- In early versions of the DSM, somatoform and dissociative were put under the anxiety
- Anxiety is not always observable in these 2 disorders
- Somatoform Disorders are when the individual complains of bodily symptoms that
suggest a physical dysfunction, but there is no physiological evidence behind this.
- Dissociative Disorder is when the individual experiences a disruption in consciousness,
memory, identity etc.
- Onset of both disorders is related to stressful event, and they can sometimes co-occur
- Psychological problems take physical form
- Thought to be linked to psychological factors (anxiety)
- pain that causes significant impairment and stress, may be sever and chronic
- may have relation to some conflict or stress, or attempt by patient to get attention
- diagnosis is difficult, as pain is a feeling, and there is no way if detecting the pain felt is
real or not.
- Patients with physically based pains, unlike with the disorder, can localize, give more
detail and link the pain to increases and decreases.
Body Dismorphic Disorder
- person is preoccupied with self-image and feels there is some defect in them, Ex: a
wrinkle, excess hair or shape of nose.
- Women: skin, hips, breasts, legs
- Men: height, penis length, too much body hair
- Occurs mostly among women in late adolescence, comorbid with depression and social
- People argue this might not be a disorder itself but a symptom of many disorders
- individuals are preoccupied with the fear that they are ill, such as deadly disease
- over 60% of diagnosed cases still had the disorder during follow-up
- frequent consumers of medical goods and prolly have anxiety disorders
- patients over react to bodily sensations such as irregular heartbeat, sore spot, coughing
etc. they can make catastrophic interpretations over small things
- evident in 5% of general population, higher in women than men.
- Health Anxiety is a condition in which you have anxiety over your health, and can lead to
misinterpretations of body signs as being ill. This includes hypochondriasis And illness
phobia, which is a fear of becoming sick.
- The IAS is an illness anxiety scale which consists of 4 factors
- In this disorder, physiologically normal ppl experience cognitive and motor symptoms
such as paralysis, loss of vision etc. although the body and nervous system seems to be
- People may experience seizures, coordination disturbances, pricking or tingling, and a
loss or impairment of sensations, called anesthesias
- Aphonia, loss of speech, and Anosma, loss of smell, are other types of conversion
- These symptoms appear suddenly in stressful situations, maybe to avoid some activity or
to receive attention.
- Freud thought repressed instinct was diverted to blocking these functions. Ex: loss of
eyesight in soldiers that didn’t want to fight
- Hysteria was originally used to describe conversion disorders, Hippocrates thought it was
a disorder pertaining to women only, where the uterus would wander through the body.
Longing production of child.
- Prevalence is 1% in population, and more in women than men. An episode of this
disorder can end abruptly then resurface another time with added or different symptoms
- Frequently comorbid with other Axis I disorders.
Malingering and Factitious Disorder
- individual fakes a conversion disorder in order to escape a responsibility, such as work,
or to get money on insurance. The difference between malingering and conversion
disorder, is that malingering is totally under the persons control
- La belle Indifference is what people can use to tell conversion disorder and malingering
apart. This is the fact that patients with real conversion disorder show concern over their
“life-threatening” illness, while ppl who are malingering are willing to talk about it
openly and discuss all of their symptoms.
- Fictitious Disorder is when a person intentionally produces physical symptoms
(sometimes psychological). They do things like report acute pain, or inflict injuries on
themselves. It is different from malingering because there is no clear goal, for some
unknown the reason, the person wants to assume role of patient.
- Munchausen syndrome/factitious disorder by proxy is when a parent intentionally
makes a child sick, for example to make themselves feel like they are a very caring
- Initially called Briquet’s syndrome, Somatization disorder is characterized by recurrent,
multiple somatic complaints with no physical cause, for which medical attention is
sought. To be diagnosed, the person must have:
-  four pain symptoms in different locations
-  two gastrointestinal symptoms (diarrhea, nausea)
-  one sexual symptom other than pain (indifference to sex, erectile dysfunction)
-  one pseudoneurological symptom (those of conversion disorder)
- Disorder may be more frequent in cultures that inhibit overt emotional display