10: Somatic & Dissociative Disorders

illness anxiety disorder

formerly known as hypochondriasis

hypochondriac

someone who exaggerates the slightest physical symptom, continually run to the doctor even though there is nothing really wrong with them, preoccupation with their health or appearance becomes so great that it dominates their lives

Somatic Symptom and Dissociative Disorders

used to be categorized under one general heading, “hysterical neurosis”

hysterical

came to refer more generally to physical symptoms without a known organic cause or to dramatic or “histrionic” behavior thought to be characteristic of women

conversion hysteria

Freud suggested that unexplained physical symptoms indicated the conversion of unconscious emotional conflicts into a more acceptable form

soma

means body

Somatic Symptom Disorders

there is an excessive or maladaptive response to physical symptoms or to associated health concerns

Somatic Symptom Disorders

sometimes grouped under the shorthand label of “medically unexplained physical symptoms”

Pierre Briquet

a French physician, described
patients who came to see him with seemingly endless lists of somatic complaints for which he could find no medical basis

Briquet’s syndrome

former term for somatic symptom disorder in 1859

Illness Anxiety Disorder

more worried about the idea of being sick rather than any particular symptom.

disease conviction

Individuals mistakenly believe they have a disease, a difficult- to-shake belief sometimes

disease conviction

core feature of illness anxiety disorder

Psychodynamic psychotherapy

treatment that was used to be common clinical practice to uncover unconscious conflicts but it had little proven effectiveness

Explanatory Therapy

treatment wherein the clinician went over the source and origins of their symptoms in some detail associated with a significant reduction in fears and beliefs about somatic symptoms and a decrease in health-care usage

paroxetine (Paxil)

antidepressant drug (SSRI)

Psychological Factors Affecting Medical Condition

This disorder occurs when a real medical condition (like asthma, diabetes, cancer, or chronic pain) becomes worse due to one or more psychological or behavioral factors

Functional Neurological Symptom Disorder

formerly referred to as conversion disorder

Conversion Disorder or Functional Neurological Symptom Disorder

generally have to do with physical malfunctioning, such as paralysis, blindness, or difficulty speaking (aphonia), without any physical or organic pathology to account for the malfunction

aphonia

complete loss of voice, difficult speaking

Astasia-abasia

defined as the inability to stand and to walk, despite sparing of motor function underlying the required balance and gestures.

malingering

the deliberate faking or exaggeration of illness or disability for personal gain

factitious disorder

fall somewhere between malingering and conversion disorders. under voluntary control but no obvious reason for voluntarily producing the symptoms

Factitious Disorder Imposed on Another

previously known as Munchausen Syndrome By Proxy

Munchausen Syndrome By Proxy

former term for Factitious Disorder Imposed on Another

Dissociative Disorders

Characterized by a disruption of and/or discontinuity in the normal integration of consciousness, memory, identity,emotion, perception, body representation, motor control, and behavior.

depersonalization

experiences of unreality or detachment from one’s mind, self, or body

derealization

experiences of unreality or detachment from one’s surrounding

Cognitive disconnection schemata

reflect defectiveness and emotional inhibition and subsume themes of abuse, neglect, and deprivation.

Overconnection schemata

involve impaired autonomy with themes of dependency, vulnerability, and incompetence

Dissociative Amnesia

The individual may be unable to remember important personal information.

Generalized Amnesia, Localized & Selective Amnesia

Several patterns of dissociative amnesia

Generalized Amnesia

People who are unable to remember anything, including who they are

Localized & Selective Amnesia

A failure to recall specific events, usually traumatic, that occur during specific period.

Localized Amnesia

forgets everything from a certain time.

Selective Amnesia

forgets only some parts of what happened and not the whole event

fugue

means fight

Dissociative fugue

Apparently purposeful travel or bewildered wandering that is associated with amnesia for identity or for other important autobiographical information

amok

An apparently distinct dissociative state not found in Western culture

running amok

only one of a number of
“running” syndromes in which an individual enters a trance-like state and, suddenly, is imbued with a mysterious source of energy, runs or flees for a long time

pivloktoq

called frenzy witchcraft among the Navajo tribe (Arctic natives)

vinvusa

term for dissociative trances in India

phii pob

term for dissociative trances in Thailand

other specified dissociative disorder (dissociative trance)

When the state is undesirable and considered pathological by members of the culture, particularly if the trance involves a perception of being possessed by an evil spirit or another person, the individual would be diagnosed with __

15

average identities in DID

multiple personality disorder

former term for DID

host identity

the patient who has DID who asks for a treatment, main personality

Switch

the transition from one personality to another

alter

personalities within the system

autohypnotic model

people who are suggestible may be able to use dissociation as a defense against extreme trauma