ch 9: disorders featuring somatic symptoms

Somatic symptoms

● Factitious disorder

● Conversion disorder

● Somatic symptom disorder

● Illness anxiety disorder

● Psychological factors affecting other medical conditions

Malingering

● Not a DSM-5-TR diagnosis.

● Intentionally pretending to be sick or disabled to reap external (secondary) gain:

- Money

-Drugs

-Time off

Fictitious disorder imposed on self

1. False creation of physical or psychological symptoms, or deceptive production of injury or disease, even without external rewards for such ailments.

2. Presentation of oneself as ill, damaged, or hurt

Fictitious disorder imposed on another

1. False creation of

   physical or psychological

   symptoms, or deceptive

   production of injury or

   disease, in another person,

   even without external

   rewards for such ailments

2. Presentation of another

   person (victim) as ill,

   damaged, or hurt

Conversion disorder

1. Presence of at least one symptom or deficit that affects voluntary or sensory function.

2. Symptoms are found to be inconsistent with known neurological or medical disease.

3. Significant distress or impairment.

Somatic symptoms disorder

1. Person experiences at least one upsetting or repeatedly disruptive physical (somatic) symptom.

2. Person experiences an unreasonable number of thoughts, feelings, and behaviors regarding the nature or implications of the physical symptoms, including one of the following:

A. Repeated, excessive thoughts about their seriousness.

B. Continual high anxiety about their nature or health implications.

C. Disproportionate amounts of time and energy spent on the symptoms or their health implications.

3. Physical symptoms usually continue to some to degree for more than 6 months.

Psychodynamic Theory of Conversion

Disorder and Somatic Symptom

Disorder

● Underlying emotional conflicts converted into

physical symptoms

● Primary gain

● Relief of anxiety/distress

● Noted by “la belle indifference”

Cognitive-Behavioral Model and

Conversion Disorder and Somatic

Symptom Disorder

Physical symptoms of disorder are rewarded and maintained through reinforcement.

● Bring attention

● Secondary gain

-Miss work

-Get money

-Avoid responsibility

Conversion Disorder and Somatic

Symptom Disorder Treatments

● Conversion disorder often resolves on its own.

● Somatic symptom disorder treatment is not very successful.

-Insight

-Education

-Reinforcement

-Exposure

-Antidepressants

Illness Anxiety Disorder symptoms

1. Person is preoccupied with thoughts about having or getting a significant illness. In reality, person has no or, at most, mild somatic symptoms.

2. Person has easily triggered, high anxiety about health.

3. Person displays unduly high number of health-related behaviors (e.g., keeps focusing on body) or dysfunctional health-avoidance behaviors (e.g., avoids doctors).

4. Person’s concerns continue to some degree for at least 6 months.

Illness anxiety disorder

● Used to be called hypochondriasis.

● The disorder can begin at any age, but usually starts in early adulthood.

● The main symptom is anxiety about a physical illness.

Illness anxiety disorder treatment

Biological

● Medications - SSRIs

Cognitive-behavioral approaches

● CBT

● Exposure

Psychophysiological disorders

● Affected persons have a medical condition.

● Psychological factors negatively affect the medical condition.

-Lengthen the medical condition

-Create obstacles to the treatment of medical condition

-Trigger or worsen the medical condition