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Lecture 5

Abnormal Psychology Lecture 5.docx

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Konstantine Zakzanis

Abnormal Psychology: Lecture 5 Somatoform and Dissociative Disorder  Somatoform disorder  Bodily symptoms that suggest a physical defect of dysfunction but no physiological basis can be found  Dissociative Disorders  Disruptions of consciousness, memory and identity  Difference is that somatoform are very common, but dissociative disorders are rare. However the similarities are that psychological factors are presumed to cause a major role in development and growth of both disorders. Somatoform Disorders  Pain Disorder  Psychological factors play a significant role in the onset and maintenance of pain  DSM includes three subtypes  Pain Disorder associated with Psychological Factors  Pain Disorder associated with both Psychological Factors and a General Medical Condition  Pain Disorder associated with a General Medical Condition  Pain is a biopsycho social factors that can’t be determined by only one factor.  Pain must be life affecting and cause distress and disability before being diagnosed.  Comorbid diagnosis creates an additional problem such as drug abuse.  Acute if less than 6 months and Chronic is more than 6 months  One lady worked hard before her accident and then once she had pain, she didn’t have to do such hard work and gained sympathy from her family which made her reject her recovery from pain.  Igotrinetic?? Disability- avoid unpleasant activity to secure attention and sympathy  We distinguish these people from people actual physical pain, because people with physical pain have a more detailed area of pain rather than general pain and will tell you what actions make the pain better and what actions make the pain worse. Also no evidence for the physical pain through physiological matters.  Histrionic Personality Disorder- Someone seeking attention (will also usually have a pain disorder). For example the case of the lady who claimed to have pain after a car accident, but it was found that prior to the accident her husband and her were not sexually satisfying each other and that there was going to be trouble in her marriage due to his infidelity. After the accident the couple decided to try again, but the pain was preventing them from moving forward sexually, thus she hung on to this pain. Important to note, that no pain is solely psychological.  Body dysmorphic disorder  Preoccupation with imagined or exaggerated defects in physical appearance. Differs between men and women. Both for face. Women with breasts, body shape where as with men it is hair and genital area.  Must cause distress and disability for diagnosis.  These people will spend so much time trying to fix these defects that it leads them with financial problems, health problems and more especially through surgery. Only 9% of people with this disorder are satisfied after surgery.  Affects more female than men and usually starts in late adolescence when individuals becomes more aware of their looks.  Can be comorbid with depression and social phobia. Can lead to eating disorders, thoughts of suicide, personality disorders and substance abuse.  Case Example Elephant Man: Shy 30 year old male hospitalized after suicide attempt. Asks to see psychiatrist in dark room and says that he has no friends no job and no girlfriend. He blames the marks on his nose which he thinks about every day and has nightmares about it. Psychiatrist couldn’t see the marks on the nose, even in a lighted room. Started staying home and avoiding any relationship with others.  Case Example: Man who took steroids continually for his muscles (video)  Hypochondriasis  Preoccupation with fears of having a serious illness; more apparent in med students. Also seen in email from student.  Catastrophic generalization from minor factors.  Somatization disorder  Characterized by a long history for recurrent of multiple sematic complaints with NO physical cause and the individual will seek multiple medical treatment  Must satisfy:  4 pain symptoms in different locations  2 gastrointestinal symptom  1 sexual symptom other than pain  1 pseudo neurological symptom  Comes with anxiety, mood disorders, substance abuse (remedial use).  More common in women. Onset in early adulthood  Different from a pain disorder  Conversion disorder  Sensory or motor symptoms with any physiological cause  Only neurological cause which differs from somatization such as loss of vision, seizures, paralysis, coordination and balance problems, insensitivity to pain.  Malingering vs Factitious disorder  Main difference between malingering and factious disorder is that in malingering, the complains whether neurological, physical, or cognitive are consciously produced. Through volunteer control and an incentive. Possibly to get out of something. More concrete reason.  Factious disorder has the same symptoms but it’s under unconscious control. Will intentionally produce symptoms and have no external incentive to do so. Wants to take on the role of the sick person.  Manchosim - purposely make themselves sick  Biproxy- Sometimes others people diagnose another with disorders in order to assume the role of care taker.  In order to distinguish between the two there are a couple of tests.  Measures of dissimulation  Forced choice recognition  Atypical/Unlikely NP Scores Dissociative Disorder- incredibly rare, thus based on case studies  Dissociative amnesia  Person is unable to recall important personal information  Usually after some stressful episode.  Interograde vs Retrograde amnesia- in retrograde
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