Somatic Symptom and Related Disorders

Question 1

Somatic Symptom Disorder (Somatization Disorder/Briquet’s syndrome)

Answer 1

-one or more somatic symptoms that are distressing or result in significant disruption in daily life
-duration at least 6 mons
-more emphasis on the distress and behavior accompanying symptoms, rather than the number or range of somatic symptoms
-specifier: with predominant pain
-individual’s suffering is authentic even no proof
-associated with depressive disorders
-have heritable basis
-2 types in DSM IV-TR
hysterical somatoform (theres actual physical change)
preoccupation somatoform (no actual physical change)

Question 2

Illness Anxiety Disorder

Answer 2

• preoccupation with having a serious illness
• at least 6 months
• specific illness that is feared may change
• Specifier: care-seeking type and care-avoidant type
• faulty interpretation of physical signs and symptoms
• only diagnosed if person has minimal or no somatic symptoms
• co-occur with with anxiety and mood disorders
• Other cultures: Koro, Dhat

Question 3

Functional Neurological Disorder (Conversion Disorder)

Answer 3

-finding find evidence of incompatibility between symptom and recognized neurological condition
-la belle indifference: lack of concern about the nature or implications of symptom
-usually develop in adolescence or early adulthood after a major life stressor or traumatic event
-GLOBUS HYSTERICUS: lump in the throat that makes it difficult to swallow, talk
*CAUSES
-Psychodynamic
individual repress conflict and make unconscious after the trauma
-anxiety increase and converts to physical symptoms, deal indirectly
-Primary gain: reinforcer of conversion symptom
-Secondary: avoidance of a difficult task

Question 4

Malingering (Feigning)

Answer 4

• person intentionally fakes a symptom to avoid a responsibility
• manipulate others to a desired end

Question 5

Factitious Disorder

Answer 5

• people intentionally produce physical symptoms to assume the role of a patient
• goal is to gain attention
• Munchausen syndrome: extreme, long-term form of factitious disorder
• Munchausen by proxy: individual makes someone else sick

Question 6

Causes of Somatoform Disorders

Answer 6

• BEHAVIORAL
• Classical conditioning (results from the repeated pairing of a neutral stimulus and an unconditioned stimulus that evokes a response)
• Operant conditioning (attention and sympathy from others, euphoric effects of pain medications, or a decrease in responsibilities may reinforce pain behaviors)
• COGNITIVE
• Misinterpretation of bodily cues
• emotions converted to physical symptoms as physical language
• PSYCHODYNAMIC
• conversion of underlying emotional conflicts into physical symptoms
• unresolved Oedipus complex
• Primary and secondary gain
• BIOLOGICAL
• Placebos -pretend treatment

Question 7

Treatment for Somatic Symptom Disorders

Answer 7

• uncover unconscious conflicts from childhood (catharsis)
• remove secondary reinforcers or secondary gain
• CBT: ERP
• antidepressants