Somatoform / Dissociative Disorder Preload (Behavior)

Criteria for Somatic Symptoms Disorder

A. One or more somatic symptoms that are distressing or result in significant disruption

B. Excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns as at least one of the following:

1. Disproportionate and persistent thought about the seriousness of one’s symptoms

2. Persistently high level of anxiety about health or symptoms

   1. Highly variable symptoms - Fatigue, weakness, pain, GI dysfunction, and SOB

3. Excessive time and energy devoted to these symptoms

C. Although any one symptom may not be continuous, the state of symptomatic is persistent (More than 6 months)

Specifiers for Somatic Symptom Disorder

With Predominant Pain

Persistent

Mild / Moderate / Severity

Criteria for “persistent” somatic symptom disorder

Severe symptoms

Marked impairment

Long duration

Criteria for “mild” somatic symptom disorder

Only 1 Criteria B

Criteria for “moderate” somatic symptom disorder

2 or more Criteria B

Criteria for “severe” somatic symptom disorder

3 of Criteria B

Multiple somatic complaints (Or one very severe)

Criteria for Illness Anxiety Disorder

A. Preoccupation with having or acquiring a serious ilness

B. Somatic symptoms are not present. If present, only mild in intensity. If medical condition is present or high risk for developing, preoccupation is clearly excessive or disproportionate.

C. High level of anxiety about healthy and easily alarmed about personal health status

D. performs excessive health related behaviors or exhibits maladaptive avoidance

E. illness preoccupation is present for at least 6 months but the specific illness feared may change over that time frame

F. Not better explained by another mental disorder

Subtypes of Illness Anxiety Disorder

Care-Seeking Type

Care-Avoidant Type

Care-Seeking Type Illness Anxiety Type

Medical care, including physician visits or undergoing tests or procedures, is frequently used

Care-Avoidant Type Illness Anxiety Type

Medical care is rarely used

Criteria of Conversion Disorder

A. One or more symptoms of altered voluntary motor or sensory function

• Motor - Weakness, Tremors, Tics, Difficulty Walking, Seizures, Paralysis

• Sensory - Numbness, Hearing or Vision Changes, Speech Difficulty

B. Clinical findings provide evidence of incompatibility between the symptoms and recognized neurological or medical conditions

C. Not better explained by another disorder

D. Significant distress or impairment in functioning

Not intentionally done (Factitious Disorder)

Specifiers for Conversion Disorder

With weakness or paralysis

With abnormal movement

With swallowing symptoms

With speech smyptom

With attacks or seizures

With anesthesia or sensory loss

With special sensory symptoms

With mixed symptoms

Acute Episode / Persistent

W/ or W/o psychological stressor

Criteria for “Acute Episode” Conversion Disorder

Symptoms present for <6 months

Criteria for “Persistent” Conversion Disorder

Symptoms present for 6 months or more

Criteria for Psychological Factors Affecting Other Medical Conditions

A. Medial symptom or condition is present

B. Psychological or behavioral factors adversely affect the medical condition in 1 of the following ways:

• 1. Factors have influenced the course of medical condition as shown by close temporal associated between the psychological factors and the development of exacerbation of, or delayed recovery from, the medical condition

• 2. Factors interfere with the treatment of medical conditions

• 3. Factors constitute additional well-established health risks

• 4. Factors influence the underlying pathology, precepting, or exacerbating symptoms

C. psychological and behavioral factors in Criterion B are not better explained by another medical disorder

Specifiers for Psychological Factors Afffecting Other Medical Conditions

Mild / Moderate / Severe / Extreme

Criteria for “Mild” Psychological Factors Affecting Other Medical Conditions

Increases medical risk

Criteria for “Moderate” Psychological Factors Affecting Other Medical Conditions

Aggravates underlying medical condition (

Criteria for “Severe” Psychological Factors Affecting Other Medical Conditions

esults in medical hospitalization or emergency room visit.

Criteria for “Extreme” Psychological Factors Affecting Other Medical Conditions

severe, life-threatening risk

Criteria of Factitious Disorder Imposed on Self

A. Falsification of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception

B. individual presents himself or herself to others as ill, impaired or injured

C. Deceptive behavior is evident even in the absence of obvious external rewards

D. Not better explained by another mental d/o

Criteria for “Single Episode” Factitious Disorder Imposed on Self/Another

Single event of falsification of illness and/or induction of injury

Criteria for “Recurrent Episode” Factitious Disorder Imposed on Self/Another

Two or more events of falsification of illness and/or induction of injury

Criteria for Factitious Disorder Imposed on Another

A. Falsification of physical or psychological s/s, or induction of injury or disease, in another, associated with identified deception

B. individual presents another individual (victim) to others as ill, impaired or injured

C. Deceptive behavior is evident even in the absence of obvious external rewards

D, not better explained by another mental d/o

Criteria for Dissociative Amnesia

A. Inability to recall important autobiographical information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting

• Localized Amnesia - Failure to recall events during a circumscribed period of time

• Selective Amensia - Can recall some but not all events during a period of time

• Generalized Amnesia - Complete loss of life history

B. Symptoms causes signinficant distress or impairments

C. Not due to substance use or other medical condition

D. Not explained by dissociative identity, PTSD, acute stress, or somatic

Specifiers for Dissociative Amnesia

W/ or w/o dissociative fugue

Dissociative Fugue

Apparently purposeful travel or bewildered wandering that is associated with amnesia for identity or for other important autobiographical information

What does the word fugue

Flight

Criteria for Depersonalization/Derealization Disorder

A. Persistent or recurrent feeling of depersonalization, derealization, or botth

• Depersonalization: Experiences of unreality, detachment, or being outside observer with respect to one’s thoughts, feelings, sensations, body, or actions

  • Perceptual alternations

  • Distorted sense of time

  • Unreal or absent self

  • Emotional and/or physical numbing

• Derealization: Experiences of unreality or detachment with respect to surrounding

  • Unreal

  • Dreamlike

  • Foggy

  • Lifeless

  • Visually distort

B. During derealization/depersonalization, reality remains intact

C. Symptoms cause significant distress

D. Not due to substance or medical conditions

E. Not better explained by schizophrenia, panic disorder, MDD, acute stress, PTSD, or another dissociative disorder

Criteria of Dissociative Identity Disorder

A. Disruption of identity characterized by 2 or more distinct personality states, which may be described in some cultures as an experience of possession

• Involves marked discontinuity in sense of self and sense of agency accomplished alteration in

  • Affect

  • Behavior

  • Consciousness

  • Memory

  • Perception

  • Cognition and/or Sensory Motor Functioning

• Signs and symptoms may be observed by others or reported by the individual

B. Recurrent gaps in recall of everyday events important personal information and or traumatic events inconsistent with ordinary forgetting

C. Symptoms cause significant distress or impairment in social, occupational, or other important areas

D. Disturbance is not normal accepted culture or religious practice (In children, not better explained by imaginary playmates or fantasy play)

E. Not attributable to substance use or medical condition