Download Ch. 18 Section 4: Somatoform Disorders

Ch. 18 Section 4: Somatoform
Disorders
Obj: Explain how the two
somatoform disorders differ.
Somatization, which comes from the Greek
word for “body,” refers to the expression of
psychological distress through physical
symptoms. People with somatoform disorders
have psychological problems (such as
depression) but experience inexplicable
physical symptoms (such as paralysis).
It is important to distinguish between somatoform
disorders and malingering, or the conscious attempt to
“fake” an illness in order to avoid work, school, or
other responsibilities. People with somatoform
disorders do not intentionally fake their illnesses. They
honestly feel pain or believe they cannot move their
limbs.
Reliable statistics on the incidence of
somatoform disorders are not available. Many
diagnoses of somatoform illness later prove to
be incorrect when patients are found to have
medical illnesses that account for their
symptoms. On the other hand, cases of
somatoform disorders may go undiagnosed
because of the focus on physical, as opposed
to psychological, symptoms.
Types of Somatoform Disorders
The DSM-IV identifies six
types of somatoform
disorders. The two most
common are conversion
disorders and
hypochondriasis.
• Conversion Disorder – People with conversion
disorder experience a change in or loss of
physical functioning in a major part of the
body for which there is no known medical
explanation. For example, they may suddenly
develop the inability to see at night or to
move their legs, even though no medical
explanation can be found for their sudden
physical disability. These behaviors are not,
however, intentionally produced. That is, the
person is not faking it.
Conversion disorder is
further complicated
because many people
who experience
conversion disorder
show little concern
about their symptoms,
no matter how serious or
unusual those symptoms
may be. This lack of
concern about the
symptoms may help in
the diagnosis of
conversion disorder.
• Hypochondriasis – Also called hyponchondria,
hypochondriasis is defined as a person’s
unrealistic preoccupation with thoughts that he
or she has a serious disease. People with
hyponchondriasis become absorbed by minor
physical symptoms and sensations, convinced
that the symptoms indicate a serious medical
illness. These people maintain their erroneous
beliefs despite reassurances from doctors that
there is nothing physically wrong with them.
Some people with hypochondriasis visit doctor
after doctor, seeking the one physician who will
find the cause of their symptoms.
Explaining Somatoform Disorders
Explanations for somatoform disorders in general,
and specifically conversion disorder or
hypochondriasis, are primarily psychological.
According to psychoanalytic theory, somatoform
disorders occur when individuals repress
emotions associated with forbidden urges and
instead express them symbolically in physical
symptoms. The physical symptoms thus represent
a compromise between the unconscious need to
express feelings and the fear of actually
expressing them.
More recently, other psychologists have argued that
people with conversion disorder “convert”
psychological stress into actual medical problems.
For example, a fighter pilot may lose the ability to
see at night as a response to the great anxiety he
feels about flying nighttime bombing missions.
Another individual may suffer paralysis of the legs
after nearly being in a car accident.
Some behavioral theorists have suggested that
somatoform symptoms can serve as a reinforcer
if they successfully allow a person to escape from
anxiety. There are also some indications that
biological or genetic factors may play a role in the
development of somatoform disorders.