Physiological Factors

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Unlike previous theories, the somatization model embraces the idea that normal physical processes (e.g., the physical component of an emotional state) and minor pathological events may contribute to the development of unexplained symptoms. For example, anxiety is typically associated with increased auto-nomic arousal that may result in physical changes such as shaking, sweating, and tachycardia; moreover, fear-related hyperventilation can produce symptoms such as breathlessness, chest pain, and fatigue. Similarly, the sleep problems and physical inactivity often associated with depression may give rise to fatigue, pain, and the feeling that increased effort is required to execute everyday tasks. Other physical processes unrelated to emotional states may also contribute to the development of medically unexplained symptoms. For example, muscle wasting resulting from illness-related inactivity may produce fatigue that perpetuates itself by preventing the resumption of physical exercise after illness remission.

A recent model of the interaction between these different factors has been described by Lawrence Kirmayer and colleagues (Fig. 3). According to this model, illness, emotional arousal, and everyday physiological processes produce bodily sensations that capture the individual's attention to varying degrees. These sensations may be interpreted as indicators of disease, an attribution that can serve to generate illness worry, catastrophizing, and demoralization. As a result, individual may adopt the sick role by pursuing assessment and treatment for his or her putative condition, thereby exposing himself or herself to social forces that may reinforce their illness behavior and experience. This process may be moderated by many situational and dispositional factors, including previous illness experience, environmental contingencies that reward illness behavior, the response of significant others to illness worry, and individual differences in personality, attentional set, coping behavior, and autonomic reactivity.

Despite their obvious explanatory power, there are certain problems with models based on the concept of somatization. First, such models obscure potentially important differences between the various forms of medically unexplained symptoms, such as those that are the physical concomitants of conditions such as anxiety and depression, normal physical sensations or minor pathological events that are mistakenly attributed to serious illness through hypochondriacal misinterpretation, and those characteristic of the conversion and somatoform disorders. Although there is considerable overlap between these conditions in clinical practice, these different forms of somatization can be distinguished both conceptually and empirically. Although the somatization model offers a powerful account of the medically unexplained symptoms associated with depression, anxiety, and hypochondriasis, it fails to provide an adequate account of the mechanisms underlying conversion and somato-form symptoms. Arguably, a proper understanding of

Attribution to illness

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Do Not Panic

