Somatoform Disorders Flashcards
Define Somatic
Of or relating to the body, especially as distinct from the mind
Somatic Symptoms Disorder
One or more somatic symptoms that are distressing or result in significant disruption of daily life
Excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns
The state of being symptomatic is persistent
Somatoform Symptoms
Suggest physical disorder
Cannot adequately be explained physiologically
Often described in dramatic ways
Often co-exist with anxiety/mood/personality disorders
Characteristics of Somatization Disorder
Reports of multiple physical symptoms with a medical basis
Runs in families
Rare
Onset usually in adolescents
Treatment of Somatization Disorder
CBT
Therapy to broaden basis for relating to others
Epidemiology of Somatization Disorder
Women > Men
5-7% general population
Older age of onset
Chronic course
Cultural influences affect gender ratios & body locations
Symptoms vary across cultures
Lower levels with higher education levels
Somatization Disorder Pathophysiology
Patient needs to be sick
Causes of Somatization Disorder
Family Hx of illness
Relation with antisocial personality disorder
Weak behavioral inhibition system
Treatment for Somatization Disorder
Assign a PCP
Reduce supportive consequences of talk about symptoms
Frequent, short visits
Define Conversion Disorder
Physical symptoms suggesting neurological problems
Types of Neurological Problems in Conversion Disorder
Sensory impairment
Paresthesias
Blindness
Paralysis
Epidemiology of Conversion Disorder
Suden onset, sudden termination, sudden reappearance
Women > Men except men in combat
Often misdiagnosed
Onset in late childhood
More common in rural areas, lower SES, & lower educational levels
Conversion Disorder Criteria
One or more symptoms or deficits affecting voluntary motor or sensory function
Psychological factors are judged to be associated with symptoms or deficit because issue is preceded by conflicts or other stressors
Symptom or deficit in not intentionally feigned
Symptom or deficit cannot be fully explained by a general medical condition, substance use, or culturally sanctioned behavior or experience
Symptom/deficit causes significant distress or impairment in functioning
Symptom/deficit not limited to pain or sexual dysfunction
Characteristics of Conversion Disorder
Severe physical dtysfunctioning without pathology
Affect people genuinely unaware that they can function normally
May coincide with other problems
Treatment of Conversion Disorder
Assign PCP
Attend to trauma
Remove success of secondary gain
Reduce supportive consequences of talk about symptoms
Causes of Conversion Disorder
Freudian psychodynamic view
Focus on past trauma & conversion
Address primary & secondary gain
Detachment from trauma
Define Illness Anxiety Disorder
Severe anxiety of the possibility of having a disease
Preoccupied with normal sensations being serious disease
Criteria for Illness Anxiety Disorder
Preoccupation with having or acquiring a serious illness
Somatic symptoms mild or not present
High level of anxiety about health; easily alarmed by personal health status
Individual performs excessive health related behaviors or exhibits maladaptive avoidance
Preoccupation present for at least 6 months; specific illness may change
Preoccupation not better explained by another mental disorder
Epidemiology of Illness Anxiety Disorder
Male = Female
Any age at onset
Chronic course that waxes & wanes
Associations with Illness Anxiety Disorder
Fears of aging and death Doctor shopping Poor relationships with providers Past experience with disease Family & work problems
Causes of Illness Anxiety Disorder
Cognitive perceptual distortions
Family history of illness
Treatment of Illness Anxiety Disorder
Challenge illness-related misinterpretations
Provide substantial & sensitive reassurance
Biological Factors as Etiology of Illness Anxiety Disorder
Increased level of cortisol
No concordance for any somatoform disorder
Symptoms more likely on the left half of the body
Other Specified Somatic Symptom & Related Disorder Criteria
Brief somatic symptom disorder (
Psychoanalytic Theory of the Etiology of Somatoform Disorders
Controlling repressed sexual urges
Deny knowledge but use information
Behavior Theory of the Etiology of Somatoform Disorders
Malingering
Social learning & reinforcement
Secondary gain
Define Body Dysmorphic Disorder
Excessive concern with real or imagined defects in appearance
Criteria for Body Dysmorphic Disorder
Preoccupation with an imagined defect in appearance
Preoccupation causes clinically significant distress or impairment in functioning
Preoccupation not better accounted for by another mental disorder
Characteristics of Body Dysmorphic Disorder
Fixation with or avoidance of mirrors
Suicidal ideation
Suicidal behavior
Facts about Body Dysmorphic Disorder
Men = Women
Onset in adolescence
Chronic course
Associations with Body Dysmorphic Disorder
Excessive checking/grooming Removal of mirrors Social isolation Surgical procedure Suicide
Causes of Body Dysmorphic Disorder
Genetic Developmental Psychosocial Social Cultural Similarities with OCD
Treatment for Body Dysmorphic Disorder
CBT
SSRIs
Plastic surgery NOT HELPFUL
