PW

week 7

Somatic Disorders Overview

  • Definition: Physical symptoms without clear medical explanation.
  • Key Quote: "You should not treat body without soul" - Socrates.
  • Context: Patients experience physical symptoms causing distress despite lack of identifiable medical cause.

Types of Specific Somatic Disorders

  • Involuntary Preoccupation with Symptoms
  • Illness Anxiety Disorder:
    • Intense anxiety over the potential of having a serious illness despite few or no symptoms.
  • Somatic Symptom Disorder:
    • Significant distress from symptoms possibly lacking biological basis, persisting over six months.
  • Conversion Disorder:
    • Neurological symptoms that don't align with medical conditions, arising after stress and not under voluntary control.
  • Voluntary Aspects
  • Factitious Disorder:
    • Intentional feigning or induction of symptoms to assume sick role; can involve self (Munchausen’s) or others (by Proxy).
  • Malingering:
    • Deliberately misleading to obtain external benefits (e.g., financial gain).

Mechanisms and Motivations

  • Primary Gain:
  • Internal benefits like attention or care derived from symptoms.
  • Secondary Gain:
  • External advantages such as evasion of responsibilities or financial compensation.
  • Psychological Underpinnings:
  • Symptoms as communication of distress; cultural variations in interpretation.

Somatic Symptoms in Comorbid Conditions

  • Depression:
  • Symptoms include low appetite, sleep disturbances.
  • Anxiety:
  • Symptoms like muscle tension and sleep issues.
  • Panic Disorders:
  • Symptoms such as racing heart and difficulty breathing.
  • PTSD:
  • Physical responses triggered by trauma reminders.

Treatment Approaches

  • General Strategies:
  • Psychotherapy:
    • Addressing underlying traumas (often a last resort).
  • Physical Treatments:
    • Use of physical and speech therapy.
  • Cognitive-Behavioral Therapy (CBT):
    • Adjusting distorted health thoughts.

Function and Diagnosis

  • Conversion Disorder:
  • Diagnosed when symptoms contradict known medical issues; may appear suddenly post-stress.
  • Over Diagnosis Risk:
  • Challenges in differentiating conversion disorder from actual medical conditions.

Psychophysiological Disorders

  • Definition: Physical illnesses worsened by psychological and social factors, differing from somatic disorders.
  • Examples: Ulcers, hypertension, migraines.

Development Influences

  • A combination of genetic predispositions, social factors, and psychological traits.
  • Critical factors: poverty, discrimination, and healthcare access.

Psychoneuroimmunology

  • Examines the relationship between psychological factors and immune responses to stress.
  • Key Pathways: SNS & HPA axis.
  • Key Influences on Stress:
  • Biochemical pathways, personality styles, social support systems.
  • Stress management techniques (e.g., relaxation training, support groups).

Addictive Disorders Overview

  • Substance Use Disorders:
  • Definition of Substance: Effects bodies or minds, including alcohol, tobacco, caffeine.

Key Symptoms of Substance Use Disorders

  • Maladaptive usage causing significant impairment/distress; requires at least 2 symptoms for diagnosis within a year.
  • Examples:
    • Larger amounts than intended.
    • Unsuccessful control efforts.
    • Time spent using or obtaining.
    • Failure in major obligations.
    • Continued use despite issues.
    • Cravings, tolerance, withdrawal.

Tolerance and Withdrawal

  • Tolerance: Need for increased doses for effect.
  • Withdrawal: Unpleasant symptoms upon cessation, dangerous in cases like alcohol and benzodiazepines.

Types of Substances

  • Depressants: Slow CNS activity (e.g., alcohol, sedatives, opioids).
  • Alcohol Use Disorder Statistics:
  • 5.4% of U.S. population affected; 2:1 ratio men to women.
  • 27% of middle schoolers and 38% of college students engage in binge drinking.

Effects of Alcohol Abuse

  • Physical health damage, social issues, cognitive effects, family and career damage.

Sedative-Hypnotic Drugs

  • Used for relaxation; high addiction risk (e.g., benzodiazepines).

Opioids

  • Morphine, heroin, oxycodone; high addiction and overdose risk.

Opioid Use Disorder

  • Rapid dependency development, severe withdrawal, significant overdose risk.

Stimulants

  • Increase CNS activity (e.g., cocaine, amphetamines, caffeine).

Hallucinogens

  • Produce sensory changes (e.g., LSD, MDMA, psilocybin).

Cannabis

  • THC effects; potential for social and cognitive impairments.

Causes of Substance Abuse

  • Sociocultural Factors: Influence of socioeconomic conditions and family attitudes.
  • Psychological Factors: Dependency linked to childhood and parental support.
  • Cognitive-Behavioral Theories: Substance use seen as a stress relief reward.
  • Biological Factors: Genetic vulnerabilities, neurotransmitter changes.
  • Developmental Psychopathology: Focus on genetics and environmental stressors.

Treatment for Substance Abuse

  • Target underlying conflicts and behavior changes:
  • Detoxification, antagonistic drugs, community prevention programs.
  • Multidimensional approaches yield best outcomes.
Behavioral Addictions
  • Gambling Disorder: Features impulse control issues, significant impairment.
  • Internet Use/Gaming Disorder: Not in DSM but under consideration.
  • Social Media Impact: Triggers dopamine, compulsive use linked to anxiety and mental health issues; shows patterns of substance use disorders.