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Chapter 7

PSYB32H3 Chapter Notes - Chapter 7: Malingering, Wrinkle, Psychoanalysis

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Konstantine Zakzanis

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Somatoform disorders = person complain about bodily ymptoms that uggest physical defect but NO
Dissociative disorders = person has disruption of conciousnes, memory, identity.
These 2 classes sometimes co occur
Somatoform Disorders
Psychological problems take physical form.
symptoms thought to be linked with anxiety ---> not under voluntary control
Onset and maintanance of pain caused by psycological factors
Preoccupation with imagined defect in the phyical appearance
preoccupation with having a eriouse illne
Conversion disorder
sensory/motor symptom without a physiologial cause
recurrent multiple phyical complait - no physiological bai
Person experiences pain that causes significant distress and impairment.
Psych. Factors are important in onset, maintainance, and severity of the pain.
Client may be unable to - dependant on tranquilizers or pain killers.
Allow person to avoid unpleasant activity or get attention and sympathy.
Person preoccupied with body distortion ---> typical in face (wrinkle, acces facial hair, shape/size
of nose)
Women = skin, hips, breasts, legs
Men = height, penis length (haha zak :D)
Clients spend hours checking themelves in the mirror .
Other hide "defect" by removing all mirrors, wearing looe clothes
Mat consult cosmetic surgery, or plastci urgery
Onset = adolescence
Co morbid with= depression, social phobia, suicide, eating disorder.
Typically in women
Ome believe thi diorder should be a subtype of OCD (b/c peo
ple are always checkingor not checking their appearance ----> leads to compulsive behaviour)
Person precoccupied with having a seriouse illness despite thefacttheres nothing wrong with them
Clients use medical servises a lot and also have anxiety and mood disorders
Clents overreact to physical sensations thinking that they are a seriouse desease (Eg. A stomach
ache might seem as stomach cancer)
Occures in 5% of general population.
Anxiety aboutyour health was found to be moderatly heritable but most variatuon is due to
envirenmental factors ----> health anxiety is mostly learned.
Critical precipitating incident
Previouse experience of illness or medical factors
Presence of negative cognitive assumptions ( believing that bodily chages are sign of a
seriouse illness when they are not)
Health anxiety increased by the cost and burden of the illness that the person thinks
he/she has and the precieved likelyhood of the illness.
Health anxiety can be decreased by = precieved ability to cope and precieved
Severity of anxiety
Cognitive factors related to having this disorder
Chapter 7 - Somatoform and Dissociative Diporder
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Health anxiety can be decreased by = precieved ability to cope and precieved
presence of rescue factors (a nearby hospital or pharmacy)
Eg. Sudden loss of vision or paralysis.
Siezures and coordinationdisturbances
Prickling, tickeling of the skin
Physiologicaly normal people experience sensory or motor symptoms
Allows person to avoid activity or responsibilty or get attention
Psychological nature of these symptoms show that they appear suddenly in stressful situations
"Coversion" - term created by frudwhere he thought repressed anxiety was diverted to sensory or
motor sysptoms, blocking their function
Syptoms develop in adolescents or early adulthood.
Prevalance is less than 1% and women have iit more than men
Co morbid with depression, susbstance abuse, anxiety, anddissociative disorders
People with conversion report a history of physical or sexual abuse.
They were misdiagnosed
Using current imaging techniques, misdiagnosis has decreased
In 1960's 60% were foundin a floow up study to have actually died of their conversion symptoms
Person fakes a incapacity in orde rto avoid a responsibilty, military duty, or to achieve a goal
Diagnosed when conversion -like symptoms are under voluntary control
Malingering -
Characterized by a lack of concern about the symptoms.
Clients with conversion have this behaviour
They also talk endlessly about their symptoms.
Malingerers are more cautious or quiet about heir symptoms.
La belle indifference - used to distinguish conversion frm malingering
Perso makes up physcial or psych disorder
Difference frm malingering is that it does not have a goal -----> people do it for no reason.
Factitious disorders -
People actually hurt themselves for no apparent reason.
Munchausen -
Recurrent, multiple somatic complaints with no cause for which people seek medical help.
4 pain symptoms in different locations
2 gastrointestinal symptoms
One sexual symptom
1 pseudoneuroloogical syndrom (eg. Conversation disorder)
To meet the diagnostic criteria people must meet -
Symptoms more persuasive than hypochondrasis, and cause impairment
Visits to doctor are frequent including hospitalization and surgery
Comorbidity with anxiety, mood disorders, susbtance abuse, and severe personality disorders.
Lifetimeprevalence is 0.5% and happens more in women and among patients inmedical treatment.
Usually begins in early adulthood.
Seems to run in the family.
Etiology of somatoform disorders
Etiology of somatization disorder
People with somatization attend to physical sensations more, and interpret them catastrophically
Also have memory bias for info that connots physical threat.
Symptoms are acutally unrealistic anxiety about the bodliy systems.
Behavioural view -
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