Understanding Bodily Preoccupation Disorders: Symptoms and Coping Strategies

1. Chapter 6 DISORDERS OF BODILY PREOCCUPATION

2. DSM-IV DISORDERS • PAIN DISORDER • SOMATOFORM DISORDER • FACTITIOUS DISORDER AND MALINGERING

3. SOMATOFORM DISORDERS • Pain disorder – Psychological factors play a large role in pain • Somatization disorder – Multiple complaints over a period of years • Conversion disorder – Unexplained bodily symptoms • Hypochodriasis – Preoccupation with idea of getting or having a serious disease • Body dysmorphic disorder – Preoccupation with imagined or exaggerated physical defect

4. COPING WITH PAIN • What is pain? • Complex determination involving biological, psychological, and social factors • Coping mechanisms • Active coping • Passive coping • Treating pain disorders • Reduce anxiety • Psychological interventions • Cognitive behavioral therapy, biofeedback, insight psychotherapy • Pain medication

5. SOMATIZATION DISORDERS • Multiple somatic complaints that are recurrent or chronic • Formerly known as Briquet’s syndrome • Seek treatment for multiple physical complaints that do not appear to be feigned • DSM-IV requires at least four pain symptoms in different bodily sites and gastrointestinal and sexual nonpain complaints • Occurs mainly in women – One percent of female population • Seems to run in families • Cognitive and psychodynamic therapies are often effective

6. SURGERY IN SOMATIZING PATIENTS

7. CONVERSION DISORDERS • Patients report loss of some bodily function • Does not appear to be voluntary • Not explained by physical causes or related to a medical condition • Patient often unconcerned about the symptom • Frequently traced to specific triggering events

8. HYPOCHONDRIASIS • Persistent belief of having serious illness in spite of reassurance and no physical finding • Preoccupation with condition of bodily organs • Constant worry about health • Attune to most subtle physiological functions • Cognitive-behavioral therapy is helpful

9. BODY DYSMORPHIC DISORDER • Disorder of body image • Preoccupation with imagined bodily defect or excessive concerns about minor unwanted feature • Patients report feelings of depression, phobias, obsessions and compulsions but don’t mention bodily preoccupations • Cognitive-behavioral therapy is promising.

10. FACTITIOUS DISORDERSAND MALINGERING • Patients with these disorders usually have lifelong, severe personality disorders • Munchausen syndrome • Physical and psychological symptoms are voluntarily self-induced in order to receive medical attention • Factitious disorder by proxy • Usually a mother producing symptoms in a child in order to get attention for the mother • Malingering • Seek treatment for specific goal such as compensation, disability payments, or evasion of police.