Chapter 6 somatization only

1. Part 1: Somatoform Disorders Somatoform Features and Epidemiology Somatoform Disorders: Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment

2. Normal Optimism regarding health. No concerns about health. Attending regular, preventive checkups with a physician. Emotions Cognitions Behaviors SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology

3. Normal Mild Mild physical arousal and feeling of uncertainty about certain physical symptoms. Some worry about health, perhaps after reading a certain magazine article. Checking physical body a bit more or scheduling one unnecessary physician visit. Emotions Cognitions Behaviors SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology

4. Normal Mild Moderate Moderate physical arousal and greateruncertainty about one’s health. Strong worry about aches, pains, possibledisease, or appearance. Fleeting thoughts about death or dying. Scheduling more doctor visits but generally feeling relieved after each one. Emotions Cognitions Behaviors SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology

5. Normal Mild Moderate Somatoform Disorder – Less Severe Intense physical arousal misinterpreted as a signor symptom of some terrible physical disorder. Intense worry about physical state or appearance. Intense fear that one has a serious disease. Common thoughts about death or dying. Regular doctor-shopping and requests for extensive and repetitive medical tests with little or no relief. Checking body constantly for symptoms. Emotions Cognitions Behaviors SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology

6. Normal Mild Moderate Somatoform Disorder – Less Severe Somatoform Disorder – More Severe Extreme physical arousal with great trouble concentrating on anything other than physical state or appearance. Extreme worry about physical state or appearance. Extreme fear of having a serious potential disease. Frequent thoughts about death and dying. Avoidance of many social and work activities.Scheduling regular surgeries, attending specializedclinics, or searching for exotic diseases. Emotions Cognitions Behaviors SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology

7. Essential Features Disorder Somatization disorder Pattern of recurring, multiple, clinically significant somatic complaints. SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology

8. Essential Features Disorder Conversion disorder Presence of symptoms or deficits affecting voluntary motor or sensory function that suggest a neurological or other general medical condition. SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology

9. Essential Features Disorder Pain disorder Pain is the predominant focus of clinical presentation and is of sufficient severity to warrant clinical attention. SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology

10. Essential Features Disorder Hypochondriasis Preoccupation with fears of having, or the idea that one has, a serious disease based on a misinterpretation of one or more bodily signs or symptoms. SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology

11. Essential Features Disorder Body dysmorphic disorder Preoccupation with a defect in appearance. SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology

12. 0.4% Somatization disorder 0.3% Conversion disorder 0.6% Pain disorder 4.8% Hypochondriasis 0.7% Body dysmorphic disorder Prevalence Rates of Major Somatoform Disorders SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology

13. Prefrontal cortex Cingulate cortex Hypothalamus Somatosensory cortex Amygdala SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology

14. Illness behavior and reinforcement Cognitive factors Cultural factors SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology

15. Misperception of symptoms Feelings of uncontrollability Over attention to minor bodily changes SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology

16. Acknowledge that the symptoms are real and distressing to the client. Accept the need to address somatic complaints. Avoid attempts to convince the client of a psychological cause for symptoms. Continue to gently refer to the role of tension and stress. Discuss various topics, not just symptoms. Schedule regular visits not predicated on complaints. Develop goals in conjunction with the client. Discuss how symptoms limit a client’s functioning instead of what might be physically wrong. Maintain empathy with a client but set limits on behavior. SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology

17. Antidepressant Medication SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology

18. Somatosensory Amplification Scale I am often aware of various things happening within my body. When I bruise myself, it stays noticeable for a long time. I can sometimes feel the blood flowing in my body. I can sometimes hear my pulse or my heartbeat throbbing in my ear. I am quick to sense the hunger contractions in my stomach. Even something minor, like an insect bite or a splinter, really bothers me. I have a low tolerance for pain. SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology

19. Predictors of chronic somatoform disorders Female gender Low socioeconomic status Substance use Eating disorders and depression Severe cognitive distortions Trauma SomatoformDisorders:Causes and Prevention Somatoform Disorders: Assessment and Treatment Dissociative Disorders: Features and Epidemiology Dissociative Disorders: Causes and Prevention Dissociative Disorders: Assessment and Treatment Somatoform Features and Epidemiology