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Chapter 6

Abnormal Psychology CHAPTER 6 NOTES - I got a 4.0 in the course

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Department
Psychology
Course
PSY 240
Professor
All Professors
Semester
Winter

Description
Chapter 6: Somatic Symptom and Dissociative Disorders (do not follow the book as much because it is not up to date with the DSM 5) • Preoccupation with their health or appearance becomes so great that it dominates their lives • There is usually no identifiable medical condition causing the physical complaints • Labeled “medically unexplained physical symptoms” Somatic Symptom Disorder: Clinical Description: • Some type of very disruptive apparent medical problems causes a huge amount of attention to those symptoms but as far as the medical personnel are concerned, they are very excessive and very unnecessary • Excessive attention to somatic (soma=body) symptoms o Cognitively exaggerates the seriousness of the symptoms o Stubborn, intense anxiety about the symptoms o Inordinate energy and time spent on symptoms or health concerns • Person is not symptom-free for about 6 months; called persistent if severe and lasts > 6 months Causes: • Chronic illness among family members • Rough upbringing • Neuroticism (negative affect) • Norms of stigmatizing psychological suffering, physical attributions for stressors, etc Cultural: • China- koro: concerned that genitals are retracting into our bodies and will kill us • India- dhat: male concern about losing their semen. Dizziness and fatigue • Culturally Specific Tactile Hallucinations:Africa and Pakistan Treatment: • Education and Support: o Frequently and sensitively give detailed info about the disorder o Beneficial for mild cases • Cognitive-Behavioral o Identify and challenge misinterpretations o “symptom creation” o Perhaps “gatekeeper” physician  Reduce visits to numerous specialists o Stress reduction o Efficacy unknown IllnessAnxiety Disorder: Clinical Description: o Excessive concern with acquiring or having a serious illness o Physical symptoms are absent or minimal o Extremely anxious about or easily becomes distressed about personal health o Repeatedly checks self for signs of disease or, contra wise, actively avoids doctors apts o Above has lasted more than 6 months o Repeated medical visits may lead to anxiety or to iatrogenic (thinking that if even a doctor can’t figure out what is wrong, it must be really bad) complications Statistics: • Prevalence: ~ 1.2 – 5% • Similar in females and males • Rare in children • Prevalence unknown in other cultures • Onset most likely in early to middle adulthood Cause: • Major life stressor • Previous serious health threat, especially in childhood Functional Neurological Symptom Disorder/Conversion Disorder: Clinical Description: • Physical malfunctioning (paralysis, blindness, difficulty speaking) without any physical or organic pathology to account for the malfunction • Incompatible with known neurological or other medical condition o Must be clear evidence of this incompatibility • Apparently lacks awareness • Sometimes but far from always or exclusively o “la belle indifference” o Complaint non sensical physiologically Statistics: • Rare 2-5 per 100,000 • Female > Male • Onset=most likely in 20s and 30s • Chronic, intermittent course • More prevalent in Soldiers and children • Common if: o Low social economic status o Childhood neglect or abuse o Limited disease knowledge o Family history of neurological illness Culture: • Religious experiences • Rituals Causes: • Freudian psychodynamic view o Trauma, conflict experience + repression o ‘conversion’to physical symptoms= primary gain o Attention and support= secondary gain • Behavioral view o Traumatic event must be escaped o Avoidance is not an option o Social acceptability of illness o Negative reinforcement Treatment: • Attending to trauma • Remove secondary gain o Often involves family therapy • Reduce supportive consequences • Reward positive health behaviors Intentional faking (these are NOT conversion disorders but are closely related)  Malingering  Deliberate faking of a physical or psychological disorder motivated by gain  Intentionally produced symptoms  Clear benefit  No precipitating stressful event  Impaired function • Factitious Disorder/Munchausen’s  Nonexistent physical or psychological disorder deliberately faked for no apparent gain except possibly sympathy and attention  Intentionally produced symptoms  No obvious benefit  ¿Sick role?  Also called “Factitious Disorder imposed on another” or “Munchausen’s by proxy” Psychological FactorsAffecting Other Medical Conditions  Psychological/behavioral factors that will negatively influence an existing medical condition  Influence course of the medical condition  Interfere with treatment  Create known risk for the patient  Affect the underlying pathophysiology  FormerlyAxis III DISSOCIATIVE DISORDERS:  Dissociation = Loss of important personal information, usually of a stressful nature; may include changes in consciousness, identity and/or perception.  Dissociative Disorders are such dissociations that result in significant distress or significant impairments in  Identity  Memory  Consciousness  Dissociative Disorders seem to function to avoid the stress of unacceptable events or to deny responsibility for unacceptable behavior or desires.  Aut
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