1. Part 2: Dissociative Disorders 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
2. Normal Feeling good connection with others and environment. No concerns about forgetfulness. Occasional forgetfulness but little problem remembering with a cue. Emotions Cognitions Behaviors SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology
3. Normal Mild 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 SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology
4. Normal Mild Moderate 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 SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology
5. Normal Mild Moderate Dissociative Disorder – Less Severe 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 SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology
6. Normal Mild Moderate Dissociative Disorder – Less Severe Dissociative Disorder – More 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 SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology
7. SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology
12. SystematizedSomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology
13. SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology
14. All of the following DSM-IV-TR symptoms are necessary for a diagnosis of depersonalization disorder 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. SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology
15. Please click on this link for a five-minute video of a man with Dissociative Identity Disorder Robert Oxnam DID video SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology
16. Causes of Dissociative Identity Disorder Childhood trauma Cultural factors Hypnosis and suggestion
17. Frontal cortex Cingulate cortex Thalamus Amygdala Hippocampus Locus coeruleus SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology
18. Sample Items from the Adolescent Dissociative Experiences Scale 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. I am quick to sense the hunger contractions in my stomach. I find myself someplace and don’t remember how I got there. SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology
19. SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology 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
20. SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology
Notas do Editor
Childhood trauma is the most common explanation for DID. The idea is, when a child is abused and has no escape, they develop alternate personalities that cope with the abuse, then the main personality does not have to suffer the abuse. However, this does not explain why so many children who are abused do NOT develop DID.Cultural factors– DID is primarily a Western disorder. Most common in the U.S. and Canada, less common in Europe, practically unheard of in other countries. After the movie Sybil came out in 1976, new diagnosis of DID skyrocketed. Something about the publicity surrounding that movie caused the emergence of many more instances of the disorder.One of the primary treatments for DID involves hypnosis. BUT some studies indicate that most people with DID first learn they have the disorder after they’re in therapy– some scientists think the therapy is CAUSING the disorder. Hypnosis does NOT lead to the recovery of deeply repressed memories, as a general rule, but instead is most reliable as a means for suggesting things to people. As in, a good technique for helping people learn to relax, even some evidence it can help with smoking cessation. BUT, memories recovered during hypnosis are highly susceptible to suggestion, so if the therapist asks to speak with a different personality, the patient will produce one to comply with the suggestion, even if no personality was originally there.Elizabeth Loftus has done extensive work demonstrating that memory is malleable, so not only DID but also amnesia and fugue may be susceptible to tricks our memory is playing on us.
