Transcript Somatoform and Dissociative Disorders

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Definition?
Common Features
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Lots of Physical Complaints
Appear to be Medical Conditions
But No Identifiable Medical Cause
Pathological Concern about
 Functioning of body or
 Physical appearance
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Five Somatoform Disorders
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Hypochondriasis
Somatization Disorder
Conversion Disorder
Pain Disorder
Body Dysmorphic Disorder
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Physical Complaints
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No Known Medical Cause
Preoccupied with Bodily Symptoms
 Misinterpretation of Symptoms
 Strong Disease Conviction
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Differentiated from Illness Phobia
Severe Anxiety About Possibly Having a
Serious Disease
 Many Medical Visits and Tests
 Reassurance Doesn’t Help
 Impaired Functioning/Distress
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Causes?
Disorder of Cognition / Perception
 More Disease in Family
 More Illness Concern in Family
 More Attention for Sick Behavior
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Psychological Treatment
Challenge illness-related misinterpretations
 Provide more substantial and sensitive reassurance
 Stress management and coping strategies
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Medical Treatment?
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Previously Called Briquet’s Syndrome
Many Physical Complaints
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No Known Medical Cause
Concern about Symptoms
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Starting before age 30
but Not What They Mean
Life/Identity Revolves Around Symptoms
Impaired Functioning
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Causes?
 Family
Link
 Link to Antisocial Personality
Weak
Behavioral Inhibition
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Treatment
 Difficult
to Treat
 No Proven Treatments
 Treatment Focuses on
Reduction
Assign
of Medical Visits
a “Gatekeeper” Physician
Reducing
Secondary Gain
 Popularized
by Freud
 Physical Malfunctioning
 Often
involves sensory-motor areas
Paralysis,
Blindness, Mutism,
Anesthesia
 No
Organic Pathology
 La Belle Indifference
 Impaired Functioning
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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
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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
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 Previously
known as
dysmorphophobia
 Preoccupation with Defect in
Appearance
 “Imagined”
Often
Ugliness
seek multiple plastic surgeries
 Fixation
or Avoidance of Mirrors
 Ideas of Reference
 Suicidal Ideation and Tendencies
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Causes?
 Little
is Known
 Runs in Families
 Similarities to OCD
 Intrusive
Thoughts and Checking Compulsions About
Appearance
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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
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