Psychology on Persistent Somatic Symptoms

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Questions and Answers

Which enzyme deficiency was studied in the experiment?

  • Amylase Deficiency
  • Lactase Deficiency
  • Thiamine Acetylase Deficiency (correct)
  • Lipase Deficiency

What symptom was NOT associated with the illness schema given in the experiment?

  • Diarrhea
  • Nausea (correct)
  • Back pain
  • Headache

What effect did a 'positive' test result for TAA deficiency have on participants?

  • They reported no change in symptoms.
  • They felt increased relief from symptoms.
  • They experienced significantly more symptoms. (correct)
  • They experienced fewer symptoms.

Which factor contributes to symptom reporting in individuals with high negative affect?

<p>Increased symptom awareness and memory bias (C)</p> Signup and view all the answers

Which of the following is NOT a reason for the link between distress and physical symptoms?

<p>Increased risk of infectious diseases (D)</p> Signup and view all the answers

What does the Gate Control Theory propose about the experience of pain?

<p>A 'gate' can open or shut in the spinal cord affecting pain perception. (A)</p> Signup and view all the answers

Which of the following is NOT a component of perception in relation to pain?

<p>Neurological (D)</p> Signup and view all the answers

How does negative emotion influence the experience of pain according to the content?

<p>It can lead to decreased pain tolerance. (C)</p> Signup and view all the answers

What impact do beliefs about pain have on the pain experience?

<p>Positive beliefs can decrease the pain sensation perceived. (C)</p> Signup and view all the answers

What role does modulation play in relation to pain perception?

<p>It can be both excitatory and inhibitory. (C)</p> Signup and view all the answers

In the study involving blood pressure machines, how did the groups differ in pain tolerance?

<p>The positive group could tolerate pain for significantly longer periods. (C)</p> Signup and view all the answers

What does an open gate in the Gate Control Theory signify?

<p>Pain signals flood through and are fully experienced. (D)</p> Signup and view all the answers

Which statement best describes acute pain?

<p>It is often a temporary result of a specific injury or disease process. (B)</p> Signup and view all the answers

What is the most common response people have to their everyday symptoms?

<p>Self medicate (A)</p> Signup and view all the answers

What percentage of symptoms were found to be caused by organic illness over a year period?

<p>10-15% (C)</p> Signup and view all the answers

According to the Competition of Cues Hypothesis, where does the natural state of attention focus?

<p>Internally on body sensations (A)</p> Signup and view all the answers

In the study involving participants running indoors versus outdoors, what was reported more by those on the indoor track?

<p>More exercise symptoms (A)</p> Signup and view all the answers

What is the term used for the broad idea of what a particular illness involves, such as influenza?

<p>Illness schema (C)</p> Signup and view all the answers

What factor can influence the likelihood of an individual reporting symptoms?

<p>Attention and beliefs (A)</p> Signup and view all the answers

What phenomenon occurs when individuals pay more attention to their bodies when they are focused internally?

<p>Heightened awareness of symptoms (D)</p> Signup and view all the answers

What might influence a person's symptom reporting through heightened attention to specific symptoms?

<p>Schema-guided search process (D)</p> Signup and view all the answers

What best describes persistent somatic symptoms (PSS)?

<p>Physical symptoms that are experienced and may have no identifiable disease. (B)</p> Signup and view all the answers

What is a defining characteristic of conversion disorder?

<p>Unconscious symptoms in response to underlying stress. (B)</p> Signup and view all the answers

According to studies on viral infections, what was found regarding people with biological evidence of infection?

<p>75% did not report having any flu symptoms. (B)</p> Signup and view all the answers

What can be inferred about the relationship between disease and symptoms?

<p>Some diseases can be present without showing any symptoms. (A)</p> Signup and view all the answers

What percentage of people reportedly have at least one symptom every week?

<p>About 90%. (A)</p> Signup and view all the answers

What psychological and social aspects affect the perception of physical symptoms?

<p>Cultural beliefs can shape how symptoms are experienced. (C)</p> Signup and view all the answers

Why is early screening for diseases emphasized in the context of symptoms?

<p>Many people may have diseases without realizing it. (C)</p> Signup and view all the answers

What challenge is often faced regarding the nature of physical symptoms?

<p>Recognizing the psychological origins of symptoms. (D)</p> Signup and view all the answers

What is the primary function of nociceptors?

<p>Respond to noxious stimuli and tissue damage (A)</p> Signup and view all the answers

What type of nerve fibers are associated with sharp, localized pain?

<p>A delta fibers (A)</p> Signup and view all the answers

Which stage of pain processing involves converting noxious stimuli into electrical signals?

<p>Transduction (B)</p> Signup and view all the answers

Congenital analgesia leads to individuals often failing to recognize which of the following?

<p>Pain from injuries or illnesses (D)</p> Signup and view all the answers

What is the definition of nociception?

<p>The encoding of impending or actual tissue damage (B)</p> Signup and view all the answers

What characterizes Somatic Symptom Disorder?

