Definition? Common Features

Lots of Physical Complaints Appear to be Medical Conditions But No Identifiable Medical Cause Pathological Concern about

Functioning of body or Physical appearance

Five Somatoform Disorders Hypochondriasis Somatization Disorder Conversion Disorder Pain Disorder Body Dysmorphic Disorder

Physical Complaints No Known Medical Cause

Preoccupied with Bodily Symptoms Misinterpretation of Symptoms Strong Disease Conviction

Differentiated from Illness Phobia Severe Anxiety About Possibly Having a

Serious Disease Many Medical Visits and Tests Reassurance Doesn’t Help Impaired Functioning/Distress

Causes? Disorder of Cognition / Perception More Disease in Family More Illness Concern in Family More Attention for Sick Behavior

Psychological Treatment Challenge illness-related misinterpretations Provide more substantial and sensitive

reassurance Stress management and coping strategies

Medical Treatment?

Previously Called Briquet’s Syndrome Many Physical Complaints

Starting before age 30 No Known Medical Cause Concern about Symptoms

but Not What They Mean Life/Identity Revolves Around Symptoms Impaired Functioning

Previously Called Briquet’s Syndrome Many Physical Complaints

Starting before age 30 No Known Medical Cause Concern about Symptoms

but Not What They Mean Life/Identity Revolves Around Symptoms Impaired Functioning

Causes? Family Link Link to Antisocial Personality

Weak Behavioral Inhibition

Causes? Family Link Link to Antisocial Personality

Weak Behavioral Inhibition

Treatment Difficult to Treat No Proven Treatments Treatment Focuses on

Reduction of Medical VisitsAssign a “Gatekeeper” Physician

Reducing Secondary Gain

Treatment Difficult to Treat No Proven Treatments Treatment Focuses on

Reduction of Medical VisitsAssign a “Gatekeeper” Physician

Reducing Secondary Gain

Popularized by Freud Physical Malfunctioning

Often involves sensory-motor areasParalysis, Blindness, Mutism, Anesthesia

No Organic Pathology La Belle Indifference Impaired Functioning

Popularized by Freud Physical Malfunctioning

Often involves sensory-motor areasParalysis, Blindness, Mutism, Anesthesia

No Organic Pathology La Belle Indifference Impaired Functioning

Causes? Psychodynamic view is still popular Emphasis on the role of trauma,

conversion, and secondary gain Detachment from the trauma and

negative reinforcement seem critical Getting physically sick is culturally

acceptable

Causes? Psychodynamic view is still popular Emphasis on the role of trauma,

conversion, and secondary gain Detachment from the trauma and

negative reinforcement seem critical Getting physically sick is culturally

acceptable

Treatment Similar to Somatization Disorder No Well Established Treatments Address the Trauma Remove Sources of Secondary Gain Reduce supportive consequences of

talk about physical symptoms

Treatment Similar to Somatization Disorder No Well Established Treatments Address the Trauma Remove Sources of Secondary Gain Reduce supportive consequences of

talk about physical symptoms

Pain is Real Pain May Initially Have Organic Cause Psychological Factors Maintain Pain Can Be Debilitating

Pain is Real Pain May Initially Have Organic Cause Psychological Factors Maintain Pain Can Be Debilitating

Previously known as dysmorphophobia

Preoccupation with Defect in Appearance“Imagined” UglinessOften seek multiple plastic surgeries

Fixation or Avoidance of Mirrors Ideas of ReferenceSuicidal Ideation and Tendencies

Previously known as dysmorphophobia

Preoccupation with Defect in Appearance“Imagined” UglinessOften seek multiple plastic surgeries

Fixation or Avoidance of Mirrors Ideas of ReferenceSuicidal Ideation and Tendencies

Causes? Little is Known Runs in Families Similarities to OCD

Intrusive Thoughts and Checking Compulsions About Appearance

Treatment Parallels OCD treatment Medications (i.e., SSRIs) that work for OCD

provide some relief Exposure and Response Prevention Plastic surgery is typically unhelpful

Causes? Little is Known Runs in Families Similarities to OCD

Intrusive Thoughts and Checking Compulsions About Appearance

Treatment Parallels OCD treatment Medications (i.e., SSRIs) that work for OCD

provide some relief Exposure and Response Prevention Plastic surgery is typically unhelpful

Malingering Factitious Disorders Munchausen’s Syndrome by Proxy

Malingering Factitious Disorders Munchausen’s Syndrome by Proxy