Class Notes (836,591)
United States (324,596)
Psychology (193)
PSY-0012 (27)
Lecture

Chapter 8.docx

12 Pages
102 Views
Unlock Document

Department
Psychology
Course
PSY-0012
Professor
Jackquelyn Mascher
Semester
Fall

Description
Chapter 8: Somatoform Disorders & Dissociative Disorders 04/15/2014 Somatoform Disorders 1. Somatic symptom disorder 2. Illness anxiety disorder 3. Conversion disorder 4. Malingering 5. Factitious disorder What is Somatization? When psychological problems take physical form  Physical symptoms with… No known medical cause Psychological factors key in onset, exacerbation, maintenance Not intentionally produced or under voluntary control  Not better accounted for by another disorder Not caused by substance use Must be out of cultural norm to be considered disorder  A kind of dissociation ▯ subconscious dissociation between mind and body How Do We Know It’s Somatization? Caused or intensified by psychological factors such as conflict, stress, fear, anger Diagnosis process often challenging (patient not relieved) Unlike symptoms caused by organic pathology, individuals have trouble localizing, describing pain  Individual unaware of psychological origins Symptoms have metaphorical significance  Accompanied by certain other emotional, cognitive, behavioral, interpersonal  problems Individuals seek medical, not psychological, treatment With no medical solution, distress increases Hospitalization, medications, and surgery common (from different medical providers, haven’t caught on) Seek help from multiple physicians Exaggeration to the presentation of symptoms and complaints in order to feel heard 1. Somatic Symptom Disorder To be diagnosed: At least one distressing, impairing somatic symptom (e.g. pain, gastro­intestinal, sexual, neurological) Often multiple symptoms  Multi­systems symptoms that do not make sense Excessive thoughts, feelings, behaviors related to physical symptom(s), with at least one: Health related anxiety Over­concern about medical seriousness Excessive time and energy devoted to cause At least 6 months in duration Treatment  Antidepressants Aspects of psychotherapy for disorder: Validation of patient’s pain (don’t challenge as delusion) Relaxation training Reinforce shift of focus away from site (look for metaphor) Help patient develop ability to cope with stress and gain sense of control over symptom Analysis of triggers/antecedents Increase insight/awareness in context of therapeutic attachment (want relationship with person you’re  helping and show caring) 2. Illness Anxiety Disorder (“hypochondriasis”) To be diagnosed:  Preoccupation with and high anxiety about having serious disease (e.g. thinking that a headache means a  brain tumor) Excessive and unreasonable illness related behavior despite medical reassurance (e.g. avoidance,  reassurance seeking, checking) Believe self over doctors  Excessively seek medical attention  Replace one concern with another concern  Duration at least 6 months No more than mild somatic symptoms  Characteristics Critical of medical professional (view them as incompetent, uncaring) Typical onset in early adulthood, chronic Commonly low insight (not aware) Often comorbid with mood, anxiety disorders Treatment Cognitive behavioral therapies Reduce excessive attention to bodily sensation, challenge negative perceptions about sensations Psychoanalytic therapies Increase insight and awareness Psychodynamic/attachment therapies Gestalt techniques Discourage reassurance­seeking from medical professionals 3. Conversion Disorder To be diagnosed: One or more apparently neurological symptoms: Affecting voluntary motor function Sensory function Seizure­like episodes Diagnostic findings internally inconsistent or incongruent with recognized neurological disorder No known medical cause Symptoms significant enough to warrant medical evaluation or cause functional impairment (but not  emphasis on medical attention seeking)  Duration at least 6 months Examples of psychogenic conversion (converting core fear into neurological symptom) Vision impairment or tunnel vision Partial, complete paralysis of arms, legs Seizures or coordination problems Anesthesia (loss of sensation) Aphonia (loss of speech) Anosmia (loss of smell) History Hippocrates Believed disorder occurred in women Attributed it to a wandering uterus (“Hysteria”) Freud Coined term conversion Anxiety and conflictconverted  into physical symptoms  Characteristics Symptoms rarely occur when alone  Not better accounted for by another disorder Onset usually adolescence or early adulthood Often parallels life stress More commonly diagnosed in women than men Often comorbid with: Major depressive disorder Substance abuse Personality disorders  Treatment  Collaborate with other professionals (make sure it’s not a real medical issue) Avoid dismissing physical complaints Minimize use of diagnostic tests and medication Avoid providing attentiononly  when patient is complaining Treat underlying issue Clues to pseudo­neurological presentations Common syndromes  Psuedoblindness ▯ normal pupils, normal optokinetics Psuedoseizures ▯ no post ictal confusion, pelvic thrusting, normal ictal EEG, normal serum prolactin   Pseudo aphonia ▯ normal cough, normal laryngoscopy Pseudoparalysis ▯ drop test (drop arm,
More Less

Related notes for PSY-0012

Log In


OR

Join OneClass

Access over 10 million pages of study
documents for 1.3 million courses.

Sign up

Join to view


OR

By registering, I agree to the Terms and Privacy Policies
Already have an account?
Just a few more details

So we can recommend you notes for your school.

Reset Password

Please enter below the email address you registered with and we will send you a link to reset your password.

Add your courses

Get notes from the top students in your class.


Submit