Lecture 7: Somatic Symptom Disorders: Chapter 8 (vanaf 246) Flashcards
What is the main characteristic of somatic symptom and related disorders?
Excessive concerns about physical symptoms or health
What is hypochondriasis? How does this term relate to the DSM diagnoses?
Chronic worries about developing medical illness
It’s a popular used term and it overlaps to some degree with somatic symptom disorder and illness anxiety disorder (high levels of distress about health concern)
What are the 3 main DSM diagnoses in somatic symptom related disorders?
- Somatic symptom disorder (SSD)
- Illness anxiety disorder (IAD)
- Functional neurological disorder (conversion disorder)
What are 2 criticism of the diagnostic criteria for somatic symptom and related disorders?
- Threshold for when to diagnose somatic symptom and related disorders is very subjective (80% of population report having had a symptom in the past week that led to concern/impairment)
- Diagnosis is stigmatizing, what can interfere with applying diagnoses in clinical practice
Why are there no epidemiology numbers for somatic symptom and related disorders?
These disorders are defined differently than in the DSM IV (somatoform disorders)
What is the prevalence of somatic symptom disorder vs. illness anxiety disorder?
SSD is estimated to be 3x as common as IAD
What can you say about the behavior of people with somatic symptom and related disorders around medical health care? (3)
- Seek frequent medical treatment
- Dissatisfaction with doctors, because they can’t find a cure or explanation
- Risk of dependency on painkillers
What are the 4 defining symptoms of somatic symptom disorder?
- At least one somatic symptom that is destressing or disrupts daily life
- Excessive thought, distress and behavior related to somatic symptoms or health concerns
- Duration of at least 6 months
- Specify if predominant pain
What are 3 aspects of excessive thought, distress and behavior related to somatic symptoms or health concerns in somatic symptom disorder?
What is the minimum number needed to fit a criterium of somatic symptom disorder?
- Health-related anxiety
- Disproportionate and persistent concerns about seriousness of symptoms
- Excessive time and energy devoted to health concerns
At least one necessary
How long do somatic symptom disorder and illness anxiety disorder often exist in clients?
It’s chronic
less than 50% achieve full remission within 5 years
What are common comorbid disorders with somatic symptom/related disorders?
Anxiety, mood, personality disorders
How are people with somatic symptom and related disorders often viewed upon by outsiders? How does this reflect the way clients with these disorders see themselves?
Seems like person is using the health concern to avoid some unpleasant activity or to get attention or sympathy
Clients themselves: they experience their symptoms as completely medical and have authentic stress
What is somatization according to Briquet?
Symptoms being purely caused in the body and not psychologically
What is the difference between top-down and bottom-up processes?
Top-down: when expecting an image, more likely to perceive it
Bottom-up: seeing something and recognizing it (from sensory input to interpretation)
What is the difference between linear and parallel processing?
Linear: process goes one step at a time
Parallel: processes go together at the same time
What is malingering?
Intentionally faking psychological or somatic symptoms to gain from those symptoms
What is factitious disorder?
Falsification of psychological or physical symptoms without evidence of gains from those symptoms
What distinguishes malingering and factitious disorder from somatic symptom disorder, illness anxiety disorder and functional neurological disorder?
Malingering/factitious disorder are produced consciously
What type of disorder is the Munchhausen by-proxy syndrome?
Factitious disorder directed to another person
What is the difference between factitious disorder imposed on self vs. imposed on others?
Self: person presents self as ill, impaired or injured
Others: person fabricates or induces symptoms in another person and then presents that person to others as ill, impaired or injured
Why is factitious disorder such a weird disorder?
There is deceptive behavior with no obvious external reward present for it
What is the difference in focus between the DSM IV and DSM V concerning somatic symptom disorders?
DSM IV: physical symptoms have no physical cause
DSM V: focus on positive symptoms (somatic symptoms explained or not + psychological and behavioral factors)
How is conversion disorder now called in the DSM 5 TR?
Functional neurological disorder
What are 4 defining symptoms of illness anxiety disorder?
- Preoccupation with and anxiety about having acquired a serious disease
- Excessive illness behavior or maladaptive avoidance
- No more than mild somatic symptoms present
- Preoccupation lasts at least 6 months, no need for continuous presence during that time
Give some examples of excessive illness behavior and maladaptive avoidance
Excessive illness behavior: check for signs of illness, seeking reassurance
Maladaptive avoidance: avoiding medical care
What is the difference between illness anxiety disorder and OCD with fear of acquiring disease?
OCD: fear of acquiring disease
IAD: actual having the disease is fearful
What are the similarities between SSD and IAD?
Excessive thoughts and behavior regarding illness
Both require duration of 6 months
What is the main difference between SSD and IAD?
SSD: actual have 1 distressing somatic symptom
IAD: no more than mild somatic symptoms present