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Somatoform Disorders
* when physical illness is
largely psychological in
origin
Somatoform Disorders
3 types: somatization, coversion,
hypochondriasis
 Marked by a pattern of recurring, multiple
and significant bodily (somatic)
symptoms that extend over several years
 These symptoms (pain, vomiting,
paralysis, etc) are not under voluntary
control & have no known physical causes
 Often misdiagnosed so no firm data
about the prevalence of these disorders

Somatization Disorder

Historically called
hysteria
 About 2.7% of
population- more
common in women

Person usually has a
long history of medical
treatment
 This disorder is often
co-morbid (exist with)
depression & anxiety
disorders
 Could be a means of
coping with a stressful
situation
 Mix of symptoms
alerts doctor to
unlikelihood of illness
Conversion Disorder

Significant loss of
physical function (with
no organic basis)
 Common symptoms:
loss of vision, loss of
hearing, paralysis,
laryngitis
 Mass Hysteriacondition experienced
by a group of people
who through suggestion
or observation develop
the same symptoms
Hypochondria
http://www.youtube.com/watch?v=VJr7ewKHY4
 Excessive preoccupation with their
health and constant worry about
developing a physical illness
 Skeptical & disbelieving of doctors who
tell them there is nothing wrong with
them
 Often co-morbid with depressive &
anxiety disorders (particularly OCD)

Etiology (causes)

Personality Factors
– Histrionic personality disorder
– Neuroticism

Cognitive Factors
– Tend to draw catastrophic conclusions about
minor bodily complaints

The Sick Role
– Enjoy the attention they get from being sick
– May get indirect rewards from being sick
(positive reinforcement)
– Avoid facing real life problems with the
attention from these “problems”
Anxiety Disorders
* Marked by feelings of
excessive apprehension
Generalized Anxiety Disorder
(GAD)




High level of anxiety not specific to any threat
Constant worry
Worry is out of proportion to actual event
Some Symptoms: trembling, dizziness,
sweating, heart palpitations, difficultly
concentration, irritable
http://www.youtube.com/watch?v=dRmBJhtys
9g
Phobias
Most common anxiety disorder
 Irrational fear of a specific thing
that presents no realistic
danger
 Most common phobia is Social
Phobia
 http://www.youtube.com/watch
?v=JDvDCqLCdEE

Exposure Therapy
Type of behavior therapy
 Gradually exposing the person to actual
anxiety producing situations or objects
 The purpose is to reduce the maladaptive
behavior

Systematic Desensitization (type
of exposure therapy)
Goal is to weaken the association btw
the CS and CR
 Involves 3 steps:

– Therapist helps the client build an anxiety
hierarchy (list or triggers)
– Teaching the client deep relaxation
techniques
– Client tries to work through the hierarchy,
learning to remain relaxed while imagining
each stimulus
Sampling of Phobias: A’s
Ablutophobia- Fear of washing or bathing.
Acarophobia- Fear of itching or of the insects that cause itching.
Acerophobia- Fear of sourness.
Achluophobia- Fear of darkness.
Acousticophobia- Fear of noise.
Acrophobia- Fear of heights.
Aerophobia- Fear of drafts, air swallowing, or airbourne noxious substances.
Aeroacrophobia- Fear of open high places.
Aeronausiphobia- Fear of vomiting secondary to airsickness.
Agateophobia- Fear of insanity.
Agliophobia- Fear of pain.
Agoraphobia- Fear of open spaces or of being in crowded, public places like markets.
Fear of leaving a safe place.
Agraphobia- Fear of sexual abuse.
Agrizoophobia- Fear of wild animals.
Agyrophobia- Fear of streets or crossing the street.
Aichmophobia- Fear of needles or pointed objects.
Ailurophobia- Fear of cats.
Albuminurophobia- Fear of kidney disease.
Alektorophobia- Fear of chickens.
Algophobia- Fear of pain.
Alliumphobia- Fear of garlic.
Allodoxaphobia- Fear of opinions.
Altophobia- Fear of heights.
Amathophobia- Fear of dust.
Amaxophobia- Fear of riding in a car.
Ambulophobia- Fear of walking.
Amnesiphobia- Fear of amnesia.
Amychophobia- Fear of scratches or being scratched.
Anablephobia- Fear of looking up.
Ancraophobia- Fear of wind. (Anemophobia)
Androphobia- Fear of men.
Other Common Phobias
Agoraphobia- fear of going out in public
places because escape might be
difficult (more common in women)
 Acrophobia- fear of heights
 Claustrophobia- fear of small enclosed
spaces
 Hydrophobia- fear of water
 Animals & Insects

Panic Disorder
Recurrent attacks of overwhelming
anxiety that occur suddenly and
unexpectedly
 Panic attack- (must have 4 of the
following symptoms) racing heart,
sweating, trembling, feelings of choking
or that you have difficulty breathing,
chest pain, nausea, dizzy

Obsessive Compulsive Disorder
(OCD)

Uncontrollable &
unwanted thoughts
(obsessions) and urges
to engage in senseless
rituals (compulsions) to
reduce the thoughts
 Common rituals:
counting, cleaning, &
checking
 http://www.youtube.com/
watch?v=44DCWslbsN
M
Etiology

Biological Factors
– Concordance rates- percentage of twin
pairs and other pairs of relatives who exhibit
the disorder
• Identical twins 35%; fraternal twins 15%
– Neurochemical activity- inbalance of GABA &
serotonin may play a role
– OCD involves problems in communication
between the front part of the brain and
deeper structures (basil ganglia)
Etiology (cont.)

Conditioning & Learning
– Phobias may be acquired through classical
conditioning & maintained through operant
conditioning
– Once the fear is acquired the person will
show an avoidance response (-R)
– Fears can also be created by observational
learning
– Seligman: Preparedness by evolutionary
history to acquire certain fears
Etiology (cont.)
Cognitive Factors
 “The doctor examined little Emma’s
growth” (subjective)
 Anxious subjects were more likely to
perceive the growth as a tumor

– Certain styles of thinking make some people
more vulnerable to certain anxiety disorders
Stress Factors- correlation btw amount of
stress and anxiety disorders
 Personality type neuroticism

Anxiety Treatments
Anti-anxiety Medications
Benxodiazepines (tranquilizers, valium,
xanax)
 CNS depressors (downers)- reduce activity
in brain and body
 Effects occur immediately but they only
last a few hours
 Potential for abuse, dependence, &
overdose

Aversion Therapy
Using classical conditioning to create a
negative response to a stimulus that
has elicited problematic behavior
 Alcoholics given an emetic drug with
their favorite drinks to induce vomiting
 Therapist hopes to create a conditioned
aversion (learned-taste aversion)
 Sexual deviance, drug and alcohol
abuses, stuttering & overeating

Social Skills Training
Improve interpersonal skills by
emphasizing modeling, behavioral
rehearsal, & shaping
 Modeling- client watches socially
skilled friends
 Behavioral Rehearsal- practice social
techniques in role playing exercises
 Shaping- client gradually given more
complicated social situations to handle
