Common Features Lots of Physical Complaints Appear to be Medical Conditions No Identifiable Medical Cause Pathological Concern About

– Physical Appearance– Functioning of Their Bodies

Common Features Lots of Physical Complaints Appear to be Medical Conditions No Identifiable Medical Cause Pathological Concern About

– Physical Appearance– Functioning of Their Bodies

Five Somatoform Disorders Hypochondriasis Somatization Disorder Conversion Disorder Pain Disorder Body Dysmorphic Disorder

Five Somatoform Disorders Hypochondriasis Somatization Disorder Conversion Disorder Pain Disorder Body Dysmorphic Disorder

Clinical Description Ancient Roots Physical Complaints No Known Medical Cause Severe Anxiety / Fear About

Possibly Having a Serious Disease Reassurance Doesn’t Help

Clinical Description Ancient Roots Physical Complaints No Known Medical Cause Severe Anxiety / Fear About

Possibly Having a Serious Disease Reassurance Doesn’t Help

Clinical Description Essential Problem is Anxiety Preoccupied With Bodily Symptoms Misinterpretation of Symptoms Strong Disease Conviction Many Medical Visits and Tests

Clinical Description Essential Problem is Anxiety Preoccupied With Bodily Symptoms Misinterpretation of Symptoms Strong Disease Conviction Many Medical Visits and Tests

Why not Classify Such Persons With an Illness Phobia?

Why not Classify Such Persons With an Illness Phobia?

Facts and Statistics 1% to 14% Medical Patients Equal Rates (Males vs. Females) May Occur Any Time Strong Disease Conviction Many Medical Visits and Tests

Facts and Statistics 1% to 14% Medical Patients Equal Rates (Males vs. Females) May Occur Any Time Strong Disease Conviction Many Medical Visits and Tests

Causes Disorder of Cognition / Perception More Disease in Family More Illness Concern in Family More Attention for Sick Behavior

Causes Disorder of Cognition / Perception More Disease in Family More Illness Concern in Family More Attention for Sick Behavior

Psychological Treatment Modify Illness Perceptions Evoke Bodily Sensations Provide “Appropriate” Reassurance More Research is Needed!

Psychological Treatment Modify Illness Perceptions Evoke Bodily Sensations Provide “Appropriate” Reassurance More Research is Needed!

Five Somatoform Disorders Hypochondriasis

Somatization Disorder Conversion Disorder Pain Disorder Body Dysmorphic Disorder

Five Somatoform Disorders Hypochondriasis

Somatization Disorder Conversion Disorder Pain Disorder Body Dysmorphic Disorder

Clinical Description Briquet’s Syndrome Many Physical Complaints No Known Medical Cause Little Concern About Symptoms

La Belle Indifference Life Revolves Around Symptoms

Clinical Description Briquet’s Syndrome Many Physical Complaints No Known Medical Cause Little Concern About Symptoms

La Belle Indifference Life Revolves Around Symptoms

Facts and Statistics Extremely Rare About 4.4% of Population Onset in Adolescence Females > Males Often a Chronic Condition

Facts and Statistics Extremely Rare About 4.4% of Population Onset in Adolescence Females > Males Often a Chronic Condition

Causes Family Link Link to Antisocial Personality

– Weak Behavioral Inhibition– Strong Behavioral Activation– Short Term Gain

Causes Family Link Link to Antisocial Personality

– Weak Behavioral Inhibition– Strong Behavioral Activation– Short Term Gain

Treatment Difficult to Treat No Proven Treatments Extensive Medical Visits Treatment Focuses on

– Reduction of Medical Visits– Reducing Secondary Gain

Treatment Difficult to Treat No Proven Treatments Extensive Medical Visits Treatment Focuses on

