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psych 509 ch 6


disorders that appear to be medical but are actually caused by psychosocial factors somatoform disorders (patient almost always believes genuinely medical)
patterns ofmemory loss and identity change that are caused almost entirely psychosocial factors rather than physical ones dissociative disorders
actual change in physical functioning as result of psych disorder hysterical somatoform disorders
people who are healthy mistakenly worry something physicall wrong preoccupation somatoform disorders
three hysterical somatoform disorders conversion disorder, somatiziation disorder, pain disorder associated with psych factors
psychosocial conflict or need >> into drmatic physical sysmtoms that affect voluntary motor or sensory functioning conversion disorder (symptoms often seem neurological like paralysis, blindness)
onset of conversion disorder late childhood and young adulthood (appear SUDDENLY)
conversion disorder women : men 2 to 1
frequency of conversion disorder 5 in 1,000
long term physical ailments that have little or no organic basis somatization disorder
symptoms that must be part of disorder for somatization diagnosis seeverl pain symptoms (i.e. headaches, chest pain); gastrointestinal problems (nausesa and diarrhea); sexual symptom; neurological symptom (blindness, paralysis)
briquettes syndrome somatization disorder
occurence in US, women and me women: b/w .2 and 2.0% in any given year >> families: 20% of close female relatives of women with disorder develop it men: less than .2%
somatization disorder onset adolescence and young adulthood
% of people with somatization disorder who receive treatment for physical ailments/yr 2/3rds
psychosocial factors play central role in onset, severity or continuation of pain pain disorder associated with psychological factors (often develops with accident or illness that has caused genuine pain)
women : men pain disorder women more likely
ways doctors distinguish b/w real pain and pain disorder -goes against way nervous system is known to work (glove anestesia) -persons muscles dont atrophy in paralysis
intentional faking of illness for external gain malingering
patient intentionally produces or fakes symptoms out of wish to be a patient factitious disorder
extreme and long term form of factitious disorder munchausen (munchausen by proxy= parents make up or produce physical illnesses in their children 6-30% of these children die)
category for hypochondriasis and body dysmorphic disorder preoccupation somatoform disorders
people unrealistically interpret bodily symptoms as signs of serious illness hypochondriasis ( 6 months or more)
hypochondriasis: onset and women : men early adulthood, men and women equally affected 1-5% experience disorder
% of patients seen by primary care physicians w/ hypochondriasis 7%
people deeply concerned about some imaged or minor defect in their appearance (most often focus on wrinkles, spots, facial hair) body dysmorphic disorder
% of people with bdd that seek plastic surgery 50% (15% of people overall who seek plastic surgery
men : women bdd equal
somatoform disorders: behaviorist perspective learned thru classical conditioning or modeling
somatoform disorders: cognitive theorists people with disorders are so sensitive to and threatened by bodily cues that they come to misinterpret them
anna O person freud treated for somatoform disorder: hysterical deafness, paralysis etc. ; part of basis for his belief that underlying conflicts convert into physical symptoms
girls sexual feelings towards father (freud), if parents over react to sexual feelings, develop: electra complex - electra conflict will be unresolved and child will experience sexual anxiety --- during PHALLIC STAGE (3-5yrs)
psychodynamic theorists proposed mechanisms at work in hysterical somatoform disorders (2) 1. primary gain- keep internal conflicts out of awareness 2. secondary gain - symptoms further enable them to avoid unpleasant activities or receive sympathy from others
hysterical disorders: behavioral view physical symptoms bring rewards to sufferers-remove individuals from unpleasant relationship or attention. in response, display more prominently. (often develops after friend has similar medical issue)
hysterical disorders: cognitive view hysterical disorders are forms of communication, expressin emotions otherwise hard to convey *also believe that they're converting emotions into physical but different is not to defend against axiety but COMMUNICATE feelings in a familiar way
hysterical disorders: -transformation of of personal distress into somatic complaints isnorm in non-western cultures
why placebos work belief or expectation can trigger certain chemicals thruout body into action - can spark interhnal healing
treatment for preoccupation somatoform - antidepressant drugs -exposure and response prevention (prevented from checking appearance) -cognitive: identify, test and change distorted thoughts about appearance
treatment for hysterical somatoform focus on cause of disorder (trauma, anxiety) psychodynamic: try to help individuals become conscious of and resolve fears -behavior: exposure treatment, repeated exposure -biological: antianxiety or antidepressants
ways to address phyiscal symptoms in hysterical disorders suggestion reinforcement (remove rewards for sick behaviors), conforontation (force out of sick role by straightforwardly telling them dont have physical basis
increase in number of asian women who pursue cosmetic surgery sevenfold
key to our best present and future memory!
when changes to memory lack clear physical cause dissociative disorder
disorder in which people feel as though they have become detached from their own mental processes or body and are observing from outside depersonalization disorder
most common form of amnesia- person loses all memory of events that took place within a limited period of time (usually disturbing occurence) localized amnesia (forgotten period called amestic episode)
second most common form of dissociative amnesia- remember some but not all events that occur during a period of time selective amnesia
amnesia in which can't remember earlier periods of life in addition to traumatic event generalized amnesia (in extreme cases might not recognize family and friends)
amnesia in which forgetting continues into the present continuous amensia (more likely in organic amnesia)
% of population with dissocitative fugue .2%
3 types of relationships in DID -mutually amnesic relationships (no awareness of one another) -mutually cognizant patterns (well aware of rest) -oneway amnesic relationships *most common*subpersonalities are aware of others, but awareness not mutual -co-conscious subpersonalities
co conscious personalities quiet observers personalities who watch actions and thoughts of other subpersonalities but do not interact
DID produced by practitioners iatrogenic
dissociative disorders: psychodynamic perspective caused by repression. DID is thought to result from a lifetime of excessive repression esp of abusive parenting
dissociative disorders: behavioral learned via operant conditioning (relief)
steps taken in therapy for DID 1. recognize fully the nature of the their sidorder 2. recover the gaps in their memory and 3. integrate their subpersonalities into one funtional personality
Created by: lwstewart