Download Somatoform Disorders

Psychosomatic Disorders
 REAL physical illness with psychological CAUSES such as stress or anxiety
 Tension headaches, for example
 Research indicates that most, if not all, illnesses may have a psychosomatic component
Somatoform Disorders
Somatization Disorder
Key features: The person experiences VAGUE, recurring physical symptoms for which medical
attention has been sought repeatedly but no MEDICAL cause has been found.
May be seen through
 Back pains, dizziness, partial paralysis, abdominal pains, and sometimes anxiety and
depression.
DSM Criteria
A. A history of many vague physical complaints that occur over a period of several years and result
in treatment being sought or significant impairment in functioning beginning before age 30
B. Each of the following must have been met, with individual symptoms occurring at any time
during the course of the disturbance:
1. 4 pain symptoms
2. 2 gastrointestinal symptoms
3. 1 sexual symptom
4. 1 pseudoneurological symptom
C. Either 1 or 2:
1. After appropriate investigation, each of the symptoms in Criterion B cannot be fully
explained by a known GMC or substance
2. When there is a related GMC, the physical complaints or resulting social or occupational
impairment are in excess of what would be expected from the history, physical
examination, or laboratory findings.
D. The symptoms are not intentionally produced or feigned
Conversion Disorder
Key features: dramatic specific disability (paralysis, blindness, deafness, seizures, loss of feelings, or
false pregnancy) has no physical cause but instead seems related to psychological problems. – glove
anesthesia
These may happen because the ‘illness’ resolves a difficult conflict or relieves the patient of the need to
confront a difficult situation.
DSM Criteria
A. One or more symptoms or deficits affecting voluntary motor or sensory function that suggest a
neorological or other GMC
B. Psychological factors are judged to be associated with the symptom or deficit because the initiation
or exacerbation of the symptom or deficit is preceded by conflicts or other stressors
C. The symptom or deficit is not intentionally feigned
D. The symptom or deficit cannot, after appropriate investigation, be fully explained by a general
medical condition, or by the direct effects of a substance, or as a culturally sanctioned behavior or
experience
E. The symptom or deficit causes clinically significant distress or impairment in functioning
F. The symptom or deficit is not limited to pain or sexual dysfunction, does not occur exclusively
during the course of Somatization Disorder, and is not better accounted for by another mental
disorder
Hypochondriasis
Key features: a person interprets insignificant symptoms as signs of serious illness in the absence of any
organic evidence of such illness.
DSM Criteria
A. Preoccupation with fears of having, or the idea that one has, a serious disease based on the person’s
misinterpretation of bodily symptoms
B. The preoccupation persists despite appropriate medical evaluation and reassurance
C. The belief in Criterion A is not of delusional intensity
D. The preoccupation causes significant distress or impairment in functioning
E. The duration of the disturbance is at least 6 months
F. The preoccupation is not better accounted for by another mental disorder
Body Dysmorphic Disorder
Key features: Imagined ugliness. Person is so preoccupied with their imagined ugliness that normal life
is impossible.
DSM Criteria
A. Preoccupation with an imagined defect in appearance. If a slight physical anomaly is present, the
person’s concern is markedly excessive.
B. The preoccupation causes clinically significant distress or impairment in functioning
C. The preoccupation is not better accounted for by another mental disorder
Causes
 Psychodynamic
o Symptoms related to traumatic experience in the past
o Primary Gains – Super ego protects the mind by stopping the body from acting out the forbidden
desires/behaviors
o Secondary Gains – the person is able to avoid unpleasant activities
 Cognitive behavioral
o Examines ways in which the behavior is being rewarded
 Biological perspective
o May be real physical illnesses that are misdiagnosed or overlooked