Psychopathology (Final) Somatoform and Dissociative Disorders

somatoform disorders

prominence of somatic symptoms (physical symptoms) associated with
significant distress and impairment.
somatic symptom disorder, illness anxiety disorder
(hypochondriasis in DSM IV) conversion disorder,
factitious disorder

Dissociative disorders

disruption of and/ or discontinuity in the normal integration
of consciousness memory, identity, emotion, perception, body
representation, motor control, behavior Depersonalization/
derealization dx Dissociative amnesia
Dissociative fugue Dissociative identity
disorder Little empirical attention given to
dissociative dx Notoriously difficult to treat with
pharmacotherapies Little research on response in patients
with DID Research shows that medication for
dissociative amnesia is nonexistent
Psychotherapy is helpful

Hypochondriasis

now called illness anxiety disorder in DSM5) Types of
somatic dx preoccupation with fear of having serious
disease beyond appropriate medical assessment. Belief that you
have the disease**

Somatization dx

Types of somatic dx A history of many physical
complains w significant impairment Pain, GI, sexual, and
neurological symptoms Series of physical complaints and as
a result takes on a sense of always being ill**

Conversion dx

Type of somatic dx Refers to physical malfunctioning
such as paralysis, blindness but there is no medical etiology
(happening in their head pretty much) Differing from
malingering or factitious disorders and getting benefits of
attention Includes Indifference
Precipitating stress can function normally but are
unaware of nature of the disorder

Pain dx

Types of somatic disorder Client is exhibiting real
pain which is the focus of clinical attention Psych factors
impact onset and intensity of pain Not feigned
Effective treatment methods include biofeedback, cognitive
behavioral, alternative medicines, and groups

Body dysmorphic disorders

Types of somatic dx Fear of ugliness, desiring changes
in appearance based on this fear (goes beyond discomfort)
Often described as a social disorder Clients afraid to
disclose defeat so it will not become more noticeable
Usually seek help from dermatologists, plastic surgeons, but not
mental health providers

Depersonalization/ derealization dx

Type of dissociative dx Persistent recurrent
experiences of feeling detached from one�s own mental body.
Reality testing remains intact Impact on
functioning Can present as depersonalization and
derealization

Dissociative amnesia

Most severe of dissociative disorders One or more
episodes of inability to recall personal information of a traumatic/
stressful nature Generalized amnesia- unable to remember
anything, including who they are Localized amnesia- failure
to recall specific events that occur during a specific time

Dissociative fugue

Type of dissociative disorder Unexpected travel away
from home/ work and inability to recall one�s past Usually
leaving behind a difficult situations Assumption of a new
identity (partial or complete) Not substance induced or
DID Ends abruptly

Trance and possession Dx

Only if it is undesirable is it considered pathological
Under consideration but not in the DSM now

Dissociative Identity Disorder

Type of dissociative dx Presence of 2+ distinct
identity states At least 2 states recurrently take
control Inability to recall personal information Not
due to substances Host identity is holding fragments
together Switching- instantaneous change, come cues
Score differently on psych tests Can be faked
Comorbid with abuse, depression, somatization, panic attacks

Depersonalization

I am not real Altered sense of selfhood
Feeling outside of one�s body; emotional or physical numbing;
time distortion; absent sense of self

Derealization

The world is not real Feels of unreality with regard
to one�s surroundings Object or people appear to be
visually distorted or foggy/ dreamlike/ robotic/ lifeless

Treatment of BDD

refers to body dysmorphic disorder Treatments
SSRIs CBT Exposure and response
prevention family therapy Insight-oriented
therapy

Treatments that do not work for BDD

Contraindicated tx Surgery= do not relieve
symptoms