Chapter 8 Somatic Disorders

Question 1

Describe somatic symptom and related disorders.

Answer 1

Difficult to diagnose, somatic disorders are when a person fakes, imagines or exaggerates physical symptoms or imagines a disorder that is caused to something else such as stress of another mental disorder (Think Chuck in Better Caul Saul). But they all share a somatic symptom that shares a significant distress or impairment.

Question 2

Describe how somatic symptom disorder presents.

Answer 2

-Multiple somatic symptom that causes disruption to ones ability to live life. Often the report excessive thoughts, feelings or behaviors around their somatic symptoms

-Can be localized to one spot or diffused over the entire body.

-It is assumed the persons suffering is authentic so a lack of medical diagnosis is not needed and is also often present with another medical disorder.

-The client will often believe a simple issue is much more serious than it actually is and will “shop” for a doctor to confirm their beliefs

Question 3

Describe how illness anxiety disorder presents.

Answer 3

-Also known as hypochondriasis is excessive worry over possibly having or acquiring a serious medical condition that has a severe impact on a client’s life.

-occasionally a somatic symptom will be present with illness anxiety disorder but its highly uncommon and its mild if it does

-they spend lots of time scanning their body for signs that they are ill and sometimes becomes part of their self-image and when its part of their identity, it becomes much harder to treat.

Question 4

Describe how functional neurological symptom (conversion) disorder presents.

Answer 4

called conversion disorder form a psychoanalytic term as the psychological symptoms are “converted” to physical ones. it Presents with one of more symptoms of altered voluntary motor or sensory function. Common symptoms are weakness or paralysis, abnormal movements (tremors) and gait abnormalities (limping).

Question 5

What are symptoms of Neurological symptom (conversion) disorder

Answer 5

Sensory Symptoms include altered, reduced or absent skin sensation, vision or hearing.

Less common are seizures, fainting and coma

is symptoms not being explained by a neurological disease is not sufficient. There must be direct evidence of incompatibility of the medical disorder and the symptoms. (Think Chuck in Better Caul Saul with the cell phone scene)

Question 6

Describe how factitious disorder presents.

Answer 6

There is a deliberate falsification of medical or psychological symptoms imposed on oneself. They are pulling a con. And the presentation is more excessive than the deception needs.

Question 7

What do people with facetious disorder do to convince others of their conditions?

Answer 7

fake tests, consume medications to fake sickness, self-harm to pull off a con.

Question 8

Why do people with facistious disorder do what they do?

Answer 8

There could be other reasons to do this such as depression or trying to bring attention to themselves or need for social support

Question 9

What are some commonly shared features of somatic disorders?

Answer 9

person fakes, imagines, believes in or exaggerates physical symptoms or imagines a disorder

Question 10

Which somatic disorder usually accompanies a medical diagnosis?

Answer 10

Somatic Symptom disorder because its often diagnosed with another medical condition present but the two are not mutually exclusive

Question 11

What are the key distinctions between illness anxiety disorder and somatic symptom disorder?

Answer 11

Somatic symptom disorder believes they have somatic symptoms while illness anxiety disorder worry about acquiring symptoms

Question 12

What are the key differences between factitious disorder and the other somatic disorders?

Answer 12

Factitious disorder is a con. They are consciously deceiving for some reason. Other somatic conditions are real to the client and are unconscious

Question 13

Describe the epidemiology of somatic disorders.

Answer 13

Difficult to determine but its thought about 1-10% of the population suffers from these disorders

Question 14

Create a table of the prevalence rates across the various somatic disorders. What are the differences between the disorders?

Answer 14

Somatic Symptom disorder is a 4-6% prevalence with females more than males

Illness Anxiety disorder is from 1.3-10% of the population and is gender equal

Facetious disorder is unknown because they are lying

Functional Neurological Symptom disorder is unknown as well but across the US and Europe its thought 4-12 of every 100,000 people

Question 15

What gender differences are evident in the disorders, if any?

Answer 15

Somatic symptom disorder is more common among women than men but illness anxiety disorder is gender equal

Question 16

Describe the comorbidity of somatic disorders.

Answer 16

Given that half of psychiatric patients also have an additional medical disorder, 35% have an undiagnosed medical condition, and approximately 20% reported medical problems caused their mental condition, it should not come as a surprise that somatic disorders, in general, have high comorbidity with other psychological disorders

Question 17

In general, what other disorders often occur with somatic disorders?

Answer 17

-Anxiety Depression disorders in general

-Illness anxiety disorder patients show risk of developing OCD and personality disorders

-personality disorders are more common in functional neurological symptom disorder

-Facetious disorder has no comorbidities

Question 18

Which disorder do we not know anything about?

Answer 18

CSS or central sensitivity symptoms. Disorders included in this group are fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome. Comorbidity rates are estimated at 60% for these functional syndromes and somatic pain disorder

Question 19

Describe the psychodynamic causes of somatic disorders.

Answer 19

manifests as a response to unconscious emotional issues. Classified as Primary gain or internal motivator and secondary gain or external motivators. The somatic symptoms provide a shield of sorts from anxiety or emotional conflicts. Secondary gain is the external bit as in the sympathy from others, attention, getting financial assistance, etc.

Question 20

Describe the cognitive causes of somatic disorders.

Answer 20

Manifests due to exaggerated beliefs, fears or sensations. A possible sensitivity is combined with maladaptive thoughts that lead to altered behavior accordingly

Question 21

Describe the behavioral causes of somatic disorders.

Answer 21

People presenting somatic symptoms are reinforced by the attention of others to their symptoms or even receiving disability payments. Like good ole behaviorists, they don’t concern themselves with inner stuff

Question 22

Describe the sociocultural causes of somatic disorders

Answer 22

Family influence plays a factor. Possibly for attention by a close family member. They also might have an overly attentive parent who has high anxiety about their health.

Think of Eiminem

Question 23

How does catastrophizing contribute to the development and maintenance of somatic disorders?

Answer 23

A person with somatic symptoms may catastrophize a headache into a possible belief that they have a brain tumor as opposed to something like stress.

Question 24

How do somatic disorders develop according to behavioral theorists? Does this theory also explain how the symptoms are maintained? Explain.

Answer 24

Somatic Behaviors are reinforced by attention from others. This actually gives some credence as a bit of a feedback loop. If they present the symptoms and get the attention then they are likely to maintain it and make it a part of their identity

Think how Chuck’s authority as a powerful lawyer reinforced his condition. People capitulated to him and reinforced his condition because of his power

Question 25

What does the sociocultural model suggest regarding somatic disorders across cultures?

Answer 25

Eastern societies focus more on mind body relations and thus treat the minds effect o the body more seriously. Eastern countries are more likely to repost physical symptoms are related to stress over Western Countries

Question 26

Describe treatment options for somatic disorders.

Answer 26

Kinda difficult considering most believe they have a medical disorder. However, they usually come to psychotherapy when a physician gives them the clear. Usually needs a multidisciplinary approach of physiology, psychology and psychiatry which makes the treatment more difficult. It requires multiple specialists coordinating approaches which if there is a lack of specialists then its kinda a problem

Question 27

How does the Psychodynamic approach treat Somatic Disorders

Answer 27

The Psychodynamic approach uses interpersonal therapy to discuss the clients relationship between self-experience and the unconscious and is shown to reduce anxiety, depression and improve life quality but effects diminish over time

Question 28

How does CBT treat Somatic Disorders

Answer 28

CBT addresses maladaptive coping strategies and misattributions like catastrophic thinking or rumination and focuses on acceptance, avoidance behaviors and expectations

Question 29

How does the Behaviorists treat somatic disorders

Answer 29

Behavioral approach brings attention to the physiological symptoms and teaches how to manage pain and anxiety caused by them

Question 30

Discuss the difference between multidisciplinary and interdisciplinary approaches to treatment of somatic disorders.

Answer 30

Multidisciplinary approach is the use of multiple fields for the client, interdisciplinary is those fields mainly physiology, psychology and psychiatry interacting to find a treatment plan for the person

Question 31

What is the biopsychosocial model for treatment of somatic disorders? What are the three main components of this treatment?

Answer 31

It considers the various biological, psychological and social reasons why the disorder manifests and is pretty effective for somatic disorders

Question 32

Are there any treatments that are not effective in treating somatic disorders? If so, why?

Answer 32

Psychopharmacology is pretty ineffective because they don’t have anything and side effects may be worse than the disorder itself.

Question 33

Describe how psychological factors affecting other medical conditions presents.

Answer 33

the focus is not the mental disorder but the physical disorder. Psychological factors effect the course of the treatment, and that psychological distress and maladaptive psychological strategies exacerbate these conditions

Question 34

What are the most common types of psychophysiological disorders?

Answer 34

Headaches: Migraines, tension Headaches

Gastrointestinal: Ulcers and IBS

Insomnia, cardiovascular illness and hypertension

Question 35

Discuss the differences between the different types of headaches.

Answer 35

The main difference is that Migraines are accompanied by nausea, vomiting, sensitivity to light and vertigo however tension headaches lack these symptoms and are normally just painful headaches. Both are still brought on by stress.

Question 36

What is the difference between ulcers and irritable bowel syndrome?

Answer 36

Ulcers are holes in the stomach lining due to a lack of mucus to protect from digestive acids or bacteria. IBs may be a somatic problem.

Question 37

What are the identified predictors to coronary heart disease and other cardiac events?

Answer 37

Depression, anxiety and anger

Question 38

What are the most effective treatment options for psychophysiological disorders?

Answer 38

Relaxation training, biofeedback, hypnosis and group therapy

Question 39

Describe headaches

Answer 39

Headaches, migraines and tension headaches. Effect 23 million people in US. Can be reduced by biofeedback and relaxations techniques. Stress makes headaches because of muscles tension in the facial muscles and restricting blood flow

Question 40

Describe Psychophysiological gastrointestinal disorders

Answer 40

Gastrointestinal including ulcers and irritable bowel syndrome or IBS. Ulcers are caused when mucus in the stomach lining is reduced and digestive acids burn holes in the stomach lining or peptic ulcers which are caused by bacteria (H. pylori). Stress may impact the digestive fluids and increase the amount or concentration thus making ulcers more likely. IBS however may be a somatic case as there seems to be no structural or chemical problems in the body causing it.

Question 41

Describe Insomnia

Answer 41

Insomnia effects 10% of the population and may be predisposed by depression, anxiety and overactive arousal symptoms. Insomnia is difficulty falling asleep and is causes a cyclical relationship between sleep and stress

Question 42

Describe Cardiovascular diseases

Answer 42

Leading cause of death in the US for the last few decades costing 444 billion per year. Depression is a predictor of early onset coronary heart disease with a five fold increase vs the normal population. Anxiety and near also show increased risk of heart attacks

Question 43

Describe Hypertension

Answer 43

Hypertension or chronically high blood pressure which are caused by constant stress, anxiety and depression. These help produce plaque instability thus predisposing these individuals to heart attacks