Somatization is the psychological mechanism whereby psychological distress is expressed in the form of physical symptoms. The psychological distress in somatization is most commonly caused by a mood disorder that threatens mental stability. Conversion disorder occurs when the somatic presentation involves any aspect of the central nervous system over which voluntary control is exercised. Conversion reactions represent fixed ideas about neurologic malfunction that are consciously enacted, resulting in psychogenic neurologic deficits. Treatment is complex and lengthy; it includes recovery of neurologic function aided by narcoanalysis and identification and treatment of the primary psychiatric disorder, usually a mood disorder.
"Malingering is the intentional amplification of cognitive and/or emotional symptoms for secondary gain. Conversion disorders, however, are the result of unintentional symptom amplification for psychological reasons (Hurwitz, 2004). Since neither condition is the result of an organic impairment (Boone & Lu, 1999), a major differentiating factor is one of intentionality (Sellbom, Wygant, & Bagby, 2012). "
[Show abstract][Hide abstract] ABSTRACT: This study examined differences in raw scores on the Symptom Validity Scale and Response Bias Scale (RBS) from the Minnesota Multiphasic Personality Inventory-2 in three criterion groups: (i) valid traumatic brain injured, (ii) invalid traumatic brain injured, and (iii) psychogenic non-epileptic seizure disorders. Results indicate that a >30 raw score cutoff for the Symptom Validity Scale accurately identified 50% of the invalid traumatic brain injured group, while misclassifying none of the valid traumatic brain injured group and 6% of the psychogenic non-epileptic seizure disorder group. Using a >15 RBS raw cutoff score accurately classified 50% of the invalid traumatic brain injured group and misclassified fewer than 10% of the valid traumatic brain injured and psychogenic non-epileptic seizure disorder groups. These cutoff scores used conjunctively did not misclassify any members of the psychogenic non-epileptic seizure disorder or valid traumatic brain injured groups, while accurately classifying 44% of the invalid traumatic brain injured individuals. Findings from this preliminary study suggest that the conjunctive use of the Symptom Validity Scale and the RBS from the Minnesota Multiphasic Personality Inventory-2 may be useful in differentiating probable malingering from individuals with brain injuries and conversion disorders.
The Clinical Neuropsychologist 03/2013; 27(4). DOI:10.1080/13854046.2013.779032 · 1.72 Impact Factor
"Moreover, we are aware of the criticism directed against the heterogeneous concept of somatoform disorders in general (Mayou et al. 2005). However, here we are based on an etiological approach towards somatoform disorders, which interprets somatoform disorders as a patient ' s strategy to deal with emotional distress (Hurwitz, 2004; Nijenhuis et al. 2004; Waller and Scheidt 2006; Beutel et al. 2008). While our patients described a variety of different symptoms (see Table I), their unconscious emotional confl icts centered around common themes. "
[Show abstract][Hide abstract] ABSTRACT: Somatoform disorder patients demonstrate a disturbance in the balance between internal and external information processing, with a decreased focus on external stimulus processing. We investigated brain activity of somatoform disorder patients, during the processing of rewarding external events, paying particular attention to the effects of inpatient multimodal psychodynamic psychotherapy.
Using fMRI, we applied a reward task that required fast reactions to a target stimulus in order to obtain monetary rewards; a control condition contained responses without the opportunity to gain rewards. Twenty acute somatoform disorder patients were compared with twenty age-matched healthy controls. In addition, 15 patients underwent a second scanning session after participation in multimodal psychodynamic psychotherapy.
Acute patients showed diminished hemodynamic differentiation between rewarding and non rewarding events in four regions, including the left postcentral gyrus and the right ventroposterior thalamus. After multimodal psychodynamic psychotherapy, both regions showed a significant normalization of neuronal differentiation.
Our results suggest that diminished responsiveness of brain regions involved in the processing of external stimuli underlies the disturbed balance of internal and external processing of somatoform disorder patients. By providing new approaches to cope with distressing events, multimodal psychodynamic psychotherapy led to decreased symptoms and normalization of neuronal activity.
The World Journal of Biological Psychiatry 06/2011; 12(4):296-308. DOI:10.3109/15622975.2010.539269 · 4.18 Impact Factor
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