PSY 309 Lecture Notes - Lecture 20: Factitious Disorder, Somatic Symptom Disorder, Conversion Disorder
Lecture note 20 PSY 309:
• Somatic
• Related to the body (physically). Used to be referred to as hysteria
• Somatization
• Experience psychological/emotional distress and it manifests itself as physical problems.
People with a somatic disorder tend to do this.
• 1600s
• By this time hysteria came to mean less about a wandering uterus and more to refer to
any physical problems
• 1800
• Freud was the first to say physical problems may be related to emotional distress
• 1980
• DSM3 was released and hysteria no longer appeared as a diagnostic word
• Somatic disorders
• There are four types and individuals with one generally fall into two camps. They are
also highly comorbid with anxiety disorders
• Care-seeking
• Patient with somatic disorder is constantly seeking medical help/clarification
• Care-avoidant
• Patient with somatic disorder does not seek a Doctor's help because they don't want
their beliefs to be confirmed
• Somatic Symptom Disorder
• Must have at least one somatic symptom (including pain) w/o a medical/physical
understanding that causes distress/impairment for at least 6 months. Lots of time spent
worrying/thinking about. Most commonly associated with pain. Focus on symptoms.
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• ex. eye floaters are normal but an individual with this thinks they may die, lose their
vision or something excessive.
• Illness Anxiety Disorder
• Individual is preoccupied with concern about a serious illness/disease. No or only mild
symptoms present
• Conversion Disorder
• Must have at least one altered voluntary motor/sensory function that causes significant
distress. Most publicized of all somatic disorders. Altered functioning must be
incompatible with a medical explanation for symptoms. AKA Functional Neurological
Symptom disorder.
• ex. Patient saying they can't see when medically there is nothing found wrong with their
vision/body
• Challenges of Somatic Disorders
• Tough to rule out other causes ie. environmental causes; technology is limited
• Very hard to treat
• Difficult for the individual to accept 'they're doing this to themselves'
• Factitious Disorder
• Individual makes up symptoms (purposeful deception) w/o an external reward ex. lying
but not receiving money
• Malingering
• Deception for a visible/external reward ex. money
• Different than Factitious disorder
• Treatments for Somatic disorders
• Often anxiety treatments ie. expose patient to thing the disorder is getting them to
avoid.
• Not much evidence on treatments for these disorders.
• Dissociation
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• Separating from normal behaviors. Can be typical/normal ie. daydreaming, imaginary
friend
• Clinical Dissociation
• Normally integrated elements of consciousness, memory and personal identity become
splintered. ie. may impair memory of personal experiences, feeling
objects/surroundings aren't real, emotional detachment
• Biological stress
• Age, gender, genetics, psychological reactions, tissue health. Contribute to stress across
lifespan
• Psychological stress
• Mental health, emotional health, beliefs/expectations. Contribute to stress across
lifespan
• Sociological stress
• Interpersonal relationships, social support, dynamic socioeconomics. Contribute to
stress across lifespan
• Neurocognitive disorders
• Significant decline in at least one area ex. learning/memory, complex attention,
visual/motor skills, planning/decision making, social behavior, personality and behavior.
• Most of these affect older adults 65+ with the exception of MS.
• Divided into major and minor.
• Causes: Alzheimer's, Parkinson's, Vascular Disease, HIV, Traumatic brain injury etc. One
of the 2 categories of disorders of cognition within the DSM5
• Geropsychology
• Field of psychology dedicated to the mental health of elderly people. Important and
growing field but little is known about the elderly brain
• Depression in Older Adults
• Stays the same with some exceptions of it increasing/decreasing. About 20% prevalence
in older adults
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