Chapter 9

Primary gain

(defense mechanism) Ppl derive primary gain when their bodily (somatic) symptoms keep their internal conflicts out of awareness (Freud's psychodynamic view of conversion disorders & somatic symptoms disorder)

secondary gain

(defense mechanism) Ppl derive secondary gain when their bodily (somatic) symptoms further enable them to avoid unpleasant activities or to receive sympathy from others (Freud's psychodynamic view of conversion disorders & somatic symptoms disorder)

Illness Anxiety Disorder

(previously known as hypochondriasis) chronically anxious about their health and are convinced that they have or are developing a serious medical illness, despite the absence of somatic symptoms repeatedly check their body for signs of illness and misinterpret various bodily events as signs of serious medical problems Absence of substantial somatic symptoms Fewer than 1% of all ppl experience the disorder

conversion disorder (functional neurological symptom disorder)

(type of somatic disorder) - Neurological-like symptoms (ex: paralysis, blindness, or loss of feeling) inconsistent w/ known neurological or medical disease - Usually beginning in late childhood and young adulthood; often appears suddenly during extreme stress - Not consciously wanted or purposely produced - rare (occurs in 1-5 of every 500 persons)

checklist of somatic symptom disorder

- At least one upsetting or repeatedly disruptive physical (somatic) symptom - An unreasonable number of thoughts, feelings, and behaviors - Physical symptoms usually continue to some degree for more than 6 months

Commonality btw conversion disorder and somatic symptom disorder

- Both may occur in response to severe stress - Both have traditionally been viewed as forms of escape from stress - A number of individuals suffer from both types of disorders - Theorists and clinicians often explain and treat the two groups of disorders in similar ways

factitious disorder: imposed on another

- False creation of physical or psychological symptoms, or deceptive production of injury or disease, in another person, even w/o external rewards - Presentation of another person (victim) as ill, damaged, or hurt - Munchausen syndrome by proxy

Factitious disorder: imposed on self

- False creation of physical psychological symptoms, or deceptive production of injury or disease even w/o external rewards - Presentation of oneself as ill, damaged, or hurt (Usually go to the extremes to create appearance of illness (taking medications secretly, inject drugs to cause bleeding/ infections) - Munchausen syndrome

somatic symptom disorder: predominant pain pattern

- Person's primary bodily problem is the experience of pain - When the primary feature of somatic symptom disorder is pain, person is said to have a predominant pain pattern Key symptom - Pain source known or unknown and the concerns and disruptions produced by the pain are disproportionate to its severity and seriousness - May develop after an accident or illness that initially caused genuine pain - Pattern fairly common - Begin at any age and women seem more likely to experience it - Often develops after an accident or during an illness that has caused genuine pain, after which the pain takes on a life of its own

Conversion Disorder & Somatic Symptom Disorder: multicultural view

- Some western clinicians don't advocate excessive focus on somatic symptom disorders included in DSM-5; others see this as a western bias - Formation of somatic complaints is the norm in many non-western cultures - bodily and psychological reactions to life events are often influenced by one's culture

Psychoneuroimmunology

- area of study that ties stress and illness to the body's immune system - examnies how stressful events result in viral or bacterial infection

Most stressful life events for undergrad students using stress questionnaire

1. Death (family member/friend) 2. Had a lot of tests 3. Finals week 4. Applying to grad school 5. Victim of a crime 6. Assignments in all classes due same day 7. Breaking up w/ boyfriend/girlfriend 8. Found out boy/girlfriend cheated on you 9. Lots of deadlines to meet 10. Property stolen 11. You have a hard upcoming week 12. Went into a test unprepared

