Week 6: Somatic Disorders, Dissociative Disorders, Stress and Trauma-Related Disorders Flashcards
What is ‘dissociative identity disorder (DID)?’
Dissociative disorder in which a person has two or more distinct or alternate personalities.
* Sometimes referred to as split personality, two or more personalities with well-defined traits and memories that “occupy” one person.
* Experiences of possession that are culturally accepted would not be considered DID
What are some characteristics of ‘dissociative identity disorder (DID)?’
- Often have themes of sexual ambivalence (sexual openness versus inhibition) and shifting sexual orientations
- Dominant personality is unaware o the existence of the alternate personalities; suggests that the mechanisms of dissociation are controlled by unconscious processes.
- DID can lead to gaps in memory and hallucinations (believing something is real when it isn’t).
What are possible explanations for ‘dissociative identity disorder (DID)?’
- DID is not a distinct disorder but a form of role-playing; ppl construe themselves as having multiple selves and begin to act in ways that are consistent with their conception of the disorder
- Reinforcers encourage role-playing behaviour, such as:
- evading accountability for unacceptable behaviour
- validation form clinicians’ interest and concern
- clinicians unintentionally cue clients to adopt a role
What is meant by ‘role-playing?’
It is the changing of one’s behaviour to assume a role, either unconsciously to fill a social role or consciously to act out an adopted role.
* not “faking” the role any; instead, it should be seen in the way that an individual assumes the role of a ‘student.’
* ppl learn to organize their behaviour according to the nature of the role because they have been rewarded for doing so (social reinforcement)
* ppl identify so closely with a role it becomes real to them
How does ‘dissociative identity disorder (DID)’ differ from ‘schizophrenia?’
Schizophrenia is more likely to be marked by disorganized thoughts and behaviours and a distorted perception of reality. In contrast, dissociative disorders are more likely to cause feelings of detachment from the self and reality.
* A major difference is that someone with DID has two or more distinct identity states, sometimes known as alternate identities or alters but still maintains integrated functioning on cognitive, emotional, and behavioural levels.
What is ‘dissociative amnesia?’
Type of dissociative disorder, in which a person experiences memory loss in the absence of any identifiable organic cause.
* General knowledge and skills are usually retained.
* Inability to recall autobiographical information
* Usually related to traumatic or stressful experiences
* Not related to a medical condition (brain injury)
* Can be reversible
What is ‘localized dissociative amnesia?’
Events occurring during a specific event or time period are lost to memory.
What is ‘selective dissociative amnesia?’
A specific aspect of an event. People forget the disturbing particulars that take place during a certain time period.
* Usually forget events or periods that were traumatic.
What is an example of ‘selective dissociative amnesia?’
Some people may recall the period of life during which they conducted an extramarital affair, but not the guilt-arousing affair itself
What is ‘generalized dissociative amnesia?’
Identity and life history. People forget their entire lives - who they are, what they do, where they are from, etc.
* Cannot really personal information but tend to retain their habits, tastes, and skills.
What is ‘dissociative fugue?’
Purposeful travel or bewildered wandering that is associated with amnesia for identity or for other important autobiographical information.
* a temporary state where a person has memory loss (amnesia) and ends up in an unexpected place.
* Described as lasting from minutes to months (most last hours to days)
* Can be accompanied by a wish to run away
What is ‘Malingering?’
Faking illness to avoid or escape work or other duties or to obtain benefits.
What is ‘depersonalization?
Feelings of unreality or detachment from one’s self or one’s body, as if one were a robot functioning on automatic pilot or observing oneself from outside.
* Experiences of unreality, detachment, or being an outside observer with respect to one’s thoughts, sensations, body, or actions (e.g. perceptual alterations, distorted sense of time, unreal or absent self, emotional and/or physical numbing).
What is ‘derealization?’
Lots of the sense of the reality of one’s surroundings, experience in terms of strange change in one’s environment (e.g. people or objects changing size or shape)or in the sense of the passage of time.
* Experiences of unreality or detachment with respect to surroundings (e.g. individuals or objects are experienced as unreal, dreamlike, foggy, lifeless, or visually distorted).
What is meant by ‘Depersonalization / Derealization Disorder?’
A disorder characterized by persistent or recurrent episodes of depersonalization.
What are the different types of ‘dissociative disorders?’
