Somatic Symptom/Dissociative Disorder Flashcards

Somatic Symptom Disorders

Syndrome of multiple somatic symptoms that can't be explained
medically. Disorder is chronic and before age 30, common in
women, less educated people and in rural areas. 0.8-1%
Anxiety, depression, and suicidal ideation are common, drug
abuse or dependence may be present. Personality
characteristics - heightened emotions, strong dependency needs, and
preoccupation with self and symptoms.

Illness Anxiety Disorder

Unrealistic/inaccurate interpretation of physical
symptoms/sensations - resulting in preoccupation for at least 6
months and fear of having a serious disease. Somatic
symptoms aren't present, if present are mild. A high level anxiety
about health, Performs excessive health-related behaviors
or maladaptive avoidance (avoids doctors office/hospitals)
Anxiety & depression are present obsessive-compulsive traits
(repeated health checks of body)

Conversion Disorder

Loss or change in body function that can't be explained by any
medical disorder or pathological disorder. Most classic
symptoms - are those that suggest neurodisease Conversion
disorder cases maybe precipitated by stress. S/s:
paralysis, aphonia - inability to speak, seizures, coordination,
difficulty swallowing, urinary retention, blindness, deafness,
double vision, loss of pain sensation.

Psychological Factors affecting other medical conditions are

With this diagnosis there is evidence to prove a medical
condition that has been precipitated or being perpetuated by
psychological/behavioral symptoms Factors that interfere
with treatment of medical conditions

Factitious Disorder /Munchausen Syndrome

Conscious intentional feigning of physical/psychological
symptoms. Individual pretends to be ill order to receive
emotional care and support associated with role of
"parent" Behavior is not better explained by
another mental disorder

Predisposing Factors
Genetic, Biochemical, Neuroanatomical, Psychodynamic

Genetic - Possible Inheritable predisposition
Biochemical - Decreased levels of serotonin and endorphins (to
do with an increase of pain stimuli) Neuroanatomical -
brain dysfunction Psychodynamic - Expression of low
self-esteem and feelings of worthlessness, and with ego mechanism
dysfunction. Psychodynamic Theory - conversion disorder may
represent emotions associated w/ traumatic event are too
unacceptable to express and are converted into physical

Somatic Symptom Disorder
Family Dynamics

Family dynamics - in dysfunctional families when a child falls
ill focus shifts to child's illness and leaves unresolved issues
that family is unable to openly confront. Somatotization
brings some stability to the family and positive reinforcement to
the child.

Somatic Symptom Disorder
, Learning Theory

Somatic complaints are often reinforced when sick persons
learns he/she may avoid stressful situations or responsibilities;
becomes prominent focus of attention; may relieve conflict within
the family. Past experiences with serious illnesses either
personal or other relatives can predispose an individual to illness
anxiety disorder.

What are the types of Dissociative Identity Disorder?

Dissociative Amnesia Dissociative Identity
Disorder Derspersonalization-Derealization Disorder

Dissociative Amnesia

Inability to recall important personal information that is too
extensive to be explained by forgetfulness, onset is usually follows
severe psychosocial stress. Subtype of this kind is Fugue -
sudden expected travel away from home with the inability to recall
some or all of one's past.

Localized vs. Selective Amnesia

Localized - inability to recall all incidents associated
with traumatic event following one Selective - Individual
can recall only
certain incidents associated w/ stressful event for a specific
period after event. Generalized - Individual has amnesia
for his or her identity and total life history - entire

Dissociative Identity Disorder

Existence of two or more personalities in within a single
individual Suddenly transitions from one personality to
another usually sudden, often dramatic and usually precipitated by

Despersonalization - Derealization Disorder

Charactized by a temporary change in the quality of
self-awareness which takes the form of: feelings of unreality,
changes in the body image Despersonalization - defined as a
disturbance in the perception of oneself Derealization - an
alteration in the perception of the external environment.

Despersonalization - Derealization Disorder S/S

Anxiety and depression Fear of going insane
Obsessive thoughts Somatic complaints
Disturbance in subjective time

Despersonalization - Derealization Disorder
Predisposing Factors

Genetics - Possible hereditary risk with DID
Neurobiology - Dissociative amnesia related to
neurophysiological dysfunction, EEG abnormalities have been observed
DID Psychodynamic Theory - Freud described dissociation as
repression of distressing mental contents from conscious awareness;
Freud's dissociative behaviors are a defense against unresolved
painful issues.

Despersonalization - Derealization Disorder
Predisposing Factors 2

Psychological Trauma - DID as a result of traumatic experiences
that overwhelm individual's capacity to cope by any means other than
dissociation. Experiences - severe physical sexual,
psychological abuse by SO in children's life - DID serves as a
survival strategy. ****Use of Repression***

Somatic Symptoms Outcomes

Copes effectively without resorting to physical symptoms
Verbalizes relief of pain, has decreased reports of physical
pain, free of physical disability. Client will be able to
recall events associated w/stressful situations, recall all events
of past life, verbalize anxiety that precipitated dissociation.
Can demonstrate adaptive coping mechanisms, verbalize existence
of multiple personalities, able maintain a sense of reality during
stressful situations.

Medical Treatment