Somatic Symptom and Dissociative Disorders

Question 1

Gabbay et al

Answer 1

BDD case study = L fronto-temporal atrophy. Region links to OCD and compulsive behaviour

Question 2

Freud

Answer 2

Anna O = conversion disorder = symptoms suggestive of neurological/medical condition. Stopped after father died (stress)

Question 3

Vuilleumier et al

Answer 3

Conversion disorder SPECT = decreased activation during contralateral sensorimotor symptoms relative to recovery in basal ganglia and thalamus

Question 4

Vuilleumier et al (review)

Answer 4

Conversion disorder = vmPFC, precuneus and limbic structures hyperactive BUT impaired primary motor and sensory pathways at level of basal ganglia = IMBALANCE

Question 5

Stonnington et al

Answer 5

TLE or CD? EEG -ve, MRI lesions in temporal lobe. Lack express emotions, sexual childhood abuse, suicidal as teenager. Concluded CD

Question 6

Sierra and David

Answer 6

Depersonalisation = fronto-limbic suppressive mechanism. Increased prefrontal, decreased insula and limbic related areas to arousing emotional stimuli BUT doesn’t explain disembodiement = vestibular system also involved?

Question 7

Sierra and Berrios

Answer 7

Neurobiological model of depersonalisation

Question 8

Simeon et al

Answer 8

Against Sierra and Berrios. Metabolic abnormalities mainly in POSTERIOR not frontal cortex = link to autoscopy (vestibular system)

Question 9

Krause-Utz et al

Answer 9

Review. DID = disruption of functions of consciousness, perception, memory, identity and affect

Question 10

DID neuroimaging

Answer 10

Orbitofrontal perfusion defects. Increased perfusion in bilateral thalamus while in “normal” identity state