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
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
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.
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
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
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
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
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