Abnormal Psychology A

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Chapter 6
Somatic Symptom and Dissociative Disorders
Chapter-at-a-Glance
DETAILED INSTRUCTORS PRINT MEDIA PROFESSOR

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OUTLINE RESOURCES SUPPLEMENTS SUPPLEMENTS NOTES
Somatic Symptom and Related Demonstrations: Test Bank: PowerPoint
Disorders Treatment and Chapter 6 Slides: Chapter 6
p. 199 Somatoform Practice Tests: Pearson Video:
Somatic Symptom Disorder Disorders: Creating Chapter 6 Henry: Illness
Conversion Disorder (Functional helpful Study Guide: Anxiety Disorder
Neurological Symptom Disorder) brochures/pamphlets Chapter 6
Illness Anxiety Disorder Lecture Ideas:
Factitious Disorder Hypochondriasis:
Functional Impairment “Medical Student
Ethics and Responsibility Syndrome”
Epidemiology Learning Objectives:
Etiology 6.1-6.9
Treatment

Dissociative Disorders Demonstrations: Test Bank: PowerPoint

p. 214 Debate: Dissociative Chapter 6 Slides: Chapter 6
Dissociative Amnesia Amnesia A Valid Practice Tests: Pearson Video:
Dissociative Identity Disorder Legal Defense for Chapter 6 Sharon:
Depersonalization/Derealization Murder? Study Guide: Dissociative
Disorder Lecture Ideas: Chapter 6 Amnesia
Epidemiology Multiple Personalities:
Etiology The Many Masks We
Ethics and Responsibility All Wear
Treatment Learning Objectives:
6.10-6.16

Malingering Demonstrations: Is it Test Bank: PowerPoint

p. 226 malingering, factitious Chapter 6 Slides: Chapter 6
disorder, or Practice Tests:
somatoform disorder? Chapter 6
Lecture Ideas: Study Guide:
Possible Encounters Chapter 6
with Health Care
Workers
Learning Objective
6.17:
Real People Real Disorders: Nancy – Test Bank:
A Case of Somatic Symptom Chapter 6
Disorder Practice Tests:
p. 227 Chapter 6
Study Guide:
Chapter 6

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111
Key Terms
amnesia (p. 215) iatrogenic (p. 223)
conversion disorder (p. 200) illness anxiety disorder (p. 203)
depersonalization/derealization disorder (p. 218) malingering (p. 203)
dissociative amnesia (p. 215) pseudoseizures (p. 200)
dissociative disorders (p. 214) somatic symptom disorder (p. 199)
dissociative fugue (p. 216) somatic symptom and related disorders (p. 199)
dissociative identity disorder (p. 216)
factitious disorder (p. 203)
factitious disorder imposed on another (p. 205)
factitious disorder imposed on self (p. 204)

Learning Objectives
After reviewing this chapter, students should be able to:

LO 6.1 Understand how normal physical sensations can create abnormalconcerns about somatic
functioning.
LO 6.2 Identify two ways in which conversion disorder differs from somatic symptom disorder.
LO 6.3 Describe how illness anxiety disorder differs from somatic symptom disorder.
LO 6.4 Identify at least two characteristics of factitious disorder that make it different from other
somatic disorders.
LO 6.6 Explain the responsibilities of mental health professionals when faced with an incident of
factitious disorder imposed on another.
LO 6.7 Discuss how these disorders are affected by demographic and sociocultural factors.
LO 6.8 Identify the contributions of biological, psychological, and environmental factors to
somatic symptom and related disorders.
LO 6.9 Identify the challenges to successful psychological treatment for somatic symptom and
related disorders.
LO 6.10 Discuss how dissociative amnesia is different from momentary forgetting or amnesia as
a result of medical conditions.
LO 6.11 Identify two ways in which the process of the diagnosis of DID differs from other
psychological disorders.
LO 6.12 Describe the symptoms of depersonalization/derealization and when those feelings are
most likely to occur.
LO 6.13 Understand one of the major challenges to establishing accurate estimates of the
prevalence of dissociative disorders, including DID.
LO 6.14 Describe how the controversy surrounding repressed/recovered memories has
influenced the etiological theories of dissociative disorders.
LO 6.15 Discuss how the research on recovered/false memories may affect our assumptions
about child abuse and its aftermath.
LO 6.16 Summarize the state of the knowledge on how to treat dissociative disorders.
LO 6.17 Define malingering, and explain why it creates issues for clinicians in diagnosing
disorders.

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Chapter Outline
➢ See Lecture Idea #1, #2 and #6; Demonstration/Activity #4 and #5

Somatic Symptom and Related Disorders

Somatoform Disorders:
1. Definition of Somatic Symptom Disorder
a. Defined as conditions in which physical symptoms or concerns about an illness cannot be
explained by a medical or psychological disorder.
b. Experience real physical symptoms, but the symptoms are not explained by a medical
condition.
c. Four different types of somatic symptom and related disorders:
i. Somatic Symptom Disorder
ii. Conversion Disorder
iii. Illness Anxiety Disorder
iv. Factitious Disorder
2. Somatic Symptom Disorder
a. The presence of many symptoms that suggest a medical condition, but without a recognized
organic basis.
b. Founded by Pierre Briquet (e.g., in 1859, he described psychiatric patients with somatic
complaints that seemed to lack a physical cause in a paper, which led to the terms “hysteria”
or “Briquet’s syndrome”).
i. Pseudoseizures (e.g., which are sudden changes in behavior and mimic
epileptic seizures, but have no organic basis).
3. Conversion Disorder
a. A pseudoneurological complaint such as motor or sensory dysfunction.
b. Symptoms are quite serious (e.g., sudden paralysis or blindness); however, cannot be
explained by a medical condition.
c. About 10 to 15% of people diagnosed with conversion disorder will find that their symptoms
do meet criteria for a diagnosable medical condition.
d. Symptoms fall into three groups (e.g., motor symptoms, sensory deficits, and seizures and
convulsions).
4. Illness Anxiety Disorder
a. A disorder consisting of fears or concerns about having an illness that persist despite medical
reassurance.
b. People do not usually suffer from physical symptoms, but merely “worry” about illness or
symptoms.
c. Typical behaviors associated with Hypochondriasis:
i. Often people seek reassurance from medical professionals.
ii. Research medical information using a variety of sources.
iii. Spend time speaking with family and friends about their concerns.
iv. Avoid fear-provoking situations (e.g., going to the hospital for fear of catching
an illness).
d. Commonly referred to as “hypochondriasis,”
e. Transient hypochondriasis (e.g., when an individual contracts an acute illness or life-
threatening illness, or may contract the illness as a caregiver for someone else with a medical
condition).

