Body-Related Disorders

Question 1

Intro to Body-Related Disorders

Answer 1

• Body and psyche not separate -> body is manifestation of psychological processes
• Soma = body
• Body-related disorders include somatoform disorders, conversion disorders, and factitious disorders

Question 2

2 types of Somatoform Disorders

Answer 2

• Somatization (Briquet’s Syndrome)

- Hypochondriasis

Question 3

Commonalities amongst somatoform disorders

Answer 3

• Body complaints or loss of function
• Often no organic pathology (ie. Body isn’t damaged in some way)
• Maladaptive response to symptoms
• Psychological factors play important role
• “La belle indifference” (person loses functioning but isn’t bothered by it)
• Precipitant

Question 4

Somatization

Answer 4

• “Grand hysterics or Chief Troublemakers” (visit doctors multiple times a week)
• Complaints splayed all over body (multiple systems involved)
• Symptoms presented in dramatic/exaggerated yet vague fashion
• Common complaints: Headaches, fatigue, heart palpitations, fainting spells, nausea, paralysis, numbness, blindness
• Poor interpersonal relationships (talk about physical complaints too much; very self-centered)

Question 5

Hypochondriasis

Answer 5

• Unrealistic interpretation of physical signs or sensations as abnormal leading to a preoccupation with having a serious disease (problem with perception)
• One of the most frequently seen somatoform disorders
• May involve several systems or may be specific preoccupation with one organ or disease
• Vagueness in presentation
• Lots of “doctor shopping”; avoid readers of medical journals, magazines, internet sites

Question 6

Conversion Disorders (Old Hysteria/Hysteria Neroses)

Answer 6

• Converting psychological pain/distress into physical symptoms -> symptoms of physical malfunction occur without organic pathology
• • Under hypnosis, symptoms can often be removed
• Not thought to have voluntary control over conversion of distress into symptoms
• Triggered by a stressful event
• Classic symptoms: paralysis, anesthesia, blindness, tunnel vision
• “La belle indifference”
• Onset often in early adults but can appear at other points in life
• Once thought to be restricted to women

Question 7

Examples of Conversion Disorders

Answer 7

• Glove Anesthesia: Pianist didn’t want to be a pianist -> developed glove anesthesia (hands)
• Hysterically blind individuals (when looking for objects, often start looking close to where it truly is; find directions in emergencies easily, but NOT faking)
• • They see things, but aren’t aware that they are (connection between visual cortex and higher-level processing disconnected) -> you can see, but you don’t know you can see
• Individuals in wartime who lose capacity to use firearms
• Neurologist who developed conversion disorder

Question 8

3 categories of Conversion Disorder symptoms

Answer 8

• Sensory: any sense can become involved
• Motor: paralysis, tremors, tics, aphonia
• Visceral: headache, lump in throat, choking, coughing

Question 9

Commonalities amongst Factitious Disorders

Answer 9

• Not real/genuine
• Characterized by physical symptoms produced by the individual and are under voluntary control
• Compulsive quality
• Present history with drama, but are vague and inconsistent
• Pathological liars
• Extensive knowledge of hospitals
• Demand attention, will undergo very painful diagnostic procedures including multiple surgeries

Question 10

3 types of factitious disorders

Answer 10

• Munchausen’s Syndrome
• Munchausen’s by Proxy
• Malingering

Question 11

Munchausen’s Syndrome

Answer 11

• 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
• • All organ systems potential targets
• Thought to occur due to “Disorder of Patienthood” -> extreme dependency and regression
• • When in hospital, all needs are taken care of for you -> you can suspend control

Question 12

Munchausen’s by Proxy

Answer 12

• aka: Factitious Disorder Imposed on Another
• Parents injuring their children or otherwise creating real symptoms to that the child (accompanied by the parent) can be admitted to the hospital
• Thought to occur due to “Disorder of Patienthood” -> even though they are not being directly cared for, they receive lots of emotional support while their child is in the hospital

Question 13

Malingering

Answer 13

patient has voluntary control of symptoms and produces them for purpose of obtaining a specific and recognizable goal (ie. Money)

Question 14

PDM - Characteristics of Factitious Disorders

Answer 14

• Affective: wide range -> anxiety, hostile, superficiality, manipulative, opportunistic
• Cognitive Patterns: Physical or psychological complaint of the moment, ruminations, chronically preoccupied (try to convince others they are suffering)
• Somatic States: Chronic tension, (in quest for attention) inflict injury upon themselves, body may be permanently compromised
• Relationship Patterns: Needy, dependent, negativism, dissatisfaction (initial overt compliance), eliciting irritation from others