Somatic Symptom Disorder the pain becomes part of their identity you have physical symptoms with or without a clear medical cause that are compounded in severity and impairment by psychological and behavioral factors like anxiety and distress why do people have this disorder has to do w cognitive appraisal the way you re responding to these bodily sensations leads to more distress focusing on pain having it become their identity teach them stress management coping strategies primary source of distress the pain you are currently experiencing Illness Anxiety Disorder physical symptoms are either not experienced at the present time or are very mild but the individual has severe anxiety about the possibility of having or developing a serious disease excessive health related behaviors or maladaptive avoidance i e avoiding ppl w colds association w hypochondriasis primary source of distress the possibility that you could develop have a disease Both misinterpretation of physical signs and sensations as evidence of physical illness disorders of cognition or perception w strong emotional contributions reassurance from numerous doctors that they are healthy doesn t relieve their anxiety b c these ppl have a disease conviction meaning that they mistakenly believe they have a disease these ppl continue going to additional doctors in an attempt to rule out or confirm disease and are likely to demand unnecessary medical treatment explanatory therapy which provides continuous reassurance and explanation of the nature of the patient s disorder in an educational framework by a mental health professional is successful in reducing fears beliefs about somatic symptoms and a decrease in health care usage for those with mild forms of somatic symptom disorders participation in support groups may also help CBT that focuses on identifying and challenging illness related misinterpretation of physical sensations and showing patients that focusing on a particular area of their body can bring about symptoms helps make ppl feel like the symptoms are under their control and is highly effective even for those w severe somatic symptom disorder SSRIs might help but may just be helping other symptoms other focuses in therapy for these disorders concentrates on reducing the frequency of help seeking behaviors going to tons of doctors and encouraging interactions w others based on other things besides their symptoms being sick Conversion Disorder physical malfunctioning i e blindness paralysis convulsions difficulty speaking aphonia loss of sense of touch without any physical or organic pathology to account for the malfunction Freudian and analytic view as an explanation from an analytical dynamic perspective this disorder is a coping mechanism you ve gone through a traumatic event you don t know how to cope w it so you convert your distress into physical malfunctioning so you don t have to directly deal w it can occur in groups a whole group of people can start experiencing symptoms at the same time treatment involves identifying and attending to the traumatic or stressful life event and reducing any supportive consequences of the conversion symptoms secondary gains hypnosis does not add any benefit to the CBT Factitious Disorder faking physical psychological symptoms falls somewhere btwn malingering faking symptoms for a clear gain i e money and conversion disorder Munchausen medical term for this construct an extreme version of factitious disorder the symptoms are under voluntary control but there is no obvious reason for voluntarily producing the symptoms except maybe to assume the sick role and receive increased attention Depersonalization Derealization Disorder persistent or recurring experiences of depersonalization derealization or both those w this disorder have cognitive deficits also tunnel vision perceptual distortions and mind emptiness difficulty absorbing new info that characterize these patients these patients also have greatly reduced emotional responding reflecting a tendency to selectively inhibit emotional expression Dissociative Amnesia includes generalized amnesia can t remember anything including who you are often in response to a traumatic event and more commonly localized selective amnesia can t remember details of a traumatic event but can remember everything else like who you are dissociative fugue memory loss revolves around an unexpected trip individuals sometimes assume a new identity or become confused about their old identity most prevalent of all dissociative disorders 1 8 7 3 amok is a dissociative state not found in Western cultures most common in males in which individuals are in a trancelike state and often brutally assault and kill people and animals Dissociative Identity Disorder DID defining feature is dissociation of personality usually these people have a history of horrible abuse and a lack of family social support as a way to dissociate from the abuse someone may exhibit these different alters so they can escape into a fantasy world and be someone else strongly related to PTSD some ppl think that there is a developmental window for DID that closes at age 9 ppl w DID also may be more suggestible than those w out DID often had imaginary friends as kids and can be easily hypnotized suggestible ppl use dissociation as a defense against extreme trauma high suicide rate up to 70 have attempted suicide focus of treatment is on reintegrating the identities into one complete person current treatment strategies are similar to those used for PTSD they include identifying cues or triggers that provoke memories of trauma dissociation or both and neutralizing them the therapist must help them visualize confront and relive aspects of the trauma until it is simply a memory rather than a current event hypnosis is often used to help ppl access unconscious memories and bring various alters into awareness Major Depressive Disorder extremely depressed mood lasting at least 2 weeks five or more symptoms during the same 2 week period at least one of the symptoms is either depressed mood or anhedonia those w Alzheimer s often have depression suicide rates are higher in older adults than in any other age group when diagnosing MDD clinicians also specify the features of the overall disorder or of the most recent major depressive episode to help them determine the most effective treatment or likely course CBT behavioral activation trying to activate someone helping them overcome the automatic