➢ See Lecture Idea #1, #2, and #4; Demonstration/Activity #3

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5. Factitious Disorder
a. Condition in which physical or psychological signs or symptoms of illness are intentionally
produced, in what appears to be a desire to assume a sick role.
b. Different from somatic symptom and dissociative disorders in that the physical or
psychological symptoms of an illness are intentionally produced.
c. Malingering is a condition in which physical symptoms are produced intentionally to avoid
military service, criminal prosecution, work, or to obtain financial compensation or drugs.
d. People may produce physical symptoms, psychological symptoms, or both.
e. Originally called Munchausen syndrome named after an 18th-century German nobleman
Baron Karl Friedrich Hieronymus von Munchausen.
f. Deceptive practices used by people with factitious disorders (see Table 6.1).
i. Faking elevated body temperature
ii. Putting blood in urine to simulate kidney/urinary tract infections
iii. Taking blood-thinning medications to produce symptoms of hemophilia
iv. Fake chest pain or abdominal pain
v. Manipulate laboratory results to substantiate their illness claims
vi. Patients often beg for medical interventions and unnecessary treatments
vii. Often visit emergency rooms during the evening and weekends when they are
more likely to be evaluated by junior clinical staff members
viii. Provide false medical information, aliases, and histories
g. Factitious disorder imposed on another
i. This is a condition in which physical or psychological signs or symptoms of
illness are intentionally produced in another person, most often in a child by a
parent.
ii. Child victims have an average of 3.25 medical problems ranging to as many
as 19 medical illnesses in one child.
iii. Factitious disorder imposed on another (e.g., when proven is a form of child
abuse where the parent or perpetrator can be prosecuted).
6. Functional Impairment
a. Tend to have numerous hospitalizations.
b. May actually develop real illnesses as result of self-administered injuries, numerous surgical
operations, or self injections.
c. Peregrination is when a patient seeks numerous treatments at different hospitals and travels
from state to state or country to country using aliases to get the treatment they desire.
d. 6 to 22% of child victims die as result of medical illnesses inflicted upon them by their parent
or caregiver, 25% of their siblings, and 7.3% of the child victims had long-term or permanent
injuries
7. Ethics and Responsibility
a. May result in serious injury or death; psychologists have a responsibility to act in the best
interest of the child.
b. The investigation requires collaboration between child protection officials, medical personnel,
and psychological professionals.
c. The child must be evaluated by a medical specialist to make sure that there is no medical
reason for the child’s symptoms.
8. Epidemiology
a. There appears to be a lack of epidemiological data on the prevalence of factitious disorders.
b. At children’s hospitals annual incidence rates of 2/100,000 or 0.002%.
c. Sex, Race, and Ethnicity
i. More likely to occur in women (e.g., 77 to 98% who are younger and have
training in health care).
ii. The perpetrator(s) are typically the biological mother, however the father or
foster mothers can also be the perpetrators.
d. Developmental Factors
i. Most common in adults, but does exist in children and adolescents.

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 ii. The victims range in age from 8 to 18 with 70% of the victims being female
children.
iii. Children can also produce their own symptoms (e.g., fever, diabetic insulin
insufficiency, bruises, and infections).
9. Etiology
a. Lack of empirical data exists.
b. Psychodynamic explanation of factitious disorder
i. An attempt to gain control
ii. Form of masochism
iii. The result of a deprived childhood
iv. An attempt to deal with trauma
c. Behavioral explanation of factitious disorder
i. Maintained because of positive reinforcement received from others
d. Cognitive explanation of factitious disorders
i. People with factitious disorder misinterpret normal physical processes for
serious illness.
10. Treatment
a. Establishing a good therapeutic relationship is a necessary first step in treatment. (Starcevic,
2015). As noted earlier, a major
b. A challenge to successful treatment is the belief of many sufferers that they do not have a
psychological disorder. They emphasize their physical symptoms and often resist a
psychological intervention.
c. There is some evidence that antidepressants and antipsychotic medications are superior to
placebo on measures of pain, health concerns, and depression.
d. But there are no long-term follow-up data to suggest that these medications produce long-
lasting effects.
e. Symptom-focused cognitive-behavioral therapy (CBT) also may be helpful.
f. CBT includes engaging in relaxation training, diverting attention away from the physical
symptoms, and correction of automatic thoughts

➢ See Lecture Idea #7; Demonstration/Activity #1, and #2

➢ See Lecture Idea #1, #2, #5, and #6; Demonstration/Activity #4 and #5

➢ See Demonstration/Activity #1, #2, and #8

➢ See Lecture Idea #3 and #8; Demonstration/Activity #6 and #7

Dissociative Disorders
Dissociative Disorders:
1. Definition of Dissociative Disorders
a. A set of disorders characterized by disruption in the usually integrated functions of
consciousness, memory, identity, or perception of the environment.
b. This group of disorders seems to be the source of controversy among mental health
professionals.
c. Five types of dissociative experiences:
i. Depersonalization
ii. Derealization
iii. Amnesia
iv. Identity confusion
v. Identity alteration

