Conversion Disorder and Factitious Disorders

Conversion Disorder Symptoms- Seizures

-Show excessive writhing with no loss of control of function -Do not show EEG abnormalities

Conversion Disorder Criteria

-1+ sxs of altered voluntary motor or sensory function -Clinical findings provide evidence of incompatibility between the symptom and recognized neurological or medical conditions -Symptom or deficit not better explained by another medical or mental disorder -Symptom or deficit causes distress or impairment in functioning or warrants medical evaluation

Conversion Disorder Etiology

-Cognitive-behavioral: Provides an "excuse" for avoiding or escaping a stressful situation without having to take responsibility for doing so

Factitious Disorder by Proxy

-Intentionally producing or feigning physical or psychological symptoms -The individual presents another individual (victim) as ill or injured -The deceptive behavior is evident in the absence of obvious external rewards

Factitious Disorder

-Intentionally producing or feigning physical or psychological symptoms -The individual presents themselves to others as ill or injured -The deceptive behavior is evident in the absence of obvious external rewards

Differing Somatic Disorders from Malingering/Factitious Disorders

-Malingering is diagnosed if the person is intentionally producing or grossly exaggerating physical symptoms and is motivated by external incentives such as avoiding work or obtaining financial compensation. -Factitious disorder is diagnosed if the person intentionally produces psychological or physical symptoms, the person's goal being simply to obtain and maintain the personal benefits that playing the "sick role" may provide -Individuals with conversion disorders (as well as with other somatic symptoms disorders) are not consciously producing their symptoms, feel themselves to be the "victims of their symptoms" and are very willing to discuss them, often in excruciating detail, as where malingering and factitious become defensive and are slow to talk about sxs.

Conversion Disorder Features

-May show la belle indifference -Often begins following a stressor

Factitious Disorders

-Prevalence unknown, ~1% of hospital patients -More common in females -Onset usually in early adulthood, following hospitalization

Conversion Disorder Prevalence

-Rare, but prevalence in general population unknown, may affect up to 5% in neurological settings -More common in women

Conversion Disorder Symptoms Motor Symptoms or Deficits

-Selective paralysis, selective loss of function, speech-related deficits

Conversion Disorder Symptoms Sensory Symptoms or Deficits

-Visual system -Auditory system -Sensitivity to feeling

Conversion Disorder Treatment

-When stressor is removed, symptoms/deficits usually disappear within 2 weeks -CBT: Identify and process stressful experience, reinforcement of specific exercises to increase movement/normal motor behaviors, remove any sources of secondary gain

Secondary Gain Conversion Disorder

External circumstances that tend to reinforce the maintenance of disability ie attention from loved ones, or financial compensation

Primary Gain Conversion Disorder

The goal achieved by sxs of conversion disorder by keeping internal intrapsychic conflicts out of awareness. In contemporary terms, it is the goal achieved by sxs of conversion disorder by allowing the person to escape or avoid stressful situations