Psychology
Somatic Symptom Disorders
Somatic Symptom Disorders are characterized by distressing physical symptoms, such as pain or fatigue, that lead to excessive thoughts, feelings, or behaviors related to the symptoms. These symptoms cannot be fully explained by a medical condition, and they cause significant impairment in daily functioning. Treatment often involves a combination of medical and psychological interventions to address both the physical and psychological aspects of the disorder.
Written by Perlego with AI-assistance
Related key terms
1 of 5
11 Key excerpts on "Somatic Symptom Disorders"
No longer available |Learn more- Michael B. First, Andrew E. Skodol, Janet B. W. Williams, Robert L. Spitzer(Authors)
- 2016(Publication Date)
- American Psychiatric Association Publishing(Publisher)
9.1Somatic Symptom Disorder
Somatic Symptom Disorder involves the individual being distressed or having his or her life disrupted by concerns about physical symptoms. Patients with Somatic Symptom Disorder typically present with multiple current somatic symptoms, although sometimes there is only one severe symptom, most commonly pain. Symptoms may be specific to a particular part of the body (e.g., localized pain) or relatively nonspecific (e.g., generalized fatigue). In some cases, the symptoms represent normal bodily sensations or discomfort that does not generally signify serious disease. Given that it is normal to experience transient somatic symptoms at times, the diagnosis requires that the symptoms be persistent, typically lasting 6 months or longer.For cases in which Somatic Symptom Disorder is accompanied by another medical condition, the disorder is often manifested by the person’s excessive level of worry about the implications of the medical condition. For example, a person who has had a complete recovery from an uncomplicated myocardial infarction may behave as an invalid or constantly worry about having another heart attack. Whether or not symptoms are related to another medical condition, a diagnosis of Somatic Symptom Disorder requires that the somatic symptoms be accompanied by excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns. Individuals may worry excessively about the symptoms and their possible catastrophic consequences and are very difficult to reassure. Attempts at reassurance are often interpreted as the physician not taking the symptoms seriously. Health concerns often assume a central and sometimes all-consuming role in the individual’s life, with the person devoting excessive time and energy to dealing with health concerns. These individuals tend to be very anxious about their health and frequently seem unusually sensitive to adverse drug effects.
No longer available |Learn more- David Sue, Derald Wing Sue, Stanley Sue, Diane Sue, David Sue, Derald Wing Sue, Diane Sue, Stanley Sue(Authors)
- 2020(Publication Date)
- Cengage Learning EMEA(Publisher)
According to the DSM-5, actual physical illnesses may or may not be present. However, these diagnoses emphasize the presence of “distressing somatic symptoms plus abnormal thoughts, feelings and behaviors in response to these symptoms” (APA, 2013, p. 309). In one study, over 30 percent of individuals with illnesses such as heart disease or arthritis met the criteria for somatic symptom disorder because of “persis-tently high levels of anxiety” or “excessive time and energy devoted to” their disorder (Häuser & Wolfe, 2013). Psychophysiological disorders, discussed in Chapter 6, are also considered part of the somatic symptom disorder category. (Differences between the Somatic Symptom Disorders are shown in Table 7.2.) We begin with a discussion of somatic symptom disorder. focus QUESTIONS 1 What are the somatic symptom and related disorders and what do they have in common? What are the causes and treatments of these conditions? 2 What are dissociations? Why do they occur, and how are they treated? Table 7.1 Somatic Symptom and Related Disorders DISORDERS CHART Disorder DSM-5 Criteria Prevalence Course Somatic symptom disorder At least one distressing somatic symptom and one of the following: a.
- David Sue, Derald Wing Sue, Diane Sue, Stanley Sue(Authors)
- 2016(Publication Date)
- Cengage Learning EMEA(Publisher)
DSM-5 groups these disorders together because they all have prominent somatic symptoms (physical or bodily symptoms) that are associated with sig-nificant impairment or distress. According to the DSM-5, actual physical ill-nesses may or may not be present (APA, 2013). In one study, over 30 percent of individuals with illnesses such as heart disease or arthritis met the criteria for somatic symptom disorder because of “persistently high levels of anxiety” or “excessive time and energy devoted to” their illness (Häuser & Wolfe, 2013). Psychophysiological disorders, discussed in Chapter 5, are also considered part of the somatic symptom disorder category. Differences between the so-matic symptom disorders are shown in Table 6.2. We begin with a discussion of somatic symptom disorder. Somatic Symptom and Related Disorders somatic symptom and related disorders a broad grouping of psychological disorders that involve physical symptoms or anxiety over illness, including somatic symptom disorder, illness anxiety disorder, conversion disorder (functional neurological symptom disorder), and factitious disorder somatic symptoms physical or bodily symptoms D i S o R D e R S C h a R T Disorder DSM-5 Criteria Prevalence Course Somatic symptom disorder At least one distressing somatic symptom and one of the following: a.
