W10 Psychosomatics + Psychosocial approaches Flashcards
Somatic problems in psychology (who influenced?)
Galen, Rome, 2nd century
Galen’s view:
“the passions such as anger, fear and lust were important causes of illness”
Galen’s views gave way to the development of two newer approaches:
- Psychosomatic Medicine
- Psychophysiological Approach
Psychosomatic Medicine:
Attempted to establish psychological causation for physical disorders such as asthma, eczema and
ulcers. This field was strongly influenced by psychoanalysis, has now declined leaving behind little practical application.
Psychophysiological Approach
This approach emphasises the importance of considering psychological processes rather than diagnostic categories.
The foundation of psychophysiological approach:
experimental work in which physiological responses are measured during experimental tasks which probe particular psychological processes (for ex: listening to stimuli, reacting by pressing a button when stimuli occur)
what is the aim of experiments that lie in the base of psychophysiological approach?
Such experiments aim to examine whether particular types of stimuli or psychological reactions consistently produce characteristic physiological reactions, since there is a stimulus-response specificity, particular stressors might be responsible for the development of specific disorders in vulnerable individuals. These concepts can help explain why some people develop headaches in response to stress when other people do not, and why some stressors precipitate headaches and others do not.
understanding of psychological approaches to somatic problems has been influenced by
tendency to refer for psychological treatment as a last resort
Patient see their problems differently from psychologists:
patients’ problems (perceived physical) become more chronic => they become more distressed with the failure of medical treatment => they perceive
themselves as having a psychological problem arising from their chronic medical condition
Although this perception leads to the acceptance of psychiatric referral, it is often for problems the patient regards as subsidiary.
effect of wrong referral pattern:
some clinicians and researchers in psychiatry regard phenomena such as hypochondriasis, headache or sleep disturbance as secondary to other clinical syndromes, most commonly
1. Depression
2. Anxiety
Somatic presentation of psychological problems fall into three broad categories:
• Problems where there are observable and identifiable disturbances of bodily functioning
• Problems where the disturbances are primarily perceived symptoms, sensitivity to or excessive reaction to normal bodily sensations
• A mixed group
major conditions included in “Problems where there is an observable and identifiable disturbance
of bodily functioning” (8):
• Irritable Bowel Syndrome
• Hypertension
• Tics and Spasms
• Asthma
• Insomnia
• Sleep Disorders
• Psychogenic Vomiting
• Skin conditions
major conditions included in “Problems where the disturbance is primarily one of perceived symptoms, sensitivity to or excessive reaction to normal bodily sensations.” (5):
• Hypochondriasis
• Somatization disorder
• Idiopathic pain disorder
• Hysterical conversion
• Dysmorphophobia
major conditions included in “Problems in which the basis of symptoms varies or is uncertain” (4):
• Headaches
• Disproportionate breathlessness
• Functional Chest Pain/ Cardiac neurosis
• Chronic Pain
Amongst the most common somatic problems seen in General Practice and psychiatric settings are:
• Insomnia
• Headaches
• Irritable bowel syndrome
• hypochondriasis
