PY Notecards 6

Used to be classified together in DSM as neuroses.

• Onset is both related to a stressful experience.
• Least understood and most controversial of disorders.
• People rarely given these diagnoses.

• Consciousness
• Memory
• Identity

• Some aspect of cognition or experience becomes inaccessible to consciousness.
• Repression and avoidance.

• Memory loss, typically of a stressful experience.
• Not due to physical injury and may last hours or years.
• Usually returns spontaneously and in spurts.

The number of people who currently have a condition.

The annual number of people who are diagnosed with a condition.

• An incurable disease can have low incidence, but high prevalence.
• A short-lived curable condition like a cold can have a high incidence, but low prevalence.

• People focus on weapon and not the face of the person giving them trauma.
• High levels of stress hormones might interfere with memory formation.
• Emotional content might have vividness, but not accuracy.
• Deficits are in explicit memory.

Involves conscious recall of experiences.

Underlies behaviors based on experiences that cannot be consciously recalled. (riding a bike)

• Degenerative brain disorders
• Substance abuse

• Alzheimer's Disease
• Not linked to stress
• Involves gradual decline over time
• Accompanied by other cognitive deficits - can't learn new info

• Memory loss accompanied by leaving home and making new identity.
• Sudden, unexpected travel with inability to recall one�s past and create a new identity.
• Memory comes back spontaneously and in spurts.
• 0.2% prevalence rate.

• Alteration in experience of self.
• Feelings of detachment or disconnection from self.
• Unusual sensory experiences - limbs enlarged or voice distant.
• No psychosis or loss of memory.
• Based on one symptom - criticized for this.

• At least two distinct personalities that act independently of each other.
• Other symptoms: headaches, hallucinations, self harm, suicide attempts.
• Most severe dissociative disorder and more common in women.

• Posttraumatic Model - results from severe psychological and/or sexual abuse in childhood.
• Sociocognitive Model - a form of role-play in suggestible individuals. Response to therapists or media.

• DID can be role-played.
• DID patients show only partial implicit memory deficits.
• DID diagnosis differs by clinician.
• For many, symptoms emerge after therapy begins.

• Empathic and supportive therapist.
• Integration of alters into one individual.
• Improvement of coping skills.
• Psychoanalytic - reexperience traumatic event
• Poor outcomes.

• Psychological problems take a physiological form.
• Bodily symptoms have no cause and are involuntary.
• Individuals seek medical treatment.

• Severe, prolonged pain.
• Can't be accounted for by organic pathology.
• Caused by conflict and stress.
• Individual unaware of psychological origins.

• Preoccupation with and extreme distress over imagined or exaggerated defect in appearance.
• Constant examination of self in mirror or avoids mirrors.
• Housebound or plastic surgery or suicidal thoughts.
• Women. Late adolescence. High comorbidity.

• Fears of having a serious disease.
• Critical of medical professionals.
• Early adulthood.

• Multiple, recurrent pain complaints with no apparent physical cause.
• Seeks treatment from multiple physicians.
• Exaggerated presentation of symptoms and complaints.
• Higher in South Am. and Puerto Rico.

• Sensory or motor function impaired but no neurological cause.
• Vision impairment, paralysis of arms/legs, seizures or coordination problems. Anesthesia, aphonia, anosmia.
• Can't be explained by medical condition.

Loss of sensation.

Whispered speech.

Loss of smell.

Believed it only occured in women and attributed to wandering uterus. Hysteria.

• Coined term conversion.
• Thought that anxiety and conflict converted into physical symptoms.

• Adolescence to early adulthood.
• Prevalence less than 1%.
• Comorbid with depressive disorder, substance abuse, personality disorders.

• Distressing event that is unexpressed and pushed to unconscious.
• In women, linked to sexual Electra Complex.

• Decrease in incidence since last half of 19th century. Less repressed sexual attitudes and higher tolerance for anxiety symptoms.
• Prevalent in rural areas, people of lower SES, non-western.

Obsessive-Compulsive Disorder

• Cognitive Behavioral Treatment
• Not many studies about this.

• Identify & change triggering emotions.
• Change thinking about symptoms.
• Replace sick role behaviors with more appropriate social interactions.

• Antidepressants (Tofranil)
• Components of psychotherapy for pain disorder

• Validation of patient�s pain
• Relaxation training
• Reinforce shift of focus away from pain
• Help patient develop ability to cope with stress and gain sense of control over pain

• Cognitive Behavioral Therapy
• Exposure plus response prevention (Prevent individual from checking appearance)
• Antidepressants (Fluoxetine & Clomipramine)

• Cognitive Behavioral Therapy:
• Reduce attention to bodily sensations.
• Challenge negative perceptions about sensations.
• Discourage reassurance seeking from medical professionals.

• Medical professionals don�t dismiss physical complaints.
• Minimize use of diagnostic tests and medication.
• Avoid providing attention only when patient is complaining (reinforcing symptoms).
• Treat underlying depression and anxiety when present.

• No controlled studies to date.
• Psychoanalytic treatments have not demonstrated usefulness.
• Reinforcement of high functioning behavior may help.