Somatic Symptom Disorders

Question 1

What feature do all Somatic Symptom Disorders have in common?

Answer 1

Prominence of somatic/health symptoms associated with significant distress or impairment, UNCONSCIOUS motivation and symptoms

Question 2

Somatic Symptom Disorder
How many?

What’s the KEY this diagnosis

Answer 2

More than ONE distressing/disruptive symptom
-One indicator of distressing thoughts/feelings behaviors about the symptom such as:
Disproportionate thoughts about seriousness/high anxiety about symptom/excessive energy or time devoted to symptom

Key: They HAVE an illness associated with the hyper distress

Question 3

Illness Anxiety Disorder

Key to Diagnosis

Answer 3

Preoccupation with having/acquiring a serious illness

Symptoms ARE NOT PRESENT-they’re worried for no reason and they have a:

• normal, psychological sensation
• benign, self-limited dysfunction
• bodily discomfort not associated with disease
• Shows Maladaptive avoidance

Key: Has no disease

Question 4

What are differentials for SSD and IAD? There are two.

Answer 4

1. Body Dysmorphic Disorder

2. Delusional Disorder-100% belief-completely delusional

Question 5

Conversion Disorder “Functional Neurological Symptom”

Key

Answer 5

Altered voluntary motor or sensory function for unexplained reason

Incompatibility of symptom and neurological condition

Ex: Getting seizures, but brain is fine

Key: NEUROLOGICAL Symptom

Question 6

Factitious Disorders

Two Types:

Answer 6

Person fakes to be in “sick role” because they want to get attention from the doctor/staff

Self
On Another-Munchausen’s Syndrome

Question 7

Malingering

Two Types:

Answer 7

If you fake Symptoms for a specific reason-to get out of work, to get more attention from spouse, to get gifts

Oneself
In Another Individual (By Proxy)

Question 8

What are the four causes of Somatic Symptom and Related Disorders

What is La Belle Indifference

Answer 8

1. Multifactorial: Physiological Factors-Overactivity of brain regions-can amplify perception of pain
2. Cognitive Biases-too much attention given to symptoms that may make it worse
3. Behavioral Consequences-person may make themselves worse or conform to the sick role
4. Psychological Consequences
   transform into body-conversion disorder
   Ex: Saw Something terrible and became blind

La Belle: the person is unconcerned with symptoms caused by a conversion disorder. A naive, inappropriate lack of emotion or concern for the perceptions by others of one’s disability, usually seen in persons with conversion disorder.

Question 9

What are the treatments for?
What do you have to be careful of?

What about specifically for Factitious Disorder?

Answer 9

1. CBT
   - Report child and make sure that they don’t get too sensitive that they don’t go to treatment

Signs that it is this disease are:
Unexplained, persistent symptoms, dramatic presentation, insistence, grid abdomen