PY Notecards 6
Card Set Information
PY Notecards 6
Relation between Dissociative, Somatoform and Anxiety disorders
Used to be classified together in DSM as neuroses.
Dissociative and Somatoform Disorders Similarities
Onset is both related to a stressful experience.
Least understood and most controversial of disorders.
People rarely given these diagnoses.
Dissociative Disorder is sudden disruption in continuity of:
Some aspect of cognition or experience becomes inaccessible to consciousness.
Repression and avoidance.
Memory loss, typically of a stressful experience.
Not due to physical injury and may last hours or years.
Usually returns spontaneously and in spurts.
The number of people who currently have a condition.
The annual number of people who are diagnosed with a condition.
Problems with prevalence vs. incidence:
An incurable disease can have low incidence, but high prevalence.
A short-lived curable condition like a cold can have a high incidence, but low prevalence.
Memory recall deficits of trauma:
People focus on weapon and not the face of the person giving them trauma.
High levels of stress hormones might interfere with memory formation.
Emotional content might have vividness, but not accuracy.
Deficits are in explicit memory.
Involves conscious recall of experiences.
Underlies behaviors based on experiences that cannot be consciously recalled. (riding a bike)
Two other causes of memory loss from dissociation:
Degenerative brain disorders
Degenerative Brain Disorders
Not linked to stress
Involves gradual decline over time
Accompanied by other cognitive deficits - can't learn new info
Memory loss accompanied by leaving home and making new identity.
Sudden, unexpected travel with inability to recall one�s past and create a new identity.
Memory comes back spontaneously and in spurts.
0.2% prevalence rate.
Alteration in experience of self.
Feelings of detachment or disconnection from self.
Unusual sensory experiences - limbs enlarged or voice distant.
No psychosis or loss of memory.
Based on one symptom - criticized for this.
Dissociative Identity Disorder
At least two distinct personalities that act independently of each other.
: headaches, hallucinations, self harm, suicide attempts.
Most severe dissociative disorder and more common in women.
Two Major Theories of Causes of DID
Posttraumatic Model - results from severe psychological and/or sexual abuse in childhood.
Sociocognitive Model - a form of role-play in suggestible individuals. Response to therapists or media.
Evidence raised in theory debate
DID can be role-played.
DID patients show only partial implicit memory deficits.
DID diagnosis differs by clinician.
For many, symptoms emerge after therapy begins.
Empathic and supportive therapist.
Integration of alters into one individual.
Improvement of coping skills.
Psychoanalytic - reexperience traumatic event
Psychological problems take a physiological form.
Bodily symptoms have no cause and are involuntary.
Individuals seek medical treatment.
Severe, prolonged pain.
Can't be accounted for by organic pathology.
Caused by conflict and stress.
Individual unaware of psychological origins.
Body Dysmorphic Disorder
Preoccupation with and extreme distress over imagined or exaggerated defect in appearance.
Constant examination of self in mirror or avoids mirrors.
Housebound or plastic surgery or suicidal thoughts.
Women. Late adolescence. High comorbidity.
Fears of having a serious disease.
Critical of medical professionals.
Somatization Disorder or Briquet's Syndrome
Multiple, recurrent pain complaints with no apparent physical cause.
Seeks treatment from multiple physicians.
Exaggerated presentation of symptoms and complaints.
Higher in South Am. and Puerto Rico.
Sensory or motor function impaired but no neurological cause.
Vision impairment, paralysis of arms/legs, seizures or coordination problems. Anesthesia, aphonia, anosmia.
Can't be explained by medical condition.
Loss of sensation.
Loss of smell.
Hippocrates & Conversion Disorder
Believed it only occured in women and attributed to wandering uterus. Hysteria.
Freud & Conversion Disorder
Coined term conversion.
Thought that anxiety and conflict converted into physical symptoms.
Conversion Disorder Onset
Adolescence to early adulthood.
Prevalence less than 1%.
Comorbid with depressive disorder, substance abuse, personality disorders.
Conversion Disorder Cause
Distressing event that is unexpressed and pushed to unconscious.
In women, linked to sexual Electra Complex.
Conversion Disorder Cause: Social and Cultural Factors
Decrease in incidence since last half of 19th century. Less repressed sexual attitudes and higher tolerance for anxiety symptoms.
Prevalent in rural areas, people of lower SES, non-western.
Body Dysmorphic Disorder co-occurs with:
Treatment of Somatoform Disorders
Cognitive Behavioral Treatment
Not many studies about this.
Cognitive Behavioral Treatment - Somatoform Disorders (3)
Identify & change triggering emotions.
Change thinking about symptoms.
Replace sick role behaviors with more appropriate social interactions.
Treatment of Pain Disorder
Components of psychotherapy for pain disorder
Four Components of psychotherapy for pain disorder
Validation of patient�s pain
Reinforce shift of focus away from pain
Help patient develop ability to cope with stress and gain sense of control over pain
Treatment of Body Dysmorphic Disorder
Cognitive Behavioral Therapy
Exposure plus response prevention (Prevent individual from checking appearance)
Antidepressants (Fluoxetine & Clomipramine)
Treatment of Hypochondriasis
Cognitive Behavioral Therapy:
Reduce attention to bodily sensations.
Challenge negative perceptions about sensations.
Discourage reassurance seeking from medical professionals.
Treatment of Somatization Disorder
Medical professionals don�t dismiss physical complaints.
Minimize use of diagnostic tests and medication.
Avoid providing attention only when patient is complaining (reinforcing symptoms).
Treat underlying depression and anxiety when present.
Treatment of Conversion Disorder
No controlled studies to date.
Psychoanalytic treatments have not demonstrated usefulness.
Reinforcement of high functioning behavior may help.