Textbook Notes (380,752)
CA (168,206)
UTSC (19,296)
Psychology (10,044)
PSYB32H3 (1,181)
Chapter 7

chapter 7

11 Pages
33 Views

Department
Psychology
Course Code
PSYB32H3
Professor
Konstantine Zakzanis

This preview shows pages 1-3. Sign up to view the full 11 pages of the document.
Chapter 7: Somatoform and Dissociative Disorders
Somatoform disorders: individual complains of bodily symptoms that suggest a physical defect or dysfunction- rather
dramatic in nature- but for which no physiological basis can be found
Dissociative disorders: individual experiences disruption of consciousness, memory and identity
The onset of both disorders is assumed by many to be related to some stressful experience and the two can co-occur
SOMATOFORM DISORDERS
Psychological problems take a physical form; the physical symptoms have no physiological explanation and are not
under voluntary control; they are thought to be linked to psychological factors, presumably anxiety, and are assumed
to be psychologically caused.
Bodily symptoms fall in two groups : arousal of ANS and accompanied with pallable distress in the form of anxiety
and depression and the other group reflects thoughts and intentions that are not consciously recognized
Pain disorders: psychological factors play main role in onset, maintenance and severity of pain
Person experiences pain that causes significant distress and impairment; patient is unable to work and become
dependent on painkillers/tranquillizers
The pain may have temporal relation to some conflict or stress, or it may allow individual to avoid some unpleasant
activity and to secure attention and sympathy not otherwise available
Pain is not a simple sensory experience therefore deciding when pain becomes a somatoform is difficult
Differentiation can be achieved in the way in which pain is described by the patient; a patient with physically based
pain localize it more specifically and give more sensory description and link their pain more clearly to situations that
increase or decrease it
Body dysmorphic disorder: preoccupation with imagined or exaggerated defects in physical appearance
Some patients with disorder may spend hours each day checking on their defect, looking in the mirror
Others take the steps to avoid being reminded of the defect by eliminating mirrors from their homes or camouflaging
the defect- these concerns are distressing and lead to frequent consultations with plastic surgeons
Occurs mostly in women; begins in late adolescence and is comorbid with depression, social phobia, eating disorders
and thoughts of suicide
BDD is chronic and only 9% of patients experience remission over the course of one year
Can be misdiagnosed as OCD or delusional disorder therefore preoccupation with imagined defects in physical
appearance may therefore not be a disorder itself, but a symptom that occur in several disorders
Hypochondriasis: preoccupation with fears of having serious illness, despite medical reassurance to the contrary
Begins in early adulthood and has a chronic course; frequent consumers of medical services and not likely to have
mood or anxiety disorders
They overreact to ordinary physical sensations and minor abnormalities such as irregular heartbeat, sweating,
coughing, sore spot or stomach ache
More likely than others to attribute physical sensations to an illness
Patient make catastrophic interpretations of symptoms such as believing red spot on skin is skin cancer
www.notesolution.com
5% of general population; Often co-occur with anxiety and mood disorders
Health anxiety: health-related dears and beliefs, based on interpretations, or more often misinterpretations of body
signs and symptoms as being indicative of serious illness
Health anxiety would be present in both hypocondriasis and an illness phobia
Hypochondriasis is a fear of having an illness. An illness phobia is a fear of contracting an illness
Illness attitudes scale (IAS) is one self-report measure that is used commonly by researchers to assess health anxiety;
intended to be 9-factor scale; IAS reliable for 1) worry about illness and pain (illness fears) 2) disease conviction
(illness beliefs) 3) health habits (safety seeking behaviours) 4) symptoms interference with lifestyle (disruptive effects)
IAS was used to confirm link b/w health anxiety and trait neuroticism; general neurotic syndrome regarded as
contributing factor in etiology of health anxiety along with more specific factors such as cognitive mechanisms
After controlling medical morbidity, health anxiety has moderately heritable and environmental factors rather than
genetic factor—health anxiety is mostly learned
Cognitive factors featured in model of health anxiety: 1) critical precipitating incident 2) previous experience of
illness and related medical factors 3) presence of inflexible or negative cognitive assumptions 4) severity of anxiety
