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Somatoform and Dissociative Disorders

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Somatoform Disorders. Common Features. Lots of Physical Complaints ... Disorder of Cognition / Perception. More Disease in Family. More Illness Concern in Family ... – PowerPoint PPT presentation

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Title: Somatoform and Dissociative Disorders


1
Somatoform
and Dissociative Disorders
2
The Nature of Somatoform Disorders
  • Common Features
  • Lots of Physical Complaints
  • Appear to be Medical Conditions
  • No Identifiable Medical Cause
  • Pathological Concern About
  • Physical Appearance
  • Functioning of Their Bodies

3
An Overview of Somatoform Disorders
  • Five Somatoform Disorders
  • Hypochondriasis
  • Somatization Disorder
  • Conversion Disorder
  • Pain Disorder
  • Body Dysmorphic Disorder

4
Somatoform Disorders Hypochondriasis
  • Clinical Description
  • Ancient Roots
  • Physical Complaints
  • No Known Medical Cause
  • Severe Anxiety / Fear About
  • Possibly Having a Serious Disease
  • Reassurance Doesnt Help

5
Somatoform Disorders Hypochondriasis
  • Clinical Description
  • Essential Problem is Anxiety
  • Preoccupied With Bodily Symptoms
  • Misinterpretation of Symptoms
  • Strong Disease Conviction
  • Many Medical Visits and Tests

6
Somatoform Disorders Hypochondriasis
Why not Classify Such Persons With an Illness
Phobia?
7
Somatoform Disorders Hypochondriasis
  • Facts and Statistics
  • 1 to 14 Medical Patients
  • Equal Rates (Males vs. Females)
  • May Occur Any Time
  • Strong Disease Conviction
  • Many Medical Visits and Tests

8
Somatoform Disorders Hypochondriasis
  • Causes
  • Disorder of Cognition / Perception
  • More Disease in Family
  • More Illness Concern in Family
  • More Attention for Sick Behavior

9
Somatoform Disorders Hypochondriasis
  • Psychological Treatment
  • Modify Illness Perceptions
  • Evoke Bodily Sensations
  • Provide Appropriate Reassurance
  • More Research is Needed!

10
An Overview of Somatoform Disorders
  • Five Somatoform Disorders
  • Hypochondriasis
  • Somatization Disorder
  • Conversion Disorder
  • Pain Disorder
  • Body Dysmorphic Disorder

11
Somatoform Disorders Somatization
Disorder
  • Clinical Description
  • Briquets Syndrome
  • Many Physical Complaints
  • No Known Medical Cause
  • Little Concern About Symptoms
  • La Belle Indifference
  • Life Revolves Around Symptoms

12
Somatoform Disorders Somatization
Disorder
  • Facts and Statistics
  • Extremely Rare
  • About 4.4 of Population
  • Onset in Adolescence
  • Females gt Males
  • Often a Chronic Condition

13
Somatoform Disorders Somatization
Disorder
  • Causes
  • Family Link
  • Link to Antisocial Personality
  • Weak Behavioral Inhibition
  • Strong Behavioral Activation
  • Short Term Gain

14
Somatoform Disorders Somatization
Disorder
  • Treatment
  • Difficult to Treat
  • No Proven Treatments
  • Extensive Medical Visits
  • Treatment Focuses on
  • Reduction of Medical Visits
  • Reducing Secondary Gain

15
An Overview of Somatoform Disorders
  • Five Somatoform Disorders
  • Hypochondriasis
  • Somatization Disorder
  • Conversion Disorder
  • Pain Disorder
  • Body Dysmorphic Disorder

16
Somatoform Disorders Conversion
Disorder
  • Clinical Description
  • Physical Malfunctioning
  • Paralysis, Blindness, Aphonia
  • Mutism, Lost Sense of Touch
  • No Organic Pathology
  • Looks Like Neurological Disease
  • Popularized by Freud

17
Somatoform Disorders Conversion
Disorder
  • Related Conditions
  • Malingering or Something Else?
  • La Belle Indifference
  • Precipitated by Marked Stress
  • Can Function Normally
  • Factitious Disorders
  • Munchausens Syndrome by Proxy

18
Somatoform Disorders Conversion
Disorder
  • Facts and Statistics
  • Relatively Rare
  • Females gt Males
  • Onset Around Adolescence

19
Somatoform Disorders Conversion
Disorder
  • Causes
  • Experience of Trauma
  • Getting Sick is Acceptable
  • Symptoms to Escape From the Effects of Trauma
  • What Influences Choice of Symptoms?

20
Somatoform Disorders Conversion
Disorder
  • Treatment
  • Address the Traumatic Event
  • Remove Sources of Secondary Gain
  • No Well Established Treatments

21
An Overview of Somatoform Disorders
  • Five Somatoform Disorders
  • Hypochondriasis
  • Somatization Disorder
  • Conversion Disorder
  • Pain Disorder
  • Body Dysmorphic Disorder

22
Somatoform Disorders Pain Disorder
  • Clinical Description
  • Pain is Real
  • Pain May Have Organic Cause
  • Psychological Factors Maintain Pain
  • Can be Debilitating

23
An Overview of Somatoform Disorders
  • Five Somatoform Disorders
  • Hypochondriasis
  • Somatization Disorder
  • Conversion Disorder
  • Pain Disorder
  • Body Dysmorphic Disorder

24
Somatoform Disorders Body Dysmorphic
Disorder
  • Clinical Description
  • Preoccupation With Appearance
  • Imagined Defect
  • Imagined Ugliness
  • Mirrors (Fixation or Avoidance)
  • Ideas of Reference
  • Suicidal Ideation and Tendencies

25
Somatoform Disorders Body Dysmorphic
Disorder
  • Common Locations of Defects
  • Hair
  • Nose
  • Skin
  • Eyes
  • Head / Face
  • Lips

26
Somatoform Disorders Body Dysmorphic
Disorder
  • Facts and Statistics
  • College Students
  • 70 Report Some Disatisfaction
  • 28 Meet Diagnostic Criteria
  • Many Consult Plastic Surgeons
  • Males Females
  • Onset Late Adolescence

27
Somatoform Disorders Body Dysmorphic
Disorder
  • The Plastic Surgery Solution?
  • Quite Popular but Expensive
  • Most are Disappointed With Results

BEFORE
AFTER
28
Somatoform Disorders Body Dysmorphic
Disorder
  • Causes and Treatment
  • Little is Known
  • Co-Occurs With OCD
  • Intrusive Thoughts and Checking Compulsions About
    Appearance
  • Exposure Response Prevention
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