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
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
Usually have co-morbid diagnosis
Common example – substance abuse examples that occur – co-morbidity often causes
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
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
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
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