The PSD patient often has a history of other conversion disorders and prior psychological stress unrelated to the symptom (Pincus and Tucker, 1974). PSD onset is sudden and tends to be linked to a specific traumatic event (e.g., surgery) or painful emotional experiences (e.g., death of a family member). In the patient interview, the speech-language pathologist determines what the patient might gain from the presenting speech disorder. Primary gain refers to the reduction of anxiety, tension, and conflict provided by the speech disorder. This could be related to a breakdown in communication between the patient and some person of importance, such as a spouse, a boss, or parent. Here the speech problem constitutes a lesser dilemma for the individual than the interpersonal problems from which it arose. Secondary gain refers to those benefits received by the individual from the external environment. This could take the form of monetary compensation, attention, and sympathy from others over perceived distress, being given fewer responsibilities (e.g., work, child care), release from social obligations, and satisfaction of dependency needs. Sometimes secondary gains reinforce the PSD and prolong its duration (Morrison and Rammage, 1994). Unlike individuals with acquired adult communication disorders resulting from structural damage or neurological disease, the PSD patient may show unusual calmness and lack of concern over the speech disorder, a phenomenon called la belle indifference. It should be understood, however, that PSD patients do not consciously produce the symptom affecting communication but truly believe they are ill. As a consequence, many PSD patients display excessive concern about their bodies and overreact to normal somatic stimuli.
Was this article helpful?
Stop Letting Anxiety Rule Your Life And Take Back The Control You Desire Right Now! You don't have to keep letting your anxiety disorder run your life. You can take back your inner power and change your life for the better starting today! In order to have control of a thing, you first must understand it. And that is what this handy little guide will help you do. Understand this illness for what it is. And, what it isn't.