Most stressful life events for adults using the social readjustment rating scale

1. Death of spouse (score of 100 life change units (LCU)) 2. Divorce 3. Marital separation 4. Jail term 5. Death of close family member 6. Personal injury or illness 7. Marriage 8. Fired at work 9. Marital reconciliation 10. Retirement (45 LCU) 11. Change in health of family member 12. Pregnancy

somatic symptom disorder checklist

1. Person experiences at least one upsetting or repeatedly disruptive physical (somatic) symptom 2. Person experiences an unreasonable number of thoughts, feelings, and behavior regarding the nature or implications of the physical symptoms, including one of the following: - Repeated, excessive thoughts about their seriousness - Continual high anxiety about their nature or health implications - Disproportionate amounts of time and energy spent on the symptoms or their health implications 3. Physical symptoms usually continue to some degree for more than 6 months

iIlness disorder checklist

1. Person is preoccupied w/ thoughts or getting a significant illness. In reality, person has no or, at most, mild somatic symptoms 2. Person has easily triggered high anxiety about health 3. Person displays Unduly high number of health-related behaviors (keeps focusing on body) or dysfunctional health-avoidance behaviors (avoids doctors) 4. Concerns continue to some degree for at least 6 months

Psychophysiological (psychosomatic) disorders: psychological factors affecting other medical conditions - checklist

1. Presence of a medical condition 2. Psychological factors negatively affect the medical condition by: a) Affect the course of the medical condition b) Provide obstacles to the treatment of medical condition c) Pose new health risks d) Trigger or worsen the medical condition

Checklist of Conversion Disorder

1. Presence of at least one symptom or deficit that affects voluntary or sensory function 2. Symptoms are found to be inconsistent w/ known neurological or medical disease 3. Significant distress or impairment

migraine headaches

A very severe headache (often nearly paralyzing) that occurs on one side of the head, often preceded by a warning sensation and sometimes accompanied by dizziness, nausea, or vomiting. Migraine headaches are thought by some medical theorists to develop in two phases: (1) blood vessels in the brain narrow so that the flow of blood to parts of the brain is reduced, and (2) the same blood vessels later expand so that blood flows through them rapidly, stimulating many neuron endings and causing pain

Psychological factors affecting other medical conditions: sociocultural factors (multicultural perspective)

Adverse social conditions that produce stress trigger and interact w/ biological and psychological factors such as poverty and dangerous environment, discrimination, health problems, and genetic predispositions

Psychological factors affecting other medical conditions - sociocultural factor: discrimination

African Americans have more health problems than do non-Hispanic white Americans. African Americans have, for example, higher rates of hypertension, diabetes, and asthma. also more likely to die of heart disease, stroke, HIV/AIDS, and COVID-19. This may be economically related or a physiological predisposition that increases their risk of developing high blood pressure or repeated experiences of racial discrimination constitute special stressors that raise blood pressure in African Americans. the more discrimination people experience over a 1-year period, the greater their daily rise in blood pressure, and the more discrimination African Americans experience over the course of their lives, the more likely they are to have high blood pressure in middle age and old age. despite such disadvantages, the health of Hispanic Americans is, on average, at least as good as (and often better than) that of both non-Hispanic white Americans and African Americans

How can physician's distinguish btw a conversion disorder and a genuine medical ailment

Because conversion disorders are so similar to genuine medical ailments, physicians may rely on oddities in the patient's medical picture to help distinguish the two - The symptoms of a conversion disorder, for example, may be at odds w/ the way the nervous system is known to work - physical effects of a conversion disorder may also differ from those of the corresponding medical problem

traditional psychophysiological disorders

Before the 1970s, clinicians believed that only a limited number of illnesses were psychophysiological: ulcers, asthma, insomnia, chronic headaches, hyptertension, coronary heart disease

coronary heart disease

Caused by a blocking of the coronary arteries, the blood vessels that surround the heart and are responsible for carrying oxygen to the heart muscle term actually refers to several problems, including blockage of the coronary arteries and myocardial infarction (a "heart attack"). The majority of all cases of this disease are related to an interaction of psychosocial factors, such as job stress or high levels of anger or depression, and physiological factors, such as high cholesterol, obesity, hypertension, smoking, or lack of exercise

psychological factors in the development of psychophysiological disorders

Certain Needs, attitudes, emotions, personality, or coping styles may cause ppl to overreact repeatedly to stressors Overreaction increases their chances of developing psychophysiological disorders

