IN CLASS QUESTIONS:
1. In the section-opening excerpt, did the prince fake his symptoms to avoid work
pressures?
2. What creates the symptoms of somatoform disorders?
3. What do people with a conversion disorder "convert"?
4. What is a sign that someone is suffering from a psychological rather than a physical
problem?
5. What is the psychonanalytic explanation for hypochondriasis?
6. How does amnesia affect memory?
7. What psychological function does a dissociative fugue probably serve?
8. In dissociative identity disorder, how do the different identities relate to one another?
9. What childhood experiences are common among people with dissociative identity
disorder?
10. What psychological function does dissociative identity disorder serve?
1. In the section-opening excerpt, did the prince fake his symptoms to avoid work
pressures?
2. What creates the symptoms of somatoform disorders?
3. What do people with a conversion disorder "convert"?
4. What is a sign that someone is suffering from a psychological rather than a physical
problem?
5. What is the psychonanalytic explanation for hypochondriasis?
6. How does amnesia affect memory?
7. What psychological function does a dissociative fugue probably serve?
8. In dissociative identity disorder, how do the different identities relate to one another?
9. What childhood experiences are common among people with dissociative identity
disorder?
10. What psychological function does dissociative identity disorder serve?
Somatoform disorders are mental illnesses that cause bodily symptoms, includingpain. The symptoms can't be traced back to any physical cause. And they are not the result of substance abuse or another mental illness.
People with somatoform disorders are not faking their symptoms. The pain and other problems they experience are real. The symptoms can significantly affect daily functioning.
Doctors need to perform many tests to rule out other possible causes before they diagnose a somatoform disorder.
A diagnosis of a somatoform disorder can create a lot of stress and frustration for patients. They may feel unsatisfied that there's no known explanation for their symptoms. Stress often leads patients to become more worried about their health. This creates a vicious cycle that can persist for years.
Types and Symptoms of Somatoform DisordersSymptoms and their severity vary depending on the type of somatoform disorder. There are several types of somatoform disorders:
Somatization disorder. This is also known as Briquet's syndrome. Patients with this type have a long history of medical problems that starts before the age of 30.
The symptoms involve several different organs and body systems. The patient may report a combination of:
Undifferentiated somatoform disorder. This is a less specific version of somatization disorder. A diagnosis requires that a person have one or more physical complaints of unexplained symptoms for at least six months.
Hypochondriasis. People with this type are preoccupied with concern they have a serious disease. They may believe that minor complaints are signs of very serious medical problems. For example, they may believe that a common headache is a sign of a brain tumor.
Body dysmorphic disorder. People with this disorder are obsessed with -- or may exaggerate -- a physical flaw. Patients may also imagine a flaw they don't have.
The worry over this trait or flaw is typically constant. It may involve any part of the body. Patients can be obsessed with things such as wrinkles, hair, or the size or shape of the eyes, nose, or breasts.
Conversion disorder. This condition strikes when people have neurological symptoms that can't be traced back to a medical cause. For example, patients may have symptoms such as:
Pain disorder. People who have pain disorder typically experience pain that started with a psychological stress or trauma.
For example, they develop an unexplained, chronic headache after a stressful life event.
Pain is the focus of the disorder. But psychological factors are believed to play a role in the perception and severity of the pain.
People with pain disorder frequently seek medical care. They may become socially isolated and experience problems with work and family life.
Somatoform disorder not otherwise specified. People with this type may have conditions that have features of other somatoform disorders. But they do not meet the full criteria for any other diagnosis.
Conditions that fall into this category include pseudocyesis. This is the mistaken belief of being pregnant based on other signs of pregnancy, including an expanding abdomen; feeling labor pains, nausea, breast changes, fetal movement; breast changes; and cessation of the menstrual period.
Dissociative Disorders
There are four major dissociative disorders defined in the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DMS), published by the American Psychiatric Association:
If you or someone you love has significant, unexplained memory loss or experiences a dramatic change in behavior when under stress, talk to a doctor. A chronic sense that your identity or the world around you is blurry or unreal also may be caused by a dissociative disorder. Effective treatment is available for these conditions. Seek medical help.
If you or your child experiences abuse or another traumatic situation, talk to a doctor as soon as possible. Early intervention and counseling may help prevent the formation of dissociative disorders.
People with somatoform disorders are not faking their symptoms. The pain and other problems they experience are real. The symptoms can significantly affect daily functioning.
Doctors need to perform many tests to rule out other possible causes before they diagnose a somatoform disorder.
