriasis is a proccupation with the fear of having, or the belief that one has, a serious medical illness, although no medical basis for the ccomplaints can be found, and fears of illness persist depsite medical reassurances.

Question 58

What is pain disorder?

Answer 58

Pain disorder is a type of somatoform disorder in which psychological factors are presumed to play important roles in explaining symptoms of pain.

Question 59

What is body dysmorphic disorder (BDD)?

Answer 59

In body dysmorphic disorder, people are preoccupied with an imagined or exaggerated defect in their physical appearance.

Question 60

What is somatization disorder?

Answer 60

People with somatization disorder have multiple and recurrent complaints of physical symptoms that have persisted for many years and that cannot be accounted for by organic causes.

Question 61

How are somatoform disorders conceptualized within the major theoretical perspectives?

Answer 61

The psychodynamic view holds that conversion disorders represent the conversion into physical symptoms of the leftover emotion or energy cut off from unacceptable or threatening impulses that the ego has prevented from reaching awareness. The symptom is functional, allowing the person to achieve both primary gains and secondary gains. Learnign theorists focus on reinforcements that are associated with conversion disorders, such as the reinforcing effects of adopting a “sick role.” One learnign theory model likens hypochondriasis to obbsessive-compulsive behaviour. Cognitive factors in hypochondriasis include possible self-handicapping strategies and cognitive distortions.

Question 62

What are the major approaches to treating somatoform disorders?

Answer 62

Psychodynamic therapists attempt to uncover and bring to the level of awareness the unconscious conflicts, orginating in childhood, belived to be at the root of the problem. Once the conflict is uncovered and worked through, the symptoms should disappear because they are no longer needed as a partial solution to the underlying conflict. Behavioural approaches focus on removing underlying sources of reinforcement that may be maintaining the abnormal behaviour pattern. More generally, behaviour therapists help people with somatoform disorders learn to handle stressful or anxiety-arousing situations more effectively. In addition, acombination of cognitive-behavioural techniques, such as exposure with response prevention and cognitive restructuring, may be used in treating hypochndriasis and body dysmorphic disorder. Antidepressant medication may prove to be helpful in treating some forms of somatoform disorders.