T6: Dissociative Disorders, Somatic and Related Disorders

• Somatic Symptom Disorder in which the person complains of bodily symptoms that suggest a physical defect or dysfunction, sometimes dramatic in nature. For some of these, no physiological basis can be found, and for others, psychological reaction to the symptoms appears excessive.
• Somatic Symptom Disorder is used to be called as Briquet's syndrome.
• Illness anxiety disorder in which physical symptoms are either not experienced at the present time or are very mild, but severe anxiety is focused on the possibility of having or developing a serious disease.
• Many of these individuals mistakenly believe they have a disease, a difficult-to-shake belief sometimes referred to as “disease conviction”.
• Illness anxiety disorder was formerly known as “hypochondriasis”.
• Dhat is an example of culture-specific disorder, prevalent in India, is an anxious concern about losing semen, something that obviously occurs during sexual activity.
• Antisocial personality disorder (ASPD) is characterized by vandalism, persistent lying, theft, irresponsibility with finances and at work, and outright physical aggression.
• "Functional" refers to a symptom without an organic cause.
• Conversion disorders generally have to do with physical malfunctioning, such as paralysis, blindness, or difficulty speaking (aphonia), without any physical or organic pathology to account for the malfunction.
• Astasia-abasia is a particular type of conversion symptom which is a weakness in legs and difficulty keeping balance, with the result that individual falls often.
• Globus hystericus is a type of conversion symptom in which there is a sensation of a lump in the throat that makes it difficult to swallow, eat, or sometimes talk.
• La belle indifference is an attitude in which patients with conversion reactions had the same quality of indifference to the symptoms thought to be present in some people with severe somatic symptom disorder.
• Malingerers are fully aware of what they are doing and are clearly attempting to manipulate others to gain a desired end. They are either trying to get out of something, such as work or legal difficulties, or they are attempting to gain something, such as a financial settlement.
• Factitious disorders, which fall somewhere between malingering and conversion disorders. The symptoms are under voluntary control, as with malingering, but there is no obvious reason for voluntarily producing the symptoms except, possibly, to assume the sick role and receive increased attention.
• Factitious disorder was previously known as Munchausen Syndrome.
• Dissociative Disorders is when the person experiences disruptions of consciousness—he or she loses track of self-awareness, memory, and identity.
• During an episode of depersonalization, your perception alters so that you temporarily lose the sense of your own reality, as if you were in a dream and you were watching yourself.
• During an episode of derealization, your sense of the reality of the external world is lost.
• When feelings of unreality are so severe and frightening that they dominate an individual’s life and prevent normal functioning, clinicians may diagnose the rare depersonalization-derealization disorder
• People who are unable to remember anything, including who they are, are said to suffer from generalized amnesia. It may be lifelong or may extend from a period in the more recent past, such as 6 months or a year previously.
• Localized or selective amnesia is a failure to recall specific events, usually traumatic, which occurs during a specific period.
• In most cases of dissociative amnesia, the forgetting is selective for traumatic events or memories rather than generalized.
• A subtype of dissociative amnesia is referred to as dissociative fugue in which memory loss revolves around a specific incident—an unexpected trip (or trips). Mostly, individuals just take off and later find themselves in a new place, unable to remember why or how they got there. During these trips, a person sometimes assumes a new identity or at least becomes confused about the old identity.
• The word "fugue" in the term dissociative fugue means "flight"
• According to DSM-5, to diagnose DID, there should be at least two separate personalities, or alters— different modes of being, thinking, feeling, and acting that exist independently of one another and that emerge at different times.
• Alters is the shorthand term for the different identities or personalities in DID.
• The transition from one personality to another is called a switch
• A model known as "sociocognitive model" suggests that symptoms of DID could mostly be accounted for by therapists who inadvertently suggested the existence of alters to suggestible individuals.
• Self-hypnosis is a phenomenon in which individuals can dissociate from most of the world around them and “suggest” to themselves that, for example, they won’t feel pain in one of their hands.
• According to the autohypnotic model, people who are suggestible may be able to use dissociation as a defense against extreme trauma
• “Functional neurological symptom disorder” is a subtitle to conversion disorder