AB Psych

• Somatic symptom and related disorders


  Conditions that involve physical symptoms combined with abnormal thoughts, feelings, and behaviors in response to those symptoms
• Dissociative disorders


  Mild alterations or detachments in consciousness or identity that are so intense and extreme that the person loses their identity entirely and assumes a new one, or they lose their memory or sense of reality and are unable to function
• Mild dissociative or somatic symptoms are experienced at least occasionally by almost all of us
• Somatic symptom disorder


  When concern about physical symptoms is severe and leads to significant distress or impairment
• Dissociative disorder


  When feelings of "being out of it" become so persistent and recurrent that the person has profound and unusual memory deficits (such as not knowing who they are)
• Pre-DSM-5, both somatic symptom disorders (formerly known as somatoform disorders) and dissociative disorders were included with the various anxiety disorders (and neurotic depression) and considered to be forms of neurosis
• In DSM-5 somatic symptom disorders and dissociative disorders are regarded as distinct diagnostic entities
• Somatic symptom and related disorders

  Lie at the interface between abnormal psychology and medicine
• Somatic symptom disorders


  People with these disorders experience bodily symptoms that cause them significant psychological distress and impairment
• Somatic symptom disorders


  Preoccupation with health or appearance becomes so great that it dominates their lives, the problems preoccupying these people seem, initially, to be physical disorders, there is an excessive or maladaptive response to physical symptoms or to associated health concerns
• Medically unexplained physical symptoms

  Shorthand label for somatic symptom disorders
• Dissociation


  A mental process of disconnecting from one's thoughts, feelings, memories, or sense of identity
• Dissociation or dissociative experiences are normal, mild alterations or detachments in consciousness or identity
• Conversion hysteria


  Unexplained physical symptoms indicated the conversion of unconscious emotional conflicts into a more acceptable form (Freud)
• Neurosis


  (in psychoanalytic theory) Suggests a specific cause for certain disorders, resulting from underlying unconscious conflicts
• Somatic symptom disorders and dissociative disorders are not well-understood
• Somatic symptom and related disorders

  • Somatic symptom disorder
  • Illness anxiety disorder
  • Psychological factors affecting medical condition
  • Conversion disorder
  • Factitious disorder
• Somatic symptom disorder


  The most major diagnosis in its category, includes several disorders that were previously considered to be separate diagnoses in DSM-IV-TR - (1) hypochondriasis, (2) somatization disorder, and (3) pain disorder
• Somatic symptom disorder


  Diagnosed when a person has a significant focus on physical symptoms, such as pain, weakness, or shortness of breath, to a level that results in major distress and/or problems functioning, the individual has excessive thoughts, feelings, and behaviors relating to the physical symptoms

  
• The physical symptoms may or may not be associated with a diagnosed medical condition, but the person is experiencing symptoms and believes they are sick (that is, not faking the illness)
• Briquet's syndrome


  Previous name for somatic symptom disorder
• Pain


  Psychological factors play a major role in maintaining or exacerbating the pain whether there is a clear physical reason for the pain or not
• Somatic symptom disorder


  The psychological experiences of anxiety and distress focused on the somatic symptoms are the most important target for treatment
• A person is not diagnosed with somatic symptom disorder solely because a medical cause cannot be identified for a physical symptom. The emphasis is on the extent to which the thoughts, feelings, and behaviors related to the illness are excessive or out of proportion

  
• People with somatic symptom disorder


  • Tend to have a cognitive style that leads them to be hypersensitive to their bodily sensations, experience these sensations as intense, disturbing, and highly aversive, tend to think catastrophically about their symptoms, often overestimating the medical severity of their condition

  
• Illness anxiety disorder


  Previously known as hypochondriasis, physical symptoms are either not experienced at the present time or are very mild, but severe anxiety is focused on the possibility of having or developing a serious disease
• Illness anxiety disorder and somatic symptom disorder share many features with anxiety and mood disorders, particularly panic disorder
• Illness anxiety disorder


  Characterized by anxiety or fear that one has a serious disease, the individual is preoccupied with bodily symptoms, misinterpreting them as indicative of illness or disease
• Reassurances from numerous doctors that all is well and the individual is healthy have, at best, only a short-term effect in illness anxiety disorder
• Disease conviction


  Many individuals with illness anxiety disorder mistakenly believe they have a disease; a difficult-to-shake belief
• Individuals with somatic symptom disorders overuse and misuse the health-care system
• Culture-specific syndromes


  • Koro (belief that genitals are retracting into the abdomen)
  • Dhat (anxious concern about losing semen)
  • Hot sensations in the head or a sensation of something crawling in the head (specific to African patients)
  • Sensation of burning in the hands and feet (in Pakistani or Indian patients)
• "Somatizing" psychological distress is fairly common, and fairly uniform, throughout the world
• Causes of somatic symptom and illness anxiety disorders


  • Quickly focus attention on physical sensations and misinterpret these as symptoms of illness, increasing anxiety which produces additional physical symptoms (cycle), enhanced perceptual sensitivity to illness cues, tendency to interpret ambiguous stimuli as threatening, restrictive concept of health as being symptom-free
• Somatic symptom disorders run in families
• Other factors in development of somatic symptom and illness anxiety disorders

  • Develop in the context of a stressful life event, disproportionate incidence of disease in the family when the individual was a child, social and interpersonal "benefits" of being sick (attention, avoiding work, etc.)
• Psychological factors affecting medical condition


  A mental disorder diagnosed when clinically significant psychological or behavioral factors adversely affect an individual's medical condition and increase their risk for suffering, death, or disability
• Functional neurological symptom disorder (conversion disorder)


  A mental disorder characterized by neurologic symptoms (either motor or sensory) that is incompatible with any known neurologic disease, generally have to do with physical malfunctioning, such as paralysis, blindness, or difficulty speaking (aphonia), without any physical or organic pathology to account for the malfunction
• Conversion symptoms often seem to be precipitated by marked stress, often in the form of a physical injury, but the occurrence of some identifiable stressor has not been a reliable sign of conversion disorder
• People with conversion symptoms can usually function normally