Behavioral deficits Conversion Disorder

English: Main symptoms of AIDS, as described in the Wikipedia:AIDS article. Model: Mikael Häggström (Photo credit: Wikipedia)

Conversion reactions can be conceptualized as behavioral excesses or deficits that follow a traumatic event or emotional state and are reinforced by particular outcomes. A conversion symptom can be used to manipulate others, to get special attention, to receive special privileges, and to avoid unpleasant tasks or responsibilities. Use of a conversion symptom can also be reinforced and facilitated by a reduction in the intensity of a drive. For example, an initial episode of a conversion paralysis can result in a reduction of a painful emotional drive such as anxiety. This initial pairing of a stimulus and response can predispose an individual to using the same palliative response whenever anxiety occurs; consequently, responding to external stressors or pressures with a conversion reaction may represent a primary, although maladaptive, coping response. Others have conceptualized conversion symptoms as an adaptation to frustrating or stressful life experiences. The influence of role-modeling in the development of a conversion symptom in children and adolescents has been noted earlier.

From a broader conceptual perspective, conversion reactions, it has been thought, result from cultural, social, and interpersonal influences. Individuals with conversion disorder learn to use their symptoms to communicate helplessness, thereby fostering an environment that reinforces helplessness and inhibits aggressive impulses. Thus, a patient’s conversion disorder can be reinforced by the reactions of caretakers or families and by the formation of a conversion symptom in times of stress or conflict. Strangely enough, much of the behavioral formulation of conversion disorder has come from psychiatrists. As behaviorally oriented clinicians get more involved in assessing and treating conversion disorder, our understanding of conversion should increase substantially. Sociological.A different approach to understanding conversion phenomena comes from the field of medical sociology. Mechanic and Parsons have been most responsible for increasing our understanding of illness behavior and the sick role.

Illness behavior can be defined by the ways in which symptoms are perceived, evaluated, and acted upon. In other words, the context in which symptoms occur and the way that they are perceived by the individual are extremely important. Once illness has been recognized and legitimized by the physician, then individuals can be relieved of their duties or responsibilities, and others in the ‘‘system’’ may be required to be considerate and supportive of the sick individual. In assuming the sick role, the patient is obliged to cooperate with treatment and to withdraw from activities, even those that are considered enjoyable. Variations of this model of conversion have been proposed by other investigators.