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Chapter 6- Dissociative and Somatoform Disorders.docx

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Western University
Psychology 2310A/B
Rod Martin

Abnormal Psychology 2310 October 2013 Chapter 6- Dissociative and Somatoform Disorders Historical Perspectives Hysteria: a symptom pattern characterized by emotional excitability and physical symptoms in the absence of any evident organic cause  Plato: believed were caused by women in the womb (hysterios)  Rise of Christianity: supernatural explanations dissociations were now seen as the result of demonic possession (treatment= exorcism)  Josef Bruer and Sigmund Freud: Studies in Hysteria o Sexual trauma was a predisposing factor and established a relationship between dissociation and hypnotic like states  Primarily studies in women who also suffered from somatoform disorders o Believed that dissociation and other defenses developed in order to protect one from their unacceptable sexual impulses (and not from traumatic memories) Primary Gain: primary reinforcement maintaining somatoform symptoms conversion of anxiety to more acceptable physical symptoms relieved pressured of dealing directly with a conflict Secondary Gain: hysteria symptoms could help patients avoid responsibility and gain attention and sympathy adopting “sick” role Dissociative Disorders  Severe maladaptive disruptions or alterations of identity, memory, and consciousness that are experiences as being beyond ones control Dissociation: a disruption in the usually integrated functions of consciousness, memory, identity, or perception  Amnesia is usually for autobiographical memory – not general knowledge  Information is not permanently lost o Often remits spontaneously after a few days o But can occasionally become chronic or recurrent  Two groups of dissociative experiences: 1. Mild, non pathological type distributed across the general population (E.g. absorption and imaginative involvement) 2. Severe, pathological type E.g. amnesia, derealization, depersonalization Prevalence  No difference between men and women with the disorder  Co morbid with anxiety, mood, and personality disorder Dissociative Amnesia: inability to recall important personal information o E.g. Own name, occupation, address Abnormal Psychology 2310 October 2013 Chapter 6- Dissociative and Somatoform Disorders  Following a traumatic event, but have no memory of the event  5 patterns of memory loss… 1. Localized amnesia: failure to recall information from specific time period 2. Selective amnesia: only parts of the trauma are forgotten Less 3. Generalized amnesia: forgets all personal information from ones past common, 4. Continuous amnesia: forgets information from a specific date until the usually present associated 5. Systematized amnesia: only forgets certain categories of information with DID Dissociative Fugue: sudden, unexpected flight from home; inability to remember past and personal identity o Some travel thousands of miles from home until they realize who they are o Lasts between a few days and weeks o Adapt well to new environment confusion only occurs if they are questioned about personal history  Most patients don’t present for treatment; typically present for memory loss o CASE of JEFF INGRAM (video) Depersonalization Disorder: feeling of unreality and being detached from oneself  Severe depersonalization is the primary problem  Persistent symptoms which cause clinically significant impairments or distress o Feel as though they are living in a dream o Begins during adolescence o Highly related to history of trauma o Numbness  Common simptoms of other disorders: PTSD, depression Derealization: experience of detachment and altered relationship to the surrounding would; perceives things are unreal, distant, or distorted Dissociative Identity Disorder (DID): presence of two or more personalities that regularly take control of ones behavior  Host and alert personalities: each significantly different o E.g. Medical conditions, gender, age, occupation, emotions etc. o Host may not be aware that the other states exist o Average of 13-16 different personalities  Much confusion; multiple diagnoses; often over diagnosed Switching: the process of changing from one personality to another o In response to stressful situation o May not be dramatic enough to catch the attention of others Abnormal Psychology 2310 October 2013 Chapter 6- Dissociative and Somatoform Disorders Etiology  The Trauma Model: (diathesis stress formation) disorders are a result of severe childhood trauma accompanied by personality traits that predispose the individual to employ dissociation as a defence mechanism or coping strategy o Certain personality traits can increase the risk that people with traumatic memories will develop dissociative disorders  Socio- Cognitive Model: multiple personality is a form of role playing in which individuals come to construe themselves as possessing multiple selves and then begin to act in ways consistent with their own or their therapists conception of the disorder o (Harold Merskey) Iatrogenic: caused by treatment; therapist plant suggestions on their patient
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