oHealth anxiety will increase as a function of related increases in 1) perceived likelihood or probability of illness 2)
perceived cost, awfulness and burden of illness
oHealth anxiety will decrease as function of 1) perceived ability to cope 2) perceived presence of rescue factors
Conversion Disorder: sensory and motor symptoms without any physiological cause
Physiologically normal ppl experience sensory or motor symptoms such as sudden vision and paralysis, suggesting an
illness related to neurological damage of some sort, although body organs and NS are found to be fine
Sufferers experience paralysis of arms/legs; seizures and coordination disturbances; a sensation of prickling, tingling
or creeping on skin; insensitivity to pain or loss of impairment of sensory sensations called anaesthesias
Vision may be impaired
Aphonia: loss of voice and all but whispered speech
Ansonia: loss or impairment of sense of smell
Appear suddenly in stressful situations, allowing individual to avoid some activity or responsibility or to receive badly
wanted attention
Anxiety and psychological conflict are believed to convert into physical symptoms
Hysteria was originally used to describe conversion disorders
Symptoms develop in adolescence or early adulthood after undergoing life stress
Episode may end abruptly but returns sooner or later; either in its original form or with symptoms of different nature
and site; prevalence is less than 1 % and more women are given the diagnosis
Frequently comorbid with Axis I diagnoses such as depression, substance abuse and personality disorders (borderline
and histrionic personality disorders)
Hysterical anaesthesias do not make anatomical sense
www.notesolution.com
Glove anaesthesia: rare syndrome in which individual experiences little or no sensation in part of the hand that would
be covered by a glove: this makes no anatomical sense because nerves here run continuously from hand up the arm
Carpan tunnel syndrome: can produce symptoms similar to GA: nerves in the wrist run thru tunnel formed by the
wrist bones and membranes; tunnel can become swollen and may pinch nerves, leading to tingling, numbness and pin
in hand
60% of individuals who were diagnosed and re-checked 9 years later either died or developed symptoms of physical
diseases; high proportion had diseases of CNS
With technological advances in detecting illness and disease, rate of misdiagnosis as declined
Malingering and Factitious disorder:
Malingering: individual fakes an incapacity in order to avoid a responsibility or to achieve some goal
oDiagnosed when conversion-like symptoms are determined to be under voluntary control which is not thought to
be in the case in true conversion disorders
oTo distinguish the two disorders clinicians attempt to determine whether symptoms have been consciously or
unconsciously adopted
oLa belle indifference: characterized by relative lack of concern or a blasé attitude toward the symptoms: helps
distinguish the disorders—patient with conversion disorder sometimes demonstrate this behaviour and appear to be
willing and eager to talk endlessly and dramatically about their symptoms ; in contrast; malingerers are likely to be
more guarded and cautious because they consider interviews challenge or threat to the success of the lie
Distinction is not foolproof and only on third of people with conversion disorders show la belle indifference
Stoic attitude is found among people with verified medical disease
Factitious disorder: patients intentionally produce physical symptoms or sometimes psychological ones
oThey might make up symptoms like acute pain or inflect injuries on themselves
oLess likely linked to recognizable goal; motivation for adopting physical or psychological symptoms is much less
clear ; the individual wants to for some reason assume role of patient
oMay also involve parent creating physical illnesses in a child: factitious disorder by proxy or Munchausen
syndrome by proxy
oFactitious disorder is more prevalent (6%) among adult psychiatric in patients than previously recognized
Somatisation: recurrent, multiple physical complaints that have no biological basis or physical cause for which medical
attention is sought
To meet diagnostic criteria the person must have 1) 4 pain symptoms in different locations 2) 2 gastrointestinal
symptoms 3) one sexual system other than pain 4) one pseudoneurological symptom (e.g. those of conversion
disorder)
These symptoms cause impairment, particularly regarding work
Specific symptoms may vary across cultures: burning hands or experience of ants crawling under skin are more
frequent in Asia and Africa than in North America
Disorder may be more frequent in cultures that de-emphasize the overt display of emotion
Shares common symptoms with CD; patient visits physician frequently and uses medically often; hospitalization and
surgery are common
www.notesolution.com

