Somatic and Dissociative Disorders

Somatic Symptom Disorder

1. 1/+ somatic symptom

2. Feelings/thoughts/behs that are disproportionate and persistent, high anxiety about health/symptoms and take up a lot of time and energy

3. Symptoms shift over time, one symptom cannot be continually present

Illness Anxiety Disorder

1. Excessive preoccupation with contracting an illness

2. Mild/no somatic symptoms

3. High health anxiety

4. Health-related behaviors such as checking for illness or maladaptive avoidance (from hospitals, care, etc.)

5. Symptoms last for at least 6 mo

Causes/Treatments for Somatic Symptom Disorder and Illness Anxiety Disorder

A stress trigger may have caused bodily activation that is now interpreted as danger. They focus on bodily sensations to search for dagner and it causes anxiety. Exposure therapy and CBT can help people draw up these sensations and see they are harmless

Psychological Factors affecting medical conditions

Mental health/behavior problems worsen a medical condition, such as anxiety affecting asthma

Factitious Disorder

Can be imposed on oneself or others

1. Falsifying physical/psychological symptoms or inducing them for deception

2. Presenting oneself as hurt, sick, or injured

3. Deceptive beh is present even when not rewarded, is not externally rewarded

This disorder is common for those who have had childhood medical trauma, depression, unsupportive parental relationships

Conversion Disorder (Functional Neurological Symptom Disorder)

1. 1/+ symptom of motor/sensory impaired function that is voluntary

2. Does not follow neurobiology or patterns of medicine (e.g., blindness, induced seizures)

Usually caused by trauma. chronic/intermittent course with an onset in adolescents. Treatment includes CBT, trauma processing and inducing reinforcement of the disorder

Dissociative Disorders

Meaning a lack of integration somewhere

Depersonalization Derealization Disorder

Adolescent onset with a chronic course. No great treatment.

1. Persistent depersonalization and/or derealization

2. Reality testing is intact (knows they are in the present)

Dissociative Amnesia

1. Cannot recall autobiographical info either related to stressful/traumatic event or more generalized

   1. Localized amnesia: Memory is gone for the traumatic event for a limited period (e.g., week of event)

   2. Selective amnesia: Some events in a traumatic period are gone, but not all (e.g., month of event)

   3. Generalized amnesia: Memory gone from the event and before, with potential to forget family/friends

   4. Continuous amnesia: Memory gone from the event and continues forward

2. Can include dissociative fugue: Starts and ends abruptly. Forgetting life details and wanders

Treatment for dissociative amnesia

Psychodynamic/trauma therapy to help people feel safe to recall forgotten information, as memories are still there.

Dissociative Identity Disorder (DID)

Typical onset is before age five. Usually caused by trauma as a way to escape it all. Suggestibility also plays a role

1. Identify disruption with 2/+ personality states (m = 15). Meaning, there is a discontinuity in self and agency

2. Recurrent gaps in memory of everyday things, personal info, or traumatic events

Sub-personality interactions

1. Primary personality is the host, and switching is usually caused by stress. Personalities may observe or talk to each other.

2. Mutually amnesic relationships: personalities are not aware of one another

3. Mutually cognizant: some personalities are aware of others

4. One-way amnesic relationships: Some personalities are not aware of others

5. Each personality has different abilities, preferences, allergies, and psychological responses

Treatment for DID

1. Safety and integration: goal is to identify triggers and help the different personalities get to know each other and communicate to work as a team

Other Specified Dissociative Disorders

includes acute dissociative reactions to stress, identity disturbances, mixed dissociative symptoms

Trance Disorder

Altered state of consciousness marked by shaking, speaking, and behaving differently (like a different personality) and detached from one’s identity and time. May feel they are possessed. Treated w/CBT