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Psychological Medicine
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Harrison Howarth, Jim Bolton, Gary Bell
A number of psychiatric syndromes that include medically unexplained symptoms are described. Somatization disorder: multiple chronic physical symptoms for which no adequate physical explanation can be foundHypochondriacal disorder: persistent preoccupation with the possibility of a serious diseaseDissociative (conversion) disorder: patients have symptoms of a neurological disorder (e.g. amnesia, paralysis, convulsions) but no evidence for a primary illness to account for the symptoms
Somatization and Posttraumatic Stress in Gulf War Illness
Published in Peter Manu, The Psychopathology of Functional Somatic Syndromes, 2020
In summary, the evidence indicates that Gulf War illness is characterized by multiple bodily complaints, somatic preoccupation, and somatic distress. The magnitude of somatization phenomena correlates with the presence and severity of posttraumatic stress symptoms. Fatigue, sleep disturbance, cognitive deficits, and panic symptoms are also commonly reported by ill veterans, but a direct relationship with depressive or anxiety disorders has not been established.
ILF Neurofeedback and Alpha-Theta Training in a Multidisciplinary Chronic Pain Program
Published in Hanno W. Kirk, Restoring the Brain, 2020
Evvy J. Shapero, Joshua P. Prager
Pain can be viewed as a signal of danger in the body until it reaches the emotional level. It is important to distinguish the sensation of pain from the experience of suffering as a result of the chronic nature of pain. The limbic system, where emotions are processed, modulates the level of pain experienced. The pain alone is often not responsible for the suffering. Anxiety, fear, a sense of loss, and anger contribute to the suffering. Suffering also occurs when relationships with family members are strained, with loss of financial status, and with loss of identity. So suffering can be a manifestation not of pain itself but of the losses that occur when pain persists.13 High levels of emotional stress caused by the constant pain can lead to somatization and hypochondria. “Fear-related experiences such as catastrophic thinking and avoidance are especially significant in exacerbating pain perceptions.”14,15 According to Main et al (2010), “Pain catastrophising is a better predictor of pain-related disability and activity intolerance than pain itself.”16 Eliminating pain behaviors such as guarding, rubbing, or grimacing leads to improved pain perception.17 Failing to address psychological issues in chronic pain patients may result in prolonged disability.
Pain Experiences in Individuals with Reported and Suspected Sleep Disorders
Published in Behavioral Medicine, 2022
Scott G. Ravyts, Joseph M. Dzierzewski
Although the prevalence of a reported sleep disorder diagnosis in the present sample was relatively low, the prevalence of suspected insomnia and sleep apnea largely coincides with rates reported in the general population.1,2 In contrast, the suspected prevalence of COMISA found in this study is lower than some previous estimates;32 however, variability in the rate of COMISA is common given the varying diagnostic methods used and samples examined.33 While participants’ average level of pain intensity fell within the mild range, this is consistent with other examinations of pain in medical populations.21 Similarly, the average level of somatization reported by the current sample was at or above that of patients in primary care settings.29,34 Taken together, these finds suggest that the lower than expected rates of COMISA are not an artifact of an overly healthy sample.
External Correlates of the MMPI-2-Restructured Form across a National Sample of Veterans
Published in Journal of Personality Assessment, 2021
Paul B. Ingram, Anthony M. Tarescavage, Yossef S. Ben-Porath, Mary E. Oehlert, Becca K. Bergquist
Correlations between criteria measures and MMPI-2-RF scales in other domains generally supported the discriminant validity of scores from these scales. Specifically, scores from the thought dysfunction, externalizing, and interpersonal problems domains of the test had very few meaningful associations with criterion measures assessing post-traumatic stress disorder, anxiety, and depression. However, scores from the MMPI-2-RF somatic/cognitive domain (particularly RC1, MLS, and COG) tended to have moderate to large associations with BDI-2 scores and BAI scores, as well as scores from PTSD measures (MISS, PCL-C, and PCL-M). Although correlations at these magnitudes were not formally hypothesized, these findings are not surprising. Somatization tends to be comorbid with mood disorders (Löwe et al., 2008) as well as trauma disorders (Andreski, Chilcoat, & Breslau, 1998) and the diagnostic criteria for depression including a variety of somatic and cognitively focused symptoms (American Psychiatric Association, 2013). The PHQ-2 is also intended for use within primary care settings as a brief screening instrument (see Arroll et al., 2010) and Veterans seen in these clinics are likely experiencing the sort of physical health complaints assessed by the somatic/cognitive domain scales (e.g., Spelman, Hunt, Seal, & Burgo-Black, 2012). Interestingly, the GAD-7 demonstrated notably better discriminant validity than the BAI, with significant elevations occurring less frequently for scales with lower conceptual overlap.
Somatization, mental health and pain catastrophizing factors associated with risk of opioid misuse among patients with chronic non-cancer pain
Published in Journal of Substance Use, 2020
Sung-Jae Lee, Maryann Koussa, Lillian Gelberg, Keith Heinzerling, Sean D. Young
Opioid misuse among patients with non-cancer chronic pain may be driven by various factors, including somatization and mental health symptoms that may facilitate opioid misuse. Somatization is one of the most common issues in health care services, associated with substantial functional impairment and health care utilization (de Vroege, Hoedeman, Nuyen, Sijtsma, & van der Feltz-cornelis, 2012; Korber, Frieser, Steinbrecher, & Hiller, 2011; Steinbrecher, Koerber, Frieser, & Hiller, 2011). Somatoform symptoms often account for sick leave and are characterized by long duration and medically unexplained symptoms (Burton, Weller, Marsden, Worth, & Sharpe, 2012; Hiller & Fichter, 2004; Hiller, Fichter, & Rief, 2003; Kroenke, Spitzer, & Williams, 2002). The most frequently reported symptoms are fatigue, low energy, sleeping trouble, and pain (back pain, headaches, abdominal pain, and chest pain) (Hanel et al., 2009; Hiller, Rief, & Brahler, 2006). Such symptoms may potentially impact opioid misuse among patients with chronic non-cancer pain.