Title: Somatoform and Dissociative Disorders
1Somatoform and Dissociative Disorders
2Somatoform Disorders
- Somatoform disorders Psychological problems
appearing in the form of bodily symptoms or
physical complaints - Conversion disorder Somatoform disorder marked
by paralysis, weakness, or loss of sensation, but
with no discernable physical cause
3Somatoform Disorders
4Somatoform Disorders
- Hypochondriasis Somatoform disorder involving
excessive concern about health and disease
5Dissociative Disorders
- Dissociative disorders Group of pathologies
involving fragmentation of the personality
Dissociative amnesia
Dissociativefugue
Depersonalization disorder
Dissociative identity disorder
6Dissociative Disorders
Dissociative amnesia
- A psychologically induced loss of memory for
personal information
Dissociative fugue
Depersonalization disorder
Dissociative identity disorder
7Dissociative amnesia
- A 29-year-old female experienced the onset of
dissociative amnesia during an academic trip to
China.2 She was found in a hotel bathroom
unconscious, with no signs of structural or
neurologic abnormalities or alcohol or chemical
consumption. The woman was sent home but could
not remember her name, address, family, or any
facts about her home life. The amnesia persisted
for nearly 10 months, until the feeling of blood
on the woman's fingers triggered the recollection
of events from the night of onset of dissociative
amnesia, and, subsequently, other facts and
events. The woman finally remembered having
witnessed a murder that night in China. She
recalled being unable to help the victim out of
fear for her own safety. She came to remember
other aspects of her life however, some memories
remain unretrievable.
8Dissociative Disorders
Dissociative amnesia
Dissociative fugue
- Dissociative amnesia with the addition of
flight from ones home, family, and job
Depersonalization disorder
Dissociative identity disorder
9Dissociative fugue
- Commonly, individuals who experience the onset of
dissociative fugue are found wandering in a dazed
or confused state, unable to recall their own
identity or recognize their own relatives or
daily surroundings. Often, they have suffered
from some post-traumatic stress, as in the case
of a 35-year-old businessman who disappeared more
than 2 years after narrowly escaping from the
World Trade Center attack in 2001, leaving behind
his wife and children. The man was missing for
more than 6 months when an anonymous tip helped
police in Virginia identify him.
10Dissociative Disorders
Dissociative amnesia
Dissociative Fugue
- Abnormality involving the sensation of mind and
body having separated
Depersonalization disorder
Dissociative identity disorder
11Depersonalization disorder
- Depersonalization disorder generally leads to
observable distress in the affected individual.
It often occurs in individuals who are also
affected by some other psychological
nondissociative disorder, as in the case of a
19-year-old college student who was suffering
from sleep deprivation at the onset of
depersonalization disorder. The young man
experienced increased anxiety as he struggled to
meet his responsibilities as a scholarship-depende
nt student athlete. Teammates expressed concern
about his apparent distress to their coach who
arranged for the young man to speak with a
therapist. The young man described feeling as
though he were observing the interactions of
others as if it were a film. The young man's
anxiety was determined to contribute to severe
sleep deprivation, which triggered episodes of
depersonalization.
12Dissociative Disorders
Dissociative amnesia
Dissociative Fugue
Depersonalization disorder
- Condition in which the individual displays
multiple identities
Dissociative identity disorder
13Dissociative identity disorder
- In a case of dissociative identity disorder, a
woman who had been physically and sexually abused
by her father throughout her childhood and
adolescence exhibited at least 4 personalities as
an adult. Each personality was of a different
age, representing the phases of the woman's
experience a fearful child, a rebellious
teenager, a protective adult, and the woman's
primary personality. Only one of the
personalities, the protective adult, was
consciously aware of the others, and during
therapy sessions was realized to have been
developed to protect the woman during the abusive
experiences. When one of the secondary
personalities took over, it often led to episodic
dissociative amnesia, during which the woman
acted out according to the nature of the
dominating personality. During intensive therapy
sessions, each personality was called upon as
necessary to facilitate their integration.