Lecture 5b - Dissociative disorders and Somatic Symptom Related disorders Flashcards
(38 cards)
Types of Dissociative and Somatic symptom disorders
- Dissociative disorders
2. Somatic symptom and related disorders
Description of Depersonalization / derealization disorder
Alteration in the experience of the self and reality
Description of Dissociative amnesia
Lack of conscious access to memory, typically of a stressful experience. the fugue subtype involves travelling or wandering coupled with loss of memory for one’s identity or past.
Description of Dissociative identity disorder
At least two distinct personalities that act independently of each other
What is Dissociation?
Some aspect of cognition or experience becomes inaccessible to consciousness
Avoidance response
Some types of dissociation are harmless and common
Sudden disruption in the continuity of: consciousness, emotions, motivation, memory and identity.
How does memory work under stress?
Psychodynamic
Traumatic events are repressed
Cognitive
Extreme stress usually enhances rather than impairs memory
Interference memory formation
No accessible to awareness later
Memory deficits and Dissociation
Memory deficits in explicit but not implicit memory
What is Explicit memory?
Involves conscious recall of experiences
What is Implicit memory?
Underlines behaviors based on experiences that cannot be consciously recalled
What is Dementia?
+Memory fails slowly over time
+ It is not linked to stress
+ Accompanied by other cognitive deficits
+Inability to learn new information
What is Depersonalization / Derealization disorder?
\+Perception of self is altered \+ Triggered by stress or traumatic event \+No disturbance in memory \+No psychosis or loss of memory \+Often comorbid with anxiety, depression \+Typical onset in adolescence \+Chronic course \+Symptoms are not explained by substances, another dissociative disorder, another psychological disorder, or a medical condition.
What is the criteria for Depersonalization / Derealization disorder?
+Experiences of depersonalization or detachment from one’s mental processes as if one is in a dream.
+Experiences of derealization
What is the characteristics of Depersonalization?
\+Unusual sensory experiences \+Limbs feel deformed or enlarged \+Voice sounds different or distant \+Feelings of detachment or disconnection \+Watching self from outside \+Floating above one's body
What are the characteristics of Derealization?
+ World has become unreal
+World appears strange, peculiar, foreign, dream-like
+Objects appear at times strangely diminished in size, at times flat
+Incapable of experiencing emotions
+Feeling as if they were dead, lifeless, mere automatons
+Experiences of unreality of surroundings
+Symptoms are persistent or recurrent
+Reality testing remains intact
+Symptoms are not explained by substance, another dissociative disorder
What is dissociative amnesia?
+ Amnesia and flight and new identify
+ Sudden, unexpected travel with inability to recall one’s past
+Assume new identity
+May involve new name, job, personality characteristics
+ More often of brief education
+Remits spontaneously
Criteria for dissociative Amnesia
+Inability to remember important personal information, usually of a traumatic or stressful nature, that is too extensive to be ordinary forgetfulness.
+The amnesia is not explained by substances, or by other medical or psychological conditions.
+Specify dissociative fugue subtype if:
the amnesia includes inability to recall one’s past, confusion about identity, or assumption of a new identify and
sudden, unexpected travel away from home or work
What is a Dissociative Identity disorder (DID)?
+ Two or more distinct and fully develop personalities (alters)
Each has unique modes of being, thinking, feeling, acting, memories and relationships
Primary alter may be unaware of existence of other alters
+ Most severe of dissociative disorders - Recovery may be less complete
+Typical onset in childhood - rarely diagnosed until adulthood
+More common in women than men
+Often comorbid with:
PTSD, major depressionn, somatic symptoms
+Has no relation to schizophrenia
No thought disorders or behavioral disorganization
Criteria for Dissociative identity Disorder (DID)?
+Disruption of identity characterized by two or more distinct personality states (alters) or an experience of possession as evidenced by discontinuities in sense of self as reflected in altered cognition, behavior, affect, perceptions, consciousness, memories, or sensory-motor functioning.
+Recurrent gaps in recalling events or important personal information that are beyond ordinary forgetting
+Symptoms are not part of a broadly accepted cultural or religious practice
+Symptoms are not due to drugs or a medical condition in children ,symptoms are not better explained by an imaginary playmate or by fantasy play
2 theories of Dissociative Identity disorder
- Posttraumatic Model
2. Sociocognitive Model
Posttraumatic model of dissociative identity disorder
DID results from severe psychological and /or sexual abuse in childhood
Sociocognitive model of Dissociative Identity disorder (DID)
A form of role-play in suggestible individuals
+It could be iatrogenic - occurs in response to prompting by therapists or media
+No conscious deception
Treatment of dissociative identity disorder (DID)
+ Empathic and supportive therapist
+Integration of alters into one fully functioning individual
+Improving of coping skills
+Psychodynamic approach - overcome repression
+Use of hypnosis - age regression - can actually worsen symptoms
What are the main somatic disorders?
- Somatic symptom disorder
- Illness anxiety disorder
- Conversion disorder
- Malingering
- Factitious disorder
What is Somatic Symptom disorder/
Excessive thought, distress, and behaviour related to somatic symptoms
