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Chapter 7

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Konstantine Zakzanis

Chapter 7: Somatoform and Dissociative Disorders Somatoform disorders: individual complains of bodily symptoms that suggest a physical defect or dysfunction but no physiological basis can be found Dissociative disorders: individual experiences disruptions of consciousness, memory, and identity (hearing voices, having multiple identities) SOMATOFORM DISORDERS 3 DSM-IV-TR categories of somatoform disorders: Pain disorder- onset and maintenance of pain caused largely by psychological factors  Unable to work and may become dependent on pain killers or tranquilizers  Pain may have temporal relation to some conflict or stress  May allow individual to avoid some unpleasant activity and to secure attention and sympathy not otherwise available Body dysmorphic disorder- preoccupation with imagined/exaggerated defects in appearance  Frequently in the face (facial wrinkles, excess facial hair, or the shape/size of nose)  Women tend to focus on the skin, hips, breasts, and legs  Men believe they are too short, genitals are too small, or they have too much body hair  Some may spend hours each day checking their defects in the mirror  Can avoid by removing mirrors, or camouflaging the defect (wearing loose clothes) Hypochondriasis- preoccupations with fears of having a serious illness  Usually begins in early adulthood and has a chronic course  Overreact to ordinary physical sensations and minor abnormalities (irregular heartbeat, occasional coughing, or a stomach ache)  Make catastrophic interpretations of symptoms (think red blotch on skin is skin cancer)  Hypochondriasis is a fear of having an illness, an illness phobia is a fear of contracting an illness Conversion disorder- sensory or motor symptoms without any physiological cause  Sudden loss of vision or paralysis  Suggests an illness related to neurological damage of some sort, although the body organs and nervous system are fine  Paralysis of arms or legs; seizures and coordination disturbances; sensation of prickling, tingling, or creeping on the skin; insensitivity to pain  Difficult to distinguish from malingering- individual fakes illness to avoid a responsibility  La belle difference: clients with conversion disorder are willing to talk dramatically about their symptoms unlike malingers who are more guarded  Factitious disorder: people intentionally produce physical symptoms (or psychological) reporting pain or inflicting pain upon themselves or parent creating illnesses on children  Munchausen syndrome: someone making themselves ill  Anesthesias: loss or impairment of sensations  Alphonia: loss of the voice and all but whispered speech  Anosmia: loss of impairment of the sense of smell  Hysteria: term originally used to describe conversion disorders (hystera means womb)  Glove anesthesia: rare syndrome in which someone experiences little or no sensation in the part of the hand that is covered by the glove (carpel tunnel syndrome can produce similar symptoms) Somatization- recurrent, multiple physical complaints that have no biological basis  To meet diagnostic criteria, the person must have:  4 pain symptoms in different locations (head, back, joint)  2 gastrointestinal symptoms (diarrhea, nausea)  1 sexual symptom other than pain (indifference to sex, erectile dysfunction  1 pseudoneurological symptom (those of conversion disorder)  Hospitalization and surgery are common  Menstrual
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