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Chapter 7

Chapter 7 notes for FALL 2010 semester

15 Pages

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Konstantine Zakzanis

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PSYB32 CHAPTER 7 OCT.25 .2010 -somatoform and dissociative disorders are related to anxiety disorders in that, in early versions of the DSM, all these disorders were subsumed under the heading of neuroses bc anxiety was considered the predominant underlying factor in each case -somatoform disorders: physical symptoms suggest a physical problem but have no know physiological cause; theyre therefore believed to be lined to psychological conflicts and needs but not voluntarily assumed; -e.g. somatization disorder (Briquets syndrome), conversion disorder, pain disorder, and hypochondriasis -indiv complains of bodily symptoms that suggest a physical defect or dysfunction sometimes rather dramatic in nature but for which no physiological basis can be found -dissociative disorders: normal integration of consciousness, memory, or identity is suddenly and temporarily altered; -e.g. dissociative amnesia, dissociative fugue, dissociative identity disorder (multiple personality), and depersonalization disorder are examples -in dissociative disorders, indiv experiences disruptions of consciousness, memory, and identity -the onset of both classes of disorders is assumed by many to be related to some stressful experience, and the 2 classes sometimes co-occur -SOMATOFORM DISORDERS: soma means body; psychological problems take physical form; physical symptoms have no known physiological explanation and arent under voluntary control; thought to be linked to psychological factors, i.e. anxiety, and are assumed to be psychologically caused -bodily symptoms of these disorders fall typically into 2 groups: -one group of symptoms reflects arousal in the ANS and is accompanied by palpable distress in the form of anxiety and depression -2 group of symptoms reflects thoughts and intensions that arent consciously recognized -pain disorder: a somatoform disorder in which the person complains of severe and prolonged pain that is not explainable by organic pathology; it tends to be stress-related or permits the patient to avoid an aversive activity or to gain attention and sympathy -experiences pain that causes significant distress and impairment; psychological factors are viewed as playing an important role in the onset, maintenance, and severity of the pain www.notesolution.com -patient may become unable to work and may become dependent on painkillers or tranquilizers -the pain may have a temporal relation to some conflict or stress, or it may allow the indiv to avoid some unpleasant activity and to secure attention and sympathy not otherwise available -accurate diagnosis is difficult because the subjective experience of pain is always a psychologically influenced phenomenon -patients with physically based pain localize it more specifically, give more detailed sensory descriptions of their pain and link their pain more clearly to situations that inc or dec it -body dysmorphic disorder (BDD): a somatoform disorder marked by preoccupation wan imagined or exaggerated defect in appearance; i.e., facial wrinkles or excessfacial or body hair; freq in the face -women focus on the skin, hips, breasts, and legs; men are more inclined to believe theyre too short, that their penises are too small, or that they have too much body hair -may spend hours each day checking on their defect, looking at themselves in mirrors; others try to avoid being reminded of the defect, e.g., by wearing very loose clothes -occurs mostly among women, typically begins in late adolescence, and is freq co-morbid wdepression and social phobia, eating disorders, and thoughts of suicide -BDD is chronic, with only 9% of BDD patients experiencing remission over the course of 1 yr -preoccupation with imagined defects in physical appearance may not be a disorder itself, but a symptom that can occur in several disorders -hypochondriasis: a somatoform disorder in which the person, misinterpreting rather ordinary physical sensations, is preoccupied with fears of having a serious disease and is not dissuaded (talk somebody out of something) by medical opinion; difficult to distinguish from somatizaton disorder -individuals are preoccupied with persistent fears of having a serious disease, despite medical reassurance to the contrary -typically begins in early adulthood and has a chronic course -theory is that they overreact to ordinary physical sensations and minor abnormalities i.e. irregular heartbeat, sweating, occasional coughing, a sore spot, or a stomach ache, seeing these as evidence for their beliefs -ppl whigh scores on a measure of hypochondriasis are more likely than others to attribute physical sensations to an illness; similarly, patients whypochondriasis make catastrophic interpretations of symptoms, i.e. believing that a red blotch on the skin is skin cancer www.notesolution.com
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