Psychosomatic Disorders Prominent physical or bodily symptoms associated with significant impairment or distress Actual physical illnesses may or may not be present Somatic Symptom and Related Disorders ID: 1047488
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1. Somatic and Dissociative DisordersPsychosomatic Disorders
2. Prominent physical or bodily symptoms associated with significant impairment or distressActual physical illnesses may or may not be present Somatic Symptom and Related Disorders
3. Somatic symptom disorder (SSD)Illness anxiety disorder(“hypochondriasis”)Conversion disorder (functional neurological symptom disorder)Factitious disorderPsychophysiological disorders (Chapter 6)Somatic Symptom and Related Disorders
4. Diagnosis, Prevalence, and Course of Somatic Symptom and Related Disorders
5. Pattern of reporting and reacting to pain or other distressing symptomsPattern occurs for at least six monthsInvolves persistent thoughts or high anxiety about the symptomsOver focus on body aches, pains, discomfortsMay have a medical dx (arthritis, asthma, back injury) Somatic Symptom Disorder (SSD)
6. Chronic pattern of preoccupation with having or contracting a serious illnessPattern must be present for at least six monthsInvolves minimal or no somatic symptomsHigh anxiety levelStrongly associated with a person’s cognitions Illness Anxiety Disorder
7. Motor, sensory, or seizure-like symptomsInconsistent with any recognized medical disorderMotor weakness and abnormal movements most common symptoms among childrenIndividuals not consciously faking symptomsBelieve problem is genuine Conversion Disorder
8. Symptoms of physical or mental illness are deliberately induced or simulated with no apparent incentiveIndividuals usually unaware of motiveDiffers from malingering Faking a disorder to achieve some goal, such as an insurance settlement Factitious Disorder and Factitious Disorder Imposed on Another
9. Presentation of oneself to others as ill or impairedThrough recurrent falsification or induction of physical symptomsMay include sabotaging or intentionally interfering with medical careNo obvious rewards except attention, support, and social relationships Factitious Disorder Imposed on Self
10. Pattern of falsification of physical or psychological symptoms in another individualIn many cases, the individual is a mother who appears loving and attentiveSimultaneously sabotaging child’s healthExp: Munchausen by ProxyDiagnosis of this condition is difficult Aaron: 3 years old Factitious Disorder Imposed on Another
11. Genetic factors – unclear heritabilityBiological vulnerabilitiesHeightened sensitivity to painHypervigilance focus on bodily sensationsDysregulated connectivity has been found in brain regions associated with symptomsNeural connections normalize after successful treatmentBiological Dimension of Somatic Disorders
12. Psychodynamic perspectiveSymptoms seen as defense against awareness of unconscious emotional issuesSecondary gain - attentionCognitive-behavioral perspectiveCause: reinforcement, modeling, cognitionsIllness identity reinforcedFamily models reward for illnessCognitions – illness makes them special Psychological Dimension of Somatic Disorders
13. History of sexual abusePrevious physical illnessParents or family members with chronic physical illnessParental attentiveness to somatic complaints Social Dimension of Somatic Disorders
14. BiologicalAntidepressant medications such as SSRIs reduce anxiety and depressionMedication rarely successful by itselfPsychological treatmentsUnderstanding the client’s view of the problemDemonstrating empathyExplaining how physical sx can be stress relatedEmotional pain manifesting as physical sx Treatment of Somatic Symptom Disorders
15. Involve some sort of dissociation (separation) of a part of a person’s consciousness, memory, or identityTypes of dissociative disordersDissociative amnesiaDepersonalization/derealization disorderDissociative identity disorder (multiple personality)Rare Dissociative Disorders
16. Summary of Dissociative Disorders
17. Partial or total loss of important personal informationMay occur suddenly after traumatic event or stressful circumstancesSexual Abuse/Physical AbuseLife Threatening Trauma Dissociative Amnesia
18. Localized Inability to recall a specific event or eventsSystematizedLoss of memory for certain categories of informationSelective amnesiaInability to remember certain details of an incidentTypes of Dissociative Amnesia
19. Repressed memoryAmnesia may come to light only after recalling details of a traumatic eventRelated to Overwhelming childhood traumaNot all researchers believe in the validity of repressed memoriesPossibility of feigning amnesiaEspecially by criminalsTypes of Dissociative Amnesia
20. Confusion over personal identityComplete loss of memory of one’s entire lifeUnexpected travel to a new locationPartial/complete assumption of new identityRecovery is often abrupt and completeSome individuals who have experienced several fugue episodes decide to wear personal identificationIn case of future occurrenceDissociative Fugue
21. Most common dissociative disorderCharacterized by feelings of unreality or being detached from oneself and the environment Depersonalization/Derealization Disorder
22. Formerly called multiple personality disorderDisruption of identityCaused by two or more personality statesAlterations in behaviors, attitudes, and emotionsAlternate personality state may appear to help deal with difficult situationsLegal debate over responsibility for actions Dissociative Identity Disorder (DID)
23. Dissociation and memoryDisruptions in memory encoding due to acute stressAtypical brain functioning has been documentedPermanent structural changes in brain due to trauma may play a role Reduction in amygdalar volume Etiology of Dissociative Disorders
24. Dissociative Identity DisorderPlease address the following: (take notes)Is there a Common History?What Types of Dissociative Amnesia?Role of Therapy ?Documentary
25. Psychodynamic theory Repression protects the individual from painful memories or conflictsContemporary theoryPersonality split develops because of the traumatic experience and the inability to deal with itDifficult to formulate and test hypotheses Psychological Dimension of Dissociative Disorders
26. Multipath Model of Dissociative Disorders
27. Post-Traumatic Model of DID
28. Sociocognitive model of DIDIndividuals learn about DID through mass media and begin to act out its rolesIatrogenic disorderCondition unintentionally produced by a therapist through mechanisms placed on the clientIndividuals who report dissociations score high on fantasy proneness and fantasy susceptibility Sociocultural Dimensions of Dissociative Disorders
29. Treating dissociative amnesia and dissociative fugue Symptoms tend to abate spontaneouslyDepression often associated with the fugue stateReasonable approach: alleviate depression and stressAntidepressants, cognitive-behavioral therapy, and stress management techniques Treatment of Dissociative Disorders
30. Subject to spontaneous remissionSlower rate than dissociative amnesia and fugueTreatment focuses on alleviating feelings of depression, anxiety, or fear of detachment symptomsAntidepressants and antianxiety medicationsBehavioral therapyReinforcement of appropriate responses Treating Depersonalization/Derealization Disorder
31. Trauma-focused therapyHelp individual develop healthier ways of dealing with stressorsMajor goal is integration of personalitiesExamples of stepsWorking on safety issues, stabilization, and symptom reductionReducing cognitive distortionsDeveloping healthy relationships and practicing self-care Treatment of DID
32. What are the somatic symptom and related disorders and what do they have in common? What are the causes and treatments of these conditions?What are dissociations? Why do they occur, and how are they treated?Review