Chapter 6

Question 1

somatic symptom disorders

Answer 1

• Somatic symptom
• Illness anxiety
• Conversion
  o Conversion related
  o Factitious disorder – some real, some fake symptoms, rare
  o Malingering – faking illness

Question 2

somatic symptom

Answer 2

• 1+ somatic symptos
• Often includes: pain, fatigue, nausea, muscle weakness, numbness, indigestion
  o Symptoms may or may not have med basis
• Significant anxiety related to symptoms – research for hours, take over the counter meds, see many docs
• Sensitivity to pain
• Symptoms cause disruption in life and impairment in other areas

Question 3

illness anxiety

Answer 3

• Preoccupation, anxiety, worry about having or acquiring a serious illness
  o Serious somatic symptoms absent
  o Concern persists despite negative medical findings
• Engage in various behaviors related to preoccupation
  o Major focus of life and activities
  o Frequent checking body, monitoring possible symptoms
  o Seeking medical help or information
  o Engaging in or avoiding specific activities
• Easily alarmed about illness, epidemics
• High alert about symptoms, seeing docs, self diagnosis
• Gets confused with ocd (germophobia) and anxiety disorders

Question 4

conversion

Answer 4

• Severe loss of physical functioning, temporary
• Symptoms may include
  o Motor deficits: paralysis, localized weakness, difficulty swallowing, seizure or convulsion like behaviors
  o Sensory deficits: blinded, double vision, deafness, loss of touch or pain sensation
• Appears due to a neurological or medically based condition, but corresponding physical pathology lacking
  o Nothing physically wrong with people
  o Loss of functioning as psychological process
• Tends to happen following severe trauma

Question 5

causes

Answer 5

• Somatic symptom and illness anxiety
  o Research identified a significant role in anxiety in both
  • Compared to anxiety disorders, anxiety expressed differently
  • Catastrophic misinterpretation of somatic sensations and symptoms
  • Disease conviction
• Conversion disorder
  o Stress or trauma has been associated with onset

Question 6

integrative biophysical model

Answer 6

• Proposes physiological, psychological and social factors interact in a series of vicious cycles
• Unique experiences/patterns result in different disorders
• Factors include
  o Physiological factors – unuaual HPA acess, may be related to pain or fatigue
  o Cognitive factors
  o Personality traits – high levels of suggestibility, tendency to express emotions through symptoms
  o Early life experiences – what was learned growing up about being sick, reinforcement for being ill

Question 7

treatment of somatic disorders

Answer 7

• Cognitive behavioral therapy helpful
• General goals are
  o Restructuring morbid thoughts and preoccupations
  o Bringing dysfunctional behavior problems under control
  o Strategies to regulate emotions
  o Psychcoeducation
• Disorder specific goals
  o Somatic symptom
  • Reduce stress
  • Minimize help seeking behaviors
  o Illness anxiety
  • Identifying/challenging illness related misinterpretations
  o Conversion
  • Address stress or traumatic event and reduce stress
  • Reduce reinforcement or supportive consequences