links to factitious disorder

Childhood trauma, such as emotional, physical or sexual abuse A serious illness during childhood Loss of a loved one through death, illness or abandonment Past experiences during a time of sickness and the attention it brought A poor sense of identity or self-esteem Personality disorders Depression Desire to be associated w/ doctors or medical centers Employment as nurse, lab technician, or aide Extensive medical treatment in childhood Poor social support or relationships and little family life Gruge against medical profession

treatments for factitious disorder

Clinicians have been unable to develop dependably effective treatments for this disorder Psychotherapists and medical practitioners often report feelings of annoyance or anger toward ppl with factitious disorder, feeling that these ppl are wasting their time; yet ppl w/ this diroder feel they have no control over the problem and often experience great distress

biological factors in the development of psychophysiological disorders

Defects in the ANS may contribute to the development of psychophysiological disorders & Other more specific biological problems also contribute (weak gastrointestinal system, people may display favored biological reactions that raise their chances of developing psychophysiological disorders.)

characteristics of Psychophysiological (psychosomatic) disorders: psychological factors affecting other medical conditions

Dif from factitious, conversion, and illness anxiety disorders that are accounted for primarily by psychological factors Involve significant medical symptoms and conditions Often result in serious physical damage

Contemporary psychodynamic theories of conversion disorder and somatic symptoms disorder

Disagree w/ fraud on many points Agree that patients carry unconscious conflicts from childhood, causing anxiety Anxiety turns into physical pain

Psychophysiological (psychosomatic) disorders: psychological factors affecting other medical conditions

Disorders in which biological, psychological, and sociocultural factors interact to cause or worsen a physical illness; also known as psychological factors affecting other medical conditions

problems with the Social Adjustment rating scale

Doesn't consider particular stress reactions within specific populations. mainly sampled whites; ongoing life experiences often differ in key ways among dif races, members of minority groups and non-Hispanic white Americans differ in their stress reactions to various kinds of life events

Conversion Disorder & Somatic Symptom Disorder: Psychodynamic view (freud)

First psychodynamic theory of these two disorders Believed that hysterical disorders represented a conversion of underlying emotional conflicts into physical symptoms and concerns. Observed that most of his patients w/ hysterical disorders were women, freud centered his explanation of such disorders on the needs of girls during their phallic stage (age 3-5). At this stage, all girls develop a pattern of desires called the Electra complex. Freud believed that if a child's parents overreact to her sexual feelings — with strong punishments, for example — the Electra conflict will be unresolved and the child may reexperience sexual anxiety throughout her life. Whenever events trigger sexual feelings, she may feel an unconscious need to hide them from both herself and others. Freud concluded that some women hide their sexual feelings by unconsciously converting them into physical symptoms and concerns.

defects in the ANS that may contribute to the development of psychophysiological disorders

If one's ANS is stimulated too easily, for example, it may overreact to situations that most people find only mildly stressful, eventually damaging certain organs and causing a psychophysiological disorder.

Formation of somatic complaints is the norm in many non-western cultures

In such cultures, the formation of such complaints is viewed as a socially and medically correct — and less stigmatizing — reaction to life's stressors. Studies have found very high rates of stress-caused bodily symptoms in non-Western medical settings throughout the world, including those in China, Japan, and Arab countries People throughout Latin America seem to display the most somatic reactions. within the United States, Hispanic Americans display more somatic reactions in the face of stress than do other populations