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2. Dissociative Amnesia
a. Definition of amnesia: is the inability to recall important information that usually occurs
after a medical condition or event.
b. Causes of amnesia
i. Head injury
ii. Epilepsy
iii. Alcohol induced “blackouts”
iv. Low blood sugar
v. Stroke
vi. Seizure
vii. After receiving Electroconvulsant Therapy (ECT)
viii. Result of drug toxicity
ix. Global dementia
c. Dissociative Amnesia is an inability to recall important information, usually of personal
nature, that follows a stressful or traumatic event.
d. Types of Dissociative Amnesia
i. Localized amnesia (e.g., failure to recall events that occur during a certain
period of time).
ii. Generalized amnesia (e.g., total inability to recall any aspect of one’s life).
iii. Selective amnesia (e.g., a person forgets some elements of a traumatic
experiences).
e. Dissociative Fugue is a disorder involving loss of personal identity and memory, often
involving a flight from a person’s usual place of residence.
i. May be related to physical or mental trauma, depression, or legal problems.
ii. Usually seek treatment after awareness of identity or mental loss or if they
encounter the police.
3. Dissociative Identity Disorder (DID)
a. A presence within a person of two or more distinct personality states, each with its own
pattern of perceiving, relating to, and thinking about the environment and self.
b. Highly publicized disorder by the media with The Three Faces of Eve and Sybil.
c. Formerly known as multiple personality disorder.
d. Christine Costner-Sizemore the real “Eve.”
e. In the 1980s and early 1990s, mental health professionals discussed DID and found that as the
media coverage of the disorder increased so did the number of people reporting they also
suffered from DID.
f. Alters (e.g., the different personality states or persons which can range from one to 60 with
13.3 being the average).
4. Depersonalization/Derealization Disorder
a. The feeling of being detached from one’s body or mind, a state of feeling as if one is an
external observer of one’s own behavior.
b. Characterized by the presence of other medical conditions or psychiatric disorders.
c. Experiencing feelings of being detached from one’s body or unfamiliarity with one’s
surroundings.
5. Epidemiology
a. There appears to be a lack of research surrounding the social and occupational impact of
dissociative disorders.
b. There is also conflict of whether the impairment is a result of the dissociative disorder or
another psychological disorder.
c. Inconsistencies exist in research reporting the prevalence rates.
d. Dissociative disorders affect 4 to 21% of all psychiatric inpatients, and among one clinic
sample 29% had a dissociative disorder.
e. Sex, Race, Ethnicity, and Developmental Factors
i. Both men and women suffer from Dissociative Disorders.
ii. Difference in worldwide prevalence rates exist compared to the U.S. which
suggests that the disorders may represent a culture-bound syndromes.

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 iii. The average age for depersonalization disorder ranges from adolescence to
adulthood (e.g., 15.9 to 22.8 years).
iv. Children who are given the diagnosis of DID also have many other
psychological disorders.
6. Etiology
a. Biological
i. Abnormal brain functioning
ii. Structural abnormalities
iii. Neurochemical changes
iv. Neurological conditions
b. Psychosocial
i. Failure of normal personality integration
ii. Severely abused children
iii. Childhood sexual abuse
iv. Recovered or false memories
v. Way of coping with trauma
vi. Way to compartmentalize trauma in the form of “alters” (e.g., different
personalities)
vii. Also viewed as an iatrogenic disease
7. Ethics and Responsibility
a. Even when a person provides a detailed memory and is confident that it is accurate does not
mean that the person remembered how an event really happened.
b. The issue of recovered/false memories is an important element in child abuse.
c. Posttraumatic Model of DID
d. Iatrogenic model is the term describing a disease that may be inadvertently caused by a
physician, by a medical or surgical treatment, or by a diagnostic procedure.
8. Treatment
a. Lack of pharmacological trials for derealization disorder or DID
b. Use of antidepressants
c. Cognitive-behavioral therapy
i. Challenge misinterpretations of normal symptoms of fatigue, stress, or even
substance abuse.
ii. Find alternative explanation or “cognitive restructuring.”
iii. Exposure therapy (e.g., to face fears).

➢ See Demonstration/Activity #6

Malingering
1. Malingering
a. creating psychological symptoms for personal gain
b. avoid something
c. obtain medication
d. gain money
e. Detecting malingering is important for criminal investigations and college student grade
analyses

Real Science Real Life: Nancy—A Case of Somatic Symptom Disorder

Real Science Real Life:

1. It is important as a psychologist or mental health professional to always conduct an initial assessment
or interview to gather the personal history.
2. The signs and symptoms should be viewed from the patient’s point of reference, keeping in mind that
the client’s perception to reality.

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117
3. It is key to identify other stressors, existing medical conditions, and social supports for the patient.
4. If a mental health professional has access and consent to gather information related to the patient’s
signs and symptoms from one’s family member.
5. When assessing the patient it is important to address issues around distress, functioning, and
psychosocial implications.
6. Remember the patient experiences symptoms as a real illness although the symptoms lack a medical
origin and may reject psychological explanations for symptoms.

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Lecture Starters or Discussion Points
1. “Gimme a Beat” (see Handout 6-1)
Psychology instructors tend to look for innovative ways to teach students course-related material
as a way to reach the different learning styles, enhance motivation, and increase participation
levels for all students. This can be done by utilizing a variety of different teaching formats,
activities, lecture material, the use of multimedia, and even pop culture. Potkay (1982) described
the use of popular song lyrics as a way to (a) highlight the importance of a concept, (b) provide a
concrete illustration of the concept, (c) demonstrate the relevance of an idea in contemporary
context, (d) increase general awareness of psychological aspects of everyday media, (e) stimulate
classroom discussion, (f) encourage personal involvement by students, who may also may find
new songs on their own, (g) add an alternative to film, television, and print media for use in the
classroom, and, (h) offer a novel, entertaining stimulus with which to break fatigue or monotony
during lengthy class sessions (p. 233).

According to Albers and Bach (2003), 74% percent of students felt the use of music not only
challenged expectations, but “set the stage for the day’s lecture.” It also allowed the instructor to
appear, “less regimented, less formal, and thus less daunting (especially for younger students)”
(pp. 239–242). A list of popular songs is provided (see Handout 6-1). It may even be helpful as a
homework assignment to ask students to select a popular song about the current chapter readings
to incorporate the student’s perception of this process.

Albers, B. D., & Bach, R. (2003). Rockin soc: Popular music to introduce sociological concepts. Teaching
Sociology, 31, 237–245.

Potkay, C. R. (1982). Teaching abnormal psychology concepts using popular song lyrics. Teaching of
Psychology, 9 (4), 233–234.

