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Chapter 11:
Somatoform, Factitious,
and Dissociative Disorders
Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Somatoform Disorders
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Convert anxiety into physical symptoms
Physical symptoms without organic disease
Reflect complex interactions between mind
and body
May cause serious impairments in social and
occupational functioning
Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
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Etiology of
Somatoform Disorders
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Biologic
Behavioral
Cognitive
Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
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Types of Somatoform Disorders
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Somatization disorder
Pain disorder
Conversion disorder
Hypochondriasis
Body dysmorphic disorder
Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
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Somatization Disorder
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Formerly called hysteria and Briquet syndrome
Frequently seeking and obtaining medical
treatment for multiple, clinically significant
somatic complaints
Diagnosis requires:
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Involvement of multiple organ systems
Early onset and chronic course without development
of physical signs or structural abnormalities
No clinical laboratory abnormalities commonly
associated with general medical conditions
Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
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Pain Disorder
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Pain in one or more anatomic sites with
significant impairment in one or more areas of
functioning
Psychologic factors may play an important
role in the onset, severity, exacerbation, or
maintenance of the pain
Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
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Conversion Disorder
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Exhibits one or more symptoms that affect
voluntary motor or sensory function
Causes significant distress in social,
occupational, or other areas of functioning
Common forms include blindness, paralysis,
seizures, deafness, or abnormal motor
movements
Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
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Hypochondriasis
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Fears having (or the idea of having) a serious
medical problem
Misinterpretation of symptoms persist despite
medical evaluation
Preoccupation with illness
Causes significant distress in everyday
function
Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
8
Body Dysmorphic Disorder
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Preoccupation with an imagined defect in
appearance
Slight anomaly has an excessive response
Causes significant distress in everyday
functioning
Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
9
Factitious Disorder
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Intentionally produces physical or psychologic
signs to assume the sick role
Behavior satisfies need for secondary gains
Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
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Types of Dissociative Disorders
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Dissociative amnesia
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One or more episodes of inability to recall
important personal information, usually of a
traumatic or stressful nature
Dissociative fugue
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Sudden, unexpected travel away from home or
one’s customary place of work, with an inability to
recall one’s past
Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
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Types of Dissociative
Disorders, cont’d.
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Dissociative identity disorder
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Demonstrates two or more distinct identities or
personality states
At least two of these personality states recurrently
take control of the person’s behavior
Depersonalization disorder
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Persistent or recurrent episodes of feelings of
detachment or estrangement from one’s self
Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
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Treatment Modalities
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Psychotherapy
Behavioral therapy
Cognitive behavioral therapy
Pharmacotherapy
Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
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