Module 9: Somatic Symptoms and Interactions Between Mental and Physical Health Flashcards
What are the DSM disorders related to somatic symptoms?
-Somatic Symptom Disorder
-Illness Anxiety Disorder
-Functional neurological symptom disorder (Conversion Disorder)
-Factitious disorder
-Psychological factors affecting other medical conditions
Somatic Symptom Disorder
One or more somatic symptoms (e.g., chronic pain, fatigue) that are distressing or cause significant disruption on daily life, accompanied by disproportionate concerns about seriousness, anxiety, and/or excessive time and energy devoted to health concerns; a diagnosed medical illness may or may not be present.
Pain
Fatigue
Muscle weakness
Numbness
Indigestion
Prone to periods of depression and anxiety
Display excessive sensitivity to minor bodily symptoms
Illness Anxiety Disorder
Preoccupation, anxiety and worry about having or acquiring a serious illness in the absence of significant somatic symptoms and despite the fact that thorough evaluation fails to identify a serious medical condition.
Previously hypochondriasis
Functional neurological symptom disorder (Conversion Disorder)
Symptoms affecting voluntary motor or sensory functions (e.g., blindness, paralysis, loss of feeling) that are incompatible with recognized neurological or medical conditions
Most dramatic of the somatic disorders
motor deficits;
-impaired coordination or balance
-inability to speak
-difficulty swallowing or the sensation of a lump
-urinary retention
-beh. resembling seizures or convulsions
Sensory deficits;
-loss of touch or pain sensation
- double vision
-blindness
-deafness
Psychological factors such as stress or conflict are presumed to be with onset or exacerbation of symptoms.
Psychological factors affecting other medical conditions
The individual has a medical condition (e.g., asthma, diabetes, heart disease) that is adversely affected by psychological or behavioural factors (anxiety exacerbating asthma symptoms, stressful work environment causing high blood pressure)
Factitious disorder
Faking or inducing symptoms of illness to gain sympathy, medical care and attention (taking excessive laxatives, contaminating urine samples, intentionally injuring oneself)
AKA Munchausen
Psychosocial mechanisms of disease?
Three body systems are are responsive to psychosocial variables:
Autonomic, immune, endocrine
Endocrine:
- Some endocrine organs tend to be highly responsive to psychosocial variables, particularly HPA-axis.
Autonomic:
- heart pounding, butterflies, perspiring, blushing, dry mouth
Immune:
-network of cells and organs to defend body and does this through a complex actions of a variety of white blood cells
*Endocrine effects rely on bloodstream to convey hormones to target hormones whereas ANS effects are rapid bc they are based on the speed of nervous conduction
What are psychosocial factors that influence disease?
-Social Status
-Social support
-Controllability
-Personality
Social Support (psychosocial factors that influence disease)
The extent to which an individual feels connected to other people in meaningful ways.
-Associated with a 50% reduction in risk of mortality
-Absence of social support appears to make existing disease worse
Social Status (psychosocial factors that influence disease)
-economic, occupational, dominance.
-effects are subtle and pervasive and has a gradient effect
*Gradient effect is extremely important - it implies that whatever is responsible for the differences varies quantitatively; there is no threshold below which one observes high mortality and above and one observes low mortality.
Personality (psychosocial factors that influence disease)
Alexithymia - a personality characteristic describing a cognitive-affective pattern of behaviour frequently observed in psychosomatic disorders.
The salient features include:
1) Difficulty identifying and describing subjective feelings
2) Difficulty distinguishing between feelings and bodily sensations of emotional arousal
3) Constricted imaginal capacities
4) Externally oriented cognitive style
It has been linked to increased risk and worsen prognosis of several medical conditions
Type A - also affects medical conditions
Controllability (psychosocial factors that influence disease)
a person’s ability to control potentially stressful events often reduces their harmful effects. Doesn’t even need to be true, they can just believe that they have control.
Ex: Job stress (2 dimensions; degree of psychological demand involved in job and amount of control they can exert over decisions in the job.)
Glove Anesthesia
A sensory symptom of conversion disorder involving loss of feeling in the whole hand and wrist. Since this pattern is incompatible with the way nerves extend from the arm into the hand, it is clearly psychogenic in origin.
la belle indifference
A surprising nonchalance or lack of concern about severity of one’s symptoms, which was previously thought to be evidence of conversion disorder
What is the most frequent bodily symptom associated with Somatic symptom disorder
pain
