- psych conflicts into
physical symptoms
- soma = body
- no physical origin
- conversion disorder
o
specific symptom
§ loss, alteration
§ involuntary
o
la belle indifference
§ not distressed by symptoms
§ 1/3 – 1/2
o
symptoms
§ 1. motor symptoms
§ 2. sensory symptoms
§ 3. seizures, convulsions
§ 4. mixed presentation
o
course
§ rare
§ 1-3%
§ women
· 2:1 – 10:1 ratio
§ children
· gait problems, seizures
§ onset
· 10-35
· sudden
· 2 weeks
- hypochondriasis
o
serious illness
o
misinterpret, exaggerate
o
preoccupied
§ 6 months
o
not delusional
o
doctor shop
o
course
§ early adulthood
§ chronic
o
causes
o
treatment
§ difficult
§ cope, not cure
§ medication
- body dysmorphic
disorder
o
preoccupied with appearance
o
avoidance
o
common complaints
§ males vs. females
o
mirrors problematic
§ special lights
§ 3+ hours daily
§ avoid
o
adolescent onset
o
associated features
§ depression
§ surgical procedures
o
12% met criteria
o
treatment
§ medication
§ thought-stopping
- malingering
o
faking, exaggerating
o
ulterior motive
o
challenging
- factitious disorder
o
fake, create, exaggerate symptoms
o
“sick” role
o
types
§ Munchausen’s syndrome
· seek medical care
· inflict injury
· males
§ Munchausen’s by proxy
· make dependent sick
o
mothers
o
child 6 or younger
· warning signs
o
in child
o
in parent
· why?
o
early loss, abuse
o
cry for help
o
attention
o
nurture
- theories of somatoform
disorders
o
primary gain
§ avoid responsibilities
o
secondary gain
§ sympathy, attention
o
costs
o
many factors
-
treatments
o
behavioral techniques
o
supportive environment
- loss of identity, awareness
- types
o
dissociative amnesia – on own in text
§ memory loss
§ forms
· localized
· selective
· generalized
· continuous
· systematized
§ difficult diagnosis
§ course
· all ages
· minutes to years
o
dissociative fugue – on own in text
§ “flight”
§ sudden unexpected travel
§ memory loss
§ identity problems
§ after trauma
§ prevalence
· .02%
o
dissociative identity disorder
§ 2+ personalities
§ memory problems
§ primary identity
· host
· memory gaps
§ alternates
· contrast with host
· specific circumstances
· differ from each other
· number
o
2-100
§ transitions
· “switching”
· physical changes
o
handedness
§ associated features
· childhood abuse
· comorbidity
o
7
§ other
· culture specific
· women
o
3-9 times
o
15 identities
· males
o
8
§ course
· childhood
o
7-9
§ theories
· problems in development of
“self”
· trauma
o
physical/sexual abuse
· alter = escape
· unknown factors
§ treatment
· integrate alters
· hynotherapy