somatic symptom disorders

exam 2

criteria for somatic symptom disorder

• One or more significantly distressing or disruptive somatic symptom

• Excessive thoughts, feelings, & behaviors related to these somatic symptoms or associated health concerns

• Chronic: duration of at least 6 months

criteria for Illness Anxiety Disorder

• Preoccupation with & high level of anxiety about having/acquiring a serious illness

• Excessive health related behaviors/exhibits maladaptive avoidance

  • Either excessively going to the doctor or avoiding anything medical related

• Somatic symptoms are not present or are very mild

• Not explained by another psychological disorder

• Duration of at least 6 months

Illness Anxiety Disorder is a newer diagnosis that replaces what diagnosis?

hypochondriasis

Criteria for Conversion Disorder (Function Neurological Symptom Disorder)

• At least one symptom/deficit that affects voluntary motor or sensory function

  • Sensation ex. Vision problems, hearing problems, things tasting/smelling weird or losing a sense of taste/smell, tingling/losing sensation in parts of the body

  • Motor deficit ex. inability to move a part of the body, extreme weakness in a part of the body

• Inconsistency/incompatibility with recognized neurological/medical disorder

• Clinically significant distress/impairment in functioning

• Unconscious psychological pain/conflict is being converted into a physical pain/symptom

somatic symptom disorder is more likely to receive a premature diagnosis than which other disorder?

illness anxiety disorder

Somatic Symptom Disorders: Biological Factors

• Not a strong genetic bias anterior cingulate & anterior insula - connected to part of cortex that processes emotion

  • Connected to how you feel about that physical sensation

Somatic Symptom Disorders: Cognitive-Behavioral Factors

• More focus on health-related cues

  • They are more likely to notice that their nose feels a little more stuffy than usual

• Attributions/interpretations

  • Catastrophic & worrying interpretation

  • May exacerbate symptoms/make symptoms worse wither psychologically or physically

• Behavioral consequences of somatic concerns

  • Avoid work and/or social obligations

    • These can be reinforcing, makes it less likely that they will view the symptoms as less scary

  • Help-seeking

Conversion Disorder (Functional Neurological Disorder) Social & Culture Factors

• Decrease in incidence of disorder in last century or so

• Lower incidence in Western societies

• More common in lower socioeconomic status

• Anytime there's a disorder in which the number is going down it suggests that there is an environmental or cultural/sociological factor going on

• Comes about when there is a need to hide away/cover up an emotional/psychological problem using a physical/somatic problem

  • It's more acceptable to have the physical symptoms

Conversion/Functional Neurological Disorder: Psychodynamic Perspective

• Role of the unconscious in symptoms

  • Ex. Vision - visual input goes from the eyes into multiple parts of the brain. One part of the brain is responsible for us being consciously aware of what we see. If it's damaged, but other parts of the brain that receive that information are working, behavior can still be influenced by what their eyes "see" even if they're not aware of seeing things. This is called blindsight.

  • This tells us that there's an unconscious component to sensation/perception

• Unconscious motivations

  • Person may not realize the reason for having certain symptoms

  • Ex. Someone who's afraid of being deployed for military service may unconsciously

*Childhood events and unconscious motivation plays a very big role in neurological functioning disorders.

Conversion/Neurological Functional Disorder: Treatments

• Psychodynamic therapies

  • Aimed at revealing conflicts & psychological factors that are contributing to these factors/symptoms. Once you know the cause you can address it in therapy & there's no reason to call them somatic anymore.

  • Short-term success of therapies, somatic symptoms often come back

• Cognitive Behavioral therapies

  • Identify & address triggers - figure out what kind of emotional & environmental factors cause symptoms/start to worsen, then address those factors

  • Change cognitions/catastrophic interpretations about somatic symptoms because becoming afraid about a pain/symptom can lead it becoming more intense & impairs with their functioning

  • Change reinforcing behaviors - all the help & symptoms will no longer be present, alleviating

• Antidepressant Medication

  • Can help regulate comorbid depressive symptom

  • Most helpful when somatic symptom is pain

  • Sometimes, low doses of antidepressive are too low to significantly help the depression symptoms can result in decrease in pain symptoms