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Somatoform disorder subjective experience of multiple physical symptoms with no organic cause 5 somatoform disorders 1) conversion disorder; 2) somatization disorder; 3) pain disorder; 4) hypochondriasis; 5) body dysmorphic disorder Conversion disorder Loss of functioning in some part of the body for psychological rather than physical reasons; person has often experienced a psychological trauma shortly before onset of symptoms that mimics the symptoms Somatization disorder History of complaints about physical symptoms, affecting many different areas of the body, for which medical attention has been sought but no physical cause found- more vague than conversion disorder 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; frequently seek medical attention Body dysmorphic disorder Excessive preoccupation with some part of the body the person believes is defective Symptoms of conversion disorder Loss of functioning in some part of the body due to psychological rather than physiological causes—there may be indifference to the loss of functioning (la belle indifference). Reaction is important! etiology/cause of conversion disorder Often can occur after trauma or stress, perhaps because the individual cannot face memories or emotions associated with the trauma tx for conversion disorder Psychoanalytic therapy focuses on helping the individual expression of emotions or memories. Behavioral therapy uses systematic desensitization and other techniques; work thru the problem- deal with the anxiety La belle indefference a person's indifference to their sudden loss of function in conversion disorder. reaction is an important feature. in some cases, the loss of function is a relief, because they have been suffering psychology. symptoms of somatization & pain disorders Somatization disorder involves a long history of multiple physical complaints for which people have sought treatment but for which there is no apparent organic cause. Pain disorder involves only the experience of chronic, unexplainable pain etiology of somatization & pain disorders These disorders run in families, but it is not clear whether this is due to genetics or modeling. Different theories claim different origins for this disorder- no strong theoretical explanation tx of somatization & pain disorders Psychoanalytic: helping people identify feelings and thoughts behind the symptoms and find more adaptive ways of coping. CBT:relaxation, constructive coping with symptoms (symptoms are really there so it's going to be important to know how to cope with them) symptoms of hypochondriasis Chronic worry that one has a serious medical disease despite evidence that one does not; frequent consultations with physicians over this worry. The symptom is linked to a fear/anxiety & presence of that stimuli triggers the symptom. etiology/cause of hypochondriasis A family history of depression or anxiety is common. These people may suffer from chronic distress and cope with this distress by exaggerating physical symptoms tx for hypochondriasis Same as somatization disorder, involving helping people identify feelings and thoughts behind the symptoms and find more adaptive ways of coping symptoms of body dysmorphic disorder Obsessional preoccupation with body parts. Elaborate behaviors to mask or get rid of body parts; takes up an extreme amount of time; not so much about the body- that is how the underlying issue is expressed etiology of body dysmorphic disorder May be a feature of an underlying depression or anxiety disorder. May be a form of obsessive-compulsive disorder tx of body dysmorphic disorder Psychodynamic therapy to uncover emotions driving the obsessions about the body; Systematic desensitization to decrease obsessions and compulsive behaviors about body; SSRI's to reduce obsessional thoughts DSM criteria for somatoform/conversion disorders http://o.quizlet.com/i/6IYdcc_4heVSLSGWr4GUbg.jpg Gate theory of pain may be related to the pain felt by those with pain disorder. anxiety level is linked to pain. Lower anxiety=close pain gate=lower pain Psychosomatic disorders Actual physical illness present and psychological factors seem to be contributing to the illness Malingering Deliberate faking of physical symptoms to avoid an unpleasant situation, such as military duty Factitious disorder Deliberate faking of physical illness to gain medical attention;AKA Muchausan's disorder. Also related- Munchausan's-by-proxy Difference in motive between malingering and factitious disorder Malingering- motivation is to avoid doing something; Factitious disorder- motivation is to gain medical attention Dissociative disorders Process in which different parts of an individual's identity, memories, or consciousness become split off from one another; When dissociation becomes chronic and a defining features of people's lives, people may be diagnosed with a dissociative disorder. How common is dissociation? Most people experience some form of dissociation— daydreaming is one example of dissociation. Dissociative identity disorder There are separate, multiple personalities in the same individual. Dissociative fugue The person moves away and assumes a new identity, with amnesia for the previous identity. Dissociative amnesia The person loses memory of important personal facts, including personal identity, for no apparent organic cause Depersonalization disorder People with this disorder have frequent episodes in which they feel detached from their own mental processes or bodies, as if they are outside observers of themselves. Symptoms of DID Presence of two or more separate personalities or identities in the same individual. These personalities may have different ways of speaking and relating to others and may even have different ages, genders, and physiological responses Etiology of DID Alters may be created by people under conditions of extreme stress, often child abuse. Self-hypnosis may be involved. Some evidence it runs in families Tx for DID Long-term psychotherapy and use of hypnosis to discover functions of the personalities and to assist in "integration." Antidepressants and antianxiety drugs may be used Symptoms of dissociative fugue Person suddenly moves away from home and assumes an entirely new identity, with no memory of previous identity Etiology of dissociative fugue Fugue states usually occur in response to some stressor, but because they are extremely rare, little is known about etiology tx for dissociative fugue Psychotherapy to help the person identify the stressors leading to the fugue state and learn better coping skills symptoms of dissociative amnesia Loss of memory due to psychological rather than physiological causes. The memory loss is usually confined to personal information only etiology of dissociative amnesia Typically occurs following traumatic events. May involve motivated forgetting of events, poor storage of information during events due to overarousal, or avoidance of emotions experience during an event tx for dissociative amnesia Help the individual remember traumatic events and accept them How common is depersonalization disorder? Occasional experiences of depersonalization are common, especially when people are sleep deprived. Depersonalization Disorder is only diagnosed when they are so frequent and distressing that they interfere with an individual's ability to function