<p>Excessive time and energy devoted to symptoms (C)</p> Signup and view all the answers

What is an essential requirement for the diagnosis of Somatic Symptom Disorder?

<p>Presence of symptoms for 6 months or more (B)</p> Signup and view all the answers

Which of the following terms describes difficulty in identifying feelings and linking them to physical symptoms?

<p>Alexithymia (D)</p> Signup and view all the answers

What is NOT a common outcome of undergoing excessive medical testing in Somatic Symptom Disorder?

<p>Reduction in overall anxiety about health (A)</p> Signup and view all the answers

Which statement accurately describes the nature of symptoms in Somatic Symptom Disorder?

<p>Symptoms can appear without any apparent underlying cause (B)</p> Signup and view all the answers

What is a significant challenge in treating Somatic Symptom Disorder?

<p>Symptoms are wrongly attributed to the disease (C)</p> Signup and view all the answers

What role does acute pain play in the context of health?

<p>It serves as a warning that something may be wrong (A)</p> Signup and view all the answers

Individuals with Congenital Analgesia are characterized by what?

<p>Inability to experience physical pain (C)</p> Signup and view all the answers

Flashcards

Gate Control Theory of Pain

A biopsychosocial model of pain, proposing a hypothetical 'gate' in the spinal cord that modulates pain signals based on both bottom-up (sensory) and top-down (psychological) input.

Pain Modulation

An extra step in the biopsychosocial view of pain, where psychological factors (emotions, thoughts, attention) influence pain perception and severity.

Biomedical View of Pain

A simplified model of pain that solely associates pain severity with the amount of tissue damage.

Psychological Factors in Pain

Emotions, thoughts, and attention significantly influence how much pain is felt, going beyond the injured tissue.

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Acute Pain

Pain that typically arises from a specific injury or disease process.

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Descending Messages

Brain-initiated signals that modulate the perception of pain.

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Ascending Messages

Sensory signals from the periphery (body) that send pain information to the brain.

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Perception of Pain

A conscious experience influenced by sensory input, motivation, emotion, and cognitive factors.

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Persistent Somatic Symptoms (PSS)

Physical symptoms experienced 'in the body' that are subjective, potentially having objective signs, and may or may not have an identifiable medical cause.

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Conversion Disorder

An extreme case of PSS characterized by neurological symptoms that seem to be triggered by underlying stress, showcasing the mind's impact on the body.

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Symptom

A departure from normal function or feeling, noticed by a patient, potentially reflecting a physiological disturbance or disease.

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Biomedical Model of Illness

The idea that a disease has an underlying pathology that causes symptoms.

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Disease ≠ Symptoms

Having a disease doesn't necessarily mean experiencing symptoms, and experiencing symptoms doesn't always mean you have a disease.

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Symptom ≠ Disease

Symptoms are more common than diseases; many people experience symptoms without having a disease.

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Screening Importance

The importance of checking for diseases even when symptoms are absent.

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Psychological and social factors

Psychological and social processes play a role in how people perceive and experience physical symptoms.

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Self-medicating

Treating symptoms without professional medical advice.

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Symptom reporting

Describing physical sensations and experiences.

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Organic illness

Illness with physical cause evident by a biological marker.

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Attention to internal sensations

Focusing on bodily signals or symptoms.

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Competition of Cues

Attention divided between internal and external stimuli.

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Illness schema

Mental representation of a particular illness.

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Schema-guided search

Looking for symptoms based on an illness schema.

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Medical visit reason

The top reason most patients visit a doctor is experiencing symptoms.

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Fictitious Enzyme Deficiency

A condition where participants were given a false diagnosis of a pancreatic enzyme deficiency (TAA deficiency), causing them to experience more symptoms, like headache, diarrhea, and back pain.

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Symptom reporting & negative affect

People with higher levels of negative emotions (anxiety, depression, anger) report more physical symptoms, regardless of whether they have a pre-existing condition.

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Somatization

The experience of negative emotions directly resulting in physical symptoms.

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Negative attentional bias

A tendency to focus on negative information and symptoms in a negative mood.

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Negative Mood & Memory

Negative emotions increase the likelihood of recalling negative memories and symptoms.

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Nociception

The nervous system's way of processing potential or real tissue damage.

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Pain

The subjective experience of discomfort, harm, or injury.

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C-fibers

Small, unmyelinated nerve fibers that carry slow, dull, or burning pain signals.

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Aδ-fibers

Large, myelinated nerve fibers that carry fast, localized, sharp pain signals.

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Transduction

The process of converting noxious stimuli into electrical signals.

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Somatic Symptom Disorder

Excessive focus on physical symptoms, causing significant distress and impacting daily life.

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Symptoms in Somatic Symptom Disorder

Experiencing physical symptoms that are real but disproportionate and persistent.

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Alexithymia

Difficulty identifying and describing emotions; inability to link emotions to physical sensations.

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Diagnosis of Exclusion

A diagnosis made when no other medical cause can explain the symptoms.

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Impact of Somatic Symptom Disorder

Financial strain, emotional distress, and difficulties with treatment due to the presumed medical basis.

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Pain (Persistent)

Chronic pain, lasting beyond the expected healing time, with possible psychological contributors.

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Congenital Analgesia

A rare condition where individuals don't experience pain.

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Negative Mood & Self-Focus

Increased internal focus on oneself, leading to noticing symptoms more intensely during negative moods.

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Study Notes

Persistent Somatic Symptoms

  • Physical symptoms can be subjective ('in the body') or objective ('signs')
  • Symptoms may or may not be explained by a medical condition or pathology
  • Conversion disorder is an extreme case of PSS, where a person's body responds to stress by having unconscious symptoms.
  • An example is Holly Longford, who lost her ability to speak and walk suddenly after a netball collision.

Case Study: Conversion Disorder

  • Conversion disorder: Body's response to underlying stress; a person's mind exerts control over the body.
  • Holly Longford lost the ability to speak and walk after a netball collision.
  • Her tests were negative for any physical explanations.

Biomedical Model of Illness

  • Underlying disease/pathology causes illness + symptoms
  • Symptoms indicate the presence of a disease
  • Sometimes symptoms occur without a diagnosable disease

Disease vs Symptoms

  • Symptoms occur more frequently than diseases.
  • 90% of people experience at least one symptom each week.
  • Psychological and social factors influence how people perceive symptoms.

Common Symptoms and Diseases

  • Zika virus (80% report symptoms)
  • Covid (80% contract, 90% asymptomatic)
  • Human Papillomavirus (HPV) (80% contract 90% asymptomatic)
  • Genital Herpes (25% US adults, 75-90% asymptomatic)
  • High blood pressure/cholesterol
  • Early-stage cancers

Responding to Everyday Symptoms

  • Self-medication
  • Asking others or using online search engines
  • Rest
  • Seeking medical help

Most Symptoms Are Unexplained

  • A study found that around half of all doctor visits are due to 14 common symptoms.
  • Only 10-15% of those with symptoms have a demonstrable organic cause.

Psychological Influences on Reporting Symptoms

  • Attention
  • Emotions
  • Beliefs/expectations

Attention to Internal Sensations

  • Attention is often drawn towards internal sensations when experiencing negative affect, which makes a person more likely to notice physical symptoms
  • Symptoms of diseases are amplified in people focusing on them. -Example: people experience symptoms more while studying for exams, or listening to boring lectures than when enjoying recreational activities.

Somatic Symptom Disorder

  • Excessive thoughts, feelings, or behaviors related to somatic symptoms.
  • Disproportionate concern over the seriousness of symptoms.
  • Persistent anxiety about symptoms.

Pain

  • Distinct physical symptoms, persisting after biological healing, causes or potential tissue damage.
  • Life with pain:
    • Some individuals do not experience pain.
    • Pain (especially acute) signals potential or actual tissue damage, alerting the individual of a need for a lifestyle change.

Genetic Mutations

  • Some genetic mutations result in neurons not sending pain signals, resulting in the individual not experiencing pain.

Pain Processing

  • Nervous system process of encoding impending or actual tissue damage leading to the physical sensation of pain.
  • The subjective experience of actual or impending harm.

Pain Stages

  • Transduction
  • Transmission
  • Perception
  • Modulation

Transduction

  • Starts at nerve endings (nociceptors) - tissue damage and inflammation initiates the pain signal process.
  • Two main fiber types transmit the pain signals: C and A-delta fibres - a larger and myelinated fibre (A-delta) transmits fast, sharp pain signals quickly, while a smaller unmyelinated C fibre transmits slow, dull pain signals more gradually.

Transmission

  • Nociceptors send signals through the spinal cord to the brainstem.
  • The brainstem distributes the signal across the brain (limbic forebrain= emotional response, Primary Sensory Cortex: location of pain, and Cortical Association Areas= Interpretation of pain).

Perception

  • Conscious awareness of all dimensions of pain stimuli
  • Biological, emotional, social, mental, and behavioural factors combine to create the complete pain experience.

Modulation

  • Extra step in biopsychosocial view.
  • Involves psychological factors affecting biological ones.
  • Can be excitatory (increase pain) or inhibitory (reduce pain).

Biological Processes of Pain

  • Peripheral Sensitization (Acute Pain) - Nociceptors have a reduced threshold, leading to an amplified pain response following injury or tissue damage; this may occur through inflammation.
  • Central Sensitization (Chronic Pain) - Increase in pain thresholds and amplification of pain signals
  • Cortical Reorganization (Chronic Pain) - Changes in the somatosensory cortex as a response to repeated pain signals from chronic injury or disease.

Treating Chronic Pain

  • Cognitive Behavioural Therapy (CBT) can help.
  • Education on processes involved in pain, helping to effectively manage emotions.
  • Restructuring unhelpful thoughts about pain can reduce pain intensity.

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