Loved by over 2.2 million students

Over 90% improved by at least one letter grade.

Leah — University of Toronto

OneClass has been such a huge help in my studies at UofT especially since I am a transfer student. OneClass is the study buddy I never had before and definitely gives me the extra push to get from a B to an A!

Leah — University of Toronto
Saarim — University of Michigan

Balancing social life With academics can be difficult, that is why I'm so glad that OneClass is out there where I can find the top notes for all of my classes. Now I can be the all-star student I want to be.

Saarim — University of Michigan
Jenna — University of Wisconsin

As a college student living on a college budget, I love how easy it is to earn gift cards just by submitting my notes.

Jenna — University of Wisconsin
Anne — University of California

OneClass has allowed me to catch up with my most difficult course! #lifesaver

Anne — University of California
Description
Chapter 7: Somatoform and Dissociative Disorders Somatoform disorders: individual complains of bodily symptoms that suggest a physical defect or dysfunction- rather dramatic in nature- but for which no physiological basis can be found Dissociative disorders: individual experiences disruption of consciousness, memory and identity The onset of both disorders is assumed by many to be related to some stressful experience and the two can co-occur SOMATOFORM DISORDERS Psychological problems take a physical form; the physical symptoms have no physiological explanation and are not under voluntary control; they are thought to be linked to psychological factors, presumably anxiety, and are assumed to be psychologically caused. Bodily symptoms fall in two groups : arousal of ANS and accompanied with pallable distress in the form of anxiety and depression and the other group reflects thoughts and intentions that are not consciously recognized Pain disorders: psychological factors play main role in onset, maintenance and severity of pain Person experiences pain that causes significant distress and impairment; patient is unable to work and become dependent on painkillerstranquillizers The pain may have temporal relation to some conflict or stress, or it may allow individual to avoid some unpleasant activity and to secure attention and sympathy not otherwise available Pain is not a simple sensory experience therefore deciding when pain becomes a somatoform is difficult Differentiation can be achieved in the way in which pain is described by the patient; a patient with physically based pain localize it more specifically and give more sensory description and link their pain more clearly to situations that increase or decrease it Body dysmorphic disorder: preoccupation with imagined or exaggerated defects in physical appearance Some patients with disorder may spend hours each day checking on their defect, looking in the mirror Others take the steps to avoid being reminded of the defect by eliminating mirrors from their homes or camouflaging the defect- these concerns are distressing and lead to frequent consultations with plastic surgeons Occurs mostly in women; begins in late adolescence and is comorbid with depression, social phobia, eating disorders and thoughts of suicide BDD is chronic and only 9% of patients experience remission over the course of one year Can be misdiagnosed as OCD or delusional disorder therefore preoccupation with imagined defects in physical appearance may therefore not be a disorder itself, but a symptom that occur in several disorders Hypochondriasis : preoccupation with fears of having serious illness, despite medical reassurance to the contrary Begins in early adulthood and has a chronic course; frequent consumers of medical services and not likely to have mood or anxiety disorders They overreact to ordinary physical sensations and minor abnormalities such as irregular heartbeat, sweating, coughing, sore spot or stomach ache More likely than others to attribute physical sensations to an illness Patient make catastrophic interpretations of symptoms such as believing red spot on skin is skin cancer www.notesolution.com 5% of general population; Often co-occur with anxiety and mood disorders Health anxiety: health-related dears and beliefs, based on interpretations, or more often misinterpretations of body signs and symptoms as being indicative of serious illness Health anxiety would be present in both hypocondriasis and an illness phobia Hypochondriasis is a fear of having an illness. An illness phobia is a fear of contracting an illness Illness attitudes scale (IAS) is one self-report measure that is used commonly by researchers to assess health anxiety; intended to be 9-factor scale; IAS reliable for 1) worry about illness and pain (illness fears) 2) disease conviction (illness beliefs) 3) health habits (safety seeking behaviours) 4) symptoms interference with lifestyle (disruptive effects) IAS was used to confirm link bw health anxiety and trait neuroticism; general neurotic syndrome regarded as contributing factor in etiology of health anxiety along with more specific factors such as cognitive mechanisms After controlling medical morbidity, health anxiety has moderately heritable and environmental factors rather than genetic factorhealth anxiety is mostly learned Cognitive factors featured in model of health anxiety: 1) critical precipitating incident 2) previous experience of illness and related medical factors 3) presence of inflexible or negative cognitive assumptions 4) severity of anxiety o Health anxiety will increase as a function of related increases in 1) perceived likelihood or probability of illness 2) perceived cost, awfulness and burden of illness o Health anxiety will decrease as function of 1) perceived ability to cope 2) perceived presence of rescue factors Conversion Disorder: sensory and motor symptoms without any physiological cause Physiologically normal ppl experience sensory or motor symptoms such as sudden vision and paralysis, suggesting an illness related to neurological damage of some sort, although body organs and NS are found to be fine Sufferers experience paralysis of armslegs; seizures and coordination disturbances; a sensation of prickling, tingling or creeping on skin; insensitivity to pain or loss of impairment of sensory sensations called anaesthesias Vision may be impaired Aphonia: loss of voice and all but whispered speech Ansonia: loss or impairment of sense of smell Appear suddenly in stressful situations, allowing individual to avoid some activity or responsibility or to receive badly wanted attention Anxiety and psychological conflict are believed to convert into physical symptoms Hysteria was originally used to describe conversion disorders Symptoms develop in adolescence or early adulthood after undergoing life stress Episode may end abruptly but returns sooner or later; either in its original form or with symptoms of different nature and site; prevalence is less than 1 % and more women are given the diagnosis Frequently comorbid with Axis I diagnoses such as depression, substance abuse and personality disorders (borderline and histrionic personality disorders) Hysterical anaesthesias do not make anatomical sense www.notesolution.com
More Less
Unlock Document


Only pages 1-3 are available for preview. Some parts have been intentionally blurred.

Unlock Document
You're Reading a Preview

Unlock to view full version

Unlock Document

Log In


OR

Don't have an account?

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