– Reduction of Medical Visits– Reducing Secondary Gain

Five Somatoform Disorders Hypochondriasis Somatization Disorder

Conversion Disorder Pain Disorder Body Dysmorphic Disorder

Five Somatoform Disorders Hypochondriasis Somatization Disorder

Conversion Disorder Pain Disorder Body Dysmorphic Disorder

Clinical Description Physical Malfunctioning

– Paralysis, Blindness, Aphonia– Mutism, Lost Sense of Touch

No Organic Pathology Looks Like Neurological Disease Popularized by Freud

Clinical Description Physical Malfunctioning

– Paralysis, Blindness, Aphonia– Mutism, Lost Sense of Touch

No Organic Pathology Looks Like Neurological Disease Popularized by Freud

Related Conditions Malingering or Something Else?

– La Belle Indifference– Precipitated by Marked Stress– Can Function Normally

Factitious Disorders– Munchausen’s Syndrome by Proxy

Related Conditions Malingering or Something Else?

– La Belle Indifference– Precipitated by Marked Stress– Can Function Normally

Factitious Disorders– Munchausen’s Syndrome by Proxy

Facts and Statistics Relatively Rare Females > Males Onset Around Adolescence

Facts and Statistics Relatively Rare Females > Males Onset Around Adolescence

Causes Experience of Trauma Getting Sick is Acceptable Symptoms to Escape From the

Effects of Trauma What Influences Choice of

Symptoms?

Causes Experience of Trauma Getting Sick is Acceptable Symptoms to Escape From the

Effects of Trauma What Influences Choice of

Symptoms?

Treatment Address the Traumatic Event Remove Sources of Secondary Gain No Well Established Treatments

Treatment Address the Traumatic Event Remove Sources of Secondary Gain No Well Established Treatments

Five Somatoform Disorders Hypochondriasis Somatization Disorder Conversion Disorder

Pain Disorder Body Dysmorphic Disorder

Five Somatoform Disorders Hypochondriasis Somatization Disorder Conversion Disorder

Pain Disorder Body Dysmorphic Disorder

Clinical Description Pain is Real Pain May Have Organic Cause Psychological Factors Maintain Pain Can be Debilitating

Clinical Description Pain is Real Pain May Have Organic Cause Psychological Factors Maintain Pain Can be Debilitating

Five Somatoform Disorders Hypochondriasis Somatization Disorder Conversion Disorder Pain Disorder Body Dysmorphic Disorder

Five Somatoform Disorders Hypochondriasis Somatization Disorder Conversion Disorder Pain Disorder Body Dysmorphic Disorder

Clinical Description Preoccupation With Appearance

– Imagined Defect “Imagined” Ugliness Mirrors (Fixation or Avoidance) Ideas of Reference Suicidal Ideation and Tendencies

Clinical Description Preoccupation With Appearance

– Imagined Defect “Imagined” Ugliness Mirrors (Fixation or Avoidance) Ideas of Reference Suicidal Ideation and Tendencies

Common Locations of Defects Hair Nose Skin Eyes Head / Face Lips

Common Locations of Defects Hair Nose Skin Eyes Head / Face Lips

Facts and Statistics College Students

– 70% Report Some Disatisfaction– 28% Meet Diagnostic Criteria

Many Consult Plastic Surgeons Males = Females Onset Late Adolescence

Facts and Statistics College Students

– 70% Report Some Disatisfaction– 28% Meet Diagnostic Criteria

Many Consult Plastic Surgeons Males = Females Onset Late Adolescence

The Plastic Surgery Solution? Quite Popular but Expensive Most are Disappointed With Results

The Plastic Surgery Solution? Quite Popular but Expensive Most are Disappointed With Results

BEFOREBEFORE AFTERAFTER

Causes and Treatment Little is Known Co-Occurs With OCD

– Intrusive Thoughts and Checking Compulsions About Appearance

Exposure + Response Prevention

Causes and Treatment Little is Known Co-Occurs With OCD

– Intrusive Thoughts and Checking Compulsions About Appearance

Exposure + Response Prevention