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36 Cards in this Set
- Front
- Back
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Somatoform Disorders
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Some individuals , the preoccupation with their health or appearance becomes so great that it dominates their lives. Their problems fall under the general heading of somatoform disorders. Soma means body, and the problems preoccupying these people seems, initially, to be physical disorders What the disorders have in common, however, is that there is usually no identifiable medical condition causing the physical complaints.
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Dissociative Experiences
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Feeling "detached" from one's self or surrondings. During these experiences some people feel as if they are dreaming. These very mild sensations that most people experience from time to time are slight alterations, or detachments in consciousness or identity.
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Neurosis
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As defined by psychoanalytic theory, suggested a specific cause for certain disorders. Specifically, neurotic disorders resulted from underlying unconscious conflicts, anxiety that resulted from those conflicts, and the implementation of ego defense mechanisms. It was eliminated from the diagnostic system in 1980 because it was too vague, applying to almost all nonpsychotic disorders, and because it implied a specific but unproven cause for these disorders.
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DSM-IV Five Basic Somatoform disorders
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Hyppochondriasis, somatization disorder, conversion disorder, pain disorder, and body dysmorphic disorder.
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Hysterical
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Freud and other early psychologists refered to this more generally to physical symptoms without known organic cause, or to dramatic or histionic behavior, thought to be a characteristic of women.
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Illness Phobia
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Somewhat similar to hypochondria, but is marked by a fear of developing a diseas, not mistakingly believing they have a diesease. Their behaviors involve avoiding contagin, not desiring disease diagnosis.
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Diagnosis of Hypochondria
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Preoccupation with fears of having serious disease, preoccupation persists despite appropriate medical evaluation and reassurance, preoccupation is not of delusional intensity and is not restricted to concern over a physical appearance, clinically significant distress or impairment due to preoccupation, with a duration of at least six months.
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Hypochondria Prevalence
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Originally believed to be between 1-14% of population, significant study determined 3%. Equally prevelant between men and women, and is spread evenly across various phases of adulthood. As with most anxiety and mood disorders, it is chronic.
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Causes of Hypochondria
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Most all agree faulty interpretation of physical signs and sensations; a disorder of cognition or perception with strong emotional contrabutions. Show enhanced perceptual sensitivity to illness cues, and interprut ambiguous stimuli as threatening.
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Etiological Processes of Hypochondira
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First, hypochondriasis seem to develop in the context of a stressful life event, as do many disorders, including anxiety disorders. Such events often involve death or illness. Second, people who develop it tend to have a disproportionate incidence of disease in their family when they were children. Third, an important social and interpersonal influence may be operating. Some people who come from families where illness is a major issue seem to have learned that an ill person is often paid more attention.
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Culture and Hypochondrias
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Culture-specific syndromes seem to fit comfortably with hypochondriasis. Among these is Koro, in which there is the belief, accompanied by severe anxiety and sometimes panic, that the genitals are retracting into the abdomen. Most victims are Chineese males, reported very rarely in West. Likely result of the extreme importance of sexual function in Chinese males, or guilt of masturbation.
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Treatment of Hypochondrasis
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Most effective treatment focused on identifying and challanging illness-related misinterpretations of physical sensations and on showing patients how to create "symptoms" by focusing attention on certain body area. Bringing on their own symptoms persuaded many patients that such events were under their control. Also given general stress management treatment and coached to seek less reassurement for their concerns. Still helped 76% after three months.
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Somatization Disorder
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Somatoform disorder involving extreme and long-lasting focus on multiple physical symptoms for which no medical cause is event. Those with this disorder, as opposed to hypochondria, are more concerned with the symptoms themselves, not what they might mean. Entire life revolves around symptoms, identify them and how they relate to others people (in context of discussing symptoms).
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Somatization Disorder Statistics
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Very rare. DSM-III-R required 13 or more symptoms from a list of 35, making diagnosis very difficult. Greatly simplified for DSM-IV, with only eight required. Onset during adolescents, many more women than men, often from lower socioeconomic groups.
