Abnormal Psychology

362 CHAPTER 8

People with conversion disorder may react in radically different ways to their

symptoms and to what they might imply: Some seem indifferent, whereas others

respond dramatically. Anna O.’s response was “a slight exaggeration, alike of cheer-

fulness and gloom; hence she was sometimes subject to moods” (Breuer & Freud,

1895/1955, p. 21). Table 8.13 provides more facts about conversion disorder.

Criticisms of the DSM-IV-TR Criteria

Some researchers have suggested that conversion disorder is not a distinct disorder,

but rather a variant of SD; these researchers point out that both disorders may

involve the bodily expression of psychological distress (Bourgeois et al., 2002). In

fact, the diagnosis of conversion disorder, and its placement among the somatoform

disorders, is controversial. Many researchers believe that conversion symptoms in

general, and pseudoseizures in particular, are more like dissociative symptoms

thanlike symptoms of other somatoform disorders (Kihlstrom, 2001; Mayou

Table 8.13 • Conversion Disorder Facts at a Glance

Prevalence

• Conversion disorder is very rare, with prevalence estimates from 0.01% to 0.05% in the general population
  and up to 3% of those who are referred to outpatient mental health services.

Comorbidity

• Studies have found that up to 85% of people with conversion disorder also have major depressive disorder
  (Roy, 1980; Ziegler, Imboden, & Meyer, 1960).


• Patients with conversion disorder may also have a neurological disorder, such as multiple sclerosis or a
  condition that produces true seizures (Maldonado & Spiegel, 2001).


• A history of sexual or physical abuse is common among patients with conversion disorder (Bowman, 1993).

Onset

• This disorder frequently begins during late childhood or early adolescence, and rarely appears after age 35.


• Symptoms typically emerge suddenly after a signifi cant stressor, such as the loss of a loved one, or a physi-
  cal injury (American Psychiatric Association, 2000; Stone et al., 2009).


• For men, the disorder is most likely to develop in the context of the military or industrial accidents
  (American Psychiatric Association, 2000; Maldonado & Spiegel, 2001).

Course

• Symptoms typically last only a brief period of time.


• Between 25% and 67% of those with the disorder have a recurrence up to 4 years later (American Psychiatric
  Association, 2000; Maldonado & Spiegel, 2001).

Gender Differences

• Conversion disorder is two to ten times more common among women than men (Bowman, 1993; Raskin,
  Talbott, & Meyerson, 1966).


• Women with the disorder may later develop SD.


• Men with the disorder may also have antisocial personality disorder (to be discussed in Chapter 13).

Cultural Differences

• Conversion disorder is more common in rural populations, among those from lower SES backgrounds, and
  among those less knowledgeable about psychological and medical concepts.


• It is also more common in developing countries than in industrialized countries, and as a country becomes
  industrialized, the prevalence of conversion disorder decreases.


• Small “epidemics” of conversion disorder have been reported in countries undergoing cultural change or
  signifi cant stress (Piñeros, Roselli, & Calderon, 1998; Cassady et al., 2005).
  Source: Unless otherwise noted, the source is American Psychiatric Association, 2000.