Week 6
Selective amnesia – forget only the
dissociative identity disorder (multiple
personality) - classified as a dissociative
disorder
- Grouping of psychological disorders
characterized by changes in
disturbances in the functions of self –
identity, memory, or consciousness
somatic symptom and related disorders –
physical complaints that defy medical
explanation and so are believed to involve
underling psychological conflicts or issues
Earlier versions of DSM classified somatic
symptom and related disorders with anxiety
disorders in a category of “neurosis”
Dissociative Disorders
dissociative disorders – dissociative identity
disorder, dissociative amnesia, and
depersonalization/derealization disorder
Dissociative Identity Disorder
dissociative identity disorder (DID) / multiple
personality or split personality – Emergence of
two or more distinct personalities, each having
its own well-defined traits and memories
Alters – the different personalities residing
Dissociative Amnesia (psychogenic amnesia) –
Inability to recall important personal material
that cannot be accounted for by medical causes
 Amnesia derives from the Greek roots
a-, meaning “not,” and mnasthai,
meaning “to remember.”
Dissociative amnesia is divided into five distinct
types of memory problems:
1. Localized amnesia – events occurring
during a specific time period are lost to
memory
2.
disturbing particulars that take place
during a certain period of time
3. Generalized amnesia – people forget
their entire lives
4. Continuous amnesia – forgets
everything that occurred from a
particular point in time up to and
including the present
5. Systematized amnesia – memory loss is
specific to a particular category of
information
 Implicit Memory – requires no
knowledge (ex. biking, typing, etc.)
 Explicit Memory – requires knowledge
Malingering – faking symptoms or making false
claims for personal gain
Fugue (“amnesia on the run”) – person may
travel suddenly and unexpectedly from his or
her home or place of work
 fugue derives from the Latin fugere,
meaning “flight.”
Depersonalization/Derealization Disorder
Depersonalization – temporary loss or change
in the usual sense of our own reality
Derealization – a sense of unreality about the
external world involving odd changes in the
perception of one’s surroundings or in the
passage of time
Theoretical Perspectives
Psychodynamic Views
 dissociative disorders involve the
massive use of repression, resulting in
the splitting off from consciousness of
unacceptable impulses and painful
memories, typically involving parental
abuse
  Dissociative amnesia may serve an
adaptive function of disconnecting or
dissociating one’s conscious self from
awareness of traumatic experiences or
other sources of psychological pain or
conflict
 dissociative identity disorder, people
may express these unacceptable
impulses through the development of
alternate personalities
 depersonalization, people stand outside
themselves
Social-Cognitive Theory
 psychologically distancing oneself from
disturbing memories or emotions
 form of role-playing acquired through
observational learning and
reinforcement
Brain Dysfunction
 possible dysfunction in parts of the
brain involved in body perception, may
help account for the feeling of being
disconnected from one’s body that is
characteristic of depersonalization
Diathesis–Stress Model
 children who experience extreme
trauma eventually develop multiple
personalities
 prone to fantasize, are highly
hypnotizable, and are open to altered
states of consciousness, may be more
likely than others to develop
dissociative experiences in the face of
traumatic abuse
Treatment of Dissociative Disorders
Much of the research interest on treating
dissociative identity disorder focuses on
integrating the alter personalities into a
cohesive personality structure
Somatic Symptom and Related Disorders
somatic derives from the Greek soma, meaning
“body
somatic symptom and related disorders
(somatoform disorders) – may have physical
(“somatic”) symptoms without an identifiable
physical cause or have excessive concerns about
the nature or meaning of their symptoms
Somatic Symptom Disorder
somatic symptom disorder (SSD) – excessively
concerned about their symptoms to the extent
that it affects their thoughts, feelings, and
behaviors in daily life
 hypochondriasis – believed their
symptoms were due to a serious,
undetected illness, such as cancer or
heart disease, despite medical
reassurance to the contrary; can lead to
IAD
Illness Anxiety Disorder
illness anxiety disorder (IAD) – anxiety
associated with illness rather than the distress
the symptoms cause
 it’s not the symptoms they find so
troubling—symptoms such as vague
aches and pains or a passing feeling of
tightness in the abdomen or chest.
Rather, it’s the fear of what these
symptoms might mean
