1. Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8 Somatoform and Dissociative Disorders

2. Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8 Somatoform Disorders Somatoform and Pain Disorders Subjective experience of many physical symptoms, with no organic causes Psychosomatic Disorders Actual physical illness present and psychological factors seem to be contributing to the illness Malingering Deliberate faking of physical symptoms to avoid an unpleasant situation, such as military duty Factitious Disorder Deliberate faking of physical illness to gain medical attention

3. Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8 Somatoform Disorders 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

4. 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—there may be indifference to the loss of functioning (la belle indifference) Etiology Often can occur after trauma or stress, perhaps because the individual cannot face memories or emotions associated with the trauma Treatment Psychoanalytic therapy focuses on helping the individual expression of emotions or memories. Behavioral therapy uses systematic desensitization and other techniques Conversion Disorder

5. 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 Psychoanalytic treatment involves helping people identify feelings and thoughts behind the symptoms and find more adaptive ways of coping Somatization & Pain Disorders

6. 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

7. Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8 Dissociative Disorders Process in which different parts of an individual’s identity, memories, or consciousness become split off from one another Most people experience some form of dissociation— daydreaming is one example of dissociation. When dissociation becomes chronic and a defining features of people’s lives, people may be diagnosed with a dissociative disorder.

8. Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8 Dissociative Disorders Dissociative Identity Disorder There are 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

9. Copyright © 2007 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 8 Symptoms Presence of two or more separate personalities or identities in the same individual. These personalities may have different ways of speaking and relating to others and may even have different ages, genders, and physiological responses Etiology Alters may be created by people under conditions of extreme stress, often child abuse. Self-hypnosis may be involved. Some evidence it runs in families Treatment Long-term psychotherapy and use of hypnosis to discover functions of the personalities and to assist in “integration.” Antidepressants and antianxiety drugs may be used Dissociative Identity Disorder

10. 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

11. 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

12. 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