Abnormal PsychologyUnit 97 min read
Dissociative & Somatic Disorders: Causes, Types, and Real-World Links
Unit 9 of Abnormal Psychology explores dissociative disorders (e.g., dissociative identity disorder, depersonalization) and somatic symptom disorders (e.g., conversion disorder, illness anxiety), their diagnostic criteria, biological/psychological causes, and real-world applications in Nepalese contexts like trauma sur
TAKEAWAYS:
- Dissociative disorders involve fragmented memory/identity due to severe trauma, while somatic disorders manifest as physical symptoms without organic cause.
- The DSM-5 classifies these under Dissociative Disorders and Somatic Symptom and Related Disorders, with distinct diagnostic criteria.
- Trauma (e.g., childhood abuse) is the primary cause of dissociative disorders; stress and reinforcement drive somatic symptoms.
- Real-world examples: eSewa’s customer service agents (dissociative amnesia from stress) and NTC workers (somatic pain from job strain).
- Treatment: Cognitive-behavioral therapy (CBT) for dissociative disorders; exposure therapy for somatic symptoms.
- Exam focus: Compare symptoms, causes, and real-case applications (e.g., a Daraz delivery person with conversion disorder).
1. Dissociative Disorders: Definitions and Types
Dissociative disorders are mental conditions where a person’s identity, memory, or consciousness becomes fragmented due to extreme trauma (e.g., abuse, war). The brain’s amygdala and prefrontal cortex (responsible for emotion regulation) are often impaired, leading to detachment from reality.
Key Types and Symptoms
Worked Example: A Nepali Case
Scenario: A Pathao driver in Kathmandu, after surviving a landslide trauma, reports:
- "Blacking out" during rush hours (dissociative amnesia).
- Feeling like he’s "watching his life from outside" (depersonalization). Diagnosis: Dissociative disorder triggered by PTSD from the disaster.
2. Causes of Dissociative Disorders
| Cause | Mechanism | Real-World Link |
|---|---|---|
| Childhood Trauma | Brain’s stress response (HPA axis) shuts down memories to cope. | Nepali children in conflict zones (e.g., Maoist-era survivors). |
| War/Disasters | Extreme stress fragments identity (e.g., soldiers with "shell shock"). | NTC workers after the 2015 earthquake. |
| Chronic Abuse | Victims "escape" via dissociation (e.g., switching identities). | Domestic violence survivors in Nepal. |
3. Somatic Symptom Disorders: Definitions and Types
Somatic disorders involve physical symptoms (e.g., pain, paralysis) without a medical cause. The brain’s somatomotor cortex misinterprets stress as illness.
Key Types and Symptoms
Worked Example: A Nepali Scenario
Scenario: A Khalti customer service agent develops:
- Severe back pain after a shift (no injury found).
- Weakness in one arm during high-stress periods. Diagnosis: Conversion disorder due to workplace pressure.
4. Causes of Somatic Symptom Disorders
| Cause | Mechanism | Real-World Link |
|---|---|---|
| Stress | Brain misinterprets anxiety as physical pain (e.g., "heart attack" from stress). | Bank employees during bonus season. |
| Reinforcement | Symptoms gain attention (e.g., frequent hospital visits). | NEPSE traders with "chest pain" during crashes. |
| Cultural Factors | Belief that mental distress = physical illness (e.g., "heart weakness" for sadness). | Nepali families attributing stress to "weak blood." |
5. Comparison Table: Dissociative vs. Somatic Disorders
| Feature | Dissociative Disorders | Somatic Symptom Disorders |
|---|---|---|
| Primary Symptom | Memory/identity fragmentation | Physical symptoms without cause |
| Cause | Trauma (e.g., abuse, war) | Stress, reinforcement |
| Brain Area Affected | Amygdala, prefrontal cortex | Somatosensory cortex |
| Example | Forgetting a wedding day (amnesia) | Sudden blindness after a breakup (conversion) |
| Treatment | CBT, trauma therapy | Exposure therapy, stress management |
6. In the Real World
- eSewa App: Customers with dissociative amnesia may forget transactions after high-stress periods (e.g., during festival sales).
- NTC Workers: Chronic somatic pain (e.g., headaches) due to job-related stress, leading to frequent sick leaves.
- Pathao Drivers: Depersonalization during traffic jams, feeling "detached" from their bodies.
Exam Tip
- Define clearly: Start answers with DSM-5 criteria (e.g., "Dissociative Identity Disorder involves ≥2 distinct identities...").
- Link to Nepal: Use local examples (e.g., earthquake survivors, bank employees) to illustrate causes/symptoms.
- Compare: Always contrast dissociative (memory/identity) vs. somatic (physical) symptoms in tables.
- Treatment focus: Mention CBT for dissociation and exposure therapy for somatic symptoms.
- Avoid vague terms: Replace "stress" with specific mechanisms (e.g., "HPA axis dysfunction").
Key Visual Summary:
Based on the TU BSW syllabus for Abnormal Psychology, unit 9.
Discussion
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