Somatoform disorders A disorder in which people have physical illnesses or complaints that cannot be fully explained by actual medical conditions Dissociative disorders A personality disorder marked by a disturbance in the integration of identity, memory, or consciousness. Historically, both somatoform and dissociative disorders used to be categorized as hysterical neurosis in psychoanalytic theory neurotic disorders result from underlying unconscious conflicts, anxiety that resulted from those conflicts and ego defense mechanisms "schizophrenia" "split mind" but it refers to a disruption of the usual balance of emotions and thinking. Schizophrenia is chronic and a severe brain disorder in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and extremely disordered thinking and behavior .

1. TSMU
Department of psychology
4th year, 1st semester, 2nd group
Done by :
Mustafa Khalil Ibrahim
Rafal Abdulrahman Jawad Almamoori

2.  Somatoform disorders
 A disorder in which people have physical illnesses or
complaints that cannot be fully explained by actual
medical conditions
 Dissociative disorders
 A personality disorder marked by a disturbance in the
integration of identity, memory, or consciousness.
 Historically, both somatoform and dissociative
disorders used to be categorized as hysterical
neurosis
 in psychoanalytic theory neurotic disorders result from
underlying unconscious conflicts, anxiety that resulted
from those conflicts and ego defense mechanisms

3.  Soma – Meaning Body
 Preoccupation with health and/or body appearance and
functioning
 No identifiable medical condition causing the physical complaints
 Types of Somatoform Disorders:
 Hypochondriasis
 Somatization disorder
 Conversion disorder

4.  Hypochondriasis
 A disorder in which individuals are preoccupied with having or
getting physical ailments despite reassurances that they are
healthy
 severe anxiety focused on the possibility of having a serious
disease
 shares age of onset, personality characteristics of running in
families with panic disorder
 illness phobia vs. hypochondriasis
 60% of patients with illness phobia develop hypochondriasis
 1% to 14% of medical patients
 treatment usually involves cognitive-behavioral therapy and
general stress management treatment (gain retained after 1
year follow-up)

6.  Somatization disorder
 A disorder characterized by unexplained physical complaints in
several categories over many years.
 Briquet’s syndrome (100 years ago)
 patients have a history of many physical complaints that can
not be explained by a medical condition, the complaints are not
intentionally produced
 20% of patients in primary care setting
 develops during adolescence (majority women)
 may be connected to Antisocial personality disorder
 difficult to treat (reassurance, stress reduction, more adoptive
methods of interacting with family are encouraged)

7.  Conversion Disorder
 A disorder in which psychological conflict or stress brings about
loss of motor or sensory function.
 Physical malfunctioning without any physical or organic pathology
 Malfunctioning often involves sensory-motor areas
 Persons show la belle indifference
 Retain most normal functions, but without awareness of this ability
 Statistics
▪ Rare condition, with a chronic intermittent course
▪ Seen primarily in females, with onset usually in adolescence
▪ Not uncommon in some cultural and/or religious groups

8.  Conversion disorder (cont.)
 Freudian psychodynamic view is still popular (anxiety converted into physical
symptoms)
 Emphasis on the role of trauma (stress), conversion, and primary/secondary
gain
 Detachment from the trauma and negative reinforcement seem critical
 Different from factitious disorder (intentional)
 Treatment
▪ Similar to somatization disorder
▪ Core strategy is attending to the trauma
▪ Remove sources of secondary gain
▪ Reduce supportive consequences of talk about physical symptoms

10.  Derealization
 Loss of sense of the reality of the external world
 Depersonalization
 Loss of sense of your own reality
 types of Dissociative Disorders:
 Dissociative amnesia
 Dissociative fugue
 Dissociative identity disorder (DID).

11.  DissociativeAmnesia
 Inability to recall personal information, usually of
a stressful or traumatic nature
 Generalized vs. selective amnesia
 Dissociative Fugue
 Sudden, unexpected travel away from home,
along with an inability to recall one’s past (new
identity)
 Occur in adulthood and usually end abruptly

12.  Dissociative Identity Disorder
 Formerly multiple personality disorder
 Many personalities (alters) or fragments of personalities
coexist within one body
 The personalities or fragments are dissociated
 Switch (transition form one personality to another,
includes physical changes)
 Can be simulated by malingers are usually eager to
demonstrate their symptoms whereas individuals with
DID attempt to hide symptoms
 Very high comorbidity
 Prevalence about 3%

13.  Dissociative Identity Disorder
 Auditory hallucinations (coming from inside their
heads)
 97% severe child abuse
 Onset – approximately 9 years
 Suggestible people may use dissociation as
defense against severe trauma
 Real and false memories
 Temporal lobe pathology (out of body
experiences)

14.  Treatment
 Dissociative amnesia and fugue
▪ Get better on their own
▪ Coping mechanisms to prevent future episodes
 DID
▪ Reintegration of identities
▪ Neutralization of cues
▪ Confrontation of early trauma
▪ hypnosis

16.  100,000 young people will have a first
episode of schizophrenia.
 5% of people with schizophrenia will die by
suicide.

17.  "schizophrenia" "split mind" but it refers to a
disruption of the usual balance of emotions
and thinking.
 Schizophrenia is chronic and a severe brain
disorder in which people interpret reality
abnormally. Schizophrenia may result in
some combination of hallucinations,
delusions, and extremely disordered thinking
and behavior .

