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This Concept Map, created with IHMC CmapTools, has information related to: Somatoform Disorders, Somatoform Disorders, etc. CONVERSION D/O High Prevalence Women:menɮ:1 -formerly "hysteria" Adolescents, young adults, uneducated, rural, low SES (less ego development) Often w/ PTSD, Somatoform Disorders, etc. UNDIFFERENTIATED Lower threshold than for som'zation d/o -may potentially explain some cases Dxed as fibromyalgia or chronic fatigue, Somatoform Disorders, etc. SOMATOFORM PAIN D/O Adolescents or young adults Women>men Higher incidence of sexual abuse ->chronic pelvic pain, fibromyalgia, HAs, back pain Often not good at expressing emotions -sudden and progressive pain, Somatoform Disorders, etc. SOMATIZATION D/O Tx: 1 doctor to coordinate -investigate all medical causes -frequent counseling to decrease subconscious defense -GENTLY and GRADUALLY tell pt there's psych component, Conscious Production FACTITIOUS D/O Munchausen's-subset -travel place over wide distances -want invasive procedures -sociopathic characteristics, imposter -dismal prognosis, Somatoform Disorders, etc. CONVERSION D/O Primary gain: contain conflict in Unconscious -repression Secondary: any other benefits: attn, release from responsibility, control, Somatoform Disorders, etc. SOMATOFORM PAIN D/O Preoccupation w/ pain for ɲmo -absence of, or exaggerated, physical findings -no evidence of psychological cause necessary for Dx (unlike Conversion) -risk substance abuse d/o w/ meds, Somatoform Disorders, etc. CONVERSION D/O Abrupt Sx due related to conflict to repress -"Compromise formation" Sx: Motor deficits (not pain or sexual) -worsen when paid attn to -pseudoseizures -Atasia-abasia-gait ABNLity -La Belle Indifference, Conscious Production FACTITIOUS D/O Primary goal: receive care Several secondary gains: drugs, etc. MEN, HEALTH CARE WORKERS -often w/ h/o abuse (neglect, sexual, physical), Somatoform Disorders, etc. BODY DYSMORPHIC D/O More like OCD, not somatoform Preoccupation w/ imagined (or exaggerated) defect in appearance Can make up 7-15% of plastic surgery consults -lash out against Dr, Conscious Production MALINGERING CONSCIOUS PRODUCTION CONSCIOUS MOTIVATION -avoid work, military, jail -get money, drugs Consider Dx when legal element, no response to Tx, pt w/ antisocial PD, etc. Verify statements, reports Pt can embellish-know common Sx, Somatoform Disorders, etc. SOMATIZATION D/O Long, complicated history before AGE 30 women:menɱ:1 Sx: 4 PAIN, 2 GI, 1 SEXUAL, 1 PSEUDONEURO -can't be during panic attacks -severe enough to self-medicate, seek help -often w/ anxiety or depression (b/c sickly) -often coexists w/ PTSD, sometimes w/ PDs, Conscious Production FACTITIOUS D/O Often many hospitalizations as kids ->clinically significant by teens Verify history Don't actively discredit pt -could be from real dz concurrently -differentiate from other primary goals Sx is BEHAVIOR not somatic CC, Somatoform Disorders, etc. SOMATIZATION D/O Focus on body to defend against painful deprivation effects NO DEFINITIVE PHYSIOLOGICAL DZ, Conscious Production FACTITIOUS D/O Intentional production of Sx: physical, psychological -can be masochistic (passive-> active defense) Most frequent Sx: amnesia, psychosis, PTSD, pain, infx -UNCONSCIOUS MOTIVATION -to assume sick role, Somatoform Disorders, etc. HYPOCHONDRIASIS Fear or belief of having serious physical dz -misinterpretation of Sx PERSISTS after reassurance -interferes w/ NL functioning Anxiety, depression, OCD common -often frustration w/ docs NOT a true delusion (not rigid)