China
Africa
Explore chapters and articles related to this topic
Diagnosis of Chronic Fatigue Syndrome
Published in Jay A. Goldstein, Chronic Fatigue Syndromes, 2020
Are CFS patients with premorbid psychiatric diagnoses more chronic in their course and more resistant to treatment? Experience might suggest that this is so, but the results of the Ampligen experiment do not support this impression. Most studies suggest, however, that premorbid psychiatric illness is more common in CFS patients than in comparison groups with other medical diagnoses, such as rheumatoid arthritis or neuromuscular disorders. It has been suggested that this CFS group may be more prone to “somatize” psychological distress and are thus subject to the “biologic” effects of depression.49 This tendency to report high levels of somatic symptoms has been called “somatosensory amplification.” Some view this as a perceptual style amenable to change through cognitive and behavioral interventions. Using this paradigm, those with no premorbid psychiatric illness and an acute onset of CFS symptoms may have a cytokine-mediated illness. The unifying concept of a limbic encephalopathy appears to be a new one, and could explain somato-sensory amplification as a dysfunction of the insula or other paralimbic areas, as previously discussed. Rats with a central defect in the secretion of CRH demonstrate behavior compatible with somatosensory amplification as well as a failure of immune suppression in response to inflammatory stimuli. These rats provide a model of the relationship between stress and the immune system.50
Medically unexplained symptoms
Published in Christopher Dowrick, Global Primary Mental Health Care, 2019
Tim olde Hartman, Christopher Dowrick, Cindy L K Lam, Sandra Fortes, David Clarke, Jinan Usta
Here are some examples of explanatory models that can be used in daily primary care:2Capacity–burden model: The balance between four factors (i.e. support, stress, strength and vulnerability) is of importance. If vulnerability and strength are unbalanced in a person, this can lead to symptoms.Stress model: High levels of stress are correlated with fatigue, pain and somatoform disorders. Psychological distress plays an important role in this relationship. That means that certain psychosocial factors combined with a chronically high level of stress can result in MUS.Somatosensory amplification model: Focusing attention on physical sensations leads to more physical sensations (for example, thinking of itching results in itching). Furthermore, this might result in concerns or anxiety in patients. Consequently, a vicious circle of maintaining and amplifying the physical symptoms is started.Neurobiological model: There exists a complex interaction between neurobiological processes (the autonomic nervous system, the HPA axis and the immune system), environmental factors, attention and behavior. Activation of the autonomic nervous systems generates symptoms, as does activation of the HPA axis (for example, adrenalin gives an increase in heartrate and breathing frequency). Activation of the immune system can result in a sickness response.Vicious circles: Vicious circles play an important role in maintaining symptoms, irrespective of the origin of the symptoms. This is a result of the interpretation of symptoms and resulting disease behavior and/or help-seeking behavior.Sensitization: Previous and repeated stimuli of pain and other symptoms in the past make the central nervous system more susceptible to these stimuli. Benign stimuli are interpreted as malign.Cultural way of understanding: All explanatory models must be culturally meaningful. It is important for health professionals to be culturally humble, respecting and understanding of how different cultures explain the many ways emotional distress relates to physical symptoms. One example is the “nerves” complaints among Latino patients that associate “shaken nerves” as a major mechanism causing MUS.
Placebo and hypnosis in the clinical setting: Contextual factors in hypnotic analgesia
Published in American Journal of Clinical Hypnosis, 2022
According to our data, one of the most influential subject-related factors was somatosensory amplification (SSAS). We show that the SSAS score was significantly linked to the response to hypnotic analgesia in terms of all pain dimensions, and the intensity of pain. In the group treated with self-hypnosis, but not in the group treated by the therapist, the higher the baseline SSAS, the better the outcome of the hypnotic analgesia. In fact, we found no influence of SSAS score on any pain outcome in Group A. As we have stated in a previous work, somatosensory amplification plays an important role in the perception of pain, enough to suggest its implication in the aetiopathogenesis of fibromyalgia (Ciaramella, Silvestri, Pozzolini, Federici, & Carli, 2020). Based on the data presented here, this amplification of sensorial perception seems itself to be a predictor of a positive response to hypnotic analgesia if the subject practices self-hypnosis. The predictive ability of SSAS score, is, however, completely eliminated by the therapist’s presence.
Cognitive, emotional, and behavioral considerations for chronic pain management in the Ehlers–Danlos syndrome hypermobility-type: a narrative review
Published in Disability and Rehabilitation, 2019
Carolina Baeza-Velasco, Antonio Bulbena, Roberto Polanco-Carrasco, Roland Jaussaud
On the other hand, EDS-H has been associated with somatosensory amplification, which is the tendency of attentional focusing on physical symptoms and experiencing somatic sensations as intense, noxious, and disturbing [54]. Interestingly, these results contrast with those obtained in studies with non-clinical populations, which showed that individuals who tend to somatosensory amplification as well as subjects considered to be high symptom reporters are, in fact, less interoceptively accurate or less capable of noticing subtle bodily sensations [55–58]. Moreover, studies in different chronic pain conditions suggest that affected individuals have a lower interoception accuracy compared to healthy subjects [59]. Thus, the relationship between interoception and somatosensory amplification should be investigated further in EDS-H to shed some light on this potential specificity. These aspects of body awareness and catastrophizing thoughts about body sensations might influence the perception and tolerance of pain [60,61], and negatively affect its trajectory [28]. In addition, in a recent study in children with EDS-H, pain catastrophizing was found to be associated with an increase in school absenteeism and health care utilization [62], also showing a maladaptive effect of pain catastrophizing in terms of indirect and direct health care costs.
Hypnotic analgesia in chronic pain: role of psychopathology and alexithymia
Published in American Journal of Clinical Hypnosis, 2023
This tool quantifies the propensity of a subject to somatosensory amplification, i.e., the tendency to experience more intense, noxious and disturbing somatic sensations (Barsky et al., 1988). It is a self-report instrument that consists of 10 statements scored on a Likert scale (0 = “never” = 1 “a little” 2 = “moderately,” 3 = “almost always” and 4 = “always”), and the higher the score (maximum 40), the greater the tendency to somatic amplification (TSSAS). This scale has previously been translated into Italian (Bernini et al., 2008).