1. v http://digital.films.com.ezproxy.librar y.ubc.ca/PortalPlaylists.aspx?aid=1759 2&xtid=7849&loid=28225 http://digital.films.com.ezproxy.librar y.ubc.ca/PortalPlaylists.aspx?aid=1759 2&xtid=7849&loid=28225 http://digital.films.com.ezproxy.librar y.ubc.ca/PortalPlaylists.aspx?aid=1759 2&xtid=7849&loid=28225 v 35:30 Somatization v 30:30 Conversion

2. Body Related Disorders: Somatoform, Conversion, Factitious

3. Psychological Disorders Related to Physical Body v Body v Somatoform Disorders, Conversion Disorders, Factitious Disorders

4. Somatoform Disorders v Somatization (Briquet’s or hysteria) v Hypochondriasis v Psychogenic Pain v Conversion Disorder v Body Dysmorphic Disorder v Undifferentiated Somatoform Disorder

5. Somatoform Disorders Commonalities 1. Have body complaints or loss of function 2. No organic pathology 3. Psychological factors play important role 4. “la belle indifference” 5. Precipitant

6. Somatization (Briquet’s Syndrome) v “Grand Hysterics or Chief Troublemakers” v Complaints: characteristics v Complaints splayed v Presentation

7. Somatization v Common Complaints: –Headaches, fatigue, heart palpitations, fainting spells, nausea, paralysis, numbness, blindness

8. Hypochondriasis v Unrealistic interpretation of physical signs or sensations as abnormal leading to a preoccupation with having a serious disease v One of the most frequently seen somatoform disorders v Video on Speaking Out

9. Hypochondriasis v May involve several systems or may be specific preoccupation with one organ or disease v Vagueness in presentation v Lots of “doctor shopping” v Avid readers of medical journals, magazines, internet sites

10. Conversion Disorders

11. v Old Hysteria or Hysterical Neuroses v Thought to be restricted to women v Pattern in which symptoms of some physical malfunction or loss of control appear with no organic pathology

12. Conversion Disorders v Voluntary control? v Stressful event v Most classic symptoms: –Paralysis, anesthesia, blindness, tunnel vision

13. Conversion Disorders v Usually appears in stressful situations v La belle indifference v Onset often in early adults but can appear at other points in life

14. Conversion Disorders v Pianist who developed Glove anesthesia v Hysterically blind individuals v Individuals in Wartime who lose capacity to use firearms v Neurologist who developed conversion disorder

16. Conversion Disorders v Three Categories of Symptoms: –Sensory: any sense can become involved –Motor: paralysis, tremors, tics, aphonia –Visceral: headache, lump in throat, choking, coughing,

17. Conversion Disorders v Primary Gain v Secondary Gain

18. Conversion Disorders vs Physical Basis v La belle indifference v Symptoms don’t conform v Selective nature of the dysfunction v Under hypnosis can remove symptom

19. Factitious Disorders v Separate Section of DSM IVTR in DSM V under vSomatic Symptom & Related Disorders (also conversion disorder) v Muncheusen’s Syndrome v Not real, not genuine v Characterized by physical symptoms produced by the individual and are under voluntary control

20. Factitious Disorder v Compulsive quality v Person will injure him/herself or do other things to create real symptoms in order to receive medical attention, typically seeking admission as an inpatient v All organ systems potential targets

21. Factitious Disorders v Present history with drama, but are vague and inconsistent v Pathological liars v Have extensive knowledge about hospitals v Demand attention, will undergo very painful diagnostic procedures including multiple surgeris

22. Disorder of Patienthood v Extreme dependency and regression

23. Muncheusen’s by Proxy (DSM-IV) or Factitious Dis. Imposed on Another (DSM – V)

25. Malingering v Patient has voluntary control of symptoms but the symptom production is for purpose of obtaining a specific and recognizable goal (e.g., money)