1. differences SOMATIZATION DISORDERS HystericalPreoccupation conversion disorder somatization disorder pain disorder hypochondriasis BDD suffer changes in physical functioning misinterpret/overreact to body symptom or features (a psychological conflict converted into a physical problem)

2. purposely faking factitious disorder to play the sick role; attnto gain profit or avoid work/jail time malingering these are NOT somatization disorders Why do it?

3. conversion disorder 1+ sensory or voluntary motor deficit an associated stressor e.g. blindness, numbness, paralysis, gait, seizures, deafness, mutism.005% prevalence onset: at time of extreme stress sex ratio: 2-10:1 course: resolves w/in 2 weeks after stressor DIAGNOSTIC CRITERIA STATS

4. conversion disorder CAUSE a trauma where escape was needed but running away was not possible or acceptable (major mood disorder + severe stress event) TREATMENT therapy for original trauma exposure to stimuli that “produce” symptoms do not reinforce with attention positive reinforcement when deficits go away SSRIs

5. somatization disorder before 30 yrs old, years of many long-lasting physical complaints (in excess or not explainable by GMC): 4 pain 2 gastro-intestinal 1 sexual 1 neurological/sensory/motor DIAGNOSTIC CRITERIA (just symptoms, not worried about a specific disease)

6. somatization disorder prevalence 4% sex ratio: 2:1 onset: adolescence course: chronic low SES, low edu, unmarried runs in families (10-20% close female relatives are concordant) STATS

7. somatization disorder impulsiveness – short term gain (attn) CAUSE – long term probs (social isolation) pleasure-seeking – provocative sexual behavior (genes for ASPD) TREATMENT teach how to interact & relate to others w/o relying on conversations about symptoms

8. pain disorder DIAGNOSTIC CRITERIA pain in 1+ sites not faked associated w/ a stressor 5-12% prevalence onset: any can start from condition w/ real pain but persists STATS cognitive therapy & relaxation TREATMENT

9. hypochondriasis DIAGNOSTIC CRITERIA prevalence 1-5% sex ratio: 1:1 onset: early adulthood; trimodal (14,45,60+) course: chronic but waxes & wanes 6+ months preoccupied that has serious disease despite medical reassurance otherwise STATS

10. hypochondriasis CAUSE SSRIs cognitive therapy modeling reinforcement by escaping circumstances, classical conditioning, cognitive misinterpretation of interoceptive sensation TREATMENT

11. body dysmorphic disorder DIAGNOSTIC CRITERIA 1-5% prevalence sex ratio: 1:1 onset: adolescence to 20’s 30% are housebound, 17% attempt suicide 50% comorbid w/ depression preoccupied w/ imagined defect or excessive concern over a defect STATS

12. body dysmorphic disorder TREATMENT SSRIs exposure & response prevention helps 80% cognitive therapy ADDITIONAL DIAGNOSIS If firmly held, get “Delusional Disorder, Somatic Type”

13. purposely faking MALINGERING (external incentive) avoid military duty avoid incarceration avoid work gain insurance or lawsuit money

14. purposely faking FACTITIOUS DISORDER Wants attention & sympathy associated features: childhood exposure to extensive med treatment childhood abuse or disruption grudge against medical profession worked in medical profession dependent personality no social supports

15. Depersonalization Disorder conscious awareness & perception (disruption in conscious awareness, perception, memory, or identity ) Dissociative Amnesia DID conscious awareness & memory conscious awareness, memory, & identity dissociative disorders

16. depersonalization disorder recurrent sense of detachment from thoughts or body (causes distress or impairment) DIAGNOSTIC CRITERIA MISC depersonalization and/or derealization mostly case study research decreased emotional responsiveness no treatments effective 1% prevalence onset: 23 yrs average course: chronic STATS

17. dissociative amnesia 1+ episodes of memory loss (usually of trauma) (causes distress or impairment) DIAGNOSTIC CRITERIA remove from threatening situation, hypnosis, tranquilizers with therapy TREATMENT “generalized” – no memory for ANYTHING including own identity “localized” – a.k.a. “selective”, can’t recall specific events or time period

18. dissociative fugue sudden, unexpected travel from home/work w/ dissociative amnesia confusion about identity (maybe new identity) DIAGNOSTIC CRITERIA same TREATMENT

19. dissociative identity disorder 2+ identities that recurrently take control memory lapses DIAGNOSTIC CRITERIA identity, conscious awareness, & memory is fragmented “alters”, “host”, & “switching” alters are not full personalities sex ratio: 3-9:1 MISC

20. dissociative identity disorder Post Traumatic Theory: repeated traumatic abuse as child & autohypnotic dissociation as defense develops by 9 yrs old (after PTSD likely) CAUSE Socio Cognitive Theory: highly suggestible person learns to adopt & enact roles of identities due to clinician suggesting & reinforcing them TREATMENT reintegrate identities, hypnosis, show client videotape of alters