1. Somatic Symptom and Related Disorders
Chapter 9
Dissociative and Somatic Symptom Disorders

2. Module Objectives What are Somatoform Disorders?
-What are some forms of somatoform disorders?
What are the causes for these disorders?
How can they be treated?

3. Somatic symptoms involving _____________________________________________________________________________________
Somatoform disorders occur when psychological conflicts become translated into physical problems or complaints.

4. Somatic Symptom Disorder
Somatic Symptom Disorder involves physical ____________________________________________________________________________________________
People with this disorder think to a disproportionate degree about the seriousness of their symptoms.
They feel extremely anxious about them, and spend a great deal of time and energy to the symptoms or their concerns about their health.
People with somatic symptom disorder have physical symptoms that may or may not be accountable by a medical condition; they also have maladaptive thoughts, feelings, and behaviors. Th ese symptoms disrupt their everyday lives. People with this disorder think to a disproportionate degree about the seriousness of their symptoms, feel extremely anxious about them, and spend a great deal of time and energy to the symptoms or their concerns about their health. Somatic symptom disorder is relatively rare, but is present with higher than expected frequency among patients seeking treatment for chronic pain.

5. Illness Anxiety Disorder
Illness Anxiety Disorder is a somatic symptom disorder characterized by the _________________ ____________________________________________
People with this disorder fear or mistakenly believe that _________________________________ ________________________________________________________________________________________
People with illness anxiety disorder fear or mistakenly believe that normal bodily reactions represent the symptoms of a serious illness. They easily become alarmed about their health and seek unnecessary medical tests and procedures to rule out or treat their exaggerated or imagined illnesses.

6. Formerly called Hypochondriasis.
I think I’m dying…
Illness Anxiety Disorder ____________________________________________________________________________________
Formerly called Hypochondriasis.

7. The fear or idea is based on the misinterpretation of _______________________________________________________________
They are not pretending for attention.
People with Hypochondriasis have no real illness, but they are overly preoccupied with normal bodily functions.
Formerly called Hypocondriasis.
They easily become alarmed about their health and seek unnecessary medical tests and procedures to rule out or treat their exaggerated or imagined illnesses.

8. Overwhelming Fear and Panic
They easily become alarmed ___________________________________________________________________________
to rule out or treat their exaggerated or imagined illnesses.
“I have a headache…I must have a brain tumor!”

9. Does assurance from doctors reduce this worry?

10. _______________________________________________________________________________________________________________________________________________________
People with Hypochondriasis often see many doctors, looking for someone to confirm the illness.

11. Who does this disorder affect?
The prevalence of this disorder in the general population is not fully known, it is approximated that this effects about _________________________
Throughout history this disorder was typically associated with women as a “hysterical” disorder.
______________________________________________________________________________________________________

12. The development and course is unclear.
This disorder is believed to be ___________________ ____________________________________________________________________________________________
It is widely agreed that Hypochondriasis is a disorder of cognition or perception with strong emotional contributions.
-Research has confirmed that patients with hypochondriasis show enhanced perceptual sensitivity to illness cues.

13. People with this disorder also ___________________________________________________
This causes them to become quickly aware and frightened of any possible sign of illness.

14. Because Illness Anxiety Disorder is new, _____________________________ __________________________________
Anxiety disorders, as well as depressive disorders, were commonly comorbid with Hypochandriasis:
______________________________________________________________________________________________________________________________________________________________________________
Approximately ______________ of people with this disorder have another disorder present.
Higher risk for somatic and personality disorders

15. Treatment
CBT focuses on identifying and challenging illness-related misinterpretations and showing patients how they can create symptoms by focusing attention on certain body parts.
Medications are seldom used, but SSRI’s may be considered.

16. Conversion Disorder _______________________
This term was made famous by Freud, who believed the anxiety resulted from unconscious conflicts that was “converted” into physical symptoms.

17. Conversion disorders (Functional Neurological Symptom Disorder)
Clients with conversion disorder show a wide range of physical ailments:
__________________________________________
Weakness
Disturbances of speech
Cognitive impairment
Clients with conversion disorder show a wide range of physical ailments:
Pseudoseizures
Disorders of movement
Paralysis
Weakness
Disturbances of speech
Blindness and other sensory disorders
Cognitive impairment

18. Those who report blindness often can avoid objects in their visual field, as well as those reporting paralysis of the legs might get up and run somewhere in an emergency and are astounded they were able to do this.
-This can account for some who are miraculously “cured” during religious ceremonies.

19. Statistics
Conversion disorders are relatively rare in mental health settings, often because people with these symptoms are more likely to consult a neurologist or specialists.
It was concluded that environmental stress, especially sexual abuse, are common among children and adolescents with conversion disorder (Roelofs et al., 2002).

20. ________________________________
Unlike conversion disorders that are not under the person’s physical control, ____________________ _________________________________________ for some form of gain.
________________________________

21. Factitious disorders
______________________________________________not for the purpose of any particular external gain to become a patient.
No apparent gain except _______________________
Commonly referred to as Munchausen’s Syndrome
Estimated that ~1% meet criteria for this disorder
The course _______________________________
Patients with this disorder knowingly fake symptoms, but do so for psychological reasons.
Factitious disorder imposed on self, people fake symptoms or disorders, not for the purpose of any particular external gain but because of an inner need to maintain a sick role.

22. Patients with factitious disorders________________ _____________________________________________ of a physical or mental illness by a variety of methods
Contaminating urine samples with blood
Taking hallucinogens
Injecting themselves with bacteria to produce infections

23. Factitious Disorder Imposed on Another (Munchausen’s syndrome by proxy)
This disorder is a factitious disorder, but really an atypical form of child abuse.
The parent may resort to extreme tactics to create the ______________________________________________
____________________________________________________________________________________________________________
The individual may also feign the illness of someone else in cases of factitious disorder imposed on another (or Munchausen’s syndrome by proxy)

24. The caregiver may exaggerate, fabricate, or induce symptoms.
Children effected are typically preschool age, although there have been reported cases in children up to 16 years old.

25. Who does this disorder effect?
There are equal numbers of boys and girls, however, 98% of the perpetrators are female.

26. Treatment
Few studies have evaluated the effectiveness of treatment, but the principle strategy is to identify and attend to the traumatic/stressful life event, if it is still present and remove the sources of ___________________________

27. Psychological Factors Affecting Medical Conditions
Disorder in which clients have a medical disease or symptom that appears to _______________________ ______________________________________________
Clinical examples:
_________________________________________________
Denial of need for treatment for acute chest pain
__________________________________________________________________________________________________________________

28. What’s Next?
Dissociative Identity Disorders