A diagnosis of a somatoform disorder can create a lot of stress and frustration for patients. They may feel unsatisfied that there's no known explanation for their symptoms. Stress often leads patients to become more worried about their health. This creates a vicious cycle that can persist for years.
Types and Symptoms of Somatoform DisordersSymptoms and their severity vary depending on the type of somatoform disorder. There are several types of somatoform disorders:
Somatization disorder. This is also known as Briquet's syndrome. Patients with this type have a long history of medical problems that starts before the age of 30.
The symptoms involve several different organs and body systems. The patient may report a combination of:
- pain
- neurologic problems
- gastrointestinal complaints
- sexual symptoms
Undifferentiated somatoform disorder. This is a less specific version of somatization disorder. A diagnosis requires that a person have one or more physical complaints of unexplained symptoms for at least six months.
Hypochondriasis. People with this type are preoccupied with concern they have a serious disease. They may believe that minor complaints are signs of very serious medical problems. For example, they may believe that a common headache is a sign of a brain tumor.
Body dysmorphic disorder. People with this disorder are obsessed with -- or may exaggerate -- a physical flaw. Patients may also imagine a flaw they don't have.
The worry over this trait or flaw is typically constant. It may involve any part of the body. Patients can be obsessed with things such as wrinkles, hair, or the size or shape of the eyes, nose, or breasts.
Conversion disorder. This condition strikes when people have neurological symptoms that can't be traced back to a medical cause. For example, patients may have symptoms such as:
- paralysis
- blindness
- hearing loss
- loss of sensation or numbness
Pain disorder. People who have pain disorder typically experience pain that started with a psychological stress or trauma.
For example, they develop an unexplained, chronic headache after a stressful life event.
Pain is the focus of the disorder. But psychological factors are believed to play a role in the perception and severity of the pain.
People with pain disorder frequently seek medical care. They may become socially isolated and experience problems with work and family life.
Somatoform disorder not otherwise specified. People with this type may have conditions that have features of other somatoform disorders. But they do not meet the full criteria for any other diagnosis.
Conditions that fall into this category include pseudocyesis. This is the mistaken belief of being pregnant based on other signs of pregnancy, including an expanding abdomen; feeling labor pains, nausea, breast changes, fetal movement; breast changes; and cessation of the menstrual period.
Dissociative Disorders
There are four major dissociative disorders defined in the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DMS), published by the American Psychiatric Association:
- Dissociative amnesia
- Dissociative identity disorder
- Dissociative fugue
- Depersonalization disorder
- Memory loss (amnesia) of certain time periods, events and people
- Mental health problems, including depression and anxiety
- A sense of being detached from yourself (depersonalization)
- A perception of the people and things around you as distorted and unreal (derealization)
- A blurred sense of identity
- Dissociative amnesia. The main symptom of this condition is memory loss that's more severe than normal forgetfulness and that can't be explained by a medical condition. Amnesia that comes on suddenly following a traumatic event, such as a car accident, is rare. More commonly, you simply can't recall traumatic periods, events or people in your life, especially from childhood.
- Dissociative identity disorder. This condition, formerly known as multiple personality disorder, is characterized by "switching" to alternate identities when you're under stress. In dissociative identity disorder, you may feel the presence of one or more other people talking or living inside your head. Each of these identities may have a unique name, personal history and characteristics, including obvious differences in voice, gender, mannerisms and even such physical qualities as the need for corrective eyewear. There also are differences in how familiar each identity is with the others. People with dissociative identity disorder typically also have dissociative amnesia.
- Dissociative fugue. The main sign of this condition is creating physical distance from your real identity. For example, you may abruptly leave home or work and travel away, forgetting who you are and possibly adopting a new identity in a new location. People experiencing dissociative fugue may be easily able to blend in wherever they end up. A fugue episode may last only a few hours or, rarely, as long as many months, and then end as abruptly as it began. When it lifts, you may feel intensely out of sorts, with no recollection of what happened during the fugue or how you arrived in your current circumstances.
- Depersonalization disorder. This disorder is characterized by a sudden sense of being outside yourself, observing your actions from a distance as though watching a movie. The size and shape of things, such as your own body or other people and things around you may seem distorted. Time may seem to slow down, and the world may seem unreal. Symptoms may last only a few moments or may come and go over many years.
If you or someone you love has significant, unexplained memory loss or experiences a dramatic change in behavior when under stress, talk to a doctor. A chronic sense that your identity or the world around you is blurry or unreal also may be caused by a dissociative disorder. Effective treatment is available for these conditions. Seek medical help.
If you or your child experiences abuse or another traumatic situation, talk to a doctor as soon as possible. Early intervention and counseling may help prevent the formation of dissociative disorders.