2. Movies and Mental Illness

Films provide great opportunities to introduce and expand on the key concepts outlined
throughout each chapter. Given classroom time restraints, it is best to show movie clips ranging
from five to ten minutes. The utilization of popular films can be a way to capture your students’
attention by applying chapter content to real-world pop cultural settings, thus facilitating class
discussion. Zimmerman (2003) listed several examples of popular feature films, both new and
older releases (see films discussed and/or cited), to consider. Although Hollywood films tend to
distort the realities surrounding mental health issues, they can be used as “classroom assets rather
than liabilities” because films offer a visual representation as to how it would be to live with a
mental disorder, including being socially excluded and experiencing discrimination (Livingston,
2004, p. 119).

Livingston, K. (2004). Viewing popular films about mental illness through a sociological lens. Teaching
Sociology, 32, 119–128.

Zimmerman, J. N. (2003). People like ourselves: Portrayals of mental illness in the movies. Lanham, MD:
Scarecrow Press, Inc.

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3. The Controversies with Dissociative Disorders, Specifically Dissociative Identity
Disorder (DID): Is DID a real disorder?
The dissociative disorders diagnostic group, especially Dissociative Identity Disorder (DID),
has been a topic of discussion and controversy among mental health professionals for many
years. It seems that professionals cannot agree on the validity of the diagnostic group, with
the text mentioning that 97% of psychologists who work at the VA believe the disorders
exist, 55% of Australian psychologists believe the disorders exist, 25% of American
psychiatrists and 14% of Canadian psychiatrists believed the disorders were supported by
sound scientific evidence. Dissociative Identity Disorder was formerly known as Multiple
Personality Disorder (MPD).

Elzinga, van Dyck, and Spinhoven (1998) pointed our three major controversies surrounding
DID: “Is DID iatrogenic in nature, DID as a diagnostic entity, and amnesia and recovered
memory” (pp. 13–17). The text defines iatrogenic as a term describing a disease that may be
inadvertently caused by a physician, by a medical or surgical treatment, or by a diagnostic
procedure. Elzinga et al. (2009) state that DID is the “result of implicit instructions of the
therapist, the knowledge that the patient has of DID, and of subtle demand characteristics,
especially present in the therapy setting” (p. 14). These writers further espoused that DID is
overdiagnosed due to the “vagueness of the diagnostic criteria” and the inability of
experiencing amnesia (“inability to recall important personal information”) again is rather
vague and open to suggestion (Elzinga et al., 1998, p. 16). Lastly, Elzinga et al reported that
“false memory syndrome as an iatrogenic created disorder in patients who uncritically accept
the suggestions of a history of childhood sexual abuse while they have no actual abuse
history” with DID patients “may be especially highly hypnotizable, and hypnosis is often
uses as a therapeutic tool” (pp.17–18). Questions for students: What controversies do you see
regarding the dissociative disorders diagnostic group or specifically DID? Do you feel DID is
a legitimate clinical diagnosis? Why or why not? What other factors or concerns contribute to
this group of disorders being controversial?

Elzinga, B. M., van Dyck, R., & Spinhoven, P. (1998). Three controversies about dissociative identity disorder.
Clinical Psychology and Psychotherapy, 5, 13–23.

4. Possible Encounters with Health Care Workers with Factitious Disorder Imposed
on Another: The Case of Beverley Gail Allitt “The Angel of Death”
According to the Tru TV Crime Library (2009), Beverley Allitt is one of Britain’s most
notable female serial killers. She was “charged with four counts of murder, eleven counts of
attempted murder, and eleven counts of causing grievous bodily harm” by harming and even
killing her young children patients at the hospital where she was employed (Chapter 6).
Beverley Allitt a 23-year-old nurse worked at the “Children's Ward 4 at England's Grantham
and Kesteven Hospital in Lincolnshire,” and was perceived to have both Factitious Disorder
(e.g., inflicting illness or harm on oneself for some type of secondary gain) and Factitious
Disorder Imposed on Another (e.g., inflicting harm or illness on others, most often children
for some type of secondary gain) (Tru TV Crime Library, 2009, Chapter 1). Her symptoms of
Munchausen Syndrome began in childhood with her constantly wearing bandages and casts
to seek attention, but she often refused treatment and the ability to be examined. This
behavior continued during her court trial with her rapidly losing weight and developing

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Anorexia Nervosa, and then once she was sentenced she continued inflicting harm by trying
to stab herself with paper clips and to pour boiling water onto her skin (Tru TV Crime
Library, 2009). Repper (1995) reported that “at least 14 criminal trials have occurred
between 1975 and 1993 in which health care providers were associated with epidemics of
adverse patient outcomes,” and she goes on to describe cases of nurses, a babysitter, and a
foster mother who murdered individuals under their care (p. 302). Repper (1995) goes on to
mention that several factors should be considered when it comes to health care workers and
Factitious Disorder Imposed on Another such as: (a) it is not clear what the impact of this
diagnosis will have on the courts of law, (b) “careful and clear-headed surveillance is
therefore necessary” to validate accusations against nurses, (c) it is suggested to use
“personal and professional behavior and backgrounds of staff may lead to a more efficient
and sensitive investigation,” (d) any indication of a “previous history of self-harm or
suspicious behavior” may help in employee selection, and (e) health care workers must be
educated on the diagnosis of Factitious Disorder Imposed on Another (p. 303). Questions for
students: Why do you think a person in the health care profession would systematically harm
or even murder patients? What precautions if any do you believe can be used as a way to
screen individuals, specifically individuals in the health care field with direct contact with
patients? What factors do you feel contribute to the etiology of Factitious Disorder or
Factitious Disorder Imposed on Another? If you have Internet access in your classroom, ask
students to research the Internet for other court cases where Factitious Disorder was used as a
legal defense or just find other infamous cases of Factitious Disorder.

Pepper, J. (1995). Munchausen syndrome by proxy in health care workers. Journal of Advanced Nursing, 21,
299–304.

Ramsland, K. (Tru TV Crime Library, 2009). Beverley Allitt: Suffer the children.

5. Hypochondriasis: “Medical Student Syndrome” in Abnormal Psychology Students

(see Handout 6-2)
Abnormal psychology tends to be one of the most popular courses offered in psychology
departments across the nation. A variety of reasons exist for this heightened popularity, such
as taking the class to explore one’s own personal mental health, an information-gathering
attempt to understand friends or family with mental illness, or the basic fascination with
human abnormal behavior. Woods, Natterson, and Silverman (1966) reported that it is
commonplace for medical students to experience hypochondriacal anxieties around the
different ailments they are learning about in medical school.

