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Martha Mc Kay

PSY240 chapter 8- Somatoform and dissociative disorders Somatoform and Dissociative Disorders: Somatoform disorders: A group of disorders in which people experience significant physical symptoms for which there is no apparent organic cause. Symptoms: inconsistent with possible physiological processes, and there is strong reason to believe that psychological factors are involved. People with somatoform disorders usually do not consciously produce or control the symptoms. They truly experience the symptoms, and the symptoms pass only when the psychological factors that led to the symptoms are resolved. Diagnosis of somatoform disorder is easier when the psychological factors leading to the development of the symptoms can clearly be identified or when physical examination can prove that the symptoms cannot be physiologically possible. Individuals truly experience the symptoms, which do not go away until the psychological issues are resolved. Pseudocyesis: an extreme example of a somatoform disorder, or false pregnancy in which women believes she is pregnant but physical examinations and laboratory tests confirm that she is not. History: Long history within psychology Case of Anna O: launched psychoanalysis as a form of psychotherapy. She experienced physiological symptoms that were a result of painful memories or emotions she was not ale to confront. Consider these disorders as an extreme form of escape Surrounded by controversy (disagreements among different psychoanalysts. Somatic and related-disorders: Somatoform and Pain Disorders Subjective experience of many physical symptoms, with no organic causes. Person with this disorder does not have any illness or defect that can be documented with tests. Psychosomatic Disorders Actual physical illness present and psychological factors seem to be contributing to the illness, e.g. high blood pressure. Malingering Deliberate faking of physical symptoms to avoid an unpleasant situation, such as military duty. Factitious Disorder Deliberate faking of physical illness to gain medical attention Factitious Disorder by Proxy Deliberate faking or even creation of physical illness in ones child to gain attention for oneself Factitious: formerly known as Munch-hausens syndrome Parents with factitious disorder by proxy may be very adept at hiding what they are doing to their children, especially if they have a medical background. 20% of patients diagnosed with one or more somatoform disorders. Also had another psychiatric diagnosis, most often depression or anxiety. More common in family doctors practices among patients presenting with psychiatric complaints. 17% had a lifetime history or medically unexplained symptoms, 8% were hypchondriacal. PSY240 chapter 8- Somatoform and dissociative disorders Somatoform disorders come in five types: (except for Body dysmorphic disorder. Each of Conversion disorder Loss of functioning in some part of the body for psychological rather than physical reasons. Somatization disorder History of complaints about physical symptoms, affecting many different areas of the body, for which medical attention has been sought but no physical cause found. Pain Disorder History of complaints about pain, for which medical attention has been sought but that appears to have no physical cause . Hypchondriasis Chronic worry that one has a physical disease in the absence of evidence that one does; frequently seek medical attention. Body dysmorphic Involves a preoccupation with an imagine defect in ones appearance that is disorder so severe that it interferes with ones functioning in life. these is characterized by the experience of one or more physical symptoms. Somatic disorders: Conversion disorder: is diagnosed when individuals lose functioning in a part of their bodies apparently because of neurological or other medical conditions. Symptoms: Loss of functioning in some part of the body due to psychological rather than physiological causesthere may be indifference to the loss of functioning (la belle indifference) Prevalence: Rare, 2.7% men and none women. Etiology: Often can occur after trauma or stress, perhaps because the individual cannot face memories or emotions associated with the trauma. Theories: back in the days, conversion hysteria womb was thought to be only developed in women as these symptoms arose when a womens desires for sexual gratification and children were not fulfilled. Theory was thought to be that womb wandered into various parts of the body, causing relates symptoms such as sensation of choking or paralysis. Symptoms are resulting from the transfer of the psychic energy attached to repressed emotions or memories into physical symptoms. Often symbolizing the specific concerns or memories that were being repressed. Quite common during the two world wars, when soldiers inexplicably became paralyzed or blind and therefore were unable to return to the front. Some soldiers seemed unconcerned about their paralysis or bindliness, showing la belle indifference. Sometimes, physical symptoms represented traumas the soldiers had witnessed. More common among survivors of sexual abuse and other traumatic events. People with conversion disorder are highly hypnotizable. Supports the idea that conversion symptoms result from spontaneous self-hypnosis, in which sensory or motor functions are dissociated, or split off, from consciousness in reaction to extreme stress.PSY240 chapter 8- Somatoform and dissociative disorders Treatment: Psychoanalytic therapy focuses on helping the individual express painful emotions or memories and insight into the relationship between these and the conversion symptoms. Chronic conversion disorder is more difficult to treat. When symptoms are present for more than a month, persons history often resembles somatization disorder. Behavioural therapy uses systematic desensitization and other techniques. Focus on relieving the persons anxiety around the initial trauma that caused the conversion symptoms and on reducing any benefits the person is receiving from the conversion symptoms. People with conversion disorder are difficult to treat because they do not believe there is anything wrong with them psychologically. If they have la belle indifference they are not even motivated to cooperate with psychological treatment to overcome their physical symptoms. Conversion disorder vs. psychological disorder: o Important to rule out physiological cause. Must be shown that no physiological cause exists for the individuals symptoms. o Studies suggest that approx. 62% people diagnosed with conversion disorder were actually suffering from physical disorder. o Most common medical problem found in conversion group was head injury, which usually occurred about 6 months before conversion
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