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PS280 - Ch 7 Textbook.docx

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Wilfrid Laurier University
Todd Ferretti

Chapter 7  Dissociative & Somatoform Disorders Historical Perspective  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 Dissociative Disorders  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
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