Exam 3 study guide PART ONE I Somatization Disorder a Diagnostic Criteria i History of many physical complaints beginning before the age of 30 which occur over several years and result in treatment being sought or significant impairment in important areas of functioning ii 4 pain symptoms 2 gastrointestinal symptoms other than pain 1 sexual reproductive symptom 1 pseudoneurological symptom paralysis vision balance breathing etc iii Not fully explained by a known medical condition or the effects of a substance iv Substantial impairment in social or occupational v Concern about the symptoms not necessarily what functioning they mean vi Symptoms become the persons identity b Etiology i Rare ii Onset is usually in adolescence iii Unmarried low socioeconomic status women ratio is 2 1 female to male iv Chronic v Family history of illness during childhood heritable vi Linked to anti social personality disorder basis while women get somatization disorder the two disorders share a weak neurobiologically based behavioral inhibition system patients are very impulsive vii Social isolation men get ASPD c Treatment i Difficult to treat ii CBT is best treatment iii Reduce the tendency to visit numerous medical specialists by assigning a gatekeeper physician iv Reduce supportive consequences of talk about physical symptoms II Conversion Disorder a Diagnostic Criteria i One or more conditions affecting voluntary motor or sensory function paralysis blindness difficulty speaking aphonia without corresponding physical pathology ii La belle indifference iii Retain most normal functions but lack awareness iv Conversion Disorder verse malingering factitious disorders b Etiology i Rare with chronic intermittent course ii Comorbid with anxiety and mood disorders iii Mostly in females but has been seen in males who have been in combat but symptoms usually will go away on own iv Onset in adolescence v Common in some cultural religious groups evidence of contact with God held to high esteem does not qualify for the disorder vi Freudian psychodynamic view experience trauma conflict then repress those feelings to which they are converted into physical symptoms vii Address primary and secondary gains c Treatment i Similar to somatization disorder ii Attend to the trauma iii Remove sources of secondary gain iv Reduce supportive consequences of talk about physical symptoms III Hypochondriasis a Diagnostic Criteria i Preoccupation with fears of having a serious disease severe anxiety ii Preoccupation persist despite appropriate medical evaluation and reassurance physical complaints without a clear cause iii Preoccupation is not of delusional intensity and is not restricted to concern over physical appearance iv Clinically significant distress or impairment because of preoccupation v Strong disease conviction vi Duration of at least 6 months b Etiology i Prevalence between 1 and 5 ii Onset at any age iii Sex ratio equal iv Chronic course v Cognitive perceptual distortions faulty interpretation of physical sign or sensations leads to a perceived threat which leads to increased focus on body checking behavior and reassurance seeking leads to preoccupation which leads to misinterpretation of body sensations leads back to perceived threat vi Family history of illness during childhood genetics vii Stressful life event viii Social interpersonal influence if you are sick you get a lot of attention and are able to avoid work or other responsibilities c Treatment education i Challenge illness related misinterpretation ii Provide more substantial and sensitive reassurance and iii Stress management and coping strategies iv CBT also teaching patients how to create symptoms by focusing attention on them and learn how these symptoms are under their own control v Antidepressants are of some help i Preoccupation with an imagined defect in appearance or gross exaggeration of a slight physical anomaly imagined ugliness ii Preoccupation causes significant distress or impairment in functioning iii No accounted for by another mental disorder iv Often display ideas of reference for the imagined defect v Suicidal ideation and behavior are common vi Often there are attempts to correct the defect b Etiology i Top locations are face nose teeth eyes eyebrows shape chin lips etc skin and hair ii More common than previously thought iii 4 28 of college students iv Sex ratio is equal between genders IV Body Dysmorphic Disorder a Diagnostic Criteria v Onset usually between 14 and 19 vi Most do not marry and seek out plastic surgery vii Lifelong chronic course viii Little is known but does tend to run in families ix Similar to OCD c Treatment i Parallels treatment for OCD ii Medications SSRI s that block reuptake of serotonin iii Exposure and response prevention iv Plastic surgery is often unhelpful V What are the central features of the somatoform disorder Preoccupation with health and or body appearance and functioning no medical condition is causing the physical complaints What does soma mean Body VI What is Pain Disorder and why is it included in this group of disorders a Pain Disorder is a somatoform disorder featuring true pain but for which psychological factors play an important role in onset severity or maintenance Pain in one or more sites in the body that is associated with significant distress or impairment May have been a clear physical reason for pain got shot amputation but psychologically maintain the pain and anxiety focused on the experience of pain The pain is real and it truly hurts the patient Prevalence is 5 8 12 VII Describe some ways that a person with a conversion disorder might differ for an individual with a biologically caused physical malfunction a Biologically caused physical malfunction might be that a person was in a wreck and got nerve damage and is paralyzed but a conversion disorder would be an individual who had a stressor and internalized the anxiety and formed a paralysis but it is not linked to any biological cause nerve damage VIII Describe factitious disorder and malingering How are they different from one another a Malingering deliberate faking of a physical or psychological disorder motivated by gain get disability win law suit if there was no marked stressor in the individuals life then that might be an indicator of faking b Factitious disorder nonexistent physical or psychological disorder deliberately faked for no apparent gain except IX Definitions possibly sympathy and attention Must be caused by