Impact of Childhood Psychosocial Stressors on Adolescence Period and Its Management: A Case Study of Conversion Disorder

摘要

AbstractFunctional Neurological Symptom Disorder, previously called as Conversion disorder, is very common psychological disorder in eastern countries like Pakistan. This case study is describing how psychosocial factors produce stress and made a young girl dysfunctional in all aspect of life. The patient F.Z was18 years old unmarried girl and educated up till intermediate. She was unemployed and last born among 6 siblings; 4 sisters and 2 brothers. She was brought to the psychiatry indoor ward with speech symptom; un-able to speak (aphonia), sensory symptom; could not see (psychogenic blindness) and more over since last few months she had paralysis of lower limbs. Apart from those symptoms she reported poor appetite, remained sad and tearful. She was assessed thro-ugh both informal and formal psychological assessmentIt was interpreted that she had insecure, disturbed childhood and had lots of stressors in her life which caused severe maladjustment, interpersonal conflict, feeling of rejection and loneliness. According to DSM-5 she was diagnosed with Functional Neurological Symptom Disorder with comorbid Depressive Symptoms. The intervention plan comprised of psychodynamic, behavioral and cognitive approaches; techniques include catharsis, free association, anxiety reduction techniques, cognitive restructuring, graded task, mastery and pleasure technique, family psycho-education along with physiotherapy and physical exercise. Thirteen (13) therapeutic sessions were conducted along with anti-depressants and the patient showed marked improvement in all areas of her daily life. Family was psycho-educated to bring her for follow-up sessions.