Factitious Disorder

• Somatic Symptom and Related Disorders are primarily caused by psychological factors.
• These disorders are related to somatic symptoms or psychological factors affecting other medical conditions.

Factitious Disorder

• Involves false creation of physical or psychological symptoms.
• Deceptive production of injury or disease, even without external rewards.
• Presentation of oneself as ill, impaired, or hurt
• When imposed on another person, it's known as Munchausen syndrome by proxy.
• A perpetrator falsely creates symptoms in another person (victim).
• Symptoms disappear when the individual who the perpetrator is imposing on is removed from them
• Aims to get external gain or reward, unlike malingering.
• Individuals often induce medical symptoms through medications, laxatives, etc.
• When imposed on others, it's typically parents doing it to their children.
• Similar to the "sick role," attention-seeking behavior is seen in patients or caregivers.
• When confronted, individuals deny the charge and leave.
• Possible causes include depression, unsupportive parental relationships, and a need for attention or social support.
• Two-thirds of those with the disorder are women.
• It is common in medical workers and those with poor social support.
• Those experiencing malingering are hoping to get external gains from pretending to be sick.

Conversion Disorder

• Also known as Functional Neurological Symptom Disorder
• Characterized by presence of at least one symptom/deficit affecting voluntary motor or sensory function.
• Neurological-like symptoms are inconsistent with known neurological or medical disease.
• Includes paralysis, blindness, and loss of feeling.
• It is difficult to distinguish from known medical disease.
• Symptoms are not consciously wanted or purposely produced.
• Individuals believe their disease is genuine, and demonstrate real symptoms.
• Conversion occurs when psychological needs/conflicts turn into physical symptoms.
• It is a rare condition that often appears suddenly during extreme stress.
• Most cases last only a couple of weeks, most disappear within 6 months
• If symptoms last longer than 6 months, it is persistent conversion disorder
• Usually begins between childhood and young adulthood.
• Twice as common in women

Somatic Symptom Disorder

• Involves at least one upsetting or repeatedly disruptive physical (somatic) symptom.
• The person's concerns are disproportionate to the seriousness of the bodily problems.
• Involves an unreasonable amount of thoughts, feelings, and behaviors regarding the symptoms.
• Repeated, excessive thoughts about their seriousness.
• Continual high anxiety occurs about their nature or health implications.
• Excessive time and energy spent on symptoms/health implications.
• Physical symptoms continue to some degree for more than 6 months.

Somatic Symptom Disorder: Somatization Pattern

• Long-lasting physical ailment with little to no physical basis.
• Treatment is sought from doctor to doctor.
• People experience a large varied number of bodily symptoms.
• Also known as Briquet's syndrome
• may experience certain physical discomfort or sexual difficulties however nang of their symptoms are exaggerated

Somatic Symptom Disorder: Predominant Pain Pattern

• The pain source may or may not be known.
• May develop after an accident or illness that initially caused pain.

What Causes Conversion and Somatic Symptom Disorders?

• Previously called hysterical disorders or hysteria

Psychodynamic View

• Freud studied hysteria systematically and used such cases to build his psychoanalysis theory
• Underlying emotional conflicts converted into physical symptoms and concerns
• Has two mechanisms; primary and secondary gain.
• Bodily symptoms keep conflict out of awareness
• Bodily symptoms avoid unpleasant activities or get sympathy.

Psychodynamic View Conclusions

• Freud believed that sexual repression causes distress and anxiety
• The sexual repression is then converted into physical symptoms and concerns
• Current Day Psychodynamic Theorists believe that people derive "primary gain" when their bodily symptoms keep their internal conflicts out of awareness
• People receive secondary gain when their bodily symptoms allow them to avoid unpleasant activities of receive sympathy from others.
• Multicultural consideration: formation of somatic complaints in response to psychological distress is common and socially accepted in many non-Western cultures.
• Non-Western cultures may manifest their emotional distress as physical.
• There are high rates of stress caused bodily symptoms in non-Western countries

Conversion and Somatic Symptom Disorders Treatment

• Focus on the cause of the disorder.
• Insight, exposure, and medication
• Focus on the symptoms.
• Education: explain disorder while offering support
• Reinforcement involves the removal of reinforces for clients with sick symptom
• Cognitive restructuring: guide clients to think differently about symptoms.
• Psychodynamic Therapists try to make individuals aware of their underlying fears, thus eliminating the need to convent anxiety into physical symptoms
• Behavioral Therapists use exposure therapy in an attempt to enable patients to face their fears directly.
• Biological Therapists use antidepressant drugs

Illness Anxiety Disorder

• Person is preoccupied with thoughts about having or getting a significant illness
• The person displays unduly high number of health-related behaviors (e.g., keeps focusing on body) or dysfunctional health-avoidance behaviors (e.g., avoids doctors).
• The person's concerns continue to some degree for at least 6 months
• Medical care is frequently or rarely used
• Previously known as hypochondriasis.
• Many use the internet to search symptoms, turned into "cyberchondria”.
• Repeatedly check body for signs of illness and misinterpret common symptoms for severe diseases.
• The disorder can begin at any age, but starts most often in early adulthood.
• Chronically anxious of their health and are convinced that they have or are developing a serious medical illness
• There may be a misinterpretation that can continue regardless of friends, physicians, and families beliefs.
• Behavioral Therapists believe that classical conditioning and modeling play a role in the development of this disorder.