Somatic and Dissociative Disorders

  • Somatic Symptom Disorder (SSD)

    • Characterized by vague bodily complaints not specific to a single disorder.

    • Example: Cheryl experiencing dizziness and vertigo, with vague bodily complaints that are not specific to an existing medical disorder.

    • People with SSD often exhibit obsessive preoccupation with their symptoms, extensively researching conditions online and reporting them to healthcare providers.

    • Such preoccupation leads to significant cognitive distortion, distress, and dysfunction in daily life.

    • Common Symptoms: Gastrointestinal issues (e.g., nausea), pseudoneurological symptoms, reproductive pain, cardiovascular issues (e.g., chest pains, palpitations), cardiopulmonary concerns (e.g., shortness of breath), and general complaints like joint pain, headaches, impaired mobility, chronic fatigue, and feeling dizzy.

  • Illness Anxiety Disorder

    • Involves a constant, pervasive fear of having a serious, undiagnosed medical condition, even in the face of medical reassurance.

    • Example: A person who, as a teenager, had a cousin die from an undiagnosed heart problem, then developed a constant fear of undiagnosed cardiac disease with frequent heart palpitations and lightheadedness. As they aged, these concerns expanded to include fears of appendicitis and diabetes, leading to extensive online research and repeated calls to parents.

    • Key difference from SSD: The focus is on the anxiety about having an illness, rather than primarily the bodily symptoms themselves.

  • Neurological Somatic Disorder (Conversion Disorder)

    • Manifests as motor or sensory disturbances, where the symptoms do not align with any known medical (neurological) evidence.

  • Factitious Disorder

    • Defined by the fabrication or induction of physical or mental symptoms in oneself or others (e.g., Munchausen syndrome for oneself, Munchausen by Proxy for others).

    • The individual presents themselves or another person as ill.

    • Distinction from Malingering: There is no obvious external reward for the behavior, although the speaker argues that attention and support from others can function as a reward.

    • Example: Mandy faked a leukemia diagnosis at age 37 after her husband left her, claiming chemotherapy damage, a stroke, and weeks in a coma. She posted her story online, garnering support from a virtual community. It was later discovered the entire story was fabricated, with no actual illness.

    • More common in women.

  • Malingering

    • Faking an illness for a clear, identifiable external purpose or reward.

    • Examples: Faking migraines to avoid work for several days, or pretending to have cancer to solicit donations via a GoFundMe campaign.

    • Distinction from SSD: Individuals with SSD genuinely believe their problem is real and uncontrollable, whereas malingerers are consciously faking.

    • Distinction from Factitious Disorder: Malingering has clear external incentives, unlike the debated