Lecture 4: Disorders Featuring Somatic Symptoms

Question 1

sickness

Answer 1

failure to fulfill social roles, calling sick at work, limited functioning, patient role

Question 2

illness

Answer 2

the feeling of being ill
- somatic condition with a cluster of symptoms
- a specific organic cause
- a defined course
- specific outcome

Question 3

biopsychosocial model

Answer 3

biological, psychological, and social aspects can result in somatic symptoms

Question 4

somatic symptoms disorder (SSD)

Answer 4

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

Question 5

types of somatic symptom disorder

Answer 5

• 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

Question 6

illness anxiety disorder

Answer 6

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

Question 7

types and treatment of illness anxiety disorder

Answer 7

• 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

Question 8

conversion disorders (functional neurologic disorders)

Answer 8

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

Question 9

psychodynamic view on causes of conversion and somatic symptom disorders

Answer 9

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

Question 10

cognitive-behavioral view on causes of conversion and somatic symptom disorders

Answer 10

• 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

Question 11

multicultural view on causes of conversion and somatic symptom disorders

Answer 11

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

Question 12

treatment of conversion and somatic symptom disorders

Answer 12

• 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

Question 13

factitious disorder (Munchausen syndrome)

Answer 13

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

Question 14

factitious disorder imposed on another (Munchausen syndrome by proxy)

Answer 14

people can make up illnesses for others

Question 15

factitious disorder vs malingering

Answer 15

• motivation for falsification is to become a ‘patient’ (even without obvious external rewards) – a factitious disorder
• external rewards motivate behavior – malingering

Question 16

psychophysiological disorders (psychosomatic disorders/psychological factors affecting other medical conditions)

Answer 16

disorders in which psychological, biological, and sociocultural factors interact to cause or worsen a physical illness

Question 17

ulcers

Answer 17

lesion that forms in the wall of the stomach or duodenum

Question 18

asthma

Answer 18

disease marked by narrowing of trachea and bronchi

Question 19

insomnia

Answer 19

difficulty falling or staying asleep

Question 20

muscle contraction/tension headaches

Answer 20

headache caused by the narrowing of muscles surrounding the skull

Question 21

migraine headache

Answer 21

very severe headache that occurs on one side of the head

Question 22

hypertension

Answer 22

chronic high blood pressure

Question 23

coronary heart disease

Answer 23

illness of the heart caused by a blockage in coronary arteries

Question 24

biological factors in psychophysiological disorders

Answer 24

defects in ANS or weaknesses in other parts of the body

Question 25

psychological factors in psychophysiological disorders

Answer 25

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

Question 26

sociocultural factors in psychophysiological disorders

Answer 26

bad social conditions

Question 27

psychoneuroimmunology

Answer 27

study of links between the immune system and stress
- stress slows down the immune system

Question 28

4 main contributors to stress slowing down the immune system

Answer 28

• 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

Question 29

social readjustment rating scale

Answer 29

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

Question 30

psychological treatments for physical disorders

Answer 30

• behavioral medicine
• relaxation training
• biofeedback
• meditation
• hypnosis
• cognitive-behavioral interventions
• support groups and emotion expression
• combination approaches

Question 31

behavioral medicine

Answer 31

field that combines psychological and physical interventions to treat or prevent medical problems

Question 32

relaxation training

Answer 32

treatment procedure that teaches clients to relax at will so they can calm themselves in stressful situations

Question 33

biofeedback

Answer 33

technique in which the client is given information about physiological reactions as they occur and learns to control reactions voluntarily

Question 34

meditation

Answer 34

turning awareness inwards in order to achieve a different state of consciousness which can help ignore stress-inducing factors

Question 35

hypnosis

Answer 35

being guided into a suggestible state

Question 36

cognitive-behavioral interventions

Answer 36

taking a new attitude toward a particular illness

Question 37

support groups and emotion expression

Answer 37

different forms of therapy that help people deal with their emotions

Question 38

SSRD-patient (somatic symptoms and related disorders)

Answer 38

• 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

Question 39

bodily focused mentalization

Answer 39

deducing emotions from bodily sensations; three emotional regulation systems:
- drive system – driven, excited, vitality
- soothing system – content, safe, connected
- threat system – anger, anxiety, disgust