Module 9 - Somatic Symptoms and Interactions Between Mental and Physical Health Flashcards
Individuals with Somatic Symptom and Related Disorders view themselves as having a _________ rather than a psychological disorder
Medical disease or illness.
Why are “medically unexplained symptoms” no longer such a central criterion for diagnosis of somatic disorders in the DSM-5?
Because of the implication that their physical symptoms were “all in their head,” many patients viewed these diagnoses as demeaning and pejorative.
What is the most dramatic of the somatic symptom and related disorders?
Conversion Disorder.
Describe the features of conversion disorder (also called functional neurological symptom disorder)?
Individuals with this disorder have a loss of functioning in a part of their body that appears to be due to a neurological or other medical cause, but without any underlying medical abnormality to explain it.
Ie: motor deficits, impaired balance, difficulty swallowing, seizure-resembling behaviour etc.
What is presumed to be associated with the onset or exacerbation of conversion disorder.
Psychological factors, such as conflict or stress.
In making a diagnosis of conversion disorder, clinicians often look for particular signs that help to distinguish these symptoms from those with an organic origin. What are some of these signs?
1) EEG might show that a patient’s seizures are not accompanied by the distinctive brainwave activity seen in epilepsy.
2) Inconsistencies in behaviour complaints or unusual symptom patterns ( inadvertently moving a “paralyzed” limb when attention is directed elsewhere)
3) Symptoms are likely due to conversion disorder is when they are clearly inconsistent with known physiological mechanisms (ie: the glove anesthesia example)
What is Somatic symptom disorder?
Multiple, recurrent somatic symptoms such as pain, fatigue, nausea, muscle weakness, numbness, or indigestion. These symptoms must be very distressing to the individual and result in significant disruption of daily life. Sometimes a medical examination leads to the discovery of a genuine illness or disease, but the individual’s level of anxiety and functional impairment continues to far exceed what is normal or realistic for their particular health problem. More often, however, no serious medical problem is found, but these individuals are not reassured and may become resentful that the doctor is not taking their symptoms seriously enough.
Somatic symptom disorder and panic disorder both involve excessive concern with and misinterpretation of bodily symptoms. How can they be differentiated?
Those with panic disorder typically fear immediate symptom-related disasters that might occur during the panic attack itself.
Individuals with somatic symptom disorder focus on the long-term process of illness and disease.
What is Illness anxiety disorder?
Applies to a subset of the individuals who would previously have been diagnosed with hypochondriasis. People with illness anxiety disorder are preoccupied with the fear that they may have a serious medical disease, despite the fact that thorough medical examination reveals that there is nothing seriously wrong with them.
What is the main difference between illness anxiety disorder and somatic symptom disorder?
Individuals with illness anxiety disorder do not have any significant bodily symptoms and are primarily concerned with the idea that they are ill.
Those with somatic symptom disorder have significant symptoms such as pain and may actually have a diagnosed medical illness.
What is Factitious disorder (also called Munchausen syndrome)?
Deliberately fake or generate the symptoms of illness or injury to gain medical attention.
To be diagnosed with this disorder, there must not be any obvious external rewards for this behaviour, such as evading military service/avoiding an exam. Instead, the motivation of these individuals seems to be to gain sympathy, care, and attention that accompany the sick role.
Although genetic factors likely have some role in the development of somatic symptom and related disorders, more is known about the influence of ____________ factors.
Physiological.
(Ie: Chronic stress produces activation of the HPA axis, producing high levels of cortisol, which can adversely affect the immune system and also produce feelings of fatigue, pain, and general malaise. These feelings in turn can cause individuals to perceive themselves as having a physical illness when they are actually experiencing stress.)
How do cognitive factors seem to play an important role in the development of these disorders?
Individuals with somatic symptom disorders spend substantial time monitoring their bodies and thus they are more likely to notice the various changes that take place. They also tend to interpret bodily sensations in a distorted manner, attributing them to serious illnesses, leading to increased distress and further physiological arousal.
What is the cognitive-behavioural model of health anxiety?
Distorted and catastrophic interpretation of bodily symptoms produces anxiety and uncertainty, which prompts a person to engage in various safety-seeking behaviours. Specifically, individuals with health-related anxiety often avoid illness-related information, frequently check symptoms, and repeatedly seek help from medical professionals to receive reassurance regarding their concern. Vicious cycle.
T/F
Negative affectivity and emotion regulation deficits, have also been proposed as contributors to the development of somatic symptom and related disorders.
True
