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Lecture 6

Week 6- Dissociative & Somatoform Disorders .docx

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Psychology 2310A/B
Rod Martin

Dissociative Disorders The Dissociation Continuum - Dissociation – a disruption in the usually integrated functions of consciousness, memory, identity, or perception, parts of the self are broken off from conscious awareness. - Mild dissociation is very common- Very common phenomenon. Most people experience. - E.g., déjà vu, absorption- reading a book, so engrossed and caught up in it and you are completely unaware about what others are saying to you, daydreaming, kind of know hypnosis, people can vary in being hypnotized. - Genetic basis to it – so some biological basis in the brain – ex in twins. People with this disorder they learn to use dissociation for a coping strategy. But if that‟s the only way of coping. Then it becomes a psychological problem - Continuum of “dissociative ability” - Related to hypnotic susceptibility, absorption - Dissociative Experiences Scale (DES) - Can become a defense mechanism – way of coping with stress, trauma Historical rise and fall of interest in dissociation Late 1800s – high; early 20 C – low; 1980s, 90s – high Today – low again (over-diagnosis, exaggerated claims, false memory syndrome). Dissociative Disorders in DSM-IV - Ddissociative Amnesia - Dissociative Fugue - Dissociative Identity Disorder (DID) (previously Multiple Personality Disorder) - Depersonalization Disorder Dissociative Amnesia - Person is unable to recall important personal information - But behave normally - Amnesia is usually for autobiographical memory – not general knowledge. Ex if you ask who is PM, they will know but if you ask your name, they wont. - Usually after a very stressful experience- traumatic situation, soldiers, - Information is not permanently lost - Often remits spontaneously after a few days - But can occasionally become chronic or recurrent - Ct. organic amnesia- if person has had brain damage, you can lose your memory- cant form new memories. o Lost memory for general info - They cant remember before a particular point, but they can make new memories (dissociative amnesia) Types of Amnesia - Localized – loss of memory for circumscribed period of time- common - Selective – some but not all events during specific time period- common - Generalized – loss of memory for entire life - Continuous – loss of memories subsequent to a specific time up to the present - Systematized – specific categories of information (eg, particular person). Dissociative Fugue (flight, fleeing away) - Sudden, unexpected travel away from home with inability to recall one‟s past - Confusion about personal identity or assumption of a new identity – otherwise seems normal - Cant remember passed life- but later on they can start to remember tings – can varies - Can last for hours to months to years - Usually associated with life stress- can be abusive, or mild- marital difficulties - Typically spontaneous, rapid recovery - Relatively rare (0.2 %) - Often comorbid with mood disorders, substance abuse - Case of Jeff Ingram – video- 2008 a guy suddenly showed up in Denver, in a fugue state originally Alberta o Doesn‟t know his identity, he was asking for clothes, more than 5 weeks his identity was lost o Earliest recollection was a m month ago- woke up in Denver with no wallet no nothing o Only sketches were the clues- maybe his hat o He was hypnotized before this event o Unexpected stressor- unexpected travel o Last seen- driving on the highway to visit parents o Has an issue where he disappeared for 9 months in the passed. – Similar experience in a fugue o Follow-up:  he never fully recovered his memories; he was reunited with her but never regain memories, but fell in love with her again. Didn‟t recognize his parents. He was in therapy for couple of years. o He said that on the way to Edmonton, he was going to visit his friend who was dying of cancer- thus that can be a possibility of the stressor that caused it. Depersonalization Disorder - Doesn‟t involve loss of memory - Frequently feeling detached from one‟s mental processes or body - Feeling like “in a dream” not „out of body experience‟- more feeling that they‟re not in control of their own life. Not a psychotic disorder - Reality testing remains intact - Significant distress or impairment - Numbness, “Derealization”- not really in touch with life. - Depersonalization- is a common symptom that people experience in their life. Ex anxiety disorders and experience depression in their lives. It‟s a common symptom for something else. (3 most common – after anxiety and depression) - A common experience at mild levels (50%) - Adolescence; life-threatening trauma; life stress, teen years - Also common symptom of other disorders – eg, PTSD, depression, panic disorder Somatoform Disorders - Separate category – have to do with bodily – Somatoform Disorders - Soma = body - Physical symptoms not explained by a medical condition - Different from: o Psychophysiological conditions (“psychosomatic” illnesses) o Malingering o Factitious Disorders- re conditions in which a person acts as if they have an illness by deliberately producing, feigning, or exaggerating symptoms . - Thorough medical examination essential for diagnosis - Medically unexplained syndromes are very common – although rarely diagnosed as somatoform disorders unless evidence of contributing psychological factors Somatoform Disorders in DSM-IV - Conversion disorder - Ssomatization disorder - Pain disorder - Body dysmorphic disorder - Hypochondriasis - Don‟t go to psychologist Conversion Disorder - Freud – “conversion hysteria”- due to people converting their unconscious psychology conflicts into a physical symptom - One or more symptoms affecting voluntary motor or sensory function - Symptoms mimic a neurological condition o E.g., blindness, paralysis, seizures, visceral, pseudo-pregnancy – menstruation stops, morning sickness - Conversion and dissoci
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