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Diagnosing Somatization Disorder
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History of many physical complaints beginning before 30, for a long time, resulting in treatment or significant impairment. Each of the following a)4 pain symptoms b)two gastrointestinal symptoms other than pain c)one sexual symptom d)one pseudoneurologic symptom (i.e. double vision). Physical complaints not explainable by a know general medical model, appear in excess of what would be expected, but are not intentionally produced or feigned.
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Somatization Disorder and Anti-Social Personality Disorder
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Strongly linked in family and genetic studies to one another. ASPD occurs primarialy in males and somatization disorder in females, but they share a number of features. Both begin early in life, chronic, predominate among lower socioeconomic classes. Impulsiveness is a common factor, the continual development of new somatic symptoms gains immediate sympathy and attention (for awhile) but eventually result in social isolation. Also impulsive with sex, seeing doctors, etc. concern for symptoms as seeing her as important. Sexual relationships are never satisfing or fulfilling, but greatly painful when the end.
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Somatization Disorder Treatment
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Exceedingly difficult to treat and there are no treatments with proven effectiveness. However, trials of treatments have involved providing reassurance, reducing stress, and in particular-reducing frequency of help-seeking behaviors. Also, gatekeeper physicans are assigned to each patient to screen all physical complaints. Subsequent visits to specialists must be specifically authorized by this doctor. Also seek to reduce relating to significant others on basis of physical symptoms.
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Conversion Disorder
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Physical malfunctioning, such as blindness or paralysis, or difficulty speaking, without any physical or organic pathology to account for the malfuntion. Most symptoms suggest that some kind of neurological disease is affecting sensory-motor symptoms, although conversion symptoms can mimic the full range of physical malfunctioning.
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Freud and Conversion
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Freud believed the anxiety resulting from unconscious conflicts somehow was converted into physical symptoms to find expression. This allowed the individual to discharge some anxiety without actually experiencing it.
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Distinguishing Between Conversion and Malingering (Faking)
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1)Converion reactions often have the same quality of indifference to the symptoms that is present in somatization disorder. 2)Conversion symptoms are almost always precipitated by marked stress, thus if there is no stressful event to be identified, one might more carefully consider the resence of a true physical condition. (some say 25% of diagnosed conversions turn out to be physical disorders). 3)Although people with conversion symptoms can usually function normally, they seem truly unaware either of this ability or of sensory input. (those with conversion blindness can usually avoid objects in their visual field.)
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Factitious Disroder
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Fall somewhere between malingering and conversion disorders. The symptoms are under voluntary control, as with malingering, but there in no obvious reason for voluntarily producing the symptoms except, possibly, to assume the sick role and receive increased attention.
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Conversion Disorder Symptoms
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One or more conditions affection voluntary motor or sensory function that suggest a neurological or general medical condition. Psych factors are judged to be associated with the condition because of preceeding conflicts or other stressors. Condition cannot otherwise be explained by a general medical condition, effects of a substance, or as a culturally sanctioned behavior or experience. Clinically significant distress or impairment caused by condition.
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Munchausen syndrome by proxy
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Really an atypical form of child abuse. Offending parent goes to extreme measures to either make or have her child look sick.
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Conversion Disorder Statistics
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Like somatization disorder, conversion disorders are found primarily in women and typically develop during adolescence or slightly thereafter. However, it occurs relatively frequently in males at times of extreme stress. Conversion reactions are not uncommon in soldiers exposed to combat. In some cultures, some conversion symptoms are very common aspects of religious or healing rituals. Seizures, paralysis, and trances are common in some rural fundamentalist relgions.
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Pain Disorder Symptoms
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Includes the presence of serious pain in one or more anatomical sites. Pain causes clinically significant distress or impairment in functioning. Psychological factors judged to play primary role in onset, severity, exacerbation, or maintenance of the pain. Pain is not feigned or intentionally produced.
