Ch 17 somatic symptom disorders (EX 3)

exam 3

Somatization

Somatization is the psychological and emotional expression of stress through physical symptoms

• individuals experience head, back and chest pain, paralysis, unexplained skin rashes, and other symptoms.

Somatic symptom disorder

Somatic symptom disorder is characterized by a focus on somatic (physical) symptoms, such as pain or fatigue, to the point of excessive concern, preoccupation, and fear.

• high level of functional impairment.

• without significant physical findings & medical diagnosis

• suffering is authentic

Factitious disorder

factitious disorder consciously pretend to be ill to have their emotional needs met and achieve the status of patient.

• older term Munchausen syndrome

• GYPSY ROSE

Malingering 

Malingering is a consciously motivated act of fabricating an illness or exaggerating symptoms.

• Malingering is associated with antisocial, narcissistic, and borderline personality disorders.

• more common in men than in women

Somatic symptoms disorder cont.

Epidemiology: prevalence may be 5%-7%

Comorbidity: Anxiety disorders & major depressive disorders

Medical illnesses w/ higher degree of impairment than expected

Risk Factors: Biological & environmental

Somatic symptoms disorder treatment

Offer support

Avoid unnecessary or repetitive diagnostics

Possible hypnotherapy

CBT in conjunction w/ medication

illness anxiety disorder 

is characterized by extreme worry and fear about the possibility of having a disease. 

illness anxiety disorder cont.

epidemiology: estimated at about 1.3% to 10%. Males and females are equally affected by this disorder.

Comorbidity: Anxiety disorders—including generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, depressive disorder, Personality disorders and somatic symptom disorder.

illness anxiety disorder risk factors

• Anger, aggression, or hostility that had its source in past losses or a disappointment may be expressed as a need for help and concern from others

• Illness anxiety may also be a defense against guilt or low self-esteem.

(Environmental risk factors) 

• Illness anxiety may also be a defense against guilt or low self-esteem.

• history of adverse childhood experience, such as abuse or illness, may predispose adults to this disorder.

Treatment for illness anxiety disorder

• pharmacotherapy (SSRIs)

• ECT

• CBT/iCBT (internet-delivered cognitive-behavioral therapy)

Conversion disorder

• Conversion disorder, also known as functional neurological disorder, manifests itself as neurological symptoms in the absence of a neurological diagnosis

• Lack of emotion “La belle indifférence”

• Symptoms: paralysis, blindness, movement disorder, gait disorder, numbness, paresthesia (tingling or burning sensations), loss of vision or hearing, or episodes resembling epilepsy.

conversion disorder treatment & treatment modalities 

Body oriented psychological therapy (BOPT)

Dialectial-behavior therapy 

psychodrama 

physical therapy 

(treat anxiety, depression, loneliness/ treatment modalities)

factitious disorder imposed on another

factitious disorder imposed on another (also known as Munchausen syndrome by proxy), in which a caregiver deliberately falsifies illness in a vulnerable dependent.

GYSPY ROSE MOTHER

factitious disorder imposed on self

Patient with a dramatic description of an illness using unusually proper medical terminology.

• “crisscrossed” or “railroad-track” scars from exploratory surgeries

treatment for factitious disorder 

CBT focusing on childhood trauma