For example, Hardy and Calhoun (1997) stated that “when learning about brain tumors
students may worry that their headaches are a sign of serious illness or after learning about
congestive heart failure, they may believe that their heartburn means impending coronary
failure” (p. 192). In turn, Hardy and Calhoun (1997) conducted a study to see if the same
“medical student syndrome” existed for abnormal psychology students and found that “those
planning to major in psychology reported significantly more concern about their overall
psychological functioning than those not planning to major in psychology,” and students who
planned to pursue graduate degrees in psychology were “significantly more likely to report a
history of psychological treatment” (pp. 192–193). These authors conclude that the
“phenomenon of the wounded healer may be apparent early in the career process of future

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121
clinicians” and that some abnormal psychology students may become “junior clinicians as
they begin to diagnose those in their family” (Hardy & Calhoun, 1997, p. 193). On a positive
note, Hardy & Calhoun (1997) reported that “students are more willing to seek help for
psychological distress after learning about the disorders and the treatment options available”
(p. 193). This provides an opportunity to discuss the concepts of “medical student syndrome”
and “wounded healer” and how that applies to students taking abnormal psychology. You
may also want to normalize this experience for students. In addition (see Handout 6-2), make
copies of this handout and pass it out to your students to complete anonymously. After you
have compiled the data, you may want to use SPSS and share the results with your class. It
may also be beneficial to complete this towards the beginning of the semester and then again
towards the end of the semester to complete a correlation.

Hardy, M. S., & Calhoun, L. C. (1997). Psychological distress and the “medical student syndrome” in abnormal
psychology students. Teaching of Psychology,24(3), 192–193.

Woods, S. M., Natterson, J., & Silverman, J. (1966). Medical students’ disease: Hypochondriasis in medical
education. Journal of Medical Education, 41, 785–790.

6. Multiple Personalities: The Many Masks We All Wear

It may be helpful to show a short clip from the movie, The Breakfast Club, a 1985 film by
John Hughes which depicts how five teenagers each wear different masks depending on
where they are and whom they are around. After you watch a clip from the film, ask the
students to acknowledge the different masks and personas each of these characters wear. Can
you relate to any of these characters? Why or why not? Raise the question, “Don’t all of us
have multiple masks or personas that we portray to the world in some type of capacity?”
Some may hypothesize that dissociative identity disorder, formerly known as multiple
personality disorder, may be an exaggerated version of all of those multiple personas and
masks that we all wear on a day-to-day basis intertwined into our personality. Each of our
masks or personas represents our ideals, wants, needs, morals, our worldview, self-image,
experiences, others’ perception of us, and the different social roles integrated as a part of the
whole personality. These varying personas and masks may explain the fickleness in how we
act, think, and feel from time to time.

Hughes, J. (Writer and Producer) (1985). The Breakfast Club [Motion Picture]. U.S.: Universal Studios.

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Demonstrations/Activities
1. Is it malingering, factitious disorder, or somatic symptom disorder?
The text defines malingering as intentionally feigning physical or emotional symptoms for some
type of gain. Reid (2000) reports that although these three concepts can be confused, malingering
refers to “feigning or significantly exaggerating symptoms for a conscious gain or purpose,”
factitious disorder indicates one is “feigning symptoms for a largely or wholly unconscious
purpose,” and somatoform disorder is largely psychosomatic in nature and references several
disorders “that do not involve feigning at all, but rather the largely or wholly unconscious
creation of symptoms for an unconscious purpose” (p. 226). Ask students to give a case example
of each of the above terms. Then ask the students how they would tell the difference between the
three conditions.

Reid, W. H. (2000, July). Law and psychiatry: Malingering. Journal of Psychiatric Practice, 226-228.

2. Hypochondriasis: My Girl Movie Review

Laurice Elehwany’s 1991 film, My Girl, begins with Vada Sultenfuss, played by Anna
Chlumsky, who is a hypochondriac who is obsessed with death as well as developing a disease.
Show segments of the movie when Vada is making frequent trips to her primary care physician
for fear she is dying or developing a serious disease, and when she is worrying about death due
to her father working in a morgue. Ask students to pay attention to her behavior, actions, and
thoughts. Do you notice any irrational beliefs or special precautions she takes to avoid
contracting illness? Then use this movie clip to spark discussion on potential causes, signs and
symptoms, and the treatment of hypochondriasis. How do you think hypochondriasis begins in
childhood? Could hypochondriasis be viewed as an anxiety disorder, more specifically a “health
anxiety disorder”? Compare the signs and symptoms, as well as treatment options for anxiety
disorders versus hypochondriasis. Do you see any similarities or major differences? Why or why
not? If one experiences some trauma or witnesses someone with a terminal disease, does this put
them at risk to develop hypochondriasis?

Elehwany, L. (Writer) & Grazer, B., Caracciolo, J. M., Friendly, D. T. (Producers). (1991). My Girl [Motion
Picture]. United States

3. Body Awareness and Illness Log

This exercise is designed for students to increase their own insight into how they experience and
perceive bodily symptoms, sensations, pain, and even illness. It may be helpful to have students
complete this activity over a couple of days before discussing the topic of hypochondriasis or the
somatoform disorders diagnostic category. Ask the students to keep a log of all the different
sensations they experience in their body on a day-to-day basis. In this log ask the students to
write out the physical sensation (i.e., pain, ache, itches, dryness, nausea, dizziness, etc.), the
location where they experienced the sensation, the antecedent to the sensation if there was one,
and then their immediate thought(s) after the physical sensation. If the sensation was one of pain
or the beginning signs of illness, ask students to further mention if the sensation(s) caused such a
state of worry or concern to make an appointment with one’s primary care physician. Use the
discussion of the personal logs to inquire about the overreporting or underreporting of symptoms
in need of medical attention. Discuss how people with hypochondriasis are overly sensitive to
these bodily physical sensations that we all may experience and tend to misinterpret them as

Copyright © 2017, 2014, 2012 by Pearson Education, Inc. All rights reserved.
123
needing serious medical attention. In addition, with one who suffers from hypochondriasis, these
benign symptoms are thought to be an impending serious disease or illness.

