Somatoform Disorders and Dissociative Disorders - Health - Lecture Slides, Slides of Public Health

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Somatoform Disorders & Dissociative Disorders Docsity.com Outline  Somatoform Disorders  Somatization Disorder  Pain Disorder  Hypochondriasis  Conversion Disorder  Body Dysmorphic Disorder  Dissociative Disorders  Dissociative Amnesia  Dissociative Fugue  Depersonalization Disorder  Dissociative Identity Disorder Docsity.com 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 Docsity.com 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 Docsity.com Hypochondriasis Diagnostic Criteria for Hypochondriasis A. Preoccupation with fears of having, or the pational, or other important areas of func- idea that one has, a serious disease based on tioning. the person’s misinterpretation of bodily E. The duration of the disturbance is at least 6 symptoms. months. B. The preoccupation persists despite appropri- : The preoccupation is not better accounted ate medical evaluation and reassurance. for by Generalized Anxiety Disorder, Obses- C. The belief in Criterion A is not of delusional sive-Compulsive Disorder, Panic Disorder, a intensity and is not restricted to circum- Major Depressive Episode, Separation Anxi- scribed concern about appearance. ety, or another Somatoform Disorder. D. The preoccupation causes clinically signifi- cant distress or impairment in social, occu- Cc American Psychiatric Association; Diagnostic and Statistical Manual of Mental Disorders, Edition. Washington, DC, American Psychiatric Association, 1994. Docsity.com Causes & Treatment  Contributors  Triggered by a stressful / traumatic event Primary & Secondary Gain  Treatment  Need to address initial stressful event  Remove reinforcers Glove Anesthesia Docsity.com Body Dysmorphic Disorder  Dysfunctional preoccupation about imagined physical defects  Ideas of reference  Successive changes & surgeries  With insight  Without insight  Delusional Disorder 0 10 20 30 40 50 60 70 % H air N ose Skin Eyes Stom ach B reasts Penis Docsity.com 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 Docsity.com 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 can’t remember doing Docsity.com 10. Not sure if remembered event happened or was a dream 11. Being approached by people you doesn’t know who call you by a different name 12. Feeling as though you were two different people 13. So involved in fantasy that it seems real 14. Driving a car and realizing you don’t remember part of the trip 15. Not remembering important events in your life 16. Being in a familiar place but finding it unfamiliar 17. Being accused of lying when you are telling the truth 18. Finding notes or drawings that you must have done but don’t remember doing Docsity.com 19. Seeing yourself as if looking at another person 20. Hearing voices inside your head 21. Not recognizing friends or family members 22. Other people and objects do not seem real 23. Looking at the world through a fog 24. Finding unfamiliar things among your belongings 25. Feeling as though your body is not your own 26. Finding yourself in a place but unaware of how you got there 27. Finding yourself dressed in clothes that you don’t remember putting on 28. Not recognizing your own reflection in a mirror Docsity.com Depersonalization Disorder  Person’s perception or experience of the self is disconcertingly and disruptively altered  Frequent episodes  Reality does remain intact during episodes  No amnesia or new identities Docsity.com Causes & Treatment Docsity.com Dissociative Identity Disorder (DID) Diagnostic Criteria for Dissociative Identity Disorder A. The presence of two or more distinct identi- D. The disturbance is not due to the direct ties or personality states (each with its own physiological effects of a substance (c.g., relatively enduring pattern of perceiving, re- blackouts or chaotic behavior during Alco- lating to, and thinking about the environ- hol Intoxication) or a general medical condi- ment and self), tion (e.g., complex partial seizures). B. At least two of these identities or personal- ity states recurrently take control of the per- son’s behavior. C. Inability to recall important personal infor- Note: In children, the symptoms are not mation that is too extensive to be explained attributable to imaginary playmates or by ordinary forgetfulness. other fantasy play. urce: American Psychiatric Association; Diagnostic and Statistical Manual of Mental Disorders, ourth Edition, Washington, DC, American Psychiatric Association, 1994. Docsity.com