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8.4: Somatic Symptom and Related Disorders - Etiology

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    161390

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    Learning Objectives
    • Describe the psychodynamic causes of somatic disorders.
    • Describe the cognitive causes of somatic disorders.
    • Describe the behavioral causes of somatic disorders.
    • Describe the sociocultural causes of somatic disorders.

    Psychodynamic

    Psychodynamic theory suggests that somatic symptoms present as a response against unconscious emotional issues. Two factors initiate and maintain somatic symptoms: primary gain and secondary gain. Primary gains produce internal motivators, whereas secondary gains produce external motivators (Jones, Carmel & Ball, 2008). When you relate this to somatic disorders, the primary gain, according to psychodynamic theorists, provides protection from the anxiety or emotional symptoms and/or conflicts. This need for protection is expressed via a physical symptom such as pain, headache, etc. The secondary gain, the external experiences from the physical symptoms that maintain these physical symptoms, can range from attention and sympathy to missed work, obtaining financial assistance, or psychiatric disability, to name a few.

    Cognitive

    Cognitive theorists often believe that somatic disorders are a result of negative beliefs or exaggerated fears of physiological sensations. Individuals with somatic related disorders may have a heightened sensitivity to bodily sensations. This sensitivity, combined with their maladaptive thought patterns, may lead individuals to overanalyze and interpret their physiological symptoms in a negative light.

    For example, an individual with a headache may catastrophize the symptoms and believe that their headache is the direct result of a brain tumor, as opposed to stress or other inoculate reasons. When their medical provider does not confirm this diagnosis, the individual may then catastrophize even further, believing they have an extremely rare disorder that requires an evaluation from a specialist.

    Behavioral

    Keeping true with the behavioral approach to psychological disorders, behaviorists propose that somatic disorders are developed and maintained by reinforcers. More specifically, individuals experiencing significant somatic symptoms are often rewarded by gaining attention from other people (Witthoft & Hiller, 2010). These rewards may also extend to more significant factors, such as receiving disability payments.

    While the behavioral theory of somatic disorders appears to be like the psychodynamic theory of secondary gains, there is a clear distinction between the two – behaviorists view these gains as the primary reason for the development and maintenance of the disorder, whereas psychodynamic theorists view these gains as secondary, only after the underlying conflicts create the disorder.

    Sociocultural

    There are a couple of different ways that sociocultural factors contribute to somatic related disorders. First, there is the social factor of familial influence that likely plays a significant role in the attention to somatic symptoms. Individuals with somatic symptom disorder are more likely to have a family member or close friend who is overly attentive to their somatic symptoms or report high anxiety related to their health (Watt, O’Connor, Stewart, Moon, & Terry, 2008; Schulte, Petermann, & Noeker, 2010).

    Culturally, Western countries express less of a focus on somatic complaints compared to those in the Eastern part of the world. This may be explained by the different evaluations of the relationship between mind and body. For example, Westerners tend to have a view that psychological symptoms sometimes influence somatic symptoms, whereas Easterners focus more heavily on the mind-body relationship and how psychological and somatic symptoms interact with one another. These different cultural beliefs are routinely seen in research where Asian populations are more likely to report the physical symptoms related to stress than the cognitive or emotional problems that many in the United States report (Sue & Sue, 2016).

    Key Takeaways

    You should have learned the following in this section:

    • Psychodynamic causes of somatic disorders include primary and secondary gains.
    • Cognitive causes of somatic disorders include negative beliefs or exaggerated fears of physiological sensations.
    • Behavioral causes of somatic disorders include reinforcers such as attention gained from others or receiving disability.
    • Sociocultural causes of somatic disorders include familial influence and culture.
    Review Questions
    1. How does catastrophizing contribute to the development and maintenance of somatic disorders?
    2. How do somatic disorders develop according to behavioral theorists? Does this theory also explain how the symptoms are maintained? Explain.
    3. What does the sociocultural model suggest regarding somatic disorders across cultures?

    This page titled 8.4: Somatic Symptom and Related Disorders - Etiology is shared under a CC BY-NC-SA 4.0 license and was authored, remixed, and/or curated by Alexis Bridley and Lee W. Daffin Jr. via source content that was edited to the style and standards of the LibreTexts platform; a detailed edit history is available upon request.