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Chapter 6
DISORDERS OF BODILY
PREOCCUPATION
DSM-IV DISORDERS
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PAIN DISORDER
SOMATOFORM DISORDER
FACTITIOUS DISORDER AND
MALINGERING
SOMATOFORM DISORDERS
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Pain disorder – Psychological factors play a
large role in pain
Somatization disorder – Multiple complaints
over a period of years
Conversion disorder – Unexplained bodily
symptoms
Hypochodriasis – Preoccupation with idea of
getting or having a serious disease
Body dysmorphic disorder – Preoccupation with
imagined or exaggerated physical defect
COPING WITH PAIN
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What is pain?
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Coping mechanisms
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Complex determination involving biological,
psychological, and social factors
Active coping
Passive coping
Treating pain disorders
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Reduce anxiety
Psychological interventions
 Cognitive behavioral therapy, biofeedback,
insight psychotherapy
Pain medication
SOMATIZATION DISORDERS
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Multiple somatic complaints that are recurrent or
chronic
Formerly known as Briquet’s syndrome
Seek treatment for multiple physical complaints
that do not appear to be feigned
DSM-IV requires at least four pain symptoms in
different bodily sites and gastrointestinal and
sexual nonpain complaints
Occurs mainly in women – One percent of female
population
Seems to run in families
Cognitive and psychodynamic therapies are often
effective
SURGERY IN SOMATIZING PATIENTS
CONVERSION DISORDERS
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Patients report loss of some bodily function
Does not appear to be voluntary
Not explained by physical causes or related to a
medical condition
Patient often unconcerned about the symptom
Frequently traced to specific triggering events
HYPOCHONDRIASIS
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Persistent belief of having serious illness
in spite of reassurance and no physical
finding
Preoccupation with condition of bodily
organs
Constant worry about health
Attune to most subtle physiological
functions
Cognitive-behavioral therapy is helpful
BODY DYSMORPHIC DISORDER
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Disorder of body image
Preoccupation with imagined bodily
defect or excessive concerns about minor
unwanted feature
Patients report feelings of depression,
phobias, obsessions and compulsions but
don’t mention bodily preoccupations
Cognitive-behavioral therapy is promising.
FACTITIOUS DISORDERS
AND MALINGERING
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Patients with these disorders usually have
lifelong, severe personality disorders
Munchausen syndrome
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Factitious disorder by proxy
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Physical and psychological symptoms are voluntarily
self-induced in order to receive medical attention
Usually a mother producing symptoms in a child in
order to get attention for the mother
Malingering
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Seek treatment for specific goal such as
compensation, disability payments, or evasion of
police.