Social, Biological and Cultural Factors in Conversion Disorder

One piece of evidence that social and cultural factors play a role in conversion disorder is shown from the decreasing of this disorder in the last few centuries. Several hypotheses that explain that this disorder begin to decrease is such therapists who are experts in the field of psychoanalysis to mention that in the second half of the 19th century, when the rate of occurrence of conversion disorder is high in France and Austria, seyual behavior in repress may contribute to the increased prevalence of this disorder. The reduced interference may be caused by the increasing versatility of seyual norms and the development of the science of psychology and medicine in the 20th century, which is more tolerant of anxiety due to dysfunction not related to physiological terms than before. In addition, the role of social and cultural factors also indicate that conversion disorder is more often experienced by those who live in rural areas or at the level of low socioeconomic (Binzer et al., 1996; Folks, Ford & Regan, 1984 in Davidson, Neale, Kring, 2004 ). They experience this due to lack of knowledge about the medical and psychological concepts. Meanwhile, the diagnosis of hysteria reduced in industrialized societies, such as the UK, and is more common in underdeveloped countries, such as Libya (Pu et al., In Davidson, Neale, Kring, 2004).

Although genetic factors expected to be an important factor in the development of conversion disorder, research does not support this. Meanwhile, in several studies, conversion symptoms more often appears on the left side of the body than the right side (Binzer et al., In Davidson, Neale, Kring, 2004). This is an exciting discovery because the function of the left side of the body is controlled by the right hemisphere of the brain. The right hemisphere of the brain is also expected to play a bigger role than the left hemisphere is associated with negative emotions. However, based on a larger research note that there is no observable difference of the frequency of symptoms on the right versus the left side of the brain (Roelofs et al., In Davidson, Neale, Kring, 2004).

Psychoanalysis Theory and Behavioral Theory of Conversion Disorder


Psychoanalysis Theory of Conversion Disorder

Studies in Hysteria (1895/1982), Breuer and Freud states that conversion disorder is caused when a person experiences events that lead to a large increase in emotion, but affect can not be expressed, and the memory of the event is removed from consciousness. Specific symptoms mentioned conversion can be causally associated with the traumatic event that gave rise to these symptoms.

Freud also hypothesize that conversion disorder in women occurs early in life, caused by unresolved Electra complex. Based on psychodynamic view of Sackheim and colleagues, verbal reports and behavior can be separated from each other unconsciously. Hysterically blind person can say that he can not see and can simultaneously influenced by the visual stimulus. The way they show that they can see depends on the extent of blindness.


Behavioral Theory of Conversion Disorder

The views behavioral, proposed by Ullman and Krasner (in Davidson, Neale, Kring, 2004), states that conversion disorder similar to malingering, where individuals adopt a symptom to achieve a goal. In their view, individuals with conversion disorder is trying to behave according to their views on how a person with a disease affecting motor or sensory abilities, will react. This raises two questions: (1) Whether a person is able to do so? (2) Under what conditions such behavior often appear?

Based on existing evidence, the answer to question (1) is yes. A person can adopt behavior patterns that correspond to the classic symptoms of conversion. For example paralysis, analgesias, and blindness, as we know, can also appear in people who are in hypnosis. As for the question (2) Ullman and Krasner specifies two conditions that can increase the tendency of motor and sensory inability inimitable. First, the individual must have experience with the role to be adopted. Such individuals may have physical problems that are similar or the symptoms observed in others. Secondly, the game of the role must be given rewards. Individuals will show an inability only if the behavior was expected to reduce stress or to obtain other positive consequences. However, this behavioral view is not fully supported by the evidence of the literature.

Modern Theories that Discuss Somatoform Disorders


Modern theories that discuss somatoform disorders, such as dissociative disorders, psychodynamic theory and learning theory.

1. Psychodynamic Theory

Freud developed a theory of mind that threaten or unconscious. Freud believed that the ego functions to control seyual impulses and aggressive threatening or unacceptable that arise from id through such self-defense mechanism of repression. Control as it inhibits the onset of anxiety that would occur if the person becomes aware of the impulses it.

