Post on 02-Jan-2016
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Somatoform Disorders
• Overly preoccupied with health and or body appearance
• Usually no identifiable medical condition causing the physical complaints
Somatoform Disorders
• Hypochondriasis
• Somatization disorder
• Conversion disorder
• Pain disorder
• Body dysmorphic disorder
Hypochondriasis
• Physical complaints without a clear medical cause and severe anxiety focused on the possibility of having a serious illness
• Medical reassurance does not seem to help
• Comorbidity with anxiety and mood disorders
Hypochondriasis
• Anxiety and features of panic disorder
• Expression of anxiety is different– Preoccupation with physical symptoms
• Reassurance seems to have temporary impact at best
• Disease Conviction: core diagnostic feature
Hypochondriasis
• Differs from illness phobia: fear of getting a disease
• Hypochondriasis: fear they already have a disease
• Chronic course
Hypochondriasis
• Distortions in cognition, perception and emotion
• Interpret minor pain as threatening
• Self focusing creates anxiety which leads to more symptoms
• View of health as being completely symptom-free
Somatization Disorder
• Extended history of physical complaints starting before age 30 and substantial impairment in social or occupational functioning
• Multitude of symptoms– 4 pain– 3 gastrointestinal– 1 sexual– 1 neurological
Somatization Disorder
• Focus on symptoms instead of what they might mean
• Often show little urgency to do anything about symptoms
• Symptoms become major part of indentity
• Most are unmarried women, lower SES
• chronic
Somatization Disorder
• Family studies: link to antisocial personality disorder
• Males more likely to show aggression
• Females more likely to display dependence
• No known effective treatment
• Physician as “gatekeeper”
Conversion Disorder
• Physical malfunctioning without apparent physical cause
• Often resemble neurological diseases
• Usually apathy towards symptoms
• Usually stressful precipitator
• Extremely rare
Body Dysmorphic Disorder
• Preoccupation with imagined defect
• Fixated on mirrors, engage in suicidal behavior, display ideas of reference and avoidance
• Severe disruption of daily functioning
• CBT and SSRI’s
• Big business for plastic surgeons
Dissociative Disorders
• Depersonalization– Distortion in perception– Sense or reality is lost– Person dissociates from reality
• Derealization– Losing sense of external world
• Both can be panic and acute stress disorder
Dissociative Disorders
• Alterations or detachments in consciousness or identity involving either dissociation or depersonalization
• Extreme variants on normal phenomena
Depersonalization Disorder
• Severe and frightening feelings of detachment and unreality
• Very rare
• Cognitive deficits– Attention, short-term memory, spatial
reasoning– Reports of tunnel vision and mind emptiness
Dissociative Amnesia
• Psychogenic memory loss
• Usually in females
• Generalized– Unable to recall anything including identity
• Selective (localized)– Selective forgetting related to trauma
Dissociative Fugue
• Leaves and may set up another identity in another place
• Very rare
• Inability to recall why or how they got there and little memory of the past
Dissociative Identity Disorder (DID)
• Adoption of new identities• Often display unique behaviors, voice
and posture• As many as 100 “Alters”• Host: identity that seeks treatment• Switch• Mostly female• Severe, chronic sexual abuse