somatic, sex and gender disorders Flashcards
what are the 4 somatic symptoms disorders?
a) Factitious disorder
b) Conversion disorder
c) Somatic symptoms disorders
d) Illness anxiety disorder
Factitious disorder aka Munchausen Syndrome
WHAT
- making up a physical or psychological illness (will go to extremes)
- for external gain (£/attention/deferment from military service/wish to be patient)
- Prev is unknown due to secretive nature
- another instance: factitious disorder imposed on another
Factitious disorder aka Munchausen Syndrome CAUSES
- most have poor social support, few enduring social relationships + little family life (Mcdermot et al. 2012)
- Depression
- unsupportive childhood
Conversion disorder
• Alteration of some voluntary or sensory function (overlaps w phantom limb/weakness or paralysis)
• Symptoms cannot be accounted for by what we know about neurology; medical and neurological examinations reveal nothing
*** i.e. they have neurological symptoms (blindness, paralysis, loss of feeling) BUT NO NEUROLOGICAL BASIS.
• Symptoms cause significant distress / problems in functioning. THESE ARE GENUINE
– may be that we just don’t know it/understand another disorder to recognise it tho?
Somatic symptom disorder - differential diagnosis (5)
Differential diagnoses:
1) Panic disorder – anxiety/SS bout health tend to occur in episodes. In SSD theyre more persistent
2) GAD – may worry about illness but somatic symptoms are NOT the main thing in GAD
3) Depressive disorders – commonly come together. BUT constant low mood in dep.
4) Delusional disorder – but those in delusional disorder are much stronger than in SSD
5) OCD – but in SSD the thoughts are less intrusive + there is no repetitiveness with it
somatic symptom disorder
WHAT
- most common symptom is pain
- some cases the somatic symptoms have NO known cause, but in other cases the cause can be identified (i.e. medical cause); either way the person’s concerns are disproportionate to the seriousness to the bodily problem.
- have high levels of worry about illness; appraise their bodily senstations as unduly harmful/troublesome
2 patterns of somatic symptom disorder have received attention
1) Somatisation pattern:
- long lasting physical ailments; most have no physical basis
- Suffers symptoms often include – pain symptoms, gastrointestinal symptoms (nausea, runs), sexual symptom (erectile or menstrual probs) and neurological type symptoms (double vision + paralysis)
- rarely goes without therapy; appears to run in families
2) Predominant Pain Pattern
- primary feature is pain
- may be unknown or known source BUT distress is disproportionate
- quite common; but unknown for defs
- often follows an illness/accident that does cause pain
Behavioural view of conversion disorder and somatic symptom disorders
- Symptoms bring rewards to sufferers (removal from relationships/wanted attention)
- in response to awards suffers learn to display bodily symptoms more + more
Behavioural view of conversion disorder and somatic symptom disorders EVALUATION
- kinda like secondary gain in psychodynamic approach ((when the pain prevents them doing things they don’t want to do or they receive sympathy)) but the gain isn’t secondary
- received little research support
- in many cases the pain + upset > rewards
Cognitive view of conversion disorder and somatic symptom disorders
- EMOTIONS –> PHYSICAL SYMPTOMS
- physical symptoms are a form of communication providing a means for expressing emotions that the person might find otherwise difficult to convey
- purpose is to communicate extreme feelings in “physical language” that is comfortable for the person with the disorder
- those ho find it hard to recognise or express their emotions = good candidates for SDD/conversion disorder
Cognitive view of conversion disorder and somatic symptom disorders EVALUATION
Not much research OR support
Multicultural View of somatic symptom disorders + conversion disorders
- Most western clinicians think it is inappropriate to focus on somatic SYMPTOMS in response to personal distress (why they have been included as a “disorder” in the DSM 5
- But a lot of people think it is a western bias – a bias which sees somatic symptoms as an inferior way of dealing with emotions; why is having somatic symptoms = mental health disorder?
BUT - converting distress into physical complaints is common practice in some cultures (seen as socially + medically correct reaction to life stressors) + shouldn’t be seen as maladaptive coping behaviours
a) stress induced bodily symptoms seen in China, korea, japan etc
SO NOT TAKING CULTURE INTO ACCOUNT WILL LEAD TO MISDIAGNOSES + STIGMATISATION
Multicultural View of somatic symptom disorders + conversion disorders EVALUATION
- truth
- there’s too often a drive to look for a biological cause for these ‘conditions’ that they might overlook the social/cultural ones
- It is part and parcel of western
science’s preoccupation with empirical causes and effects, and it reflects bioscience’s
discomfort with the notion that mind and body can possibly have any meaningful dialogue.
call for a paradigm shift from bio —> social when looking @ stuff like this; need to be more mindful of the body + mind links
How is conversion disorder + SSD treated?
- medical prof to make sure nothing is wrong
- then therapy – focus on trauma//anxiety//stress
a) There is evidence that short-term treatments such as cognitive behaviour therapy and
educational interventions are effective in somatization, solutions that are non-biological in
nature .
Illness anxiety disorder
WHAT
- preoccupation with having or acquiring a serious illness
- convinced that they’re developing a serious illness
- somatic symptoms arent present
- high levels of anxiety//excessive checking
- Some know that their concerns are excessive and some do not
- *TH CRITERIA DOES NOT RULE OUT IF THEY’VE HAD A SERIOUS ILLNESS PREVIOUSLY; i.e. if youve had canger & worry excessively about getting is again = disorder?
- diagnosis might help get treatment though
- – ALSO, the majority of patients with clinically meaningful levels of FCR (fear of cancer return) do not meet the criteria for thoughts or behavior (i..e dont have pathological worry about health in general).
- *IAD –> health in general + anxiety about health and diseases
- suggesting that FCR is a unique and significant mental health issue in its own right cos it only looks @ fear of cancer RETURN
