Transcript Somatic Symptom and related disorders

 Somatic symptom disorder→ a disorder in which persons become
excessively distressed, concerned and anxious about bodily symptoms
they are experiencing
 Somatization pattern→ the individual experiences large and varied
number of bodily symptoms
 Long-lasting physical ailments typically have little or no physical cause
 Ailments could include pain symptoms, gastrointestinal symptoms,
sexual symptoms and neurological-type symptoms
 Typically go from doctor to doctor in search of relief
 Often feel anxious and depressed and describe their many symptoms
in dramatic and exaggerated terms
 Between .2 and 2% of all women in the U.S. may experience
somatization pattern in a given year, compared to less than .2% of men
 Pattern often runs in families and develops between adolescence and
young adulthood
 Predominant pain pattern→ the person’s primary bodily problem is the
experience of pain
 Source of pain may be known or unknown, but either way, the concerns
and disruption produced by the pain are disproportionate to its
severity and seriousness
 Conversion disorder→ a disorder in which medically unexplained bodily
symptoms affect voluntary motor and sensory functions
 Individuals experience neurological like symptoms—for example
paralysis, blindness or loss of feeling—that have no neurological basis
 Difficult to distinguish from a genuine medical problem
 Physicians often rely on oddities in the patient’s medical picture to
distinguish the two
 Glove anesthesia- numbness beginning sharply at the wrist and
extends evenly right to the finger tips. Real neurological damage, on
the other hand, is rarely as abrupt or evenly spread out
 People do not consciously want or purposely produce their symptoms.
Symptoms cause significant distress or impairment.
 Usually begins between late childhood and young adulthood
 Very rare disorder, occurring in at most 5 of every 1000 persons
 Etiology of Conversion and Somatic Symptom Disorder
 Psychodynamic theorists, such as Freud, argue somatic symptom
disorders are the result of bottled up emotional energy that is transferred
into physical symptoms
 Behaviorists believe that operant responses are learned and maintained
because they result in rewards
 Cognitive behaviorists add that the rewards enable individuals with
somatoform symptom disorders to avoid some unpleasant or threatening
situation, provide an explanation or justification for failure, or attract
concern, sympathy or care.
 Social cognitive theorists think that individuals with somatoform
disorders focus too much attention on their internal physiological
experiences, amplifying bodily sensations and forming disastrous
conclusions about minor complaints.
 Treatment of Conversion and Somatic Symptom Disorder
 People with these disorders usually seek psychotherapy only as a last
result, since they believe their problems are medical
 Many therapists focus on the causes of these disorders (trauma or anxiety
tied to physical symptoms) and apply insight, exposure and drug
therapies
 Psychodynamic therapists try to help individuals with somatic symptoms
become conscious of and resolve their underlying fears, eliminating the
need to convert anxiety into physical symptoms
 Behavior therapists use exposure treatments, exposing clients to features
of horrific events that first triggered their physical symptoms
 Biological therapists use anti-anxiety drugs or certain antidepressant
drugs to help reduce anxiety associated with these disorders
 Some therapists try to address the physical symptoms of these disorders
 Suggestion- offer emotional support to patients and tell them
persuasively that their physical symptoms will soon disappear
 Reinforcement- arrange removal of rewards for “sick” symtoms and
increase rewards for healthy behaviors
 Confrontational approach- straightforwardly telling them their bodily
symptoms are without medical basis
 Researchers have not fully evaluated the effects of these approaches
 Illness anxiety disorder (formerly known as hypochondriasis)→ a
disorder in which persons are chronically anxious about and preoccupied
with the notion that they have or are developing a serious medical illness,
despite the absence of substantial somatic symptoms
 Patients experience chronic anxiety about their health and are convinced
they have or are developing a serious medical illness
 Repeatedly check bodies for signs of illness and misinterpret various
bodily events as signs of serious medical problems, even when they are
signs of normal bodily changes such as occasional coughing, sores or
sweating
 Individuals persist in misinterpretation no matter what physicians, friends
or family say
 Between 1 and 5% of all people experience the disorder
 Occurs among men and women in equal numbers
 Etiology
 Behaviorists believe it may be acquired through classical conditioning
or modeling
 Cognitive theorists suggest people are so sensitive to and threatened
by bodily cues they come to misinterpret them
 Treatment
 Treatments applied to OCD patients are often used to effectively treat
 Antidepressant drugs
 Behavioral approaches such as exposure and response prevention-
therapists repeatedly point out bodily variations to clients, while at
the same time, preventing them from seeking their usual medical
attention
 Cognitive therapists guide the client to identify, challenge and change
the illness-related beliefs that are helping to maintain their disorder
 Factitious disorder (popularly known as Munchausen syndrome)→ a
disorder in which an individual feigns or induces physical symptoms,
typically for the purpose of assuming the role of a sick person
 Often goes to extremes to create the appearance of illness
 May give themselves medications to induce symptoms—inject drugs to
cause bleeding, use laxative to produce chronic diarrhea, creating high
fevers
 Often research supposed ailments and are very knowledgeable about
medicine. Many eagerly undergo painful testing or treatment, even
surgery
 When confronted with evidence symptoms are factitious, they often deny
the charges and leave the hospital, sometimes entering another the same
day
 Usually begins in early adulthood
 Precise causes are unknown- clinical reports have pointed to factors such
as depression, unsupportive parental relationships during childhood, and
an extreme need for social support that is not otherwise available
 Effective treatments have not been found
 Factitious disorder imposed on another (popularly known as Munchausen’s
by proxy)- parents or caretakers make up or produce physical illnesses in
their children, leading in some cases to repeated painful diagnostic tests,
medication and surgery