SOMATOFORM DISORDERS - SOMATOFORM DISORDERS DSM-IV 300.81...

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DSM-IV 300.81 Somatization disorder 300.11 Conversion disorder 300.7 Hypochondriasis 300.7 Body dysmorphic disorder 307.xx Pain disorder 307.80 Associated with psychological factors 307.89 Associated with both psychological factors and a general medical condition 300.82 Undifferentiated somatoform disorder 300.82 Somatoform disorder NOS Somatization refers to all those mechanisms by which anxiety is translated into physical illness or  bodily complaints. The expression of physical symptoms suggests the presence of physiological disorder,  but there are no demonstrable organic findings/known pathological mechanisms, or the symptoms are not  fully explained by any physical disorder. That is, the symptoms are in excess of what would be expected  from   the   history,   physical   examination,   or   laboratory   findings.   There   does   exist,   however,   positive  evidence, or a strong presumption, that the symptoms are linked to psychological factors or conflicts. These  disorders are more common in women than in men, with somatization disorder rare in men. ETIOLOGICAL THEORIES Psychodynamics This   disorder   may   represent   an   unconscious   transformation   of   internal   conflicts   into   physical  symptoms that can be explained in terms of the ego’s ability to control the sensory and motor apparatus,  which may have specific meaning for the client. Dependency is common in individuals with somatoform disorders, and fixation in an earlier level of  development may be evident. Repression is the primary defense mechanism, as severe anxiety is repressed  and manifested by the presence of physical symptoms. Biological Although   biological   and   neurophysiological   influences   in   the   etiology   of   anxiety   have   been  investigated, no relationship has yet been established. However, there does seem to be a genetic influence  with a high family incidence. The autonomic nervous system discharge that occurs in response to a frightening impulse and/or  emotion is mediated by the limbic system, resulting in the peripheral effects of the autonomic nervous  system seen in the presence of anxiety. These manifestations of anxiety may be related to physiological  abnormalities. Family Dynamics The family contributes to these conditions by initiating, reinforcing, and perpetuating the behavior  patterns. The children learn (overtly or covertly) that physical complaints are acceptable ways of coping  with stress and obtaining attention, care, and gratification of dependency needs. The client may gain  attention and meet these needs by overdramatization of the symptoms, resulting in overinvolvement of  other family members in enmeshed behavior patterns. In the beginning, the client may exaggerate minor 
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SOMATOFORM DISORDERS - SOMATOFORM DISORDERS DSM-IV 300.81...

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