-bodily symptoms that suggest a physical defect or dysfunction - no physiological basis found

-onset follows stressful event

-disorders include:

pain disorder

body dysmorphic disorder

hypochondriasis

conversion disorder

somatization

-disruptions of conscoiusness, memory, identity

-onset related to stressful event

-include:

dissociative amnesia

dissociative fugue

dissociative identity disorder

depersonalization disorder

-onset and maintenance of pain, caused largely by psychological factors

-causes significant stress & impairment

-grey-matter decreases in prefrontal, cingulated and insular cortex (regions of brain critically involved in modulation of subjective pain)

-preoccupation w/ imagined or exaggerated defects in physical appearance

-often in the face (ex. size/shape of nose, wrinkles, hair)

-women: skin, hips, breasts, legs

-men: height, penises, body hair

-frequent consultations w/ plastic surgeons

-occurs most in females

-onset in late adolescence, comorbid w/ depression, social phobia, eating disorders, suicidal tendencies, substance use, etc

-usually chronic

-some say should be subtype of OCD

-muscle dysmorphia: body build too small

-preocccupation w/ fears of having a serious illness

-onset usually in early adulthood

-cleared medically

-chronic

-comorbid w/ mood/anxiety disorders

-overreact to ordinary physical sensations, minor abnormalities

-catastrophic interpretations of symptoms

-recurrent, multiple physical complaints w/ no biological basis

-similar to hypochondriasis but more pervasive

-to meet diagnostic criteria:

-4 pain symptoms in diff locations

-2 gastrointestinal symptoms

-1 sexual symptom other than pain

-1 pseudoneurological symptom

-behavioural & interpersonal problems

-hospitalization & surgery common

-physiologically normal people experience sensory/motor symptoms (sudden loss of vision, paralysis)

-onset usually in adolescence/early adulthood

-body organs, nervous system are fine

-anesthesias: loss/impairment of sensations

-aphonia: loss of voice & all but whispered speech

-anosmia: loss/impairment of sense of smell

-possibly to avoid an activity/responsibility, receive attention

-hysteria

-faking incapacity in order to avoid a responsibility/to achieve a goal

-diagnosed when conversion-like symptoms are seen to be under voluntary control

-la belle indifference: relative lack of concern toward symptoms characteristic of (1/3) conversion disorder; those w/ malingering don't have this

-intentionally produce physical (or psychological) symptoms

-make up symptoms/inflict injuries on themselves

-motivation less clear than in malingering

-factitious disorder by proxy or Munchausen syndrome by proxy: parent creates illness in a child

-more sensitive to physical sensations

-may have memory bias for info that connotes physical threat

-high levels of cortisol (stress)

-possibly learned responses

Behavioural:

-aches, discomforts, etc are manifestation of unrealistic anxiety about bodily symptoms

-caused when a person experiences an event that creates great emotional arousal

-affect not expressed

-memory of event cut off from conscious experience

-similar to malingering: symptom adopted for gain

-attempt to behave according to conception

-individual must have had experience w/ the role

-enactment of role must be rewarded

-psychoanalysts: high rates of conversion in 19th C b/c of repressed sexual attitudes

-more common among lower socio-economic status people & those from rural areas

-research does NOT support genetic factors

-symptoms more likely to occur on left side of body (left side functions controlled by right hemisphere of brain)

-majority of symptoms may be related to functioning of right hemisphere

-"talking cure" - based on assumption that a massive repression had forced psychic energy to be transformed into the symptoms

-free association commonly used

-short term sessions of CBT (or just one)

-inability to recall important personal info

-usually after stressful event

-info not permanently lost

-doesn't recognize relatives & friends

-retains abilities to read, talk, reason, and any talents/previously acquired knowledge of world etc

-memory loss accompanied by leaving home & establishing a new identity

-memory loss more extensive than in dissociative amnesia

-often occurs after sever stress

-altered experience of the self

-involves no disturbance in memory

-unusual sensory experiences

-impression of being outside their body

-usually begins in adolescence

-chronic

-onset associated w/ traumatic life events or specific events involving sexual abuse

-having at least two distinct ego states (alters) that act independently of each other

-usually one primary personality (treatment usually sought by them)

-typically 2-4 alters at time of diagnosis - over treatment more emerge

-at least one alter has no contact w/ others

-may have diff handedness, diff glasses prescriptions, diff allergies

-presumably begins in childhood

-under stress, memories of trauma may be stored in a way not accessible to awareness when a return to normal state - possible outcomes are amnesia or fugue

Two Major Theories:

-begins in childhood as a result of severe physical/sexual abuse

-abuse causes dissociation

-formation of alters as a way of escaping the trauma

-not everyone w/ DID experiences childhood abuse: diathesis may be present

-enactment of learned social roles

-not viewed as conscious deception

-issue is how it develops & maintains