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Chapter 8

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PSYC 3390
Mary Manson- Hennig

Chapter 8 Somatoform and Dissociative DisordersSomatoform disorders A group of conditions that involve physical symptoms and complaints suggesting the presence of a medical condition but without any evidence of physical pathology to account for them The people with these symptoms normally focus on one aspect of their health or appearance to the extent that they find it hard to function Due to this they frequent physicians very oftenDissociative disorders A group of conditions involving disruptions in a persons normally integrated functions of consciousness memory identity or perception The people with these conditions also may be unable to recall who they are or where they may have come from or may have two or more distinct identities or personality states that alternately take control of the persons behaviourDissociation the humans mind capacity to engage in complex mental activity in channels split off from or independent of conscious awareness Somatoform DisordersThe affected patients have no control over their symptoms and are not intentionally faking symptoms or attempting to deceive others They generally believe that there is something seriously wrong with their bodiesSomatization is common in all cultural groups and societies that have been studied Differences among groups may reflect cultural styles of expressing distress which are influenced not only by cultural beliefs and practices but also by the nature of the cultures healthcare system HypochondriasisHypochondriasis People with this condition are preoccupied either with fears of contracting a serious disease or with the idea that they actually have such a disease even though they do not Their preoccupations are based on the misinterpretation of one or more bodily changes sensations or symptoms of minor ailments eg being convinced that a slight cough is a sign of lung cancer or worrying that a blemish is a sign of skin cancerMost commonly seen somatoform disorder and occurs equally often in males and females It can start at any age although early adulthood is the most common age of onset If left untreated after development it tends to become chronic although the severity may wax and wane over time Individuals with this also suffer from mood disorders panic disorder andor other somatoform disorders Major CharacteristicsIndividuals are often anxious and highly preoccupied with bodily functions eg heart beats or bowel movements or with physical abnormalities eg a small sore or an occasional cough or with vague and ambiguous physical sensations such as tired heart or aching veins They attribute these symptoms to a suspected disease and often have intrusive thoughts about it These individuals do not fake symptoms to achieve a specific goal Their relationships with their doctors may be hostile and filled with conflict Criteria for Hypochondriasis A Preoccupation with fears of contracting or the idea that one has a serious disease based on misinterpretation of bodily symptoms B Preoccupation persists despite appropriate medical evaluation and reassurance C Preoccupation causes clinically significant distress or impairment D Duration of at least 6 months Theoretical Perspectives on Causal FactorsIt is believed that peoples past experiences with illnesses in both themselves and others as observed in the mass media lead to the development of a set of dysfunctional assumptions about symptoms and diseases that may predispose a person to developing hypochondriasis These dysfunctional assumptions could include things like Bodily changes are usually a sign of serious disease because every symptom has to have an identifiable cause or If you dont go to the doctor as soon as you notice anything unusual then it will be too lateThese individuals have an attentional bias for illnessrelated information They also perceive their symptoms to be more dangerous than they really are and look for confirming evidence to prove their theory They also tend to discount evidence that may prove they are healthy and believe that being fully healthy means they will be symptom freeThey also believe they have a lower probability of being able to cope with the illness and believe they are unable to tolerate physical effort or exerciseHypochondriacs also tend to report much childhood sickness and missing of school They also tend to have an excessive amount of illness in their families while growing up which may lead to strong memories of being sick or in pain and perhaps also of having observed some of the secondary benefits that sick people sometimes reap Treatment of HypochondriasisCognitivebehavioural treatment appears to be very effective for the treatment of this illness The cognitive components of this focus on assessing the patients beliefs about illness and modifying misinterpretations of bodily sensations The behavioural techniques include having patients induce innocuous symptoms by intentionally focusing on parts of their body so that they can learn that selective perception of bodily sensations plays a major role in their symptoms Sometimes they are also directed to engage in response prevention by not checking their body as they usually do and by stopping their constant seeking of reassurance There is also some evidence that antidepressant medication may be effective in treating this illness but it is not as effective as cognitive behavioural therapy Somatization DisorderCriteria for Somatization Disorder A History of many physical complaints starting before age 30 that occur over several years and result in treatment being sought or significant impairment in functioning B Each of the following criteria must have been met at some point1 Four pain symptoms in different sites 2 Two gastrointestinal symptoms other than pain 3 One sexual symptom other than pain 4 One pseudoneurological symptom not limited to pain C Either 1 or 2
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