Glove anesthesia

In this conversion symptom the entire hand, extending from the fingertips to the wrist, becomes numb (Real neurological damage is rarely as abrupt or evenly spread out)

somatic symptom disorder: somatization pattern

Individual experiences a large and varied number of bodily symptoms Long-lasting physical ailment w/ little/no physical basis; dramatic and exaggerated Ailments often include pain symptoms (headaches/chest pain), gastrointestinal symptoms (nausea/diarrhea), sexual symptoms (erectile or menstrual difficulties), and neurological-type symptoms (double vision or paralysis) Treatment sought from doctor to doctor prevalence : 4% Women more common than men Pattern often runs in families; as many as 20% of the close female relatives of women w/ the pattern also develop it Abuse and genetic links Also known as briquet's syndrome Pattern typically lasts for many years, fluctuating overtime but rarely disappearing Usually begins btw adolescence and young adulthood

ulcers

Lesions (holes) that form in the wall of the stomach or of the duodenum, resulting in burning sensations or pain in the stomach, occasional vomiting, and stomach bleeding. often are caused by an interaction of stress factors, such as environmental pressure or intense feelings of anger or anxiety and physiological factors, such as the bacteria H. pylori

Conversion Disorder & Somatic Symptom Disorder: Cognitive-behavioral view

Physical symptoms of disorder are rewarded and maintained thru reinforcement theorists point to somatic vigilance, rewards, and communication skills to help explain conversion and somatic symptom disorders.This view has not been widely tested and isn't supported by research

somatic symptoms disorder

Ppl become excessivley distressed, concerned and anxious about bodily symptoms that they are experiences and their lives are greatly disrupted by those symptoms - Persons's concerns are disproportionate to the seriousness of the bodily problems Symptoms last longer but less dramatic than those found in conversion disorder In some cases, somatic symptoms have no known cause; in others, the cause can be identified

causes of factitious disorder

Precise causes are not understood; Point to depression, unsupportive parental relationships during childhod, and extreme needs for attention and or social support that aren't otherwise available

causes of conversion and somatic symptoms disorders

Previously called hysterical disorders; this label was meant to convey the prevailing belief that excessive and uncontrolled emotions underlie the bodily symptoms found in these disorders. - Widely considered unique and in need of special explanation - Today's leading explanations come from the psychodynamic, cognitive-behavioral, and multicultural models; No explanation has received much research support, and poorly understood

Many therapists focus on the cause of the disorder (the trauma or anxiety tied to the physical symptoms of the somatic symptoms disorder & conversion disorder) and apply: insight

Psychodynamic therapists, for example, try to help those with somatic symptoms become conscious of and resolve their underlying fears, thus eliminating the need to convert anxiety into physical symptoms

people may display favored biological reactions that raise their chances of developing psychophysiological disorders, such as

Some individuals perspire in response to stress, others develop stomachaches, and still others have a rise in blood pressure. Research has indicated, for example, that some people are particularly likely to have temporary rises in blood pressure when stressed. It may be that they are prone to develop hypertension.

exposure and response prevention for illness anxiety disorder

The therapists repeatedly point out bodily variations to the clients while, at the same time, preventing them from seeking their usual medical attention. In addition, the cognitive-behavioral therapists guide the clients to identify, challenge, and change their beliefs about illness that are helping to maintain their disorder.

Therapists who focus on the physical symptoms of conversion disorder and somatic symptoms disorder use techniques such as: reinforcement

Therapists who take a reinforcement approach arrange for the removal of rewards for a client's "sickness" symptoms and an increase of rewards for healthy behaviors

Therapists who focus on the physical symptoms of conversion disorder and somatic symptoms disorder use techniques such as: Education

Those who employ education explain the disorder to patients, while also offering emotional support and hope that the physical symptoms may soon disappear

how is factitious disorder different than a conversion disorder

Unlike people with factitious disorder, those with conversion disorder do not consciously want or purposely produce their symptoms.

