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Lecture 6

Week 6- Chapter 5 - Somatic Symptom, Dissociative, and Factitious Disorders.docx

5 Pages
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Department
Psychology
Course Code
Psychology 2030A/B
Professor
David Vollick

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Chapter 5 - Somatic Symptom, Dissociative, and Factitious Disorders SOMATIC SYMPTOMAND RELATED DISORDERS -Physical symptoms (eg. pain) or concerns about an illness cannot be explained by a medical or psychological disorder -->Constant worrying, can't be explained Somatic Symptom Disorder -Once called hysteria or Briquet's syndrome -The presence of one or more somatic symptoms that suggest a medical condition, but without a recognized organic basis -Symptoms are distressing or result in significant disruption of daily life -Although any one somatic symptom may not be continuously present, the state of being symptomatic is persistent (typically more than 6 months) -Excessive thoughts, feelings, or behaviors related to somatic symptoms or associated with health concerns as manifested by at least one of the following: -Disproportionate and persistent thoughts about the seriousness of one's symptoms -Persistently high level of anxiety about health concerns -Excessive time and energy devoted to these symptoms or health concerns Conversion Disorder -Pseudoneurological [like but not really] (not follow known neurological patterns) complains, such as motor deficits, sensory deficits, and seizures and convulsions- not intentional -Paralysis or blindness -10-15% found to have an actual diagnosable medical condition -La Belle Indifference -->Beautiful indifference -Glove anesthesia -- loss of sensitivity in hand and wrist -Physical anatomy cannot explain the symptom pattern of glove anesthesia IllnessAnxiety Disorder -Preoccupation with/ fears of, having or acquiring a serious illness -Persists despite medical reassurance -Somatic symptoms are not present or, only mild -High level of anxiety about health -Performs excessive health-related behaviors -->Avoiding people, hospital, doctors, avoidance behavior to avoid being sick -Illness preoccupation present for at least 6 months -->All excessive behaviour -Preoccupation not better explained by another mental disorder -78% experience comorbidity with anxiety disorder and major depression -->Get really anxious -->Depressed, excessive worry -Cognitive theory -Inaccurate beliefs about illness supports a cognitive theory of somatic symptom disorder -->With someone who has cancer and thinks that you'll get it too because you were near this person -->Misrepresentation Factitious Disorder -Physical or psychological signs/symptoms of illness are intentionally produced to assume a sick role -Malingering - intentionally produces physical symptoms to avoid work, or to obtain financial compensation or drugs -Factitious disorder - imposes deceptive practices designed to produce signs of illness on self -Factitious disorder imposed on another occurs as an individual produces physical symptoms on another- normally mother imposing on a child -Giving the child Gravol… making the child sick and bringing the child to emerge because of the benefits that the parents may receive (babysit?) Impact of somatic symptom disorders -10- 15% of adults report work disability due to chronic back pain -Only 33% with conversion disorder work full-time -People with somatoform disorders work on average 7.8 days per month less than everyone else -Medically unexplained physical symptoms make up 15-30% of PCP (primary common practitioner) appointments -Doctor-shopping -->Maybe for more medications -->Not satisfied with doctor Aso go and find doctor B Risk for somatic symptom disorder -Gender, race, and ethnicity -Factitious disorder (imposed on self and others) is reported more by women -These disorders occur equally across racial and ethnic groups -Etiology poorly understood Developmental issues -Diagnostic criteria (consistent across all age groups) -Somatoform disorders (rare before adulthood) -Most common symptoms in adults -Pain, headaches Etiology -Biological (brain malfunction vs. structural abnormalities) -Psychodynamic (intrapsychic conflicts into physical symptoms, via defense mechanisms) -Behavioral (modeling & reinforcement) -Environment (stress) -Distorted cognitions (somatic amplification) -Inaccurate beliefs Treatment: Reluctance and Resistance -Challenges of getting people to reveal their symptoms to a professional -Emphasis placed on physical symptoms due to the refusal to believe one has a ps
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