Psychopathology Somatoform and Dissociative Disorders

Transcription

1 Psychopathology Somatoform and Dissociative Disorders What you should know when you finish studying Chapter 6: 1. The common features of somatoform disorders 2. The defining features of Hypochondriasis 3. The defining features of Somatization Disorder (Briquet s Syndrome) 4. The defining features of Conversion Disorder

2 Psychopathology Somatoform and Dissociative Disorders What you should know when you finish studying Chapter 6: (cont.) 5. Defining features of Body Dysmorphic Disorder 6. Common features of Dissociative Disorders 7. Defining features that distinguish different dissociative disorders 8. Factitious disorders and malingering

3 Common features of Somatoform Disorders Soma Meaning Body Overly preoccupied with health or body appearance Physical complaints without a medical condition Types of DSM-IV Somatoform Disorders Hypochondriasis Somatization disorder Conversion disorder Pain disorder Body dysmorphic disorder

4 Defining features of Hypochondriasis

5 Defining features of Hypochondriasis Causes Cognitive perceptual distortions Familial history of illness Treatment Cognitive-Behavioral treatment to help person learn to challenge illness-related misinterpretations Provide substantial and sensitive reassurance

6 Defining features of Somatization Disorder (Briquet s Syndrome)

7 Defining features of Somatization Disorder (Briquet s Syndrome) Hypothesized Causes Familial history of illness Relation with antisocial personality disorder Weak behavioral inhibition system Treatment No treatment exists with demonstrated effectiveness Reduce tendency to visit numerous medical specialists Assign gatekeeper physician Reduce supportive consequences of talk about symptoms

8 Defining features of Conversion Disorder Overview and Defining Features Physical malfunctioning Lack physical or organic pathology Malfunctioning often involves sensory-motor areas Persons show la belle indifference Retain most normal functions, but lack awareness Formerly known as Hysteria

9 Defining features of Conversion Facts and Statistics Disorder Rare condition, with a chronic intermittent course Seen primarily in females Onset usually in adolescence Not uncommon in some cultural and/or religious groups

10 Conversion Disorder

11 Pain disorder Maybe initial clear reasons for pain, but pain continues after physical reasons are (apparently) no longer present. Pain is real, but is thought to be influenced by psychological factors Very little known about the disorder Book illustrates with cases of medical student and woman with cancer

12 Body Dysmorphic Disorder ( Imagined Ugliness ) Overview and Defining Features Previously known as dysmorphophobia Preoccupation with imagined defect in appearance Either fixation or avoidance of mirrors Suicidal ideation and behavior are common Often display ideas of reference for imagined defect

13 Body Dysmorphic Disorder ( Imagined Ugliness ) Facts and Statistics More common than previously thought Seen equally in males and females Onset usually in early 20s Most remain single, and many seek out plastic surgeons Usually runs a lifelong chronic course

14 Causes Body Dysmorphic Disorder ( Imagined Ugliness ) Little is known Some similarities with obsessive-compulsive disorder Treatment Parallels that for obsessive-compulsive disorder Medications (i.e., SSRIs) provide some relief Exposure and response prevention is also helpful Plastic surgery is often unhelpful

15 Common features of Dissociative Overview Disorders Involve severe alterations or detachments Affect identity, memory, and/or consciousness Severe form of normal perceptual experiences Depersonalization Distortion in perception of reality Derealization Losing a sense of the external world

16 Common features of Dissociative Disorders Types of DSM-IV Dissociative Disorders Depersonalization Disorder Dissociative Amnesia Dissociative Fugue Dissociative Trance Disorder Dissociative Identity Disorder

17 Defining features that distinguish different dissociative disorders Overview and Defining Features of Depersonalization Disorder Severe and frightening feelings of unreality and detachment These dominate and interfere with life functioning Problem involves depersonalization and derealization

18 Defining features that distinguish different dissociative disorders Facts and Statistics (Depersonalization disorder) High comorbidity with anxiety and mood disorders Onset is typically around age 16 Usually runs a lifelong chronic course Causes Cognitive deficits in attention Cognitive deficits in short-term memory Cognitive Deficits in spatial reasoning Deficits related with tunnel vision and mind emptiness Such persons are easily distracted Treatment Little is known

19 Defining features that distinguish different dissociative disorders Dissociative Amnesia: Overview and Defining Features Several forms of psychogenic memory loss Generalized type Inability to recall anything, including their identity Localized or selective type Failure to recall specific (usually traumatic) events

20 Defining features that distinguish different dissociative disorders Dissociative Fugue: Overview and Defining Features Related to dissociative amnesia Take off to a new place Unable to remember the past Unable to remember how they arrived at a new location Often assume a new identity

21 Defining features that distinguish different dissociative disorders Facts and Statistics -- Dissociative Amnesia and Fugue Usually begin in adulthood Both show rapid onset and dissipation Both are mostly seen in females Causes Little is known Trauma and life stress can serve as triggers Treatment Most get better without treatment Most remember what they have forgotten

22 Defining features that distinguish different dissociative disorders

23 Defining features that distinguish different dissociative disorders

24 Factitious disorders & Malingering Separating Real Problems from Faking Malingering Deliberately faking symptoms Related Conditions Factitious disorders Factitious disorder by proxy False Memories and Recovered Memory Syndrome

25 Summary of Somatoform and Dissociative Disorders Features of Somatoform Disorders Physical problems without on organic cause Features of Dissociative Disorders Extreme distortions in perception and memory Well Established Treatments Are Generally Lacking Most are relatively rare