Conversion Disorder & Somatic Symptom Disorder: Treatment

Usually seek psychotherapy as last resort; they believe their problems are medical and at first reject suggestions to the contrary Eventually, many consent to psychotherapy, psychotropic drug therapy or both Many therapists focus on the cause of the disorder (the trauma or anxiety tied to the physical symptoms) and apply: insight, exposure, drug therapies Other therapists focus on the physical symptoms, using techniques such as: education, reinforcement, cognitive restructing

People who are affected by this disorder also have a medical condition a) Psychophysiological (psychosomatic) disorders: b) illness anxiety disorder c) conversion disorder

a

The view that conversion disorders and somatic symptoms disorder are explained by underlying emotional conflicts converted into physical symptoms and concerns are consistent with: a) psychodynamic view (freud) b) biological view c) sociocultural view d) cogntive-behavioral view

a

___ disorder affect men and women equally a) illness anxiety disorder b) conversion disorder c) somatic symptoms disorder

a

___ disorder is characterized by medically unexplained physical symptoms that affect voluntary motor or sensory functioning a) conversion disorder b) somatic symptom disorder c) illness anxiety disorder

a

cogntive-behavioral's focus on the role of rewards is similar to the psychodynamic's ___ a) notion of secondary gain b) notion of primary gain c) notion of electra's complex

a

during an argument, a man who has underlying fears about expressing anger may develop a conversion paralysis of the arm, thus preventing his feelings of rage from reaching consciousness. this exemplifies a) primary gain b) secondary gain

a

western bias

a bias that sees somatic reactions as an inferior way of dealing with emotions

repressive coping style

a reluctance to express discomfort, anger, or hostility ex: men w/ a repressive coping style tend to have a particularly sharp rise in blood pressure and heart rate when they are stressed

impoverished people have more psychophysiological disorders, poorer health in general, and poorer health outcomes than wealthier people, this finding supports a) sociocultural factors/multicultural perspective b) humanistic perspective c) psychodynamic perspective

a)reason for this relationship is that poor people typically experience higher rates of crime, job dissatisfaction, unemployment, overcrowding, and other negative stressors than wealthier people. In addition, they typically receive inferior medical care.

electra complex

at the phallic stage (3-5) each girl experiences sexual feelings for her father and at the same time recognizes that she must compete w/ her mother for his affection

Clients w/ the ___ disorder often improve when given same antidepressant drugs used in OCD a) conversion disorder b) illness anxiety disorder c) somatization pattern

b

Clients with the _____ disorder improve when treated w/ cognitive behavioral approach of exposure and response prevention a) conversion disorder b) illness anxiety disorder c) somatization pattern

b

___ disorder is characterized by ppl who are disproportionately concerned, distressed, and disrupted by bodily symptoms a) conversion disorder b) somatic symptom disorder c) illness anxiety disorder

b

___ disorder's theoretical explanation and treatments are similar to those for anxiety disorders (OCD) a) conversion disorder b) illness anxiety disorder c) somatization pattern

b

when a conversion paralysis allows a soldier to avoid combat duty or conversion blindness prevents the breakup of a relationship, this exemplifies a) primary gain b) secondary gain

b

studies find that many sufferers develop their bodily symptoms after they or their close relatives or friends have had similar medical problems. this finding is consistent with a) psychodynamic view b) cogntive-behavioral view c) sociocultural view

b) rewards aspect of cognitive-behavioral view

Recent research has shown that many other physical illnesses, such as _____ may also be caused by an interaction of psychosocial and physical factors

bacterial and virals infection

Many therapists focus on the cause of the disorder (the trauma or anxiety tied to the physical symptoms of the somatic symptoms disorder & conversion disorder) and apply: drug therapies

biological therapists most often use antidepressant drugs to help reduce anxiety and depression in patients with these disorders

New psychophysiological disorders

biological, psychological, and sociocultural factors combine to produce psychophysiological disorders. In fact, the interaction of such factors is now considered the rule of bodily functioning, not the exception - Many physical illnesses are linked to psychosocial stress

immune system

body's network of activities and cells that identify and destroy antigens (foreign invaders, such as bacteria, viruses, fungi, parasites, and cancer cells)

___ disorder is characterized by ppl who are anxious about their health become preoccupied w/ the notion that they are seriously ill despite the absence of bodily symptoms a) conversion disorder b) somatic symptom disorder c) illness anxiety disorder

c

Muscle contraction or tension headaches:

caused by a narrowing of muscles surrounding the skull. marked by pain at the back or front of the head or the back of the neck.

