Somatic and dissociative disorder

Disorders focusing on somatic and dissociative symptoms 

  • Somatic symptoms and dissociative symptoms have a lot in common  

  • Occur in response to severe stress  

  • Traditionally been viewed as forms of escape from stress  

  • Some people suffer from both  

  • Medical people often explain to people the two groups in a similar way  

Disorder focusing on somatic symptoms  

  • Primarly caused by psychosocial factors (psychosocial factors--> symptoms) or the symptoms trigger excessive anxiety and concern (symptoms --> psychosocial dysfunction) 

  • People with somatic symptom 

  • Two patterns of somatic symptoms disorder have receive particular  

  • Somatization pattern  

  • Long-lasting physical symptoms that have little or no organic basis : pain, gastrointestinal, sexual, and neurological symptoms 

  • Describe symptoms in dramatic and exaggerated terms  

  • Many years  

  • More women in the U.S. experience a somatization pattern in any given year than men  

  • Run in families and begin between adolescence and adulthood  

  • Predominant pain pattern  

  • Develop often after an accident or an illness that had caused genuine pain  

  • Pattern may begin at any age, more women than men  

  • What cause somatic symptoms disorder  

  • Also referred as hysterical disorder 

  • Psychodynamic view 

  • Two mechanism  

  • Primary gain : bodily symptoms keep internal/unconscious conflicts out of conscious awareness  

  • Secondary gain : bodily symptoms further enable people to avoid unpleasant activities or receive sympathy/attention form others  

  • Behavioral view  

  • Bring rewards to sufferers  

  • View gains as the primary cause  

  • Conditioning  

  • Cognitive view  

  • Provide a means for people to express difficult emotions  

  • Multicultural view 

  • Western clinician hold a bias that sees somatic symptoms as an inferior way of dealing with emotion  

  • A possible role for biology 

  • Somatoform disorder can be understood through research on placebos and the placebo effect  

  • Placebos: substance with no known medicinal value  

  • Power of suggestion with placebos expectation trigger the release of endogenous chemicals  

  • People with these disorder usually seek psychotherapy only as a last resort  

  • How is somatic symptom disorder treated  

  • Insight --> often psychodynamically oriented  

  • Exposure --> client thinks about traumatic event that triggered the physical symptoms 

  • Drug therapy --> especially antidepressant medication  

 

Disorders focusing on dissociative symptoms  

  • Dissociative disorders are each characterized by significant memory loss or identity disruption 

  • Dissociative disorder  

  • The key to our identity --> who we are and where we fit in our environment is memory  

  • Change in memory lack a clear physical cause they are called dissociative disorders  

  • There are several kinds of dissociative disorder  

  • Dissociative amnesia/fugue 

  • Dissociative identity disorder (multiple personality disorder)  

  • Depersonalization-derealization disorder  

  • Dissociative amnesia may ne  

  • Selective : loss of some memory, but not all of events, limited period  

  • Localized : most common type , loss all memory, limited period  

  • Generalized : loss memory started from an event and goes back in time, may have loss in sense of identity and may fail to recognized family and friend  

  • Continuous : forgetting continues into the future  

  • Dissociative Fugue 

  • Extreme version of dissociative  amnesia  

  • Loss of personal identity and move away from where they are  

  • Can be short (hours or days) and end suddently\ 

  • 0.2% of pop  

  • Follow severely stressful event  

  • Majority regain most of all of their memories and never have a recurrence  

  • Dissociative Identity Disorder (DID) ( multiple personality disorder)  

  • Each personality have their own set of behavior, memories, thoughts and emotions 

  • Most cases are first diagnosed in late adolescence or early adulthood 

  • Generally begin in childhood after episodes of abuse  

  • Typical onset is before age 5