Chapter 7 Dissociative & Somatoform Disorders
Dissociative and Somatoform disorders were once viewed as hysteria –
dating back to ancient Greece; used to describe a symptom pattern
characterized by emotional excitability & physical symptoms (convulsions,
paralyses, etc.) in the absence of any evident organic cause.
o Plato caused in women by wandering womb (hysteros) – if womb
was inactive for too long it became angry & wandered causing illness
o Christianity Supernatural explanations – dissociation & related
complaints were now seen as demonic possession = exorcism
Characterized by severe maladaptive disruptions or alterations of identity,
memory & consciousness that are experienced of these disorders is
dissociation – lack of normal integration of thoughts, feelings & experiences
in consciousness & memory.
Problem exists when one is unable to control these drifts in consciousness
(day dreams, etc.) or behaviour & they affect ones ability to function daily.
Research by Waller, Putnam & Carlson indicates it falls into 2 experiences:
1. Mild, non-pathological forms of dissociations; absorption & imaginative
involvement normally distributed on a continuum across the general pop.
2. More severe, pathological types of experiences; amnesia, derealization,
depersonalization & identity alteration that do not normally occur in the
general population & form a discrete category or taxon.
Dissociative Amnesia: Inability to recall significant personal information in
the absence of organic impairment. Typically occurring after a traumatic
event (car accident, war, etc.) Usually have no memory of the precipitating
traumatic event, may even not be able to recall their own name, job, events,
etc. There are 5 patterns of memory loss characterized by DSM-IV-TR:
1. Localized Amnesia: the person fails to recall info from very specific time period
2. Selective Amnesia: only parts of the trauma are forgotten, others remembered
3. Generalized Amnesia: forgets all personal information from his/her past
4. Continuous Amnesia: forgets information from a specific date until the present
5. Systematized Amnesia: forgets certain categories of info; people or places
Dissociative Fugue: Extremely rare & unusual – an individual travels
suddenly & unexpectedly and later discovers they are in a new place – unable
to remember why or how they had gotten there.
Depersonalization: Experience in which individuals feel a sense of unreality
and detachment from themselves – half of general population (from stress)
o Disorder - Experience recurrent episodes of depersonalization,
describing these experiences of unreality as if they are living a dream.
Commonly describe feeling like a robot able to respond to their
environment without feeling connected to their actions.
o Derealization – Experience of detachment, unreality and altered
relationships to the outside world.
Dissociative Identity Disorder (DID): formally multiple personality disorder
– Diasgnosed when the patient presents with 2 or more distinct personality Chapter 7 Dissociative & Somatoform Disorders
states that regularly take control of the patients behaviour. Typically one of
the personalities is the “host” whereas subsequent are the “alters”
A. Presence of 2+ distinct identities/personality states (each with its own
pattern of perceiving, relating & thinking about the environment & self
B. At least 2 of these identity states recurrently take control of the person