According to psychodynamic theory, hysterical symptoms has a function that gives the person primary and secondary advantages, namely:

Primary, namely the loss of fundamental anxiety derived from the development of neurotic symptoms.
Secondary, the fringe benefits associated with neurotic disorders or other, such as expressions of sympathy, attention increased, and free from responsibility.


2. Learning Theory

Psychodynamic theory and learning theory that the symptoms in conversion disorder can be overcome anxiety. Psychodynamic theorist looking for the cause of anxiety in conflicts that are not realized. Learning to focus on things that directly strengthen the symptoms and secondary role in helping individuals avoid or escape from an uncomfortable situation or arouse anxiety. The difference in the learning experience can be explained that the "why historically, conversion disorder is more often reported by women than men".


3. Cognitive Theory

Explanation other cognitive functioning in the role of a distorted mind.

Symptoms of Conversion Disorder

Conversion Disorder


In conversion disorder, sensory and motor symptoms, such as loss of vision or sudden paralysis, cause diseases associated with damage to the nervous system, whereas the organs and the nervous system of the individual fine. Psychological aspects of the symptoms of this conversion is shown by the fact that this disorder usually appear suddenly in an unpleasant situation. Usually this allows individuals to avoid some of the activities or responsibilities or individuals are eager to get attention. The term conversion, basically derived from Freud, which stated that the energy of instinct in repress transferred to the sensory-motor aspects and disrupt normal function. To that end, anxiety and psychological conflict is believed to be transferred to the physical symptoms.

Conversion symptoms usually develop in adolescence or early adulthood, which usually appear after the unpleasant incident in life. The prevalence of conversion disorder is less than 1%, and usually experienced by women (Faravelli et al., 1997; Singh & Lee, 1997 in Davidson, Neale, Kring, 2004). Conversion disorder is usually associated with a diagnosis of Axis I such as depression and abuse of illegal substances, and with a personality disorder, which is borderline and histrionic personality disorder (Binzer, Anderson & Kullgren, 1996; Rechlin, Loew & Jorashky, 1997 in Davidson, Neale, Kring, 2004) .


Pain Disorder and Hypochondriasis - Symptoms


Pain Disorder

In pain disorder, the patient experienced pain resulting in an inability to significantly; psychological factors thought to play an important role in the emergence, survival and perceived pain levels. The patient may not be able to work and become dependent on painkillers. The pain can be associated with conflict or stress, or it can occur so that individuals can avoid unpleasant activities and to get attention and sympathy that was not previously obtained.

Accurate diagnosis of pain disorder is somewhat difficult because of the subjective experience of pain is always a psychological phenomenon influenced, wherein the pain itself is not a simple sensory experiences, such as sight and hearing. To that end, decide whether the pain is felt a pain disorder that is classified as somatoform disorder, it is very difficult. However, in some cases can be distinguished clearly how the pain experienced by individuals with somatoform disorders with the pain of individuals who experience pain due to physical problems. Individuals who feel the pain caused by a physical disorder, showing the location of the pain that is experienced with more specific, more detailed in providing sensory description of the pain they experienced, and describes situations where pain is felt sicker or more reduced (Adler et al., in Davidson, Neale, Kring, 2004).


Hypochondriasis

Hypochondriasis is a somatoform disorder in which individuals overwhelmed with fear of having a serious disease which is quite repetitive though of medical certainty to the contrary, that he was fine. The disorder usually begins in early adolescence and tend to continue. Individuals who experience this is usually the consumers who frequently use health services; sometimes they assume their doctors are incompetent and do not care (Pershing et al., in Davidson, Neale, Kring, 2004). In theory stated that they were overreacting to the physical sensations are common and minor disturbances, such as an irregular heartbeat, sweating, coughing that sometimes occurs, pain, abdominal pain, as evidence of their belief. Hypochondriasis often coincided with anxiety and mood disorders.

Copyright © 2012 Nursing Diagnosis Nanda. Powered by Blogger.