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Somatoform and Dissociative Disorders

Compare and contrast SOMATOFORM AND DISSOCIATIVE DISORDERS.

Focus on:
*how repression and anxiety (psychodynamic model) is possibly involved,
*DSM-IV diagnosis criteria,
*and the most effective treatments.

Solution Preview

Let's look at the descriptions and DSM-IV diagnosis criteria to differentiate these disorders, which each have a number of disorders. Treatments and medications are also discussed.

RESPONSE:

Compare and contrast SOMATOFORM AND DISSOCIATIVE DISORDERS. Focus on how repression and anxiety (psychodynamic model) is possibly involved, DSM-IV diagnosis criteria, and the most effective treatments.

1. Dissociative Disorders

Patients with these mental disorders suffer disruption of memory, consciousness, identity, and general perception of themselves and their surroundings. Disorders included in this category are: (a) Dissociative Amnesia, (b) Depersonalization Disorder, (c) Dissociative Fugue, (d) Dissociative Identity Disorder, and (e) Dissociative Disorder NOS (300.15)
Disorders and DSM-IV-TR Diagnostic Criteria.

?Dissociative Amnesia

Patients with this Dissociative Disorder experience marked but reversible impairment of recall of important personal information or experience, usually involving emotional trauma.

According to DMS-IV-TR, the diagnostic criteria for 300.12 Dissociative Amnesia are as follows:

A. The predominant disturbance is one or more episodes of inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness.
B. The disturbance does not occur exclusively during the course of Dissociative Identity Disorder, Dissociative Fugue, Posttraumatic Stress Disorder, Acute Stress Disorder, or Somatization Disorder and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a neurological or other general medical condition (e.g., Amnestic Disorder Due to Head Trauma).
C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. (http://www.behavenet.com/capsules/disorders/disamnesia.htm)

?Depersonalization Disorder

Patients with this Dissociative Disorder experience episodes during which they feel detached from themselves. They may experience themselves or their surroundings as unreal. They may feel outside or lacking control of themselves. They retain awareness that this is only a feeling.

According to DMS IV-TR, the diagnostic criteria for 300.6 Depersonalization Disorder are as follows:

A. Persistent or recurrent experiences of feeling detached from, and as if one is an outside observer of, one's mental processes or body (e.g., feeling like one is in a dream).
B. During the depersonalization experience, reality testing remains intact.
C. The depersonalization causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
D. The depersonalization experience does not occur exclusively during the course of another mental disorder, such as Schizophrenia, Panic Disorder, Acute Stress Disorder, or another Dissociative Disorder, and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., temporal lobe epilepsy). (http://www.behavenet.com/capsules/disorders/depersdis.htm)

?Dissociative Fugue

Patients with this Dissociative Disorder suddenly and unexpectedly travel away from their home geographic location, experience impaired recall of their past. They may be confused about their former identity and may assume a new identity.

According to DMS IV-TR, the diagnostic criteria for 300.13 Dissociative Fugue are:

A. The predominant disturbance is sudden, unexpected travel away from home or one's customary place of work, with inability to recall one's past.
B. Confusion about personal identity or assumption of a new identity (partial or complete).
C. The disturbance does not occur exclusively during the course of Dissociative Identity Disorder and is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., temporal lobe epilepsy).
D. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. (http://www.behavenet.com/capsules/disorders/disfugue.htm)

?Dissociative Identity Disorder

Patients with this Dissociative Disorder suffer from alternation of two or more distinct personality states with impaired recall among personality states of important information.

The DSM-IV-TR criteria for dissociative identity disorder are: a) the presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self), b) at least two of these identities or personality states recurrently take control of the person's behavior, c) inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness, and d) the disturbance is not due to direct physiological effects of substance (e.g., blackouts or chaotic behavior during Alcohol Intoxication) or general medical condition (e.g., complex partial seizures). Note: In children, the symptoms are not attributable to imaginary playmates or other fantasy play. (http://www.behavenet.com/capsules/disorders/did.htm)

DID is a trauma related disorder. Individuals who suffer from it usually have experienced severe and repeated abuse as a child (Allers, & Snow, 1999). The alternate personalities develop as a way of coping and hiding from the abuse (Allers et al., 1999). It assumes the ability to "repress" memory to cope with earlier trauma.

Treatments and drugs

Psychotherapy is the primary treatment for dissociative disorders. This form of therapy, also known as talk therapy, counseling or psychosocial therapy, involves talking about your disorder and related issues with a mental health professional. The therapist works to help the patient understand the cause of her or his condition and to form new ways of coping with stressful circumstances. Psychotherapy for dissociative disorders often involves techniques, such as hypnosis, that help the person remember and work through the trauma that triggered the dissociative symptoms. The course of psychotherapy may be long and painful, but this treatment approach often is very effective in treating dissociative disorders (http://www.mayoclinic.com/health/dissociative-disorders/DS00574/DSECTION=treatments-and-drugs.

Dissociative disorders that are linked to repressed memories, psychodynamic psychotherapy is a method of psychotherapy evolved from Freudian psychoanalysis and is based on the same theories that the treatment works by bringing the unconscious into conscious awareness, achieving insight, resolving neurotic conflict, and working through resistance and the transference among others. However, this method, which is often considered standard or at least traditional among many psychiatrists and psychologists, may involve a shorter course of less frequent sessions and no psychoanalytic couch. The psychotherapist usually faces the sitting patient (http://www.behavenet.com/capsules/).

Other dissociative disorder treatment may include:

? Creative art therapy. This type of therapy uses the creative process to help people who might have difficulty expressing their thoughts and feelings. Creative arts can help you increase ...

Solution Summary

This compares and contrasts the different somatoform and dissociative disorders on several dimensions, such as how repression and anxiety (psychodynamic model) is involved, DSM-IV diagnosis criteria and the most effective treatments.

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