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6-7. Dissociative, Somatoform, and Psychophysiological disorders.docx

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PSYC 3230
James Alcock

6-7. Dissociative, Somatoform, and Psychophysiological disorders Monday, February 11, 2013 9:00 AM Dissociative Disorders  We normally have a continuous and integrated sense of self; o We know that we are the same person that we were this morning, yesterday, last year o Dissociative disorders involve a severe disruption in that sense of self  Four categories: o Dissociative amnesia o Fugue o Dissociative personality o Dissociative identity disorder Dissociative amnesia  Dissociative amnesia is said to occur when an individual cannot recall significant personal information, in the absence of brain damage  Several varieties: o Localized-- forgets information during a specific time period, e.g., around a trauma o Selective-- forgets certain aspects of the trauma o Continuous-- forgets everything from a specific date to present (rare) o Global-- forgets entire life (rare) o Systematized-- forgets only certain types of information-- e.g., bank codes  Memory recovery techniques-- very risky; may contaminate memory or even create false memories o Hypnosis; guided imagery; repeated questions o E.g., "recovered memories of childhood sexual abuse" Fugue  Amnesia plus flight  Extremely rare  Person ends up in a faraway place, with no identification and apparently no memory of who he/she is-- Mr. Nobody?  Mr. Nobody appeared, at least at first, to be suffering from a "Dissociative Disorder" Dissociative identity disorder  Dr. Jekyll and Mr. Hyde o Two or more relatively independent personalities seem to reside in one person  Formerly known as Multiple Personality Disorder (extremely rare) o Commonly diagnosed at end of 1800s  Middle of 1980s: Sudden wave of diagnoses of MPD o Assumed linked to childhood sexual abuse, even if the sufferer was not aware of having been abused Depersonalization disorder  Enduring feeling of being detached from oneself, like living in a dream Somatoform disorders  Physical complaints not explainable in terms of organic causes (Soma = Body) o Symptoms not under conscious control o Not malingering  In the past, Somatoform an Dissociative Disorders were considered as hysteria  Both seem to involve disruptions in the normal control function of consciousness Somatization disorder  Stress/emotional problems present as physical symptoms; Females > males o Previous names: hysteria, Briquet's syndrome  Criteria: o Starting before age 30, multiple specific physical complaints across several years o No apparent physical basis o The patient has sought treatment for these symptoms, or they have materially impaired social, work, or personal functioning o Symptoms are not intentional or faked  Symptoms may include such things as: o Pain symptoms o Gastrointestinal symptoms o Sexual symptoms o Pseudoneurological symptoms Conversion disorder  Loss or change in body function o Usually a dysfunction of movement; may also be blindness, deafness, or difficulty swallowing  Involves more serious physical complaints than somatization disorde
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