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Somatoform Features and Epidemiology

Somatoform Disorders: Causes and Prevention

Somatoform Disorders: Assessment and Treatment

Dissociative Disorders: Features and Epidemiology

Dissociative Disorders: Causes and Prevention

Dissociative Disorders: Assessment and Treatment

Part 2:Dissociative Disorders


SomatoformDisorders:Causes and Prevention





Emotions

Cognitions

Behaviors

Normal

Feeling good connection with others and environment.

No concerns about forgetfulness.

Occasional forgetfulness but little problem remembering with a cue.

Mild physical arousal, especially when forgetting something.

Slight worry about lack of concentration on an examination or about increasing forgetfulness as one ages.

Daydreaming during class, minor “spacing out” during a boring abnormal psychology lecture, mild forgetfulness.







Emotions

Cognitions

Behaviors

NormalMild

Greater difficulty concentrating, feeling more alienated from others and one’s environment.

Greater worry about minor dissociation, such as sitting in a car at the supermarket and wondering how one arrived there.

Highway hypnosis, more frequent forgetfulness, or acting as if in a fog or a dream.







Emotions

Cognitions

Behaviors

NormalMildModerate

Intense difficulty concentrating and feelings of estrangement from others.

Intense worry about substantial dissociation or “gaps” in memory or little realization that something is wrong.

Infrequent episodes of depersonalization, intense forgetfulness, or missing appointments with others.







Emotions

Cognitions

Behaviors

NormalMildModerateDissociative Disorder – Less Severe

Feelings of complete alienation and separation from others or one’s environment.

Potential lack of insight or thought about one’s personal identity or changed living situation.

Severe and frequent episodes of dissociation, constant amnesia or fugue, presence of multiple personalities.







Emotions

Cognitions

Behaviors

NormalMildModerateDissociative Disorder – Less SevereDissociative Disorder – More Severe







• Localized

• Selective

• Generalized

• Continuous

• Systematize

d







Persistent or recurrent experiences of feeling detached from, and as if one is an outside observer of, one’s mental processes or body.

Disorder causes significant distress or impairment in social, occupational, or other areas of functioning.

Reality testing remains intact during depersonalization.

Disorder does not occur exclusively during another mental disorder and is not due to substance use or a medical condition.

All of the following DSM-IV-TR symptoms are necessary for a diagnosis of depersonalization disorder







• Please click on this link for a five-minute video of a man with Dissociative Identity Disorder

• Robert Oxnam DID video

http://college.cengage.com/psychology/shared/videos/jwplayer/robertoxnam.html



Causes of Dissociative Identity Disorder

• Childhood trauma

• Cultural factors

• Hypnosis and suggestion







Amygdala

Cingulate cortex

Frontal cortex

Thalamus

Hippocampus

Locus coeruleus







I am quick to sense the hunger contractions in my stomach.

I find myself someplace and don’t remember how I got there.

I get so wrapped up in watching TV, reading, or playing video games that I don’t have any idea what’s going on around me.

People tell me I do or say things that I don’t remember doing or saying.

I feel like I’m in a fog or spaced out and things around me seem unreal.

I don’t recognize myself in the mirror.

Sample Items from the Adolescent Dissociative Experiences Scale







• Create safe, empathic environment• Work to improve daily functioning• Process any history of trauma

– May include repeated discussion of traumatic events (exposure)

• For DID, work on reintegration of personalities

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