chapter 9: disorders featuring somatic symptoms

factitious disorder imposed on self (munchausen by self)

faking or inducing physical disorders to play the role of a sick person

factitious disorder imposed on another (munchausen by proxy)

parent fabricates or induces physical illness onto their child

conversion disorder

patient has bodily somatic symptoms affecting voluntary, motor and sensory functions but the symptoms are inconsistent with known medical diseases. not faking it

how do doctors able to distinguish conversion disorder and a medical problem?

by observing oddities in the patient’s medical picture

somatic symptom disorder

people become very anxious and hyperaware of bodily symptoms and causes significant distress and disruption in everyday life

psychodynamic view of conversion/somatic symptom disorder

patients convert underlying emotional conflicts into physical symptoms

cognitive behavioral view of conversion/somatic symptom disorder

patients are trying to communicate and express emotions through physical symptoms

treatment for conversion and somatic symptom disorder

therapist insight, exposure, drug therapies, education, reinforcement, cognitive restructuring

illness anxiety disorder

patient is chronically anxious with the notion that they already have, or are developing a serious medical illness even when there are no symptoms

treatment for illness anxiety disorder

antidepressants and cognitive behavioral approaches originally designed for OCD

psychological factors affecting other medical conditions (psychophysiological disorders)

bio, psycho, and socio factors interact to cause and worsen a problem

psychophysiological physical illnesses

ulcers, asthma, insomnia, chronic headaches, hypertension, coronary heart disease

types of headaches

muscle contraction/tension headaches, migraine headaches

causes of psychophysiological illness

interactions of environmental pressures, anxiety/depression, abnormal physiology

biological factors of psychophysiological disorders

overreactive autonomic nervous system, weak gastrointestinal system, weak respiratory or cardiac system

psychological factors of psychophysiological disorders

the needs, attitude, emotions and coping styles of a person that can cause people to overreact to stressors, which increases chances of developing disorders. worrying, anxiety, anger, hostiliy and depression have stronger links to heart disease

sociocultural factors of psychophysiological disorders

adverse social conditions like poverty, unemployment, overcrowding, stress from racial discrimination

psychoneuroimmunology

the study of how stress affects the immune system and health

how does stress interfere with the immune system

stress slows down the immune system and lymphocyte activity

factors that influence whether stress will slow down the immune system

biochemical activity, personality, degree of social support

how does norepinephrine and cortisol affect the nervous system

extended release causes too much norepinephrine to cause lymphocytes to stop activity and slow down immune functioning and makes excessive cytokines that lead to inflammation contributing to other illnesses

how does behavior affect the immune system?

anxious/depressed people might eat and sleep poorly, drink more, exercise less, which slows down immune system

how does personality affect immune system?

optimistic people have better immune systems

psychological treatments for physical disorders

behavioral medicine including relaxation training, biofeedback, meditation, hypnosis, CBT, and support groups