SLK 310 Chapter 6
Erin Polyblank
CHAPTER 6- SOMATIC SYMPTOM AND
RELATED DISORDERS
Learning outcomes:
Engage in innovative and Describe problems operationally to study them
integrative thinking and empirically
problem solving:
Describe applications that Correctly identify antecedents and consequences of behaviour
employ discipline-based and mental processes.
problem solving: Describe examples of relevant and practical applications of
psychological principles to everyday life.
Somatic symptom disorder: Disorder involving extreme and long-lasting
focus on multiple physical symptoms, for which no medical cause is evident,
associated with distress and maladaptive use of health care resources.
o Formerly known as somatisation disorder and has incorporated the
formerly separate diagnostic entity of pain disorder.
o Historically known as Briquet's syndrome.
People with this problem, show a disproportionate response lasting at least
six months.
o They exaggerate the possible cause or consequences of fairly minor
somatic symptoms, become very anxious and constantly scan for
information about an illness, or avoid situations and behaviours they
believe are related to illness.
o At times, the medical cause of the presenting physical symptoms is known,
but the emotional distress or level of impairment in response to this
symptom is clearly excessive and may even make the condition worse.
Dissociative disorder: Disorder in which individuals feel detached from
themselves or their surroundings, and reality, experience and identity may
disintegrate.
o Dissociation involves the failure of integration of the mental modules that
constitute the totality of human experience.
1
,SLK 310 Chapter 6
Erin Polyblank
o Sigmund Freud (1894-1962) suggested a condition called conversion
hysteria, where unexplained physical symptoms indicated the conversion
of unconscious emotional conflicts into a more acceptable form.
o The term neurosis suggested a specific cause for certain disorders.
Neurotic disorders resulted from underlying anxiety caused by
unconscious conflicts, and the implementation of ego defence
mechanisms.
SOMATIC SYMPTOM AND RELATED DISORDERS
DSM-5 lists 5 basic somatic symptom and related disorders:
1. Somatic symptom disorder.
2. Illness anxiety disorder.
3. Psychological factors affecting medical condition.
4. Conversion disorder.
5. Factitious disorder.
Within these, individuals are pathologically concerned with the functioning of
their bodies.
SOMATIC SYMPTOM DISORDER
In 1859, Pierre Briquet, described patients who came to see him with
seemingly endless lists of somatic complaints for which he could find no
medical basis.
o Patients came back with the same complaints or a new list containing
slight variations.
For many years, this disorder was called Briquets syndrome.
The main emphasis of the somatic symptom disorder is linked to the person's
belief that they are suffering or will develop a serious illness/disease based on
the misinterpretation of the symptom picture they are carrying, which causes
them extreme anxiety, worry and distress.
People with somatic symptom disorder do not always feel the urgency to act
but continually feel weak and ill, and they avoid exercising, thinking it will
make them worse.
‘Sick role’ was introduced by Talcott Parsons in the 1950s.
2
, SLK 310 Chapter 6
Erin Polyblank
o It suggested that a person who has failed ill is not only physically ill but has
adopted a social role of being sick with its attendant rights and obligations
based on the prevailing social norms.
o The rights are twofold:
1. The sick person is not responsible for the sickness.
2. The sick person is exempt from certain social responsibilities.
o The sick person has an obligation to try to get well and to co-operate with
treatment efforts.
Another common example of a somatic symptom disorder would be the
experience of severe pain in which psychological factors play a major role in
maintaining or exacerbating the pain, whether there is a clear physical reason
for the pain or not.
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 behavioural factors, particularly anxiety and distress, are compounding the
severity and impairment associated with the physical symptoms.
o The emphasis in DSM-5 highlights the psychological experiences of anxiety
and distress focused on somatic symptoms as the target for treatment.
o An important feature of these physical symptoms, such as pain, is that it is
real - whether there are clear physical reasons for the pain or not.
Diagnostic criteria for somatic symptom disorder:
A) One or more somatic symptoms that are distressing and/or result in significant
disruption of daily life.
B) Excessive thoughts, feelings and behaviours related to the somatic symptoms or
associated health concerns as manifested by at least one of the following:
1. Disproportionate and persistent thoughts about the seriousness of one's
symptoms.
2. High level of health-related anxiety.
3. Excessive time and energy devoted to these symptoms or health concerns.
C) Although any one symptom may not be continuously present, the state of being
symptomatic is persistent (typically more than six months).