- Dissociative Identity Disorder
- Dissociative Amnesia
- Depersonalization/Derealization Disorder
What is the psychodynamic perspective on ‘dissociative disorders?’
Dissociative disorders involve the massive use of repression, which leads to the “splitting off” from the consciousness of unacceptable impulses and painful memories, especially sexual abuse.
* In dissociative amnesia, the ego protects itself from being flooded with anxiety by blotting out disturbing memories or by dissociating threatening impulses of a sexual or aggressive nature.
* In dissociative Identity Disorder: people may express unacceptable impulses by developing alternate personalities.
* In depersonalization, people stand outside themselves, safely distanced from the emotional turmoil within.
What are the learning and cognitive theorists’ perspective on dissociative disorders?
- View dissociation as a learned response that involves NOT THINKING about disturbing acts or thoughts to avoid feelings g guilt and shame evoked by such experiences - the habit is negatively reinforced by relief from anxiety ad the removal of feelings of guilt and shame.
- Spanos: views it as a form of ‘role rallying; acquired by means of observational learning and reinforcement.
- Diathesis-stress model: People prone to fantasize, hypnotize, and be open to other states of consciousness are predisposed to develop dissociative experiences.
How does ‘role-playing’ differ from pretending or malingering?
People come to honestly organize their behaviour patterns according to the role they have observed, they become engrossed in the role and it becomes their reality.
What is the current treatment model for those with dissociative disorders? What is the limiting factor in studies regarding the forms of treatment?
- Since episodes of depersonalization are most likely to occur when ppl are undergoing periods of mild anxiety or depression, clinicians focus on managing anxiety or depression.
- If a clinician can help ppl to learn how to cope with early childhood traumas, the self will be able to work through the traumatic memories and will no longer need to “escape” into alternative selves to avoid anxiety (therefore, reintegration of the personality is possible).
- Infrequency f this disorder makes it difficult to conduct a controlled experiment to compare different forms of treatment
*Biological approaches focus on the use of drugs to treat the anxiety and depression often associated with the disorder, but drugs have not been able to bring about the reintegration of the personality.
What are “somatic symptoms and related disorders?’
Disorders in which people complain of physical (somatic) problems, although no physical abnormality can be found.
What are the different types of ‘somatic symtom(s) and related disorders?’
- Conversion disorder (functional neurological symptom disorder)
- Illness anxiety disorder
- Somatic symptom disorder
- Factitious disorder
What is ‘conversion disorder (functional neurological symptom disorder)?’
A disorder characterized by symptoms or deficits that affect the ability to control voluntary movements (inability to walk or move arm) or impair sensory functions (inability to see, hear, feel tactile stimulation), which are inconsistent or incompatible with known medical conditions or diseases of the individual AND the medical conditions they suggest.
* Formally called hysteria or hysteria neurosis
* Symptoms are NOT intentionally produced
How did ‘conversion disorder’ get its name?
Conversion disorder is so named because of the psychodynamic belief that it represents the channelling, or conversion, of repressed sexual or aggressive energies into physical symptoms.
What does ‘la belle indifference’ refer to?
French term describes the lack of concern over one’s symptoms displayed by some people with conversion disorder and those with real physical disorders.
* Translates to “beautiful indifference.”
* Feature attributed to those with conversion disorders, and dissociative amnesia
* Provides the semblance of indifference and relives anxieties
What is ‘illness anxiety disorder?’
A disorder characterized by a preoccupation with fear of having or the belief that one has a serious medical illness, but no medical basis for the complaints can be found.
* A variant of ‘somatic symptom disorder.’
What is ‘somatic symptom disorder?’
A disorder involving one or more somatic symptoms which cause excessive concern to the extent that it affects the individual’s thoughts, feelings, and behaviours in daily life.
* Focus is on the concern about their symptoms, not the cause; focus emphasizes psychological features of physical symptoms, not whether the causes can be medically explained.
* Conviction persistent despite negative test results.
* Generally have a lower threshold for physical symptoms.
What are the subtypes of ‘illness anxiety disorder?’
- Care-avoidant subtype
- Care-seeking subtype
Describe the ‘care-avoidant subtype’ of ‘illness anxiety disorder?’
This applies to people who postpone or avoid medical visits or lab tests because of high anxiety about what might be discovered.
Describe the ‘care-seeking subtype’ of ‘illness anxiety disorder?’
This applies to people who go ‘doctor shopping’ hoping to find one medical professional who might confirm their worst fears.
