Somatoform and Conversion Disorder

Reinforcement (Conversion disorder)

of the behavior is maintained

Somatoform Symptom Disorder

features one or more symptoms that disrupt daily life, excessive thoughts/feelings/behaviors related to somatic symptoms or associated health concerns.

Perceptual/behavioral effects (Pain Disorder)

sensory, spinal cord to thalamus, and primary/secondary somatosensory cortex.

Individuals with Conversion disorder discuss...

their disease in great detail.

Patients with Conversion disorder

treated as if they have a physical/medical ailment.

Types & levels of symptoms (Pain Disorder)

4 pain symptoms 2 gastrointestinal symptoms, 1 sexual symptom 1 pseudoneurological symptom (numbness, weakness). Each symptom is typically present to at least a minimal degree.

Biological Etiology of Conversion

Activation of inhibitory neural networks. Over activation of limbic system. Specifically, activation of anterior cingulate regions.

Pain specific receptors

At least three types: Pressure, stretching, pinching, and striking. Heat, acids, and peppers. Damaged muscles, migraines, and cancers.

Acceptance based therapies (Pain Disorder)

Behavioral Activation, ACT

Sensory symptoms (Conversion disorder)

Blindness, loss of touch or pain.

Somatic Symptom Disorder

Conditions involving physical complaints or disabilities occurring in the absence of any physical pathology.

Hypochondriasis

Focus is on an unrealistic, but serious disease. Individuals are certain they suffer from every new illness/disease. They are preoccupied with health matters, bodily sensations, & digestive & excretory functions. Overreact to ordinary physical sensations (e.g., sweating) as evidence for their illness.

Consequences of pain disorders

Individuals usually end up disabled, addicted to pain meds, and undergo unnecessary surgeries.

Pain is subjective

It's very difficult to gauge with certainty the extent of patient's pain.

Difference between conversion d/o and true illness

La belle indifference: a certain unconcern; patient shows little anxiety/fear regarding their "ailment", failure of the "ailment" to clearly conform to the real disease or d/o, selective nature of the "ailment" under hypnosis (or narcosis), SX's can be removed, shifted, or reduced through suggestion.

Cognitive-behavioral therapies (Pain Disorder)

Modify irrational thoughts/beliefs

Neuron system (Conversion disorder)

PET scan shows some abnormality in the limbic system. There is less activity.

Motor symptoms (Conversion disorder)

Paralysis, weakness, coordinations.

Treatments (Pain Disorder)

Pharmaceuticals- Opioids, anticonvulsants, and antidepressants

Conversion disorder

Physical malfunction or loss of control without any underlying medical pathology.

Pain Disorder

The report of pain in the absence of medical pathology. There are two types. Pain d/o associated with psychological factors and pain d/o associated with both psychological factors & a general medical condition.

Symptoms (Conversion disorder) appear...

appear quite suddenly.

Development of Conversion disorder

can come from a desire to escape some unpleasant situations. They wish to be sick/hurt to void the unpleasant situation. They have the appearance of symptoms of some physical ailment.