Somatoform Disorders

Psychological Factors Affecting Medical Conditions

Somatoform Disorders, Psychological Factors Affecting Medical Conditions, and Dissociative Disorders

In each set of disorders covered by this chapter, the body expresses psychological conflict and stress in an unusual fashion.

Dissociative Disorders

soma = “body” in Greek

Somatoform Disorders


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A wide variety of conditions in which psychological conflicts are translated into physical problems or complaints. Impair functioning, causes distress. No physiological basis. Won’t be indicated on physical or neurological tests.
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Conversion Disorder
Conversion Disorder: A somatoform disorder involving the translation of unacceptable drives or troubling conflicts into physical symptoms.

Four categories of symptoms:
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Motor symptoms or deficits. Sensory symptoms or deficits. Seizures or convulsions. Mixed presentations.




” ‰ Mostly women. ‰ Not deliberately “faking. facial features. ƒ Women . hair. scars. 8/17/2006 8/17/2006 BODY DYSMORPHIC DISORDER „ Gender Hypochondriasis Hypochondriasis: Hypochondriasis: Somatoform disorder disorder characterized characterized by by Somatoform the misinterpretation of normal bodily the misinterpretation of normal bodily functions as as signs signs of of serious serious illness.Weight. breast size or shape. 8/17/2006 8/17/2006 Pain Disorder: A somatoform disorder in which the only symptom is pain that has no physiological basis. aging. concealing it. Body Dysmorphic Disorder Body Dysmorphic Disorder: Somatoform disorder in which people are preoccupied. functions based concerns. Related to somatization disorder is pain disorder.Somatization Disorder ‰ SOMATIZATION DISORDER May be exaggerating a real physical condition. Somatization Disorder: A somatoform disorder involving the expression of psychological issues through bodily problems that have no basis in physiological function. „ Obsessed with looking at it. „ The “defects” are imagined or grossly exaggerated. genitals. almost to the point of being delusional. thinking about it. ‰ Do not voluntarily seek psychotherapy. ƒ Men . 8/17/2006 8/17/2006 2 . illness. with the idea that part of their body is ugly or defective.Body build.

there is no abnormal bodily function or medical symptoms. Evaluate stress.HYPOCHONDRIASIS „ Preoccupation RELATED CONDITIONS These conditions and behaviors also involve a focus on the body. „ Many also suffer anxiety or depression. 8/17/2006 8/17/2006 Psychological Factors Affecting Medical Conditions 8/17/2006 PSYCHOLOGICAL FACTORS AFFECTING MEDICAL CONDITIONS ƒ ƒ ƒ ƒ ƒ AXIS I DISORDERS PSYCHOLOGICAL SYMPTOMS PERSONALITY TRAITS MALADAPTIVE HEALTH BEHAVIORS STRESS-RELATED PHYSIOLOGICAL RESPONSES 8/17/2006 3 . Provide behavioral techniques to control symptoms. ‰ ‰ ‰ ‰ with perceived abnormal functioning. 8/17/2006 MALINGERING FACTITIOUS DISORDER MUNCHAUSEN’S SYNDROME FACTITIOUS (or MUNCHAUSEN’S) BY PROXY 8/17/2006 THEORIES OF SOMATOFORM DISORDERS ‰ TREATMENT OF SOMATOFORM DISORDERS ‰ MOTIVATIONS FOR ILLNESS ‰ ‰ Primary gain Secondary gain ‰ ‰ ‰ INTEGRATIVE EXPLANATION Explore need to play the sick role. „ Unlike somatization or conversion disorder. „ Distress that medical tests do not confirm their fears. but are not somatoform disorders because the individuals know they are not really ill.

amount. Disturbances Primary Insomnia Primary Hypersomnia Circadian Rhythm Sleep Disorder Breathing-Related Sleep Disorder 8/17/2006 Sleep Disorders Parasomnias: Parasomnias: Conditionsinvolving involvingabnormal abnormalbehavior behavioror orbodily bodily Conditions eventsduring duringsleep sleepor orsleep-wake sleep-waketransitions.quality.THEORIES OF MINDBODY INTERACTION ‰ ‰ STRESS COPING STRATEGIES FOR STRESS ‰ ‰ Problem-focused Emotion-focused ‰ ‰ ‰ PSYCHONEUROIMMUNOLOGY EMOTIONAL EXPRESSION PERSONALITY FACTORS 8/17/2006 8/17/2006 TREATMENT FOR PSYCHOLOGICAL FACTORS AFFECTING HEALTH ƒ BEHAVIORAL MEDICINE ƒ Take responsibility for health ƒ Initiate and maintain healthy behaviors ƒ Stop unhealthy behaviors ƒ STRESS INOCULATION TRAINING ƒ Cognitive focus and method ƒ Guided self-dialogue ƒ Coping self-statements ƒ More adaptive lifestyle 8/17/2006 Sleep Disorders Dyssomnias: Dyssomnias: Disturbancesin inthe theamount. sleep. events Nightmare Disorder Sleep Terror Disorder Sleepwalking Disorder Narcolepsy Dissociative Disorders 8/17/2006 8/17/2006 4 .or ortiming timingof ofsleep. transitions. quality.

in which an individual develops more than one self or personality.DISSOCIATIVE IDENTITY DISORDER Dissociative identity disorder: A dissociative disorder. 8/17/2006 8/17/2006 THEORIES OF DISSOCIATIVE IDENTITY DISORDER TREATMENT OF DISSOCIATIVE IDENTITY DISORDER ‰ Highly Traumatic Childhood Explanation vs. „ Unable to remember details and experiences associated with traumatic or stressful event Four forms: ‰ ‰ ‰ ‰ Localized Selective Generalized Continuous 8/17/2006 8/17/2006 5 . ‰ METHODS ‰ ‰ Hypnotherapy Cognitive Behavioral Techniques DISSOCIATIVE AMNESIA „ DISSOCIATIVE FUGUE formerly called psychogenic fugue Dissociative fugue: A dissociative disorder in which a person. „ „ „ „ DISSOCIATIVE IDENTITY DISORDER Alters Usually fewer than 10 identities Host Memory Gaps The disorder is highly controversial. Sociocognitive Model 8/17/2006 8/17/2006 GOAL ‰ Integrate alters. confused about personal identity. formerly called multiple personality disorder. suddenly and unexpectedly travels to another place and is unable to recall past history or identity.

ranging from feeling that one's body is not connected to one's mind to the feeling that one is not real. Depersonalization Disorder: A dissociative disorder in which the individual experiences recurrent and persistent episodes of depersonalization. 8/17/2006 6 .DEPERSONALIZATION DISORDER Depersonalization: An altered experience of the self.

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