Somatoform & Dissociative Disorders

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Somatoform & Dissociative Disorders

Text of Somatoform & Dissociative Disorders

  • Common Features Lots of Physical Complaints Appear to be Medical Conditions No Identifiable Medical Cause Pathological Concern AboutPhysical AppearanceFunctioning of Their Bodies

  • Five Somatoform Disorders Hypochondriasis Somatization Disorder Conversion Disorder Pain Disorder Body Dysmorphic Disorder

  • Clinical Description Ancient Roots Physical Complaints No Known Medical Cause Severe Anxiety / Fear About Possibly Having a Serious Disease Reassurance Doesnt Help

  • Clinical Description Essential Problem is Anxiety Preoccupied With Bodily Symptoms Misinterpretation of Symptoms Strong Disease Conviction Many Medical Visits and Tests

  • Why not Classify Such Persons With an Illness Phobia?

  • Facts and Statistics 1% to 14% Medical Patients Equal Rates (Males vs. Females) May Occur Any Time Strong Disease Conviction Many Medical Visits and Tests

  • Causes Disorder of Cognition / Perception More Disease in Family More Illness Concern in Family More Attention for Sick Behavior

  • Psychological Treatment Modify Illness Perceptions Evoke Bodily Sensations Provide Appropriate Reassurance More Research is Needed!

  • Five Somatoform Disorders Hypochondriasis Somatization Disorder Conversion Disorder Pain Disorder Body Dysmorphic Disorder

  • Clinical Description Briquets Syndrome Many Physical Complaints No Known Medical Cause Little Concern About Symptoms La Belle Indifference Life Revolves Around Symptoms

  • Facts and Statistics Extremely Rare About 4.4% of Population Onset in Adolescence Females > Males Often a Chronic Condition

  • Causes Family Link Link to Antisocial Personality Weak Behavioral Inhibition Strong Behavioral Activation Short Term Gain

  • Treatment Difficult to Treat No Proven Treatments Extensive Medical Visits Treatment Focuses on Reduction of Medical Visits Reducing Secondary Gain

  • Five Somatoform Disorders Hypochondriasis Somatization Disorder Conversion Disorder Pain Disorder Body Dysmorphic Disorder

  • Clinical Description Physical MalfunctioningParalysis, Blindness, AphoniaMutism, Lost Sense of Touch No Organic Pathology Looks Like Neurological Disease Popularized by Freud

  • Related Conditions Malingering or Something Else? La Belle Indifference Precipitated by Marked Stress Can Function Normally Factitious Disorders Munchausens Syndrome by Proxy

  • Facts and Statistics Relatively Rare Females > Males Onset Around Adolescence

  • Causes Experience of Trauma Getting Sick is Acceptable Symptoms to Escape From the Effects of Trauma What Influences Choice of Symptoms?

  • Treatment Address the Traumatic Event Remove Sources of Secondary Gain No Well Established Treatments

  • Five Somatoform Disorders Hypochondriasis Somatization Disorder Conversion Disorder Pain Disorder Body Dysmorphic Disorder

  • Clinical Description Pain is Real Pain May Have Organic Cause Psychological Factors Maintain Pain Can be Debilitating

  • Five Somatoform Disorders Hypochondriasis Somatization Disorder Conversion Disorder Pain Disorder Body Dysmorphic Disorder

  • Clinical Description Preoccupation With AppearanceImagined Defect Imagined Ugliness Mirrors (Fixation or Avoidance) Ideas of Reference Suicidal Ideation and Tendencies

  • Common Locations of Defects Hair Nose Skin Eyes Head / Face Lips

  • Facts and Statistics College Students70% Report Some Disatisfaction 28% Meet Diagnostic Criteria Many Consult Plastic Surgeons Males = Females Onset Late Adolescence

  • The Plastic Surgery Solution? Quite Popular but Expensive Most are Disappointed With Results

    BEFOREAFTER

  • Causes and Treatment Little is Known Co-Occurs With OCDIntrusive Thoughts and Checking Compulsions About Appearance Exposure + Response Prevention

  • Depersonalization Altered Perception of Self Derealization Altered Perception of World Dissociative Phenomena Common Experience

  • Some people have the experience of driving a car and suddenly realizing that they dont remember what happened during all or part of the trip.0% 100%

  • 0% 100%Some people find that sometimes they are listening to someone talk and they suddenly realize that they did not hear part or all of what was just said.

  • 0% 100%Some people find that they have no memory for some important events in their lives (e.g. a wedding or graduation).

  • 0% 100%Some people have the experience of finding themselves dressed in clothes that they dont remember putting on.

  • 0% 100%Some people sometimes have the experience of feeling that other people, objects, and the world around them are not real.

