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Chapter Eight.docx

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PSYC 3140
Joel Goldberg

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Chapter Eight  Somatoform disorder— (Anna O.) she experienced physiological symptoms that Breuer argued were the result of painful memories or emotions she was not able to confront.  Dissociative disorders, in which people develop multiple separate personalities or completely lose their memory for significant portions of their lives.  Dissociation: process in which different parts of an individual's identity, memories, or consciousness become split off from one another.  The somatoform disorders are a group of disorders in which people experience significant physical symptoms for which there is no apparent organic cause. The person usually doesn’t control or produce the symptoms, they pass once psychological factors are resolved  One of the great difficulties in diagnosing somatoform disorders is the possibility that an individual has a real physical disorder that is simply difficult to detect or diagnose  Pseudocyesis: false pregnancy  Psychosomatic disorders: medical disorders in which people have an actual physical illness or defect worsened by psychological factors  Malingering: people fake a symptom to avoid a certain situation  Factitious disorders: deliberately fake an illness to gain medical attention. Also called Munchhausen’s syndrome.  Factitious disorders by proxy: parents have fakes or created illness to gain attention for themselves.  Somatoform disorders come in five types: conversion disorder, somatization disorder, pain disorder, hypochondriasis, and body dysmorphic disorder. Except for body dysmorphic disorder, each of these is characterized by the experience of one or more physical symptoms. Body dysmorphic disorder involves a preoccupation with an imagined defect in one's appearance that is so severe that it interferes with one's functioning in life Disorder Features Conversion Disorder Loss of functioning in a part of the body for psychological rather than the physical reasons Somatization disorder History of complaints about physical symptoms, affecting many different areas of the body, for which medical attention has been sought but that appear to have no physical cause Pain disorder History of complaints about pain for which medical attention has been sought but that appears to have no physical cause Hypochondriasis Chronic worry that one has a physical disease in the absence of evidence that one does; frequent seeking of medical attention Body dysmorphic disorder Excessive preoccupation with a part of the body the person believes is defective  The most dramatic type of somatoform disorder is conversion disorder. People with this disorder lose functioning in a part of their bodies, apparently because of neurological or other medical causes.  Some of the most common conversion symptoms are paralysis, blindness, mutism, seizures, hearing loss, severe loss of coordination, and anaesthesia in a limb. Usually just one. o Was ocne referred to as conversion hysteria o Glove anaesthesia: common symptom, lose all feeling in one hand. Freud noticed under hypnosis the hand was fine.  la belle indifference, “the beautiful indifference”—people appear completely unconcerned about the loss of functioning they are experiencing.  Repression led to a lot of dissociative problems.  A person with somatization disorder has a long history of complaints about physical symptoms, affecting many different areas of the body, for which medical attention has been sought but that appear to have no physical cause  People who complain only of chronic pain may be given the diagnosis of pain disorder. In contrast, people with somatization disorder must report symptoms in each of the four areas to be diagnosed with this disorder.  Usually also have anxiety disorder, drug abuse, and personality disorders  Moderate degrees of somatization are common. More common in women than men. People from China, Latin America, Rwanda, are more likely to show this than European Americans  Treatments: not easy to convince them that they need help. Therapies help, as well as SSRIs  Somatization disorder and hypochondriasis are quite similar and may be variations of the same disorder. The primary distinction in the DSM-IV-TR between the two disorders is that people with somatization disorder actually experience physical symptoms and seek help for them, whereas people with hypochondriasis worry that they have a serious disease but do not always experience severe physical symptoms.  Hypochondriacs are more likely to seek help if they see symptoms  Very prone to depression and anxiety. Generally distressed  People with body dysmorphic disorder are excessively preoccupied with a part of their bodies that they believe is defective- avoid social activities, impairs functioning, some even committed suicide, seek out plastic surgery to fix what they dislike  Psychoanalytically oriented therapy for body dysmorphic disorder focuses on helping clients gain insight into the real concerns behind their obsession with a body part.  Cognitive-behavioural therapies focus on challenging clients' maladaptive cognitions about the body, exposing them to feared situations concerning their bodies, extinguishing anxiety about their body parts, and preventing compulsive responses to those body parts  theo
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