asthma

causes the body's airways (the trachea and bronchi) to narrow periodically, making it hard for air to pass to and from the lungs. The resulting symptoms are shortness of breath, wheezing, coughing, and a terrifying choking sensation. 70% of all cases appear to be caused by an interaction of stress factors, such as environmental pressures or anxiety, and physiological factors, such as allergies to specific substances, a slow-acting sympathetic nervous system, or a weakened respiratory system

variables from across these categories may interact to help produce psychophysiological disorders in the face of life stress, particularly____

chronic life stress

illness anxiety disorder: cognitive-behavioral theorists

cognitive-behavioral theorists believe that (1) illness fears are acquired thru classical conditioning/modeling and (2) ppl w/ disorder are so sensitive to and threatened by bodily cues that they come to misinterpret them

rewards

cognitive-behavioral theorists propose that the physical symptoms of these disorders yield important benefits to sufferers symptoms remove the individuals from an unpleasant relationship or perhaps the symptoms bring attention from other people In response to such rewards, the sufferers learn to display the bodily symptoms more and more prominently. The theorists also hold that people who are familiar with an illness will more readily adopt its physical symptoms.

Many therapists focus on the cause of the disorder (the trauma or anxiety tied to the physical symptoms of the somatic symptoms disorder & conversion disorder) and apply: exposure

cognitive-behavioral therapists use exposure treatments. They expose clients to features of the horrific events that first triggered their physical symptoms, expecting that the clients will become less anxious over the course of repeated exposures and more able to face those upsetting events directly rather than through physical channels

some of the leading psychosocial causes of essential hypertension

constant stress, environmental danger, and general feelings of anger or depression. Physiological factors include obesity, smoking, poor kidney function, and an unusually high proportion of the gluey protein collagen in a person's blood vessels

When a bodily ailment has an excessive and disproportionate impact on the person, has no apparent medical cause or is inconsistent w/ known medical diseases, physicians may suspect a ____ disorder or a ____ disorder

conversion disorder; somatic symptoms disorder

according to the cognitive-behavioral view, which of the following are symptoms of a conversion disorder and somatic symptoms disorders a) create distance from unpleasant relationships b) bring attention; source of communication influenced by modeling of knowledge of medical problems c) secondary gains d) all of the above

d

Hispanic Health Paradox

despite such disadvantages, the health of Hispanic Americans is, on average, at least as good as (and often better than) that of both non-Hispanic white Americans and African Americans Ex: Hispanic Americans have lower rates of high blood pressure and live longer. The relatively positive health picture for Hispanic Americans in the face of economic disadvantage has been referred to in the clinical field as the "Hispanic Health Paradox."

Social Adjustment rating scale

developed in 1967 by Thomas Holmes and Richard Rahe - assigns numerical values to the stresses that most people experience at some time in their lives - Measures the total amount of stress a person faces over a period of time - Examined relationship btw life stress and onset of illness - Linked stressors of various kinds to a wide range of physical conditions (from trench mouth & upper respiratory infections to cancer) - the greater the amount of life stress, the greater the likelihood of illness - found a relationship between traumatic stress and death (ex: Widows and widowers, display an increased risk of death during their bereavement period)

insomnia

difficulty falling asleep or maintaining sleep, plagues one-third of the population each year. Chronic insomniacs feel as though they are almost constantly awake. They often are very sleepy during the day and may have difficulty functioning. Their problem may be caused by a combination of psychosocial factors, such as high levels of anxiety or depression, and physiological problems, such as an overactive arousal system or certain medical ailments

Psychological factors affecting other medical conditions

disorders in which psychological factors adversely affect a person's general medical condition

chronic headaches

frequent intense aches of the head or neck that are not caused by another physical disorder; caused by an interaction of stress factors, such as environmental pressures or general feelings of helplessness, anger, anxiety, or depression, and physiological factors, such as abnormal activity of the neurotransmitter serotonin, vascular problems, or muscle weakness there are two major types: muscle contraction or tension headaches & migraine headaches

