1. Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8 Somatoform and Dissociative Disorders Movie 2/27: “Amelie” (extra credit)

2. Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8 Dissociation Normal vs. abnormal dissociation (different parts of an individual’s identity, memories, or consciousness become split off from one another) When dissociation becomes chronic and a defining feature, the person may be diagnosed with a dissociative disorder.

3. Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8 Dissociative Experiences in the General Population

4. Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8 Symptoms Presence of two or more separate identities in the same individual. These personalities may have different ways of speaking and relating to others and can have different ages and genders. Etiology Alters may be created by people under conditions of extreme stress, often child abuse. Self-hypnosis may be involved. OR Created inadvertently by therapists Treatment Long-term psychotherapy to discover functions of the personalities and to assist in “integration.” Dissociative Identity Disorder Sybil

5. Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8 Symptoms Person suddenly moves away from home and assumes an entirely new identity, with no memory of previous identity Etiology Fugue states usually occur in response to some stressor, but because they are extremely rare, little is known about etiology Treatment Psychotherapy to help the person identify the stressors leading to the fugue state and learn better coping skills Dissociative Fugue

6. Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8 Symptoms Loss of memory due to psychological rather than physiological causes. The memory loss is usually confined to personal information only Etiology Typically occurs following traumatic events. May involve motivated forgetting of events, poor storage of information during events due to overarousal, or avoidance of emotions experience during an event Treatment Help the individual remember traumatic events and accept them Dissociative Amnesia

7. Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8 People with this disorder have frequent episodes in which they feel detached from their own mental processes or bodies, as if they are outside observers of themselves. Occasional experiences of depersonalization are common, especially when people are sleep deprived. Depersonalization Disorder is only diagnosed when they are so frequent and distressing that they interfere with an individual’s ability to function Depersonalization Disorder

8. Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8 Dissociative Disorders (Summary) Dissociative Identity Disorder Separate, multiple personalities in the same individual. Dissociative Fugue The person moves away and assumes a new identity, with amnesia for the previous identity. Dissociative Amnesia The person loses memory of important personal facts, including personal identity, for no apparent organic cause Depersonalization Disorder Frequent episodes where individual feels detached from his or her mental state or body

10. Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8 Differentiating Somatoform Disorders from Related Problems Somatoform Disorders Subjective experience of many physical symptoms -- no organic causes Psychosomatic Disorders Physical illness present -- psychological factors contribute to the illness Malingering Deliberate faking of physical symptoms for gain (e.g., avoid military duty, get insurance money) Factitious Disorder Deliberate faking of physical illness to gain medical attention (e.g., Munchausen Syndrome – Comer Video Sampler)

11. Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8 Symptoms Somatization disorder involves a long history of multiple physical complaints for which people have sought treatment but for which there is no apparent organic cause. Pain disorder involves only the experience of chronic, unexplainable pain Etiology These disorders run in families, but it is not clear whether this is due to genetics or modeling. Different theories claim different origins for this disorder Treatment Psychodynamic treatment involves helping people identify feelings and thoughts behind the symptoms and find more adaptive ways of coping Somatization & Pain Disorders

12. Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8 Symptoms Chronic worry that one has a serious medical disease despite evidence that one does not; frequent consultations with physicians over this worry Etiology A family history of depression or anxiety is common. These people may suffer from chronic distress and cope with this distress by exaggerating physical symptoms Treatment Same as somatization disorder, involving helping people identify feelings and thoughts behind the symptoms and find more adaptive ways of coping Hypochondriasis “Hannah and her Sisters”

13. Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8 Symptoms Loss of functioning in some part of the body due to psychological rather than physiological causes Etiology May occur after trauma or stress, perhaps because the individual cannot face memories or emotions associated with the trauma. Also, Social/cultural influences (e..g, “falling with the spirit) Treatment Psychoanalytic therapy focuses on helping the individual express emotions or memories. Conversion Disorder

14. Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8 Somatoform Disorders (Summary) Conversion disorder Loss of functioning in some part of the body for psychological rather than physical reasons Somatization disorder History of complaints about physical symptoms, affecting many different areas of the body, for which medical attention has been sought but no physical cause found Pain Disorder History of complaints about pain, for which medical attention has been sought but that appears to have no physical cause Hypochondriasis Chronic worry that one has a physical disease in the absence of evidence that one does; frequently seek medical attention Body dysmorphic disorder Excessive preoccupation with some part of the body the person believes is defective