  • NormalDissociationAmnesiaFuguePartialDIDComplexDIDPoly-FragmentedDID

  • Depersonalization Disorder Dissociative Amnesia Dissociative Fugue Dissociative Trance Disorder Dissociative Identity Disorder

  • Primary Features Depersonalization Derealization Impairs Functioning Causes Significant Distress Runs a Chronic Course Clinical Description

  • Depersonalization Disorder Dissociative Amnesia Dissociative Fugue Dissociative Trace Disorder Dissociative Identity Disorder

  • Clinical Description Localized or Selective Failure to Recall Specific Events Several Patterns Generalized Unable to Remember Anything

  • Depersonalization Disorder Dissociative Amnesia Dissociative Fugue Dissociative Trace Disorder Dissociative Identity Disorder

  • Clinical Description Go to Another Location Unaware How They Arrived Memory Loss Specific Incident May Assume New Identity Fugue Usually Ends Abruptly

  • Depersonalization Disorder Dissociative Amnesia Dissociative Fugue Dissociative Trace Disorder Dissociative Identity Disorder

  • Clinical Description Differ Across Cultures Sudden Changes in Personality Possession by Spirits Females > Males Often Related to Trauma

  • Depersonalization Disorder Dissociative Amnesia Dissociative Fugue Dissociative Trace Disorder Dissociative Identity Disorder

  • Clinical Description Formally Multiple Personality Disorder Persons Identity is Dissociated May Adopt 100 Identities Alters The Nature of Alters

  • Central Features Host Identity One Who Asks for Treatment Attempt to Hold Alters Together A Switch Abrupt Change in Personalities Usually Instantaneous

  • Facts and Statistics Average Number of Alters? 15 Females > Males (9:1) Onset in Childhood Linked to Extreme Abuse Runs a Chronic Course

  • Causes Unspeakable Childhood Abuse 97% of Cases Escape Into Fantasy World Become Someone Else Do What It Takes to Survive DID as a Means of Coping?

  • Other Related Features Suggestibility Hypnotizability Similar to Dissociation Are These Related to DID?

  • Abuse: Controversial Issues False vs. Real Memories Do Therapists Plant Memories? Can False Memories be Created? Elizabeth Loftus Other Related Research Consequences of the Debate?

  • Treatment Dissociative Amnesia & Fugue Usually Improve on Their Own Stress Reduction and Coping Dissociative Identity Disoder No Controlled Research Treatments are Similar to PTSD

    Several Images Contained in this Lecture Presentation Were Produced and Made Available From W. L. Carr at http://www.birdhouse.org/images/wcarr/wcgraph.htmSeveral Images Contained in this Lecture Presentation Were Produced and Made Available From W. L. Carr at http://www.birdhouse.org/images/wcarr/wcgraph.htmSeveral Images Contained in this Lecture Presentation Were Produced and Made Available From W. L. Carr at http://www.birdhouse.org/images/wcarr/wcgraph.htmSeveral Images Contained in this Lecture Presentation Were Produced and Made Available From W. L. Carr at http://www.birdhouse.org/images/wcarr/wcgraph.htmSeveral Images Contained in this Lecture Presentation Were Produced and Made Available From W. L. Carr at http://www.birdhouse.org/images/wcarr/wcgraph.htmSeveral Images Contained in this Lecture Presentation Were Produced and Made Available From W. L. Carr at http://www.birdhouse.org/images/wcarr/wcgraph.htmSeveral Images Contained in this Lecture Presentation Were Produced and Made Available From W. L. Carr at http://www.birdhouse.org/images/wcarr/wcgraph.htmSeveral Images Contained in this Lecture Presentation Were Produced and Made Available From W. L. Carr at http://www.birdhouse.org/images/wcarr/wcgraph.htmSeveral Images Contained in this Lecture Presentation Were Produced and Made Available From W. L. Carr at http://www.birdhouse.org/images/wcarr/wcgraph.htmSeveral Images Contained in this Lecture Presentation Were Produced and Made Available From W. L. Carr at http://www.birdhouse.org/images/wcarr/wcgraph.htmSeveral Images Contained in this Lecture Presentation Were Produced and Made Available From W. L. Carr at http://www.birdhouse.org/images/wcarr/wcgraph.htmSeveral Images Contained in this Lecture Presentation Were Produced and Made Available From W. L. Carr at http://www.birdhouse.org/images/wcarr/wcgraph.htmSeveral Images Contained in this Lecture Presentation Were Produced and Made Available From W. L. Carr at http://www.birdhouse.org/images/wcarr/wcgraph.htmSeveral Images Contained in this Lecture Presentation Were Produced and Made Available From W. L. Carr at http://www.birdhouse.org/images/wcarr/wcgraph.htmSev

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