4. Debate: Is dissociative amnesia a valid legal defense in the crime of murder?

Debates are a great way to stimulate critical thinking and student participation. In addition, this
provides a method of applying learned material from the textbook to “real world application.”
Elliot (1993) added that debates can also produce an environment conducive to “active learning”
and “cooperative learning”; she found that 50% percent of her student evaluations “emphasized
how debates illuminated class readings” (pp. 36–37).

Action
1. Divide students by either splitting the class into half or divide the class into small groups
of four to six students.
2. Explain to the students that they are all currently working in the field of mental health in
some capacity (i.e., psychologists, psychiatrists, therapists, counselors, social workers,
psychiatric nurses, etc.).
3. Tell the student that either each half of the room or small group will be given one specific
side of the argument (i.e., Dissociative amnesia is a valid legal defense for murder or
Dissociative amnesia is not a valid legal defense for murder) and they must find reasons
(i.e., facts, opinions, use of the textbook, Internet if available in the classroom, etc.) to
support why their chosen side of the argument is the “Best” argument.

Process & Review

1. After students have compiled their evidence, allow each group(s) to share their reasoning
for why their side of the argument is “Best.”
2. Once one group starts, students usually take charge of leading the discussion going back
and forth. However, if needed the instructor can select which group starts or intervene if
one group is taking control over the discussion.
3. This demonstration provides an opportunity to review the validity of the diagnosis as well
as challenges students to explore outside of their comfort zones.
4. This also provides an opportunity to discuss the controversies surrounding the
dissociative disorders group and to see if students would view having DID a valid legal
defense as well.
5. Lastly, allow the class to discuss how it felt to perhaps have to defend a side of the
argument that maybe they were not in favor of and the difficulties that came with that.

Elliot, L. B. (1993). Using debate to teach the psychology of women. Teaching of Psychology, 20 (1), 35–38.

5. Dissociative Experiences: Daydreaming, Dreams, Hypnosis, Drug-induced, and Out-of-

Body Experiences
The text discusses how just because one experiences an episode of dissociation does not always
indicate an individual has a dissociative disorder. One can become so engrossed in one activity
(“absorption”) that s/he ignore the rest of the other aspects of the environment. The textbook
defines dissociative disorders as a set of disorders characterized by disruption in the usually
integrated functions of consciousness, memory, identity, or perception of the environment.
Dissociative amnesia is defined as the inability to recall important information, usually of a
personal nature, that follows a stressful or traumatic event. Ask students to think back to a time

Copyright © 2017, 2014, 2012 by Pearson Education, Inc. All rights reserved.
124
Another random document with
no related content on Scribd:
intended to be so,) toward the men who
were disabled in the late war, but a large
majority of the prison survivors are excluded
from a pension under these laws. This
comes partly from the unfriendly spirit in
which the pension department has been
administered for the last six years, and partly
from the peculiar circumstances surrounding
their several cases.
Many paroled prisoners, on reaching the
Union lines were at once sent home on
furlough, without receiving any medical
treatment. The most of these were
afterwards discharged under General Order
No. 77, dated War Department, Washington,
D. C., April 28th, 1865, because physically
unfit for service, and hence there is no
official record whatever as to their disease.
If one of those men applies for a pension,
he is called upon to furnish the affidavit of
some army surgeon who treated him after
his release and prior to discharge, showing
that he then had the disease on which he
now claims a pension. For reasons stated,
this is impossible. The next thing is a call to
furnish an affidavit from some doctor who
treated the man while at home on furlough,
or certainly immediately following his final
discharge, showing that he was then afflicted
with identical disease on which pension is
now claimed. This is generally impossible,
for many reasons.
In most cases the released prisoner felt it
was not medicine he wanted, but the kindly
nursing of mother or wife, and nourishing
food. So no doctor was called, at least for
some months after reaching home. In the
instances where the doctor was called, not
infrequently he cannot now be found, cannot
swear that the soldier had any particular
disease for the first six months after
reaching home, as he was a mere skeleton
from starvation, and it required months of
careful nursing before he had vitality enough
for a disease to manifest itself.
Then again in many cases the poor victim
has never suffered from any particular
disease, but rather from a combination of
numerous ills, the sequence of a wrecked
constitution commonly termed by physicians,
“General Debility.” But the commissioner
refuses to grant a pension on disease save
where the proof is clear and positive of the
contracting of a particular disease while in
the service, of its existence at date of final
discharge, and of its continuous existence
from year to year for each and every year, to
present date.
In most cases it is impossible for a prison
survivor to furnish any such proof, and
hence his application is promptly rejected.
Besides these, there are hundreds of other
obstacles in the way of the surviving prisoner
of war who applies for a pension. One thing
is, he is called upon to prove by comrades
who were in prison with him, the origin and
nature of his disease, and his condition prior
to and at the time of his release. This is
generally impossible, as he was likely to
have but few comrades in prison with whom
he was on intimate terms, and these, if not
now dead, cannot be found, they are men
without sufficient knowledge of anatomy and
physiology, and not one out of a hundred
could conscientiously swear to the origin and
diagnosis of the applicant’s disease. Is it not
ridiculous for the government to insist upon
such preposterous evidence? Which, if
produced in due form, is a rule drawn up by
the applicant’s physican, and sworn to by the
witness—“cum grano salis,”—and in most
cases amounts to perjury for charity’s sake.
Hence, it will be seen the difficulties
surrounding the prison survivor who is
disabled and compelled to apply for a
pension are so numerous and
insurmountable as to shut out a very large
majority of the most needy and deserving
cases from the benefits of the general
pension laws entirely.
We claim, therefore, that as an act of
equal justice to these men, as compared
with other soldiers, there ought to be a law
passed admitting them to pensions on record
or other proof of confinement in a
confederate prison for a prescribed length of
time—such as Bill 4495—introduced by the
Hon. J. Warren Keifer, M. C., of Ohio
provides for. And if this bill is to benefit these
poor sufferers any, it must be passed
speedily, as those who yet remain will, at
best, survive but a few years longer.
This measure is not asked as a pencuniary
compensation for the personal losses these
men sustained, as silver and gold cannot be
weighed as the price for untold sufferings,
but it is asked that they may be partly
relieved from abject want, and their
sufferings alleviated to some extent by
providing them with the necessaries of life,
for nearly all of them are extremely poor,
consequent on the wreck of their physical
and mental powers.
 LIST OF THE DEAD