20.  Withdrawal from friends and family
 A drop in performance at school
 Trouble sleeping
 Irritability or depressed mood
 Lack of motivation

24.  Cognitive symptoms: For some patients, the
cognitive symptoms of schizophrenia are subtle,
but for others, they are more severe and
patients may notice changes in their memory or
other aspects of thinking. Symptoms include:
 Poor “executive functioning” (the ability to
understand information and use it to make
decisions)
 Trouble focusing or paying attention
 Problems with “working memory” (the ability to
use information immediately after learning it)

26.  1. DisorganizedType
 a person displays incoherent patterns of thinking
and grossly bizarre and disorganized behavior.
 Emotions are flattened or inappropriate to the
situation.
 Often, a person acts in a silly or childish manner,
such as giggling for no apparent reason.
 Language can become so incoherent, full of
unusual words and incomplete sentences, that
communication with others breaks down.
 If delusions or hallucinations occur, they are not
organized around coherent theme.

27.  Disorganized thinking is inferred from
disorganized speech. Effective
communication can be impaired, and
answers to questions may be partially or
completely unrelated. Rarely, speech may
include putting together meaningless words
that can't be understood, sometimes known
as word salad.

28.  2. CatatonicType
 The major feature of the catatonic type of schizophrenia is
a disruption in motor activity.
 Sometimes people with this disorder seem frozen in a
stupor. For long periods of time,
 the individual can remain motionless, often in a bizarre
position, showing little or no reaction to anything in the
environment At other times,
 these patients show excessive motor activity, apparently
without purpose and not influenced by external stimuli.
 The catatonic type is also characterized by extreme
negativism, an apparently unmotivated resistance to all
instructions.

29.  3. ParanoidType Individuals suffering from this form of
schizophrenia experience complex and systematized delusions focused
around specific themes:
 Delusions of persecution. Individuals feel that they are being constantly
spied on and plotted against and that they are in mortal danger.
 Delusions of grandeur. Individuals believe that they are important or
exalted beings—millionaires, great inventors, or religious figures such as
Jesus Christ.
 Delusions of persecution may accompany delusions of grandeur—an
individual is a great person but is continually opposed by evil forces.
 Delusional jealousy. Individuals become convinced— without due
cause—that their mates are unfaithful.
 They contrive data to fit the theory and “prove” the truth
 of the delusion.
 Individuals with paranoid schizophrenia rarely display obviously
disorganized behavior. Instead, their behavior is likely to be intense and
quite formal.

30.  4. UndifferentiatedType This is the grab-bag
category of schizophrenia, describing a
person who exhibits prominent delusions,
hallucinations, incoherent speech, or grossly
disorganized behavior that fits the criteria of
more than one type or of no clear type.The
hodgepodge of symptoms experienced by
these individuals does not clearly
differentiate among various schizophrenic
reactions.

31.  5. ResidualType Individuals diagnosed as
residual type have usually suffered from a major
past episode of schizophrenia but are currently
free of major positive symptoms such as
hallucinations or delusions.The ongoing
presence of the disorder is signaled by minor
positive symptoms or negative symptoms like
flat emotion. A diagnosis of residual type may
indicate that the person’s disease is entering
remission, or becoming dormant.

32.  Having a family history of schizophrenia.
 Exposure to viruses, toxins or malnutrition
while in the womb.
 Increased immune system activation, such as
from inflammation or autoimmune diseases.
 Older age of the father.
 Taking mind-altering (psychoactive or
psychotropic) drugs during teen years and
young adulthood

33.  Suicide.
 Any type of self-injury.
 Anxiety.
 Depression.
 Abuse of alcohol, drugs or prescription medications.
 Poverty.
 Homelessness.
 Family conflicts
 Inability to work or attend school.
 Social isolation.
 Health problems, including those associated with
antipsychotic medications, smoking and poor lifestyle
choices.

34.  Genetic Approaches .
 Environmental Stressors.
 Brain Function

35.  Genetic Approaches
 Three independent lines of research—family
studies, twin studies, and adoption studies.
 Persons related genetically to someone who
has had schizophrenia are more likely to
become affected than those who are not
(Riley, 2011)

36.  Environmental Stressors
 genetic factors place the individual at risk but environmental
stress factors must impinge for the potential risk to be
manifested as a schizophrenic disorder.
 Eg :
live in urban .
traumatic life events.

37.  A hypothesis about the cause of certain
disorders, such as schizophrenia, that
suggests that genetic factors predispose an
individual to a certain disorder but that
environmental stress factors must impinge in
order for the potential risk to manifest itself.

38.  Brain Function Another biological approach to the study
of schizophrenia is to look for abnormalities in the brains
of individuals
 MRI has shown that the ventricles—the brain structures
through which cerebrospinal fluid flows—are often
enlarged in individuals with schizophrenia (Barkataki et al.,
2006).
 MRI studies also demonstrate that individuals with
schizophrenia have measurably thinner regions in frontal
and temporal lobes of cerebral cortex; the loss of neural
tissue presumably relates to the disorder’s behavioral
abnormalities (Bakken et al., 2011).
 The study focused on changes in gray matter (largely the
cell bodies and dendrites of nerve cells in the cortex) .

43.  Atypical antipsychotics
Aripiprazole (Abilify)
Asenapine (Saphris)
Clozapine (Clozaril)
 Psychosocial interventions
1- Social skills training.This focuses on
improving communication and social interactions.
2- Family therapy.This provides support and
education to families dealing with schizophrenia.

44.  Gerrig - Psychology and Life 20th Edition
c2013 (book)
 http://www.mayoclinic.org/diseases-
conditions/schizophrenia/basics/treatment/c
on-20021077
 http://emedicine.medscape.com/article/2882
59-overview#showall
 http://www.nimh.nih.gov/health/topics/schiz
ophrenia/index.shtml