What are the 5 basic somatic symptom & related disorders?
- somatic symptom disorder
- illness anxiety disorder
- psychological factor affecting medical condition
- functional neurological symptom disorder
- factitious disorder
Somatic Symptom Disorder
extreme & long-lasting focus on multiple physical symptoms for which no medical cause is evident
(aka somatization disorders)
Illness Anxiety Disorder
severe anxiety over possibility of having disease w/o any evident physical cause
Functional Neurological Symptom Disorder
physical malfunctions (ie. blindness/paralysis) suggesting neurological impairment w/ no organic pathology
What is a important factor in somatic symptom disorder?
pain is real!
anxiety & distress is target for treatment
What is the difference b/w somatic symptom disorder and illness anxiety disorder?
illness anxiety disorder = less concerned about specific physical symptom BUT more worries abt IDEA she was ill/developing illness
Disease Conviction
convinced they have a disease & difficult to convince otherwise
When is the onset of Severe Illness Anxiety?
late age -> more physical health problem = more anxiety
What is a culture-specific disorder prevalent in India?
dhat - anxious concern about losing semen
dizziness, weakness, fatigue = semen loss
*african = hot sensation/smth crawling outta head
*Pakistani/Indian = burning in hands/feet
What is the cycle of somatic symptom disorders?
- trigger physical sensation
- focus attention on sensation
- inc arousal & inc intensity of sensation (b/c focus)
- misinterpret symptom
- inc anxiety
- inc physical symptom = CYCLE
Hyperresponsivity
overrespond to stress, may combine w/ tendency to view negative life events as unpredictable/uncontrollable = need guarded at all times
What are 3 factors that contribute to the etiological process of Somatic Symptom Disorder?
- develop in context of stressful life event
- disproportionate incidence of disease in family as children
- important social/interpersonal influence involved
Sick Role
increased attention for being ill & able to avoid work/responsibilities
Secondary Gain
positive consequences of sick role
What are effective treatments for Somatic Symptom Disorder?
explanatory therapy - clinician went over source & origin of symptom in detail
CBT - identify & challenge illness-related misinterpretations of physical sensations
exposure procedure - repeatedly conform patient w/ stimuli for health anxieties
drugs - paxil & SSRI
Psychological Factors Affecting Medical Condition
somatic condition = psychological characteristic affects diagnosed medical condition (ie. asthma worsen b/c anxiety)
How did Freud popularize the term: conversion?
believed anxiety = unconscious conflicts converted to physical symptoms to express
Functional Neurological Symptom Disorder
physical malfunctioning (ie. paralysis, blindness, difficulty speaking) w/o physical/organic pathology for malfunction
Astasia-abasia
difficulty keeping balance & fall frequently
Psychogenic Nonepileptic Seizures
“seizures” that have no significant EEG change, psychological in origin
Globus Hystericus
sensation of lump in throat, difficult to swallow, eat, talk
Malingering
deliberate faking a physical/psychological disorder motived by gain
3 ways to distinguish b/w conversion rxns w/ malingering
- la belle indifference - conversion rxn = indifference to symptoms
- conversion symptom = marked stress (as injury)
- conversion symptom = can function normally but aware of ability
Factitious Disorders
non-existent physical/psychological disorders deliberately fakes for no gain (EXCEPT sympathy & attention)
ie. mother injecting child to make kid appear sick
