Somatic Symptoms and Dissociative Disorders

dissociative disorders

characterized by changes or disturbances in the functions of self-identity, memory, or consciousness that make the personality whole

Dissociative identity disorder (multiple personality disorder) (key features)

- 2 or more personalities

- gap in recall (memories/events), especially trauma

- life distress/ impairment (splitting is used as psychological defense)

Dissociative Identity Disorder (treatment)

focuses on integrating alters into a cohesive personality structure:

therapists help patients uncover memories of trauma and establish connections between dominant personality and alters

(if successful, the person will no longer need to retreat into alters to deal with anxiety associated with trauma/ reintegration of personality becomes possible [still in experimental phase])

differences between schizophrenia and DID

-schizophrenia is a split in cognition, affect and behavior from reality is what's truly happening

-DID is the splitting into multiple personalities, but still integrated functioning of cognition, affective and behavioral levels

dissociative amnesia

inability to recall important personal material that cannot be accounted for by medical/natural causes

- information lost to memory is usually of traumatic or stressful experiences

- subtypes: localized amnesia, selective amnesia, generalized amnesia

localized amnesia

events occurring during a specific period are lost

selective amnesia

people forget only the disturbing particulars that take place during a certain period of time

systematized amnesia

memory loss is specific to a particular category of information, such as memory about family

generalized amnesia

people forget their whole lives (rare)

somatic symptoms and related disorders

physical complaints that defy medical explanation and so are believed to involve underlying psychological conflicts or issues

- mask unconscious sources of anxiety

- symptoms interfere with life/ may hold the belief they are ill

- the symptoms prevent anxiety from intruding into the consciousness

Depersonalization (disorder)

temporary loss or change in the usual sense of our own reality

- person feels detached from themselves and their surroundings

(disorder is only diagnosed when the experiences become persistent and cause significant distress in daily functioning)

Derealization (disorder)

a sense of unreality about the external world involving odd changes in the perception of one's surroundings or in the passage of time

- people and objects may seem to change in size/shape

- sounds seem different

- associated with features of anxiety (ex. dizziness)

- associated with depression

(disorder is only diagnosed when the experiences become persistent and cause significant distress in daily functioning)

malingering

falsely claiming symptoms for false gains/ motivated by external factors (ex. to escape responsibility for a crime)

(not technically a real disorder)

factitious disorder

fake or manufactured physical & psychological symptoms (enjoy the psychological benefits of of being in a sick role)

- someone could be making themselves or someone else sick

Somatic Symptom Disorder

having troubling physical symptoms and are excessively concerned about them to the extent that it affects their thoughts, feeling, and behaviors

- symptoms can last for months

- associated with personal stress or interference in daily functioning

3 disorders that fall under the somatic category:

- hypochondriasis (Illness anxiety disorder)

- somatization disorder

- pain disorder

somatic system disorder (clinical features)

- physical symptoms

- history of physician visits

-interpretation of body sensations and physical health

-treatment challenges

Illness Anxiety Disorder (hypochondriasis)

people with physical complaints who believed their symptoms were due to serious, undetected illness despite medical reassurance to the contrary

- do not consciously fake their symptoms

-anxiety about physical symptoms can produce its own physical sensations

- can go along with depression or anxiety

conversion disorder

characterized by symptoms of deficits that affect the ability to control voluntary movements or that impair sensory function (ex.inability to see, hear, feel tactile stimulation, etc.)

- believed to involve the conversion of emotional distress into significant symptoms in the motor or sensory domains

- symptoms usually come on suddenly/ can first appear after conflicts or stressors

- linked to childhood trauma or abuse