3
Erin Polyblank
CHAPTER 6- SOMATIC SYMPTOM AND
RELATED DISORDERS
Learning outcomes:
Engage in innovative and Describe problems operationally to study them
integrative thinking and empirically
problem solving:
Describe applications that Correctly identify antecedents and consequences of behaviour
employ discipline-based and mental processes.
problem solving: Describe examples of relevant and practical applications of
psychological principles to everyday life.
Somatic symptom disorder: Disorder involving extreme and long-lasting
focus on multiple physical symptoms, for which no medical cause is evident,
associated with distress and maladaptive use of health care resources.
o Formerly known as somatisation disorder and has incorporated the
formerly separate diagnostic entity of pain disorder.
o Historically known as Briquet's syndrome.
People with this problem, show a disproportionate response lasting at least
six months.
o They exaggerate the possible cause or consequences of fairly minor
somatic symptoms, become very anxious and constantly scan for
information about an illness, or avoid situations and behaviours they
believe are related to illness.
o At times, the medical cause of the presenting physical symptoms is known,
but the emotional distress or level of impairment in response to this
symptom is clearly excessive and may even make the condition worse.
Dissociative disorder: Disorder in which individuals feel detached from
themselves or their surroundings, and reality, experience and identity may
disintegrate.
o Dissociation involves the failure of integration of the mental modules that
constitute the totality of human experience.
1
,SLK 310 Chapter 6
Erin Polyblank
o Sigmund Freud (1894-1962) suggested a condition called conversion
hysteria, where unexplained physical symptoms indicated the conversion
of unconscious emotional conflicts into a more acceptable form.
o The term neurosis suggested a specific cause for certain disorders.
Neurotic disorders resulted from underlying anxiety caused by
unconscious conflicts, and the implementation of ego defence
mechanisms.
SOMATIC SYMPTOM AND RELATED DISORDERS
DSM-5 lists 5 basic somatic symptom and related disorders:
1. Somatic symptom disorder.
2. Illness anxiety disorder.
3. Psychological factors affecting medical condition.
4. Conversion disorder.
5. Factitious disorder.
Within these, individuals are pathologically concerned with the functioning of
their bodies.
SOMATIC SYMPTOM DISORDER
In 1859, Pierre Briquet, described patients who came to see him with
seemingly endless lists of somatic complaints for which he could find no
medical basis.
o Patients came back with the same complaints or a new list containing
slight variations.
For many years, this disorder was called Briquets syndrome.
The main emphasis of the somatic symptom disorder is linked to the person's
belief that they are suffering or will develop a serious illness/disease based on
the misinterpretation of the symptom picture they are carrying, which causes
them extreme anxiety, worry and distress.
People with somatic symptom disorder do not always feel the urgency to act
but continually feel weak and ill, and they avoid exercising, thinking it will
make them worse.
‘Sick role’ was introduced by Talcott Parsons in the 1950s.
2
, SLK 310 Chapter 6
Erin Polyblank
o It suggested that a person who has failed ill is not only physically ill but has
adopted a social role of being sick with its attendant rights and obligations
based on the prevailing social norms.
o The rights are twofold:
1. The sick person is not responsible for the sickness.
2. The sick person is exempt from certain social responsibilities.
o The sick person has an obligation to try to get well and to co-operate with
treatment efforts.
Another common example of a somatic symptom disorder would be the
experience of severe pain in which psychological factors play a major role in
maintaining or exacerbating the pain, whether there is a clear physical reason
for the pain or not.
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 behavioural factors, particularly anxiety and distress, are compounding the
severity and impairment associated with the physical symptoms.
o The emphasis in DSM-5 highlights the psychological experiences of anxiety
and distress focused on somatic symptoms as the target for treatment.
o An important feature of these physical symptoms, such as pain, is that it is
real - whether there are clear physical reasons for the pain or not.
Diagnostic criteria for somatic symptom disorder:
A) One or more somatic symptoms that are distressing and/or result in significant
disruption of daily life.
B) Excessive thoughts, feelings and behaviours related to the somatic symptoms or
associated health concerns as manifested by at least one of the following:
1. Disproportionate and persistent thoughts about the seriousness of one's
symptoms.
2. High level of health-related anxiety.
3. Excessive time and energy devoted to these symptoms or health concerns.
C) Although any one symptom may not be continuously present, the state of being
symptomatic is persistent (typically more than six months).
3