The following are those who died and were buried

at Andersonville, with full name, Co., Regt., date of
death and No. of grave in the Cemetery at that place,
alphabetically arranged by States. The No. before
each name is the same as marked at the head of the
graves. The list will be found to be very accurate.
ALABAMA.
Sept
7524 Barton Wm Cav 1L 64
1
Berry J M, S’t 1 May
2111 “
A 17
1 Aug
4622 Belle Robert “
A 3
1 Aug
5505 Boobur Wm “
E 13
Sept
8425 Brice J C “ 1L
11
Sept
8147 Guthrie J “ 1 I
8
1 June
2514 Henry P “
F 26
 996 Jones Jno F “ 1 Mar
K 15
1
4715 Mitchell Jno D Aug 4
A
1 Aug
5077 Ponders J Cav
H 8
Aug
5763 Panter R 1L
15
1 Aug
6886 Patterson W D
K 25
1 June
2504 Prett J R
F 3
1
10900 Redman W R Cav Oct 14
G
Aug
4731 Stubbs W 1 I
4
Total 15.

CONNECTICUT.
14 June
2380 Anderson A 64
K 23
16 July
3461 Batchelder Benj
C 17
16 July
3664 Baty John
C 19
14 Aug
7306 Brunkissell H
D 30
14 July
2833 Brennon M
B 3
7 July
3224 Burns Jno
I 12
10414 Blumly E 8 Oct
D 6
Apr
545 Bigelow Wm 7B
14
Nov
11965 Ball H A 3B
11
8 Nov
12089 Brookmeyer T W
H 18
16 Nov
12152 Burke H
D 24
Dec
12209 Bone A 1E
1
14 Oct
10682 Burnham F, Cor
I 11
16 Oct
10690 Barlow O L
E 11
18 Oct
10876 Bennett N
H 13
1 Aug
5806 Brown C H
H 15
Aug
5919 Boyce Wm 7B
17
Aug
6083 Bishop B H Cav 1 I
18
14 Aug
6184 Bushnell Wm
D 19
16 Sept
1763 Bailey F
E 4
21 June
2054 Brewer G E
A 16
6 Aug
5596 Burns B
G 14
5632 Balcomb 11 Aug 64
 B 14
16 Aug
5754 Beers James C
A 15
16 Oct
11636 Birdsell D
D 28
July
4296 Blakeslee H Cav 1L
30
18 July
3900 Bishop A
A 24
14 June
1493 Besannon Peter
B 2
30 July
2720 Babcock R
A 1
July
2818 Baldwin Thos Cav 1L
3
16 June
2256 Bosworth A M
D 21
11 Aug
5132 Bougin John
C 8
Brooks Wm D, 16 Aug
5152
Cor F 9
16 Aug
5308 Bower John
E 11
6 Aug
5452 Bently F
H 12
Aug
5464 Bently James Cav 1 I
12
2 Aug
4830 Blackman A, Cor Art
C 6
16 Sept
7742 Banning J F
E 3
Ballentine 16 Sept
8018
Robert A 6
12408 Bassett J B 11 Jan 65
B 6
Jan
12540 Bohine C 2E
27
Feb
12620 Bennis Charles 7K
8
16 July
3707 Chapin J L 64
A 21
7 July
3949 Cottrell P
C 25
11 July
3941 Clarkson
H 25
July
4367 Culler M 7E
31
18 Aug
4449 Connor D
F 1
16 Aug
4848 Carrier D B
D 6
1 Aug
6060 Cook W H Cav
G 18
16 Aug
6153 Clark H H
F 15
Aug
6846 Clark W 6A
25
10 Aug
5799 Champlain H
F 15
9 Apr
336 Cane John
H 2
Apr
620 Christian A M 1A
19
14 Apr
775 Crawford James
A 28
7316 Chapman M 16 Aug
 E 30
Aug
7348 Cleary P Cav 1B
31
Aug
7395 Campbell Robert 7E
31
16 Aug
7418 Culler M
K 31
16 Sept
7685 Carver John G
B 3
14 Sept
7780 Cain Thomas
G 4
8 Sept
9984 Crossley B
G 29
16 Oct
10272 Coltier W
B 3
11 Oct
11175 Callahan J
I 19
Oct
11361 Candee D M Art 2A 64
23
Mar
25 Dowd F 7 I
8
Aug
7325 Davis W Cav 1L
30
10 July
2813 Davis W
E 3
July
3614 Damery John 6A
20
11 Sept
7597 Diebenthal H
C 2
Sept
8568 Donoway J Cav 1A
12
16 Sept
8769 Dutton W H
K 14
5446 Dugan Charles 16 Aug
K 12
16 Oct
11339 Dean R
H 23
16 Oct
11481 Demmings G A
I 24
18 Nov
11889 Downer S
C 7
16 Nov
11991 Demming B J
G 13
16 July
3482 Emmonds A
K 17
14 July
4437 Easterly Thomas
G 31
Aug
4558 Earnest H C 6 I
2
16 Aug
7346 Ensworth John
C 31
Edwards O J, 8 Sept
7603
Cor G 2
16 Sept
8368 Evans N L
I 10
16 Oct
11608 Emmett W
K 28
Jan
12442 Eaton W 6F 65
12
14 Mar
186 Fluit C W 64
G 27
6 May
1277 Francell Otto
C 22
7 June
2612 Fry S
D 28
4444 Fibbles H 16 Aug
 G 1
Aug
4465 Fisher H 1E
1
Florence J J, 16 Aug
5123
Cor C 8
24 Aug
5382 Fuller H S
H 11
1 Aug
5913 Frisbie Levi Cav
G 17
Aug
5556 Fogg C S’t 7K
13
Sept
8028 Feely M 7 I
6
14 Sept
9089 Filby A
C 18
Oct
10255 Frederick John 7A
