Problem 1 - Abnormal Psychology: An Integrative Approach

Question

Diagnose the somatic symptom and related disorders described here by choosing one of the following: (a) illness anxiety disorder (b) somatic symptom disorder, (c) conversion disorder. Emily constantly worries about her health. She has been to numerous doctors for her concerns about cancer and other serious diseases-even though she doesn't report current notable physical symptoms-only to be reassured of her well-being. Emily's anxiousness is exacerbated by each small ailment (for example, mild headaches or stomach pains) that she considers to be indications of a major illness.

Step-by-Step Solution

Answer

Emily is likely experiencing illness anxiety disorder.

Step 1: Identify Key Symptoms

Emily is noted to constantly worry about her health without notable physical symptoms. She frequently visits doctors, seeks reassurance, but remains anxious. Her anxiety about having a serious illness persists despite medical reassurances.

Step 2: Compare with Disorder Criteria

Illness anxiety disorder is characterized by preoccupation with having a serious illness despite lack of substantial symptoms. Somatic symptom disorder involves actual significant somatic complaints, while conversion disorder involves neurological symptoms without a diagnosable medical cause.

Step 3: Match Symptoms to Diagnosis

Emily's symptoms align with illness anxiety disorder as she displays a preoccupation with having a serious illness, lacks significant somatic symptoms, and her concerns are not relieved by medical assurance, which is central to this disorder.

Key Concepts

Illness Anxiety Disorder

Illness Anxiety Disorder (IAD) is a condition where individuals intensely worry about having a severe health condition, even when there is little or no physical evidence to support these fears. People with IAD frequently interpret normal or mild bodily sensations as signs of a severe illness.
Despite seeing numerous doctors and receiving reassurances about their health, individuals may continue to feel anxious, which can take a toll on their mental well-being.
This disorder was previously known as hypochondriasis and is part of the "somatic symptom and related disorders" category in the DSM-5. It is important for those with IAD to receive appropriate psychological treatment as it can significantly impact daily life quality.

• **Behaviors** may include frequent doctor visits or excessive medical tests in search for diagnosis.
• **Cognitive Processes** involve constant checking of one's body for signs of illness.
• **Emotional Reactions** often include anxiety and stress over small or nonexistent symptoms.

Recognition and therapy are crucial, as the persistent fear and anxiety are often resistant to reassurance.

Somatic Symptom Disorder

Somatic Symptom Disorder (SSD) involves having a significant focus on physical symptoms, such as pain or fatigue, to the point where these symptoms cause major emotional distress and impair daily functioning. Unlike Illness Anxiety Disorder, the physical symptoms are present and can be overwhelming.
Individuals focus excessively and persistently on these symptoms that they might be disproportionate to the original physical issue, possibly reacting with heightened anxiety.
This disorder highlights the intricate interplay between the mental and physical health, where psychological factors can exacerbate physical symptoms.

• **Physical Symptoms** need to be significant and can vary widely in nature.
• **Emotional Distress** centers around the severity of the symptoms rather than the fear of illness itself.
• **Diagnosis** requires these symptoms to affect daily activities negatively and persist over a long period.

Treatment might involve psychotherapy and medications to manage symptoms, focusing on improving the quality of life and managing stress.

Conversion Disorder

Conversion Disorder, also known as functional neurological symptom disorder, is marked by neurological symptoms such as paralysis, blindness, or other functional impairments, which cannot be explained by a medical condition.
While these symptoms can be life-altering, they represent a genuine problem from the patient's perspective, even though they lack physiological basis.
Conversion Disorder is a striking example of how psychological factors can manifest as physical symptoms that disrupt normal functionality.

• **Neurological Symptoms** are diverse, affecting movement, senses, or speech.
• **Lack of Physical Cause** separates it from other similar conditions.
• **Psychological Trigger** may include stress or trauma, leading to the physical symptoms.

Management often focuses on psychotherapy, aiming to understand and address underlying psychological issues. Physical rehabilitation may also be important in helping patients manage their condition effectively.