 care-avoidant subtype – postpone or
avoid medical visits or lab tests because
of high levels of anxiety about what
might be discovered
 care-seeking subtype – go doctor
shopping, basically jumping from doctor
to doctor in the hope of finding the one
medical professional who might confirm
their worst fears
Conversion Disorder
Conversion disorder (functional neurological
symptom disorder) – affect the ability to control
voluntary movements or that impair sensory
functions, such as an inability to see, hear, or
feel tactile stimulation
 Conversion disorder was formerly called
hysteria or hysterical neurosis
Factitious Disorder
Factitious disorder – fake or manufacture
physical or psychological symptoms, but
without any apparent motive
1. factitious disorder on self – faking or
inducing symptoms in oneself
 Münchausen syndrome (Baron Karl von
Münchausen)
2. factitious disorder imposed on another
– inducing symptoms in others
Koro and Dhat Syndromes: Far Eastern Somatic
Symptom Disorders?
Koro Syndrome – fear that their genitals are
shrinking and retracting into their bodies, which
they believe will result in death
Dhat Syndrome – involves excessive fears over
the loss of seminal fluid in nocturnal emissions,
in urine, or through masturbation
Theoretical Perspectives
Hippocrates prescribed marriage as a “cure” on
the basis of these observations and also on the
theoretical assumption that pregnancy would
satisfy uterine needs and fix the organ in place
Hippocrates’s mistaken belief in the “wandering
uterus” has contributed throughout the
centuries to degrading interpretations of
women’s complaints of physical problems
Psychodynamic Theory
According to psychodynamic theory, hysterical
symptoms are functional: They allow the person
to achieve primary gains and secondary gains
 primary gain of the symptoms is to
allow the individual to keep internal
conflicts repressed
 allow the individual to avoid
burdensome responsibilities and to gain
the support
Learning Theory
From the learning perspective, people with
somatic symptom and related disorders may
also carry the benefits, or reinforcing
properties, of the “sick role.”
People with hypochondriasis, which is now
labeled somatic symptom disorder or illness
anxiety disorder, are often bothered by
obsessive, anxiety inducing thoughts about the
state of their health.
Cognitive Theory
cognitive perspective, we can think about
hypochondriasis in some cases as a type of self-
handicapping strategy, a way of blaming poor
performance on failing health
Brain Dysfunction
investigators proposed that conversion
symptoms may involve a disconnect or
impairment in the neural connections between
parts of the brain that control certain functions
(speech, for example) and other parts involved
in regulating anxiety
Treatment of Somatic Symptom and Related
Disorders
Psychoanalysis seeks to uncover and bring into
conscious awareness unconscious conflicts that
originated in childhood
The behavioral approach to treatment focuses
on removing sources of secondary
reinforcement (or secondary gain) that may
become connected with physical complaints
Cognitive-behavioral therapy has achieved
good results in hypochondriasis, which is now
classified as somatic symptom disorder or
illness anxiety disorder
exposure with response prevention – can help
patients with somatic symptom disorder and
illness anxiety disorder break the pattern of
running to doctors for reassurance whenever
they experience some worrisome, health-
related concerns
Asthma
Asthma – main tubes of the windpipe—the
bronchi— constrict and become inflamed, and
large amounts of mucus are secreted
Cancer
Cancer – development of aberrant, or mutant,
cells that form growths (tumors) that spread to
healthy tissue
Acquired Immunodeficiency Syndrome

Psychological Factors Affecting Physical Health Acquired Immunodeficiency Syndrome (AIDS)

– caused by the human immunodeficiency virus
psychosomatic disorders – physical disorders in (HIV)
which psychological factors are believed to play
a causal or contributing role HIV attacks the immune system, leaving it
helpless to fend off diseases it normally would
 psychosomatic is derived from the hold in check
Greek roots psyche, meaning “soul” or
“intellect,” and soma, which means
“body.”

Headaches

Migraines – involve intense throbbing pain on

one side of the head

Biofeedback training (BFT) – helps people gain

control over various bodily functions

Cardiovascular Disease

cardiovascular disease (CVD) or heart and

artery disease – leading cause of death in the
United States

Coronary heart disease (CHD) – major form of

cardiovascular disease

Arteriosclerosis (hardening of the arteries) –

artery walls become thicker, harder, and less
elastic

heart attack (myocardial infarction) – life-

threatening event in which heart tissue dies
because of a lack of oxygen-rich blood