eBook - PDF- Gordon L. Flett, Nancy L. Kocovski, Gerald C. Davison, John M. Neale(Authors)
- 2018(Publication Date)
- Wiley(Publisher)
One of the biggest challenges for physicians and for mental health personnel is to determine whether physical symptoms are due to medical explanations or psychological problems. Individual cases are often not clear, but the diagnostic situation has not been made any easier by a set of diagnostic criteria that have under- gone substantial change. Until the most recent DSM revision, a 7.1 Somatic Symptom and Related Disorders 177 7.1 Somatic Symptom and Related Disorders As noted in Chapter 1, soma means “body.” In these disorders, psychological problems take a physical form. The physical symptoms have no known physiological explanation and are not under voluntary control. They are thought to be linked to psychological factors, presumably anxiety, and are assumed to be psychologically caused (see Merskey & Mai, 2005). In this section, we look at two somatoform disorders: conversion dis- order and somatization disorder. This is preceded by brief dis- cussions of two DSM-IV-TR categories of somatoform disorders about which less information is available: pain disorder and hypochondriasis. Pain disorder and hypochondriasis are no longer distinct disorders in the DSM-5. A summary of the somatoform disorders that were included previously in DSM-IV-TR appears in Table 7.1. This category has been controversial ever since the release of DSM-IV. Indeed, a group of prominent researchers presented the radical argument that somatoform disorders should be removed from the DSM-5 (Mayouet al., 2005). They listed seven concerns that did indeed result in some major changes in the new DSM-5. Key concerns included the fact that the terminology is often unacceptable to clients and the distinction between disease-based symptoms and those that are psychogenic may be more apparent than real. In 2010, the DSM-5 Somatic Symptom Disorders Work Group noted that the DSM-IV terminology was quite confusing.
eBook - PDFAbnormal Psychology
An Integrative Approach
- David Barlow, V. Durand, Stefan Hofmann, , David Barlow, V. Durand, Stefan Hofmann(Authors)
- 2017(Publication Date)
- Cengage Learning EMEA(Publisher)
Their problems fall under the general heading of Somatic Symptom Disorders . Soma means body, and the problems preoccupying these people seem, initially, to be physical disorders. What the somatic symptom dis-orders have in common is that there is an excessive or maladaptive response to physical symptoms or to associated health concerns. These disorders are sometimes grouped under the shorthand label of “medically unexplained physical symptoms” (Dimsdale et al., 2013; Woolfolk & Allen, 2011), but in some cases the medical cause of the presenting physical symptoms is known but the emo-tional distress or level of impairment in response to this symptom is clearly excessive and may even make the condition worse. Have you ever felt “detached” from yourself or your surround-ings? (“This isn’t really me,” or “That doesn’t really look like my hand,” or “There’s something unreal about this place.”) During these experi-ences, some people feel as if they are dreaming. These mild sensations that most people experience occasionally are slight alterations, or detachments, in consciousness or identity called dissociation or dis-sociative experiences, but they are perfectly normal. For a few people, these experiences are so intense and extreme that they lose their iden-tity entirely and assume a new one, or they lose their memory or sense of reality and are unable to function. We discuss several types of dis-sociative disorders in the second half of this chapter. Somatic symptom and dissociative disorders are strongly linked historically, and evidence indicates they share common features (Kihlstrom, Glisky, & Anguilo, 1994; Prelior, Yutzy, Dean, & Wetzel, 1993).
eBook - PDFMental Disorders
Theoretical and Empirical Perspectives
- Robert Woolfolk, Lesley Allen, Robert Woolfolk, Lesley Allen(Authors)
- 2013(Publication Date)
- IntechOpen(Publisher)
Chapter 8 Somatic Symptom Disorder Lesley A. Allen and Robert L. Woolfolk Additional information is available at the end of the chapter http://dx.doi.org/10.5772/52431 1. Introduction In the chapter we present our model of treatment for somatic symptom disorder. We begin with a brief history of somatic symptom disorder followed by a discussion of theory and research on it. Finally, we describe our psychosocial treatment for somatic symptom disorder and related disorders, which employs methods from both cognitive behavioral therapy and experiential emotion-focused therapy. Physical symptoms with uncertain medical explanations are some of the most common presentations in primary care. As many as 25% of visits to primary care physicians are prompted by physical symptoms that lack any clear organic pathology [1]. Although some patients with medically unexplained physical symptoms experience mild and/or transient discomfort, others experience substantial discomfort, distress, and impairment in functioning [2,3]. It is these patients, those with impairing physical symptoms of unknown etiology, who are often refractory to standard medical treatment and overuse medical services [2]. Medicine has long recognized a group of patients with medically unexplained physical symptoms (MUPS) and excessive health concerns. Originally theorized to be caused by a wandering uterus that produced discomfort and pain, MUPS were first described by ancient Egyptians and first labeled hysteria by the ancient Greeks. It was not until 1980 and the publication of DSM-III that the terms somatization and somato‐ form were introduced for physical symptoms that were medically unexplained [4]. According to DSM-III somatization disorder was characterized by “recurrent and multiple somatic complaints of several years’ duration for which medical attention had been sought but which are apparently not due to any physical disorder” [4].
