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Somatoform and Dissociative Disorders

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Western University
Psychology 3310F/G
Peter Hoaken

Somatoform Disorders Common feature of Somatoform Disorders o The presence of physical symptoms that suggest a general medical conditionSomatization Disorder DSMIVTR Diagnostic Criteria o A history of many physical complaints beginning before age 30 years that occur over a period of several years and result in treatment being sought or significant impairment in social occupational or other areas of functioning o Each of the following must have been met1 four pain symptoms head abdomen back joings pain during sex2 2 gastrointestinal symptoms y nausea bloating vomiting diarrhea3 one sexual symptom4 one pseudoneurological symptom y coordination balance blindness paralysis o Either 1 or 2After appropriate investigation each of Culture and Gender Factors o The type and frequency of complaints differ across cultures o Occurs only rarely in men mostly affects unmarried low SES womenProbably a correlational thingLifetime Prevalence o 22 of women o less then 2 of menbut these are north American statisticsvary enormouslyOne theoretical modelNeurologically based disinhibition weak behavioural inhibition system relationship with antisocial personality Disorder o APDearly onset chronic course characterized by impulsivity aggressionSomatizationearly onset chronic course characterized by impulsivity dependenceDifferent presentations due to socializationCourse o Chronic fluctuating course that rarely remits completely o Diagnostic criteria usually met before the age of 25Familial Pattern o Observed in 1020 of female firstdegree relatives of women with somatization disorder o Male relatives of women with Somatization disorder are at greater risk of ASPD and substancerelated disorders antisociality is related to increased substance abuseSomatization DisorderTreatment Current thinking on treatment o Hard to treat no cure o Regular contact with a caring physician provide reassurance reduce stress reduce frequency or help seeking behaviours o Reduce supportive consequences of talk about physical symptomsThis is all that they talk about they are narrow in their range of conversational moves o Acceptance of symptoms as valid o Reduce supportive consequence of relating to significant others based on the basis of physical symptoms alone o SplittingOveridealizing and then devaluating of a new person o Possible utility of group psychotherapyMight just sit there complaining to each otherConversion Disorder DSMIVTR Diagnostic Criteria o One or more symptoms of deficits affecting voluntary motor or sensory function that suggest a neurological or other general medical condition o Psychological factors are judged to be associated with the symptom or deficit because the initiation or exacerbation of the symptom is preceded conflict by stress o They symptom or deficit is not intentionally produced or feigned as in factitious disorder or malingering o The symptom or deficit cannot after appropriate investigation be fully explained by a general medical disorder or the direct o Conversion DisorderCommon Symptoms Common motor symptoms o Impaired coordination or balance paralysis or localized weakness aphonia difficulty speaking difficulty swallowing or a sensation of a lump in the throat and urinary retentionCommon sensory symptoms o Loss of touch or pain sensation double vision blindness deafness and hallucinationsSymptoms may also include
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