ABNORMAL PSYCHOLOGY
DISSOCIATIVE DISORDERS AND
SOMATIC SYMPTOM DISORDERS
PSY221 | FIRST TERM
IRISH FRANCYN LABAO
DISSOCIATIVE DISORDERS
● Presumed to be caused by a common mechanism,
dissociation, which results in some aspects of cognition or
experience being inaccessible consciously.
Dissociative amnesia
○ Inability to recall important personal information, usually
information about some traumatic experience
○ Involve deficits in explicit memory but not implicit memory
Depersonalization
○ Persistent or recurrent experiences of detachment from one’s
mental processes or body
Derealization
○ Persistent or recurrent experiences of unreality of
surroundings
Dissociative Identity Disorder
○ Disruption of identity characterized by two or more distinct
personality states (alter), as evidenced by discontinuities in
sense of self, cognition, behavior, affect, perceptions, and/or
memories
ETIOLOGY OF DID
● Almost all patients with DID report severe childhood abuse
● Two models:
➢ POST-TRAUMATIC MODEL
➔ Proposes that some people are particularly
likely to use dissociation to cope with
trauma, and this is seen as a key factor in
causing people to develop alters after
trauma
➢ SOCIO-COGNITIVE MODEL
➔ Considers DID to be result of learning to
enact social roles
➔ Alters appear in response to suggestions
by therapists, exposure to media reports of
DID, or other cultural influences
TREATMENT OF DID
● Treatment for Dissociative Identity Disorder (DID) emphasizes
empathy, aiming to integrate multiple personalities into a
single individual while teaching more effective stress-coping
strategies
● Psychodynamic therapy is often used for DID, focusing on
addressing repressed memories and sometimes
involving hypnosis to access these memories
● Success in treatment varies but can lead to stable integration
of alters; DID may be comorbid with anxiety and
depression, which can be alleviated by antidepressant,
though they do not directly treat DID symptoms.
SOMATIC SYMPTOM DISORDERS
● Somatic symptom disorders are defined by excessive
concerns about physical symptoms or health
Illness Anxiety Disorder
○ Unwarranted fears about a serious illness despite absence of
any significant somatic symptoms lasting for at least 6 months
Functional Neurological Disorder
○ Neurological symptoms(s) that cannot be explained by
medical disease
Malingering
○ Intentionally faking symptoms to gain from those symptoms
Factitious Disorder
○ Falsification of psychological or physical symptoms, without
evidence of gains from those symptoms
Complex Somatic Symptom Disorder
○ Excessive thoughts, feelings, and behaviors related to
somatic symptoms:
➢ Excessive anxiety, concern, or time and energy
devoted to the somatic concern
➢ Duration of at least 6 months
ETIOLOGY OF SOMATIC SYMPTOMS DISORDER
● Neurobiological factors affecting awareness and distress
over somatic symptoms are associated with specific brain
regions like the anterior insula and anterior cingulate
➢ Increased activity in these regions can lead to
heightened somatic symptoms and pain perception
➢ Emotions, anxiety, and depression are linked to
these brain regions, which can exacerbate physical
and emotional pain experiences
● Cognitive Behavioral Models of somatic symptom disorders
assumes:
➢ More attention to negative health-related cues
➔ People with excessive distress about their
somatic symptoms may automatically
focus on cues of physical health problems
1
 ➢ People prone to worries about their health also
demonstrate an attributional style that involves
interpreting physical symptoms in the worst possible
way

➢ The tendency to be overly concerned about one’s

health may have evolved from early experiences of
medical symptoms or from family attitudes to
physical illness

● Behavioral perspectives

➢ A person may assume the role of being sick and

avoid work and social tasks, and this can intensify
symptoms

➢ The person may seek reassurance from doctors,

and this help-seeking behavior may be reinforced if
it results in the person getting attention

TREATMENT OF SOMATIC SYMPTOMS DISORDER

MEDICATIONS

● Antidepressants are likely to be helpful when pain is a

dominant symptom of somatic symptom disorder

COGNITIVE BEHAVIORAL TREATMENT

● Identify and change the emotions that trigger their somatic

concerns

● Change their cognitions regarding their somatic symptoms

● Change their behaviors so they stop playing the role of a sick

person and gain more reinforcement for engaging in other
types of social interactions

● Behavioral techniques might help people resume healthy

activities and rebuild a lifestyle that has been damaged by too
much focus on illness-related concerts