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Psychology 2030A/B Study Guide - Somatic Symptom Disorder, Body Dysmorphic Disorder, Antisocial Personality Disorder

Course Code
David Vollick

of 5
Chapter 6 Somatoform and Dissociative Disorders
7:09 PM
Overview of somatoform disorders
Overly preoccupied with their health or bodily appearance
No identifiable medical condition causing the physical complaints
Table 6.1 hypochondriasis
Problem is anxiety
Chronic onset
Hypochondriasis vs panic disorder
Similarities - both focus on bodily symptoms i.e. pain or tightness in the chest
Differences - hypochondriasis focusses on the long term process of illness, constant
concern, constant medical treatment seeking, involves a wider range of symptoms than
Defining features
Physical complaints without a clear cause
Severe anxiety focused on the possibility of having a serious long term disease v.s. panic
Strong disease conviction
Medical reassurance does not seem to help
Facts and Stats
Good prevalence, data lacking - onset, any age
Culture specific towards the symptoms they fear i.e. warts v.s. chest pain
Cognitive perceptual distortions
Sensitivity to illness, everything is threatening for these people
Ambiguous bodily stimuli are threatening
Stressful life, family disease when young
Familial history of illness
CBT is most effective
Challenge illness-related misinterpretations
Provide more substantial and sensitive reassurance
Stress management and coping strategies
DSM-IV-TR for somatization disorder in table 6.2
Somatization Disorder
Extended history of physical complaints before 30
Substantial impairment in social or occupational functioning
Concerned over the symptoms themselves or on the pain itself, not what they might mean (as
in hypercondriasis, who focus on what the pain might mean)
Symptoms become the persons identity
Facts and Stats
Rare condition
Onset usually in adolescence
Mostly effects unmarried, low SES women
Runs a chronic course
Over-attend to physical sensations
Familial history of illness
Linked with antisocial personality disorder "the ends justify the means"
Have a weak behavioral inhibition system not control behavioral activation system
No treatment exists with demonstrated effectiveness
Reduce tendency to visit numerous medical specialists by assigning "gatekeeper" physician to
avoid shopping around for physicians
Reduce supportive consequences of talk about physical symptoms "oh you're complaining
again, come talk to me when you're not complaining"
Conversion Disorder
Table 6.3
Overview and defining features
Physical malfunctioning without any physical or organic pathology
Freud's primary and secondary gain (I do this in order to get something i.e. attention)
Malfunctioning often involves sensory-motor areas - blindness, aphonia (trouble speaking)
paralysis - like a neurological disease
Difficult to discern between malingering, real physical disorders and conversion disorder
CD shows la belle indifference - they can't move their hand but ah, they don't care
Retain most normal functions but without awareness of this ability. i.e. they think they are
blind but when given a seeing tasks they will perform better than chance so it shows that they
do see and are unaware of it. Malingerers will do worse than chance here because they are
trying to prove something.
Facts and Stats
Rare condition, with a chronic intermittent course
Seen primarily in females with inset usually in adolescence
More prevalence in less educated, low SES groups - may not be able to develop the skills to
deal with stress e.t.c could have poor nutrition, the neighborhood you live in affects your
perception of the world, they may not have access to quality healthcare.
Not uncommon in some cultural or religious groups
Freudian psychodynamic view is still popular
Primary gain (gets rid of anxiety) secondary gain (gets you attention)
Lader et al - these patients are concerned, therefore it doesn’t support the secondary gain
model, they are concerned about it - they don’t do it just for the attention
Social and cultural
Similar to somatization disorder
Core strategy is attending to the trauma if a trauma were involved
Removal of sources of secondary gain
Reduce supportive consequences of talk about physical symptoms
Facticious Disorder
Voluntarily makes up symptoms with no apparent motivations - contrasts with malingering b.c it is
not for financial gain
Pain Disorder
Table 6.5
Clinical description
Pain in one or more areas
Can be sue to psychological factors and or medical conditions
Significant impairment
Psychological factors have an important role in the severity, exacerbation or maintenance of
the pain
Fairly common
5-12% of population suffer from it
Combined medical and psychological
Body Dysmorphic Disorder
Table 6.6
Overview and defining features
Previously known as dysmorphophobia
Preoccupation with imagined defect in appearance - very rare, but serious will go to great
Either fixation, or avoidance of mirrors
Suicidal ideation (high risk) and behaviour are common
Often display idea of reference or imagined defect - everything bad that happens to them is bc
of their imagined defect
Facts and Stats
More common than previously thought
Seen equally in males and females with onset usually in the early 20's
Most remain single and seek out plastic surgeons
Usually runs a lifelong chronic course
Little is known; though it tends to run in families - genetic or could be learned from parents
Shares similarities with OCD - obsessive thoughts an rituals
Cultural - size, body weight, appearance
Medications i.e. SSRI's that works for OCD provide some relief
Exposure and response prevention is also helpful
Plastic surgery is often unhelpful - leads to increases preoccupation
If they cannot get surgery they will try to fix it themselves. i.e. guy stapled his face because he
thought it was sagging
Dissociative Disorders
Involves severe alterations or detachments in identity, memory or consciousness
Depersonalization - distortion is perception of one's sense of their own reality i.e. you may
seem to move in slow-mo put people around you don't
Derealization - losing the sense of the reality on the external world. i.e. People may all seem
DSM-IV-TR table 6.7
severe and frightening feelings of unreality and detachment
such feelings and experiences dominate and interfere with life functioning
In touch with reality v.s. psychosis
Facts and stats
Comorbidity with anxiety and mood disorders is extremely high
Onset at age 16
Usually runs a chronic lifelong course