Some research suggests that ppl who develop conversion disorder tend to be

generally suggestible; many are highly suggestible to hypnotic procedures

Factitious disorder is more common among ____ and usually begins during ___

more common among women than men; but men may have more severe cases; begins usually during early adulthood

autonomic nervous system (ANS)

one way the brain activates body organs is through the operation of the autonomic nervous system (ANS), the network of nerve fibers that connect the central nervous system to the body's organs

type A personality style

pattern characterized by hostility, cynicism, driveness, impatience, competitiveness, and ambition ex: type A personality style may contribute to psychophysiological disorders; the way they interact in the world produces continual stress and often leads to coronary heart disease. Recent studies indicate that the link between the Type A personality style and heart disease may not be as strong as the earlier studies suggested. These studies do suggest, however, that several of the characteristics that supposedly make up the Type A style, particularly hostility, competitiveness, and time urgency, may indeed be strongly related to heart disease

how does blindness differ from conversion blindness

people with conversion blindness have fewer accidents than people who are organically blind, an indication that they have at least some vision even if they are unaware of it.

Disorders featuring somatic symptoms

primarily caused by psychological factors & symptoms trigger excessive anxiety or concern. Includes: factitious disorder, conversion disorder, somatic symptoms disorder

how is the cognitive-behavioral's focus on the role of rewards different than psychodynamic's notion of secondary gain

psychodynamic theorists view the gains as coming only after underlying conflicts produce the disorder; Cognitive-behavioral theorists view them as the primary cause of the development of the disorders.

consistent with _____ explanation of conversion and somatic symptom disorders, researchers have found that people with higher levels of such vigilance experience pain and pain-related anxiety more often than people with lower levels

somatic vigilance

two patterns of somatic symptom disorder

somatization pattern and predominant pain pattern

hypertension

state of chronic high blood pressure. That is, the blood pumped through the body's arteries by the heart produces too much pressure against the artery walls. Hypertension has few outward signs, but it interferes with the proper functioning of the entire cardiovascular system, greatly increasing the likelihood of stroke, heart disease, and kidney problems.Around 10 percent of all cases are caused by physiological abnormalities alone; the rest result from a combination of psychological and physiological factors and are called essential hypertension.

somatic vigilance

suggests that some ppl are more attentive than others to their bodies, and this attentiveness causes them to focus more on their bodily discomforts, experience more arousal in response to them and worry about them more (Similar to anxiety sensitivity)

mind-body dualism

the mind or soul is separate from body

explanation of the Hispanic health paradox

the strong emphasis on social relationships, family support, and religiousness that often characterizes Hispanic American cultures increases health resilience among their members. Or Hispanic Americans may have a physiological predisposition that improves their likelihood of having better health outcomes.

communication skills (cognitive-behavioral view)

theorists propose that conversion and somatic symptom disorders are forms of self-expression, providing a means for people to reveal emotions that would otherwise be difficult for them to convey. theorists hold that the emotions of people with the disorders are being converted into physical symptoms. They suggest, however, that the purpose of the conversion is to communicate extreme feelings — anger, fear, depression, guilt, jealousy — in a "physical language" that is familiar and comfortable for the person with the disorder. people who find it particularly hard to recognize or express their emotions are candidates for conversion and somatic symptom disorders Because children are less able to express their emotions verbally, they are particularly likely to develop physical symptoms as a form of communication

Therapists who focus on the physical symptoms of conversion disorder and somatic symptoms disorder use techniques such as: cognitive restructuring

those who offer cognitive restructuring guide clients to think differently about the nature and causes of physical symptoms and illness.

___ personality style are less likely to develop cardiovascular deterioration

type B - thought to be more relaxed, less aggressive, and less concerned about time

how does genuine paralysis differ from paralysis as the result of a conversion disorder

when paralysis from the waist down, or paraplegia, is caused by damage to the spinal cord, a person's leg muscles may atrophy, or waste away, unless physical therapy is applied. The muscles of people whose paralysis is the result of a conversion disorder, in contrast, do not usually atrophy.