Intro to Abnormal

PSY 235Introduction to Abnormal PsychologyChapter 6: Somatoform, Dissociative, and Factitious Disorders

Throughout this presentation you will hear audio of the lecture, you must have speakers on or earphones plugged in, to repeat any audio, simply go back and start the slide again.1Outline/OverviewSomatoform DisordersConversion DisorderSomatization DisorderPain DisorderDissociative DisordersDissociative amnesiaDissociative fugueDissociative identity disorderFactitious DisorderMunchausen Disorder/by Proxy2

Dissociative Amnesiasudden loss of memory for personally important informationtoo extensive to explain by forgetfulnessusually follows a stressful eventmust differentiate from amnesia due to an organic causeinsults to the brain can cause amnesiadissociative usually troubled by significant stress prior to onsetno identifiable neurological cause3

Dissociative Amnesia (cont.)4 signs never exhibited by organic amnesicsloss of recent and remote memoryloss of personal information, general fund of knowledge intactlack of anterograde amnesiaabrupt reversal of symptomsdifferentiate from malingering27-65% of murderers report no memoryhypnotized dissociating patients typically gain access to forgotten materialmalingering patients usually resisttypically less concerned about memory loss4

Dissociative Fuguesuddenly leaves home or worktravels to a new locationdoes not remember pre-fugue lifemost resolve within a matter of daysmost occur after a traumaprevalence is estimated at about .2%twice as many men than women5

Dissociative Identity Disordermultiple personality disorderpreceded by childhood traumatwo or more distinct identitieseach sufficiently integrated to have stable pattern of perceiving and relating6

Development of DIDtraumatic emotional problemoverwhelmingalter created to compartmentalize the problemgenerally very suggestiblecreating alters reinforced by reduction in anxiety7

Dissociative Identity Disorder (cont.)alters may not be aware of each others presencepassive identities have the most constricted memoriesmore hostile or controlling alters likely to have complete memoriesalters often differ widelytransitions may be gradual or nearly instantaneousnumber of alters reported - 2 to over 100avg. about 15 alters8

Dissociative Identity Disorder (cont.)virtually all DID patients are grade 5s in terms of hypnotizabilityretrieval of the memories may not be beneficialoutcomes of treatment for 30 randomly selected patients9

DID Treatment outcomes10

Prevalence: one small scale study placed at a little over 1%9 times more frequent in womenindividuals instructed to role play multiples show EEG difference

Treatmentneed to figure out roles various alters play in copingcognitive behavioral therapiesbehavioral interventionstreatment is aimed at addressing the depression and anxiety that make the splitting necessarypsychodynamic approach - under hypnosis alters are called up and asked to speak freelyone study reported 94% successtreatment can take 2-3 years11

Factitious DisorderAlso called Mnchausen SyndromeSymptoms produced by deliberate inductionDesire to assume the patient role

Faking or simulating a disability as illness??Can be very costly to health care system/society12

Factor% Status before% Status after

suicidal ideation1067

had been hospitalized737

self-mutilated327

employed8310