eBook - PDF- V. Durand, David Barlow, Stefan Hofmann, , V. Durand, David Barlow, Stefan Hofmann(Authors)
- 2018(Publication Date)
- Cengage Learning EMEA(Publisher)
Consider the case of the medical student. Copyright 2019 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s). Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it. Somatic Symptom and Related Disorders • 175 Once again, the important factor in this condition is not whether the physical symptom, in this case pain, has a clear medical cause or not, but rather that psychological or behavioral factors, particularly anxiety and distress, are compounding the severity and impairment associated with the physical symptoms. The new emphasis in DSM-5 on the psychological symptoms in these disorders is useful to clinicians since it highlights the psychological experiences of anxiety and distress focused on the somatic symptoms as the most important target for treatment (Tomenson et al., 2012; Voigt et al., 2012). But an important feature of these physical symptoms, such as pain, is that it is real and it hurts, whether there are clear physical reasons for pain or not (Asmundson & Carleton, 2009; Dersh, Polatin, & Gatchel, 2002). Illness Anxiety Disorder Illness anxiety disorder was formerly known as “hypo- chondriasis,” which is still the term widely used among the public. In illness anxiety disorder, 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.
eBook - PDFAbnormal Psychology
The Science and Treatment of Psychological Disorders, DSM-5-TR Update
- Ann M. Kring, Sheri L. Johnson(Authors)
- 2022(Publication Date)
- Wiley(Publisher)
Somatic symptom disorder and illness anxiety disorder both involve health anxi- ety. Anxieties about health tend to develop early in adulthood (Cloninger, Martin, et al., 1986) and tend to have a chronic course. In longitudinal studies, less than half of those with somatic symptom or related disorders achieve full remission within a 5-year period (olde Hartman, Borghuis, et al., 2009), although the severity of symptoms may wax and wane. Somatic symptom and related disorders tend to co-occur with anxiety disorders, mood disorders, and personality disorders (American Psychiatric Association, 2013). Symptoms of these disorders may begin or intensify after some conflict or stress. To an outside observer, it may seem that the person is using the health concern to avoid some unpleasant activity or to get attention and sympathy. People with somatic symptom and related disorders have no sense of this, however; they experience their symptoms as completely medical. Their distress over their symptoms is authentic. Clinical Description of Somatic Symptom Disorder The key feature of somatic symptom disorder is excessive anxiety, energy, or behav- ior focused on somatic symptoms that persists for at least 6 months. The person with this disorder is typically quite worried about his or her health and tends to view even small physical concerns as a sign of looming disease. Tormented by a broad range of somatic symptoms that were not solved by visiting 20 different doctors (Campbell & Matthews, 2005), for 6 years Charles Darwin completed a log of his bodily com- plaints, which was dominated by ratings of his flatulence and other gastrointestinal complaints. Although his symptoms were likely genuine, his extensive notes signal that he was spending too much energy monitoring his health (Dillon, 2010). As illustrated by the Clinical Case of Maria, some might experience a multitude of symptoms from many different body sys- tems.
