PRAC 6655 Dissociative and Somatic Symptom-Related Disorders

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PRAC 6655 Dissociative and Somatic Symptom-Related Disorders

PRAC 6655 Dissociative and Somatic Symptom-Related Disorders

What do I have to do? When do I have to do it?

Review your Learning Resources. Days 1–7

Assignment: Clinical Hour and
Patient Logs

Record your clinical hours and patient
in Meditrek by Day 7.

As a reminder, consult the DSM-5, clinical practice guidelines, and your textbooks from
previous coursework as needed to support the experiences you are encountering at your
site. If you encountered a patient at your practicum site with a dissociative or somatic
symptom-related disorder, consider what patient factors and behaviors you think might
impact each of these disorders. Also, consider how psychopharmacological and/or
psychotherapy interventions may be appropriate for the patient. As you progress in your
clinical practicum, you continue to use Meditrek to record your time and patient
encounters, thoughtfully considering the skills you are gaining.
Learning Objectives
Students will:
 Describe clinical hours and patient encounters

Learning Resources

Required Readings (click to expand/reduce)

Carlat, D. J. (2017). The psychiatric interview (4th ed.). Wolters Kluwer.
 Chapter 29, “Assessing Eating Disorders and Somatic Symptom Disorder”
Review the section on somatic-symptom disorder only.

Kleinstäuber, M., Witthöft, M., Steffanowski, A., van Marwijk, H., Hiller, W., & Lambert,
M. J. (2014). Pharmacological interventions for somatoform disorders in adults. Cochran
Database of Systematic Reviews, 11, 1465–1858.

Note: Use this link to log into Meditrek to report your clinical hours and
patient encounters.

Dissociative disorders

The DSM-5 includes three major dissociative disorders:

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  • Dissociative amnesia
  • Depersonalization/derealization disorder
  • Dissociative identity disorder

The dissociative disorders are all presumed to be caused by a common mechanism, dissociation. Which results in some aspect of cognition or experience being inaccessible consciously.

Dissociation and memory

Psychodynamic theory suggests that in dissociative disorder traumatic events are repressed.
In this model, memories are forgotten because they are so aversive.

Memory for emotional relevant stimuli is enhanced by stress, while memory for neutral stimuli is impaired.

Dissociative disorders involve unusual ways of responding to stress.
Extremely high levels of stress hormones could interfere with memory formation.
In the face of severe trauma, memories may be stored in such a way that they are not accessible to awareness later when the person has returned to a more normal state.
Dissociative disorders are considered an extreme outcome of this process.

Dissociative amnesia

The person with dissociative amnesia is unable to recall important personal information, usually information about some traumatic experience.
The holes in memory are too extensive to be explained by ordinary forgetfulness.
The information is not permanently lost, but it cannot be retrieved during the episode of amnesia, which may last for as short a period as several hours, or as long as several years.
The amnesia usually disappears as suddenly as it began, with complete recovery and only a small change of recurrence.

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