Somatoform Disorders: When Inner Conflict Leads To The

Somatoform Disorders
When Inner Conflict Leads to the

Unconscious production of
Physical Symptoms
Somatoform Disorders
Somatization Disorder
Conversion Disorder
Pain Disorder
Hypochondriasis
Body Dysmorphic Disorder
What is Somatization?
 Experiencing physical distress/symptoms
in response to mental/emotional conflict
 Seeking medical attention for that physical

distress
Somatization Disorder:
DSM-IV Criteria
 Seeking treatment for many physical
complaints, with onset before age 30
 Four pain symptoms
 Two gastrointestinal symptoms
 One sexual symptom
 One pseudoneurological symptom
 The symptoms are NOT intentionally
produced
Conversion Disorder:
DSM-IV Criteria
 One or more symptoms affecting voluntary
motor or sensory function
 Resembles neurological or medical disease
 Psychological factors must be involved
 The symptoms are NOT intentionally produced

Where does the concept of
“Conversion” come from?
 Freudian term
 Patients noted to “convert” psychic conflict

into bodily symptoms as a defense
mechanism
 Commonly association with trauma

Examples of Conversion Symptoms
 Sensory  Motor
– Double vision – Paralysis
(diplopia) – Difficulty
– Blindness swallowing
(dysphagia)
– Deafness – Difficulty walking
– Numbness (ataxia)
– Tremor
– Inability to talk
(aphonia)
– Seizures
(Pseudoseizures)
Pain Disorder: DSM-IV Criteria
 One or more sites of pain as primary focus
 Pain causes significant impairment
 Psychological factors are felt to have an

important role in the pain
 The symptom is NOT intentionally produced

Hypochondriasis: DSM-IV Criteria
 Preoccupation with fears of having a
serious disease based on misinterpretation
of bodily sensations
 Preoccupation goes on despite medical

evaluation and reassurance (poor insight)
 Duration is at least six months

Hypochondriasis: Associated
Features
 Serious childhood illnesses and past
experience with illness in a family member
are common
 “Doctor-shopping” and costly medical

work-ups are common
 Appears equally common in men and

women
Body Dysmorphic Disorder:
DSM-IV Criteria
 Preoccupation with an imagined defect in
appearance
 If the individual already has a mild

physical “flaw,” the concern surrounding it
is excessive
Body Dysmorphic Disorder:
Associated Features
 Frequent inspection of the “defect” can consume
many hours a day, lead to suicidal thoughts
 Insight is often poor- can become delusional
 Medical and surgical treatments are often

pursued
 High prevalence in cosmetic surgery and

dermatology clinics
Factitious Disorder
“I know I’m producing my
symptoms, but I don’t understand
why”
Factitious Disorder:
DSM-IV Criteria
 Intentional production of physical or
psychological signs and symptoms
 The motivation for the behavior is to

assume the sick role (primary gain)
 External incentives (such as economic

gain, or avoiding responsibilities) are
absent (ie, no secondary gain)
Examples of methods to produce
Factitious symptoms
Factitious Disorder:
Associated Features
 Often involves multiple hospitalizations at
multiple sites
 Invasive procedures and surgery
 Usually have few visitors while in the hospital
 Patients often have extensive knowledge of

medical terminology (health care workers, etc.)
Munchausen Syndrome?
 Another term for Factitious Disorder
 Baron Von Munchausen was a fictional
eighteenth-century character known for
story-telling, exaggeration and frequent
travel
Munchausen by Proxy
 Parent induces illness in
a child (most common)
 The child is repeatedly

hospitalized as a result
 This is abuse (a crime,

NOT a mental illness)
Malingering
“I’m faking it, I know it, and I’m
getting something out of it”
Malingering
 Intentional production of false or
exaggerated physical or psychological
symptoms
 The malingerer is aware that he is

producing the symptoms for gain
(secondary gain)
In Summary…

Somatoform Disorders: When Inner Conflict Leads To The

Uploaded by

Copyright:

Available Formats

Somatoform Disorders: When Inner Conflict Leads To The

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Somatoform Disorders: When Inner Conflict Leads To The

Uploaded by

Copyright:

Available Formats

Somatoform Disorders

When Inner Conflict Leads to the

 Seeking medical attention for that physical

 Resembles neurological or medical disease

 Psychological factors must be involved

 The symptoms are NOT intentionally produced

 Patients noted to “convert” psychic conflict

 Commonly association with trauma

 Pain causes significant impairment

 Psychological factors are felt to have an

 The symptom is NOT intentionally produced

 Preoccupation goes on despite medical

 Duration is at least six months

 “Doctor-shopping” and costly medical

 Appears equally common in men and

 If the individual already has a mild

 Insight is often poor- can become delusional

 Medical and surgical treatments are often

 High prevalence in cosmetic surgery and

 The motivation for the behavior is to

 External incentives (such as economic

 Invasive procedures and surgery

 Usually have few visitors while in the hospital

 Patients often have extensive knowledge of

 The child is repeatedly

 This is abuse (a crime,

 The malingerer is aware that he is

You might also like

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.