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PSYB32 Lec 5 Oct 16 2012.docx

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Konstantine Zakzanis

PSYB32 – Lecture 5 – October 16 2012 THESE DO NOT INCLUDE GUEST LECTURE NOTES. THOSE WILL BE UPLOADED SEPARATELY LATER. Somatoform & Dissociative Disorders:  We know very little about these disorders.  Not tested on what guest speakers say  Somatoform Disorders-  Pain Disorder –  Pain Disorder associated with both Psychological Factors and a General Medical Condition -> Important –other 2 not diagnosed as much  Pain is a biopsychosocial process – very complex symptom that we don’t have a very objective way to diagnose.  Pain must cause some sort of impact in the person’s occupational or social functioning (disability)  Usually have co-morbid diagnosis  Common example – substance abuse examples that occur – co-morbidity often causes disability  Often has a temporal relationship to some sort of stressor in the person’s life  Temporal relationship is important  No evidence of malingering – iatrogenic disabilities – e.g. woman who’s pain persisted years later because the treatment she was now getting was better than what she was receiving before the accident.  People with physical pain- localize their pain more specifically  Those with pain disorder describe a generalized pain.  People with physical pain – talk about moderating variables (when its worse or less)  Pain disorder people say everything causes pain  But pain disorder patients still aren’t malingering  Persons with a histrionic personality disorder (seeking attention) may often have a pain disorder  Body Dysmorphic Disorder – mostly fixated on face  Men preoccupied with penis size, hair and height.  Women preoccupied with breasts, skin, hips, and legs.  REMEMBER – to be a disorder, it has to result in STRESS AND DISABILITY.  Affects mostly women, begins mostly in adolescence, hard to treat, often co-morbid with other types of psychological conditions, often a social phobia develops  Video clip – extreme steroid use  Hypochondriasis – about 5% of the population will suffer from sort of hypochondriac state  Certain career positions can put people at risk for it  Person can make catastrophic generalizations from the most minor abnormalities  Somatization Disorder – Characterized by a long history of recurrent multiple somatic complaints, with no physical cause, and for which the individual will seek multiple medical treatment  Needs to have criteria listed in slide  Can also include substance abuse  Lifetime prevalence is less than 0.5%  More common in women  Onset is typically in early adulthood  Conversion Disorder – symptoms are limited to neurological symptoms  Includes a sudden loss of vision, paralysis, seizures, balance problems, coordination problems tingling sensation. In sensitivity to pain, aphonia (loss of voice) and loss of smell – with no evidence of impaired neurological structures.  Malingering – differentiated from factitious disorder – in malingering, the complaints (neurological or physical) are consciously produced (under voluntary control)  Factitious disorder- Person reports same symptoms but it’s under unconscious control.  If there is a lack of external incentive, then malingering will not occur but factitious disorder will persist – person is motivated to play role of sick person – for attention etc.  Factitious patients may be more indifferent to the problems they report  Munchausen syndrome – a form of factitious disorder wherein those affected feign disease, illness etc. to draw attention and sympathy  Munchausen can also come out by proxy – text book  Malingering tests – endorsement of improbable symptoms on psychological tests  Factitious patients will not perform below chance on psychological tests (like malingering patients)  Dissociative disorders are incredibly rare, what we know is based on case studies,  Dissociative amnesia – person is unable to recall important personal information, usually occurs after some stressful episode, person will then have an episode thereafter where they can’t remember any details (time locked)  Retrograde amnesia is N
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