3
11 Nov
12188 Fagan P D
A 28
14 July
3028 Gordon John
G 7
9 July
4096 Gray Pat
H 27
July
4974 Grammon Jas Cav 1K
7
Gulterman J, July
4005 1E
Mus 26
16 Aug
5173 Gilmore J
C 9
16 Aug
7057 Gallagher P
D 28
18 Aug
7337 Gott G, Mus
- 30
7592 Goodrich J W 16 Sept
C 2
16 Sept
7646 Graigg W
B 3
11 Sept
9423 Guina H M
G 21
11 Oct
10300 Grady M
B 4
Oct
10397 Gladstone Wm 6K
6
Mar
49 Holt Thomas Cav 1A
15
14 June
2336 Hughes Ed
D 22
16 July
3195 Hitchcock Wm A
C 12
July
3448 Hall Wm G 1K
17
14 July
3559 Holcomb D
D 18
14 May
1350 Hilenthal Jas
C 25
16 July
3033 Haskins Jas
D 8
Aug
5029 Hollister A Cav 1L
8
16 Aug
5162 Hally Thomas
F 9
15 Aug
5352 Hanson F A
I 11
1 Aug
6695 Hodges Geo Cav
H 24
4937 Harwood G 15 Aug
 A 7
17 Aug
6964 Hoyt E S
B 27
16 Aug
7012 Hull M
E 27
16 Aug
7380 Holcomb A A
E 31
16 Sept
7642 Haley W
D 3
16 Sept
7757 Hubbard H D
D 4
18 Sept
8043 Haywood
E 11
16 Sept
8613 Heath I, S’t
K 13
16 Sept
9129 Hall B
G 18
11 Sept
9369 Heart W
F 20
16 Sept
9981 Hurley R A 64
I 29
18 Nov
12086 Hibbard A
D 18
14 Nov
12117 Hancock W
G 22
11 Nov
12163 Hudson Chas
C 26
16 Nov
8148 Hubbard B
A 8
11 Sept
9340 Islay H
- 4
Jamieson 7 April
737
Charles D 26
5221 Johnson John 16 Aug
E 10
11 Aug
7083 Johnson G W
G 28
Jamison J S, Q 1 Aug
7365 Cav
MS - 31
16 Sept
7570 Jones Jno J
B 2
6 Sept
7961 Jones James R
G 6
1 Sept
8502 Johnson F
D 12
16 Nov
11970 Johnson C S
E 12
16 Dec
12340 Johnson W
E 26
14 June
1590 Kingsbury C
K 3
11 Aug
5186 Klineland L
C 9
8 Aug
6374 Kempton B F
G 21
6 Aug
6705 Kershoff B
H 25
14 Aug
6748 Kelley F
I 25
Sept
7749 Kaltry J Cav 1L
3
7 Sept
8065 Kimball H H
H 7
7 Sept
8866 Kohlenburg C
D 15
10233 Kearn T 16 Oct
 A 2
16 July
3401 Lenden H
D 16
10 Aug
5893 Lastry J
I 16
Aug
5499 Lewis J 8E
12
14 Aug
6124 Leonard W
H 19
Lavanaugh W O, 16 Sept
7912
S’t C 5
8 Sept
7956 Linker C
G 6
7 Sept
9219 Lewis G H
G 19
Oct
10228 Lee, farrier Cav 1F
2
6 Mar
74 Mills W J
D 20
14 Mar
119 McCaulley Jas
D 20
14 June
2295 Miller Charles
I 21
16 July
3516 McCord P
G 18
14 July
3644 Miller A
D 19
11 July
3410 Mould James
E 16
15 Aug
3933 McGinnis J W
E 17
July
4079 Miller D Cav 1E
27
4417 Messenger A 16 July
G 31
11 Aug
4492 McLean Wm
F 1
8 Aug
4595 Marshalls B
H 3
16 Aug
5238 Mickallis F
F 10
16 Sept
7852 Miller F D
B
10 Sept
8150 Modger A
I 8
11 Aug
6902 Mape George
B 25
8 July
6240 Marshal L
H 20
1 Sept
7547 Moore A P, S’t Cav
H 2
16 Sept
8446 Mathews S J
K 11
1 Sept
8501 Myers L Cav
- 12
11 Sept
9170 Mertis C
C 18
14 Sept
9321 Milor W, S’t
F 20
16 Aug
5328 Miller H
A 11
16 Aug
6342 Malone John
B 22
Aug
6426 Messey M 7E
22
6451 McGee Thomas 11 Aug
 D 22
Aug
6570 McDavid James 1K
23
11 Aug
6800 Meal John
D 25
14 Oct
10595 McCreieth A
H 10
7 Oct
10914 McKeon J
H 14
16 Oct
11487 Murphy W
C 26
11 Oct
11538 McDowell J
D 27
5 Nov
12134 Montjoy T
C 23
16 Aug
5044 Nichols C
G 8
7 Aug
6222 Northrop John
D 20
1 Aug
7331 North S S, S’t Cav
D 30
Oct
10895 Nichols M 7 I 64
14
Aug
4565 Orton H C 6 I
9
Sept
7511 Olena R Cav 1E
1
14 Sept
8276 Orr A
H 14
14 July
2960 Pendalton W
C 6
14 July
3808 Pompey C
B 24
4356 Parker S B 10 July
B 31
1 July
3803 Phelps S G
H 22
16 Aug
4934 Pimble A
I 7
11 Aug
5002 Plum James
G 8
Aug
5386 Patchey J Cav 1 I
12
16 Sept
7487 Post C, S’t
K 1
7 Sept
7688 Potache A
G 3
Sept
9248 Phillips J I 8B
19
Padfrey 8 Sept
9444
Sylvanus H 21
7 Sept
9533 Painter N P
C 22
Oct
10676 Puritan O Cav 1L
11
7 Oct
11616 Peir A
D 28
July
2804 Ruther J, S’t Cav 1E
3
2 July
2871 Reed H H Art
H 4
10 July
3674 Risley E, S’t
B 20
11 Aug
4636 Reins Wm
I 3
5902 Ross D 10 Aug