eBook - PDFAbnormal Psychology
The Science and Treatment of Psychological Disorders
- Ann M. Kring, Sheri L. Johnson(Authors)
- 2021(Publication Date)
- Wiley(Publisher)
Anxieties about health tend to develop early in adulthood (Cloninger, Martin, et al., 1986) and tend to have a chronic course. In longitudinal studies, less than half of those with somatic symptom or related disorders achieve full remission within a 5-year period (olde Hartman, Borghuis, et al., 2009), although the severity of symptoms may wax and wane. Somatic symptom and related disorders tend to co-occur with anxiety disorders, mood disorders, and personality disorders (American Psychiatric Association, 2013). Symptoms of these disorders may begin or intensify after some conflict or stress. To an outside observer, it may seem that the person is using the health concern to avoid some unpleasant activity or to get attention and sympathy. People with somatic symptom and related disorders have no sense of this, however; they experience their symptoms as completely medical. Their distress over their symptoms is authentic. Clinical Description of Somatic Symptom Disorder The key feature of somatic symptom disorder is excessive anxiety, energy, or behavior focused on somatic symptoms that persists for at least 6 months. The person with this disorder is typically quite worried about his or her health and tends to view even small physical concerns as a sign of looming disease. Tormented by a broad range of somatic symptoms that were not solved by visiting 20 different doctors (Campbell & Matthews, 2005), for 6 years Charles Darwin completed a log of his bodily complaints, which was dominated by ratings of his flatulence and other gastrointestinal complaints. Although his symptoms were likely genuine, his extensive notes signal that he was spending too much energy monitoring his health (Dillon, 2010). As illustrated by the Clinical Case of Maria, some might experience a multitude of symptoms from many different body systems.
eBook - PDF- Thomas F. Oltmanns, Michele T. Martin(Authors)
- 2018(Publication Date)
- Wiley(Publisher)
She kept her word about not going to other physicians. Her depressed mood improved, and she did not have any more emergency room visits. The frequency of her contact with physicians decreased and the weakness in her legs sub- sided. She eventually began another job, and she made plans to find a new apartment of her own. Discussion Somatic symptom disorder is characterized by physical symptoms that appear to be due to a somatic (bodily) disease or disorder that cause significant distress and interfere with the person’s functioning, impacting their feelings, thoughts, or behaviors, and classified in the DSM‐5 in the Somatic Symptom and Related Disorders category, which also includes illness anxiety disorder, conversion disorder, and factitious disorder (APA, 2013). Somatic symptom disorder is a new diagnostic category in the DSM‐5; disorders that appeared in the DSM‐IV‐TR but that have been eliminated to reduce overlap include somatization disorder, hypochondriasis, pain disorder, and undifferentiated somatoform disorder. People with somatic symptom disorder worry about their health, see themselves as weak, catastrophize their physical sensations, seek reassurance from health-care professionals, and avoid engaging in physical activity (Klaus et al., 2015). Somatic symptom disorder frequently leads to visits to physicians for diagnosis and treatment rather than psychologists or psychiatrists (Hurwitz, 2004). People with somatic symptom disorder do not 117 Discussion intentionally or consciously produce the symptoms, as in malingering, which is pretending to have symptoms to avoid military service or legal responsibility for a crime, or for financial gain in a lawsuit, or for disability benefits. People with somatic symptom disorder also differ from those with factitious disorder, in which people pretend to have symptoms to assume the sick role.
eBook - ePubClinical Psychology
A Global Perspective
- Stefan G. Hofmann(Author)
- 2017(Publication Date)
- Wiley-Blackwell(Publisher)
Table 16.1 ).Somatic Symptom Disorder (SSD)
Somatic symptom disorder constitutes the major diagnosis of SSRD. It requires at least one somatic distressing symptom—whether medically explained or unexplained—that is associated with disability in everyday life functioning (A‐criterion). Moreover, SSD criteria include three psychological features, of which at least one has to be met: abnormal persistent thoughts, high levels of anxiety in response to the symptoms, or behaviors associated with excessive time and energy devoted to the symptom(s) (B‐criterion). Symptoms typically persist over more than 6 months; however, they do not have to be continuously present (C‐criterion). Somatic symptom disorder includes three specifiers. The specifier “with predominant pain” (American Psychiatric Association, 2013, p. 311) replaces the former pain disorder of DSM‐IV. The specifier “persistent” is used when severe and disabling symptoms persist more than 6 months (American Psychiatric Association, 2013, p. 311). Symptom severity can be classified in three steps: “mild” if only one of the three psychological symptoms under the B‐criterion is fulfilled, and “moderate” or “severe” if two or more psychological symptoms are present. The designation “severe” is applied if the patient also reports multiple or one very severe somatic symptom. Somatic symptom disorder covers the former somatization disorder, undifferentiated somatoform disorder, pain disorder, and somatoform autonomic dysfunction from the ICD‐10, and, in part, patients who would have been previously diagnosed with hypochondriasis according to DSM‐IV. As already mentioned, a central change in DSM‐5 is that the diagnostic criteria of SSD abolish the exclusion of medical conditions explaining the physical symptoms. Moreover, presenting with a minimum number of predefined physical symptoms is no longer necessary for making a diagnosis (in contrast to DSM‐IV and ICD‐10
Index pages curate the most relevant extracts from our library of academic textbooks. They’ve been created using an in-house natural language model (NLM), each adding context and meaning to key research topics.