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Body Dysmorphic Disorder
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Somatoform disorder featuring a disruptive preoccupation with some imagined defect in appearance "imagined ugliness". Considered a somatoform disorder because its central feature is a psychological preoccupation with somatic issues.
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Body Dysmorphic Disorder Characteristics
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Psychologists still argue whether these intense, unrealistic thoughts that seems justified to victims is dellusional or not. There is also some discussion if this disorder is not just a specific type of OCD, as those who suffer from it have terrible thoughts and perform ritualistic activities. Another proposal suggests that perhaps the BDD people express could possibly be a coping mechanism to justify underlining Social Phobia. Also, BDD is the only Somatoform Disorder not to be often found in conjunction with another Somatoform Disorder.
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Depersonalization Disorder
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Symptoms include persistent or recurrent feelings of being detached from one's body or mental processes. Reality testing remains intact during the depersonalization experience. Depersonalization causes clinically significant distress or impairment in functioning. Condition does not occur exclusively as part of another mental disorder such as schizophrenia, panic disorder, acute stress disorder, etc. Patients are easily distracted, and had some trouble perceiving three-dimensional objects because they tended to 'flatten' these objects into two dimensions.
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Dissociative Amnesia
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Includes one or more episodes of inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained as ordinary forgetfulness. Episodes are not related to a medical condition, psychological effects of a substance, or seperate psychological disorder. Also has inability to recall causes clinically significant distress or impairment in functioning
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Localized (Selective) Amnesia
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A failure to recall specific events, usually traumatic, that occur during a specific period of time. Especially no rememberance of the emotional memories of an event or time period.
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Dissociative Fugue
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Related Dissociative amnesia disorder in which memory loss revolves around a specific incident. Most often, individuals just take off, and later find themselves in a new place, unable to remember why or how they got there. Usually they have left behind an intolerable situation. Fugue states usually end rather abruptly and the disintegrated experience is more thatn memeory loss, involving at least some disintegration of identity, if not the complete adoption of a new one.
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Dissociative Identity Disorder
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The presence of two or more distinct identities or personality states, each with its own relatively enduring pattern. At least two of these identities or personality states recurrently take control of the person's behavior. Inability to recall important information that is too extensive to be explained by ordinary forgetfulness. Disturbance not due to direct physiological effects of a substance or general medical condition.
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Dissociative Identity Disorder Characteristics
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Findings have suggested that those with DID tended to be highly suggestable individuals, building arguement that it was often faked. However, tests show that those who are shifting between alters usually display 4.5 times the changes in optical functioning, something very difficult to mimick. The defining characteristic is that certain aspects of the person's identity are dissociated.
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Dissociative Identity Disorder Causes
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Almost always appears to be a result of extreme abuse as a child, and develops in young childhood. A very large percentage of patients have simultaneous psychological disorders. DID is believed to be rooted in a natural tendency to escape or dissociate from the negative affect associated with severe abuse or traumatizing event, with a lack of social support to cope.
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Dissociative Indentity Disorder Treatment
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The strategies that therapists use today in treating DID are based on accumulated clinical wisdom as well as on procedures that have been successful with posttraumatic stress disorder. The fundamental goal is to identify cues or triggers that provoke memories of trauma and or dissociation and to neutralize them. More importantly, the patient must confront and relive the early trauma and gain control over the horrible events, at least as they recur in the patient's mind
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Dissociative Identity Disorder and Posttraumatic Stress Disorder
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Believed to be a strong similarity between the two, if not the same thing to different stessors or degress. Some believe that DID is the manifestation of PTSD acquired at a very young age, in which the person has not fully developed their concept of self, or fully understood reality. Also, PTSD and DID both display findings relating to the diathesis-stress model, in that regardless of the extremety of stressors, some people simply do not develop either disorder, but there is likely a predisposition to these disorders that is triggered by events to cause the disorder.
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