Somatoform Disorders

1
Somatoform Disorders Dissociative Disorders

• Kimberley Clow
• kclow2_at_uwo.ca
• http//instruct.uwo.ca/psychology/155b/

2
Outline

• Somatoform Disorders
• Somatization Disorder
• Pain Disorder
• Hypochondriasis
• Conversion Disorder
• Body Dysmorphic Disorder
• Dissociative Disorders
• Dissociative Amnesia
• Dissociative Fugue
• Depersonalization Disorder
• Dissociative Identity Disorder

3
Somatoform Disorders

• Bodily symptoms that suggest a physical defect or
  dysfunction
• BUT no physiological basis can be found
• Emotions ? Physical Symptoms
• Different from
• Malingering
• Factitious Disorder

4
Somatization Disorder
5
Causes Treatment

• Contributors
• Behaviour rewarded
• Excessive illness growing up
• Association with Antisocial Personality Disorder
• Runs in families
• Treatment
• Focus on stress
• Reduce help-seeking behaviour
• Eliminate reinforcers

6
Pain Disorder

• Predominant complain is pain and psychological
  factors have an important role in the onset,
  severity, exacerbation, or maintenance of the
  pain
• Types
• Acute
• Chronic
• Causes
• Psychodynamic
• Behavioural

7
Hypochondriasis
8
Causes Treatment
9
Conversion Disorder

• Motor or sensory symptoms suggesting a
  neurological impairment when there is none
• Conversion refers to unconscious conflicts being
  converted into physical symptoms
• Discharging anxiety without experiencing it

10
Causes Treatment

• Contributors
• Triggered by a stressful / traumatic event
• Primary Secondary Gain
• Treatment
• Need to address initial stressful event
• Remove reinforcers

Glove Anesthesia
11
Body Dysmorphic Disorder

• Dysfunctional preoccupation about imagined
  physical defects
• Ideas of reference
• Successive changes surgeries
• With insight
• Without insight
• Delusional Disorder

12
Causes Treatment

• Contributors
• Societal beauty images
• High comorbidity with OCD
• Treatment
• Drugs
• Same ones for OCD
• Behavioural Therapy
• Exposure and Response Prevention
• Same therapy as for OCD

13
General Considerations

• Psychodynamic
• Neurosis
• Primary gain
• Secondary gain
• Behavioural
• Sick role
• Modeling
• Stress Trauma
• High incidences of child abuse
• History of illness

• Cognitive
• Faulty interpretations
• Biological
• History of illness
• Sensitivity to bodily sensations
• Cultural Factors
• More prevalent in cultures that stigmatize mental
  disorders

14
Dissociative Disorders

• Disruptions of consciousness, memory, and
  identity
• Missing time
• No memory for a period
• Werent conscious when it happened
• Dont know who you are
• Lost memories
• Dont identify with self
• Multiple identities
• Dont feel real

15
Dissociative Experiences Scale

1. Able to ignore pain
2. Missing part of a conversation
3. Usually difficult things can be done with ease
   and spontaneity
4. Not sure whether you have done something or only
   thought about it
5. Absorption in TV program or movie
6. Remembering past so vividly you seem to be
   reliving it
7. Staring into space
8. Talking out loud to yourself when alone
9. Finding evidence of having done things you cant
   remember doing

16

1. Not sure if remembered event happened or was a
   dream
2. Being approached by people you doesnt know who
   call you by a different name
3. Feeling as though you were two different people
4. So involved in fantasy that it seems real
5. Driving a car and realizing you dont remember
   part of the trip
6. Not remembering important events in your life
7. Being in a familiar place but finding it
   unfamiliar
8. Being accused of lying when you are telling the
   truth
9. Finding notes or drawings that you must have done
   but dont remember doing

17

1. Seeing yourself as if looking at another person
2. Hearing voices inside your head
3. Not recognizing friends or family members
4. Other people and objects do not seem real
5. Looking at the world through a fog
6. Finding unfamiliar things among your belongings
7. Feeling as though your body is not your own
8. Finding yourself in a place but unaware of how
   you got there
9. Finding yourself dressed in clothes that you
   dont remember putting on
10. Not recognizing your own reflection in a mirror

18
Dissociative Amnesia

• Person is unable to recall important personal
  information
• Usually related to a traumatic or stressful event
• Variations
• Generalized
• Localized
• Selective

24
19
Dissociative Fugue

• Person suddenly leaves home and work and assumes
  a new identity
• Usually triggered by stress or trauma

20
Depersonalization Disorder

• Persons perception or experience of the self is
  disconcertingly and disruptively altered
• Frequent episodes
• Reality does remain intact during episodes
• No amnesia or new identities

21
Causes Treatment
22
Dissociative Identity Disorder (DID)
23
Causes Treatment
24
Is DID A Real Disorder?

• Yes It Is
• Many symptoms of PTSD are similar to those of DID
• Alters show several physiological and / or
  behavioural differences

• No It Isnt
• The use of hypnosis may be a source of therapist
  contamination
• Physiological changes are also seen in subjects
  asked to fake DID