Midterm 2 Psych 300 Ch. 6 PDF

# Disorders of obsessions & preoccupations (chap 6) ## Somatic Symptom and Related Disorders - Be able to distinguish Factitious Disorder, Malingering & Somatic Symptom Disorders - Be able to distinguish between various somatic symptoms disorders - Be aware of clinical picture in various disorders...

# Disorders of obsessions & preoccupations (chap 6) ## Somatic Symptom and Related Disorders - Be able to distinguish Factitious Disorder, Malingering & Somatic Symptom Disorders - Be able to distinguish between various somatic symptoms disorders - Be aware of clinical picture in various disorders - Be familiar with models & treatments ### Critical conceptual distinction - **Malingering:** deliberate faking - Usually some financial/legal gain from faking - **Factitious disorder:** deliberate faking for no apparent gain other than attention - **Somatic symptom disorder:** genuine belief ## Somatic Symptom Disorders - Typically present first in non-psychiatric settings - May occur in as many as 17-20% of individuals seeking hospital or outpatient medical treatment - Often comorbid with PTSD, depression - Further exacerbate pain and pain beliefs - Very difficult to diagnose - Pain and some physical symptoms inherently subjective phenomenon - DSM places emphasis on presentation, interpretation and impairment rather than pain - **Somatic symptom disorder (per se)** - Somatic symptoms are distressing or result in disruption of daily life - Excessive thoughts, feelings and behaviours related to symptoms - Disproportionate - High anxiety - Excessive time devoted to health - Focus on symptoms themselves - Multiple vague symptoms - Chronic complaints and person's life begins to revolve around symptoms - Predominant complaint: "I'm in pain" but vague, gets worse with events ### Clinical picture - Suffering is "authentic" - Often fuels avoidance - Catastrophizing thoughts - High level of medical care utilisation - Usual medical care does not alleviate symptoms - Explanatory therapy (detailed explanation and reassurance) can be effective for mild cases - Prevalence: estimated 5-7% in general population - Onset: predictors are body checking, catastrophizing beliefs about pain, negative affect, activity avoidance (which causes weakening of muscles = more physical sensations) - Culture: affects how people express their somatic symptoms - idioms of distress can vary (e.g. "my body has too much heat", "burning in head") ### Impairment - Work impairment - E.g. fired because they cannot go to work - Substance abuse - Prescription opioids - Cannabis - Alcohol - Can become housebound - Take on role of an invalid