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somatoform disorders (2).docx

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McMaster University
Richard B Day

October 31 , 2012 Psych 2AP3: Abnormal Psychology – Major Disorders Somatoform Disorders (2) Etiology - focus on psychological causes - there might be some genetic/biological underpinning - runs in families:  10-20% higher prevalence among 1 degree relatives of probands  often come from families with alcoholism, sociopathy, marital discord - other predispositions (pleiotropy): predisposes people not only to somatoform disorders but other disorders as well  male relatives at higher risk for APD and substance-use disorder  higher delinquency, work problems, marital issues among 1 degree st relatives - no clear indication of where somatoform disorders come from - reward via secondary gain: partly maintained by secondary gain  primary gain: psychological distress that the symptom is helping to deal with, persons own use of symptomology to deal with disorder  secondary gains: support reward, attention that comes from outside as a result from the symptoms, nothing to do with internal problems, external rewards and supports Conversion Disorder: DSM-IV - much rarer today than before - alteration or loss of motor or sensory functioning that has no physical cause: feelings of tingling, numbness, loss of a limb - usually follows stressful or anxiety-producing event which closely proceeded the development of this disorder - ‘la belle indifference’: fact that individuals with these symptoms seem much less concerned about them than we would be - continued functioning despite impairment: despite their loss of sensory input or motor ability they still seem to function well, part of their mind that knows there something out there even if they do not consciously experience it - four subtypes: based on primary set of symptoms  motor symptom or deficit (e.g., tics, paralyses)  sensory symptom or deficit (e.g., blindness)  seizures or convulsions  mixed presentation - pattern of deficit: pattern of nerve enervation, common to reflect articles of clothing and not patterns of nerves Epidemiology - population prevalence unknown:  Ford (1983) estimates 20-25% of general medical patients meet the criteria for conversion disorder  Lifetime prevalence estimates vary widely; as high as 33% - disagreement on sex bias:  females higher, but estimates range from 2:1 to 5:1 female/male ratio  prototype = female under 45 from rural or culturally unsophisticated background, likel
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