Lecture 4: Disorders Featuring Somatic Symptoms Flashcards
sickness
failure to fulfill social roles, calling sick at work, limited functioning, patient role
illness
the feeling of being ill
- somatic condition with a cluster of symptoms
- a specific organic cause
- a defined course
- specific outcome
biopsychosocial model
biological, psychological, and social aspects can result in somatic symptoms
somatic symptoms disorder (SSD)
a disorder in which one or more somatic symptoms are distressing or result in significant disruption of daily life
- complaints present for more than 6 months
- sometimes a cause for the symptoms can be found, but sometimes not
types of somatic symptom disorder
- predominant pain pattern: the primary symptom is pain
- somatization pattern: large and varied number of bodily symptoms
- persistent: severe symptoms, marked impairment, and long duration
- medically unexplained somatic symptoms (MUSS): somatic symptoms that do not have a medical or biological substrate or deficit to sufficiently explain the symptoms
illness anxiety disorder
a disorder in which people are chronically anxious about and preoccupied with the notion that they have or are developing a serious medical illness, despite the absence of somatic symptoms
- illness preoccupation for at least 6 months, but the specific illness can change
types and treatment of illness anxiety disorder
- care-seeking type: medical care, including physician visits or undergoing tests and procedures is frequently used
- care-avoidant type: medical care is rarely used
- treatment: similar to obsessive-compulsive disorder
conversion disorders (functional neurologic disorders)
disorders in which symptoms affect voluntary motor and sensory functions, but the symptoms are inconsistent with known medical diseases
- often triggered by an emotional event
- people do not consciously want or purposely produce their symptoms
psychodynamic view on causes of conversion and somatic symptom disorders
proposes that 2 mechanisms are at work:
- primary gain: bodily symptoms keep unconscious conflicts out of awareness
- secondary gain: bodily symptoms allow people to avoid unpleasant activities or result in sympathy from others
cognitive-behavioral view on causes of conversion and somatic symptom disorders
- physical symptoms are rewarding because of extra attention and being able to avoid unpleaseant relationships; sufferers learn to display these emotions
- symptoms are a way of communicating; people want to display extreme feelings via physical symptoms
multicultural view on causes of conversion and somatic symptom disorders
disorders are a cultural way of dealing with negative life events
- in some cultures, people display more physical symptoms
- in other cultures, people display more psychological symptoms
treatment of conversion and somatic symptom disorders
- psychodynamic therapy: looking at causes of symptoms and working through them, and making unconscious feelings conscious, so that patients do not have to convert feelings into physical symptoms
- cognitive-behavioral therapy: exposing people to the stimulus that causes symptoms, so they get used to it and symptoms gradually reduce
- antianxiety drugs/antidepressants
factitious disorder (Munchausen syndrome)
a disorder in which a person feigns or induces physical symptoms, typically for the purpose of assuming the role of a sick person
- people intentionally harm their own bodies to make it look like they have physical symptoms of illness
factitious disorder imposed on another (Munchausen syndrome by proxy)
people can make up illnesses for others
factitious disorder vs malingering
- motivation for falsification is to become a ‘patient’ (even without obvious external rewards) – a factitious disorder
- external rewards motivate behavior – malingering
psychophysiological disorders (psychosomatic disorders/psychological factors affecting other medical conditions)
disorders in which psychological, biological, and sociocultural factors interact to cause or worsen a physical illness
ulcers
lesion that forms in the wall of the stomach or duodenum
asthma
disease marked by narrowing of trachea and bronchi
insomnia
difficulty falling or staying asleep
muscle contraction/tension headaches
headache caused by the narrowing of muscles surrounding the skull
migraine headache
very severe headache that occurs on one side of the head
hypertension
chronic high blood pressure
coronary heart disease
illness of the heart caused by a blockage in coronary arteries
biological factors in psychophysiological disorders
defects in ANS or weaknesses in other parts of the body
psychological factors in psychophysiological disorders
certain needs, attitudes, emotions, or coping styles
- type a personality: personality pattern characterized by hostility, competitiveness, time-urgency, cynicism, drivenness, impatience, and ambition – coronary heart disease more likely
- type b personality: personality pattern in which the person is more relaxed, less aggressive, and less concerned about time – cardiovascular deterioration less likely
sociocultural factors in psychophysiological disorders
bad social conditions
psychoneuroimmunology
study of links between the immune system and stress
- stress slows down the immune system
4 main contributors to stress slowing down the immune system
- excessive norepinephrine activity blocks immune system activity
- stress might have an effect on behavior which can lead to people not taking proper care of themselves
- pessimistic personality
- lack of social support
social readjustment rating scale
scale that measures stress, the higher the stress score, the more life change units (LCUs) it has
- research: correlation between higher LCU scores and physical conditions
psychological treatments for physical disorders
- behavioral medicine
- relaxation training
- biofeedback
- meditation
- hypnosis
- cognitive-behavioral interventions
- support groups and emotion expression
- combination approaches
behavioral medicine
field that combines psychological and physical interventions to treat or prevent medical problems
relaxation training
treatment procedure that teaches clients to relax at will so they can calm themselves in stressful situations
biofeedback
technique in which the client is given information about physiological reactions as they occur and learns to control reactions voluntarily
meditation
turning awareness inwards in order to achieve a different state of consciousness which can help ignore stress-inducing factors
hypnosis
being guided into a suggestible state
cognitive-behavioral interventions
taking a new attitude toward a particular illness
support groups and emotion expression
different forms of therapy that help people deal with their emotions
SSRD-patient (somatic symptoms and related disorders)
- more often women
- long history of searching for an answer
- little trust in health care and clinicians
- highly critical, perfectionist, competitive – type a personality
- low SES, smaller social network
- often traumatic experiences in the past
- difficulties with mentalization: the ability to understand the mental state, of oneself or others, that underlie behavior
bodily focused mentalization
deducing emotions from bodily sensations; three emotional regulation systems:
- drive system – driven, excited, vitality
- soothing system – content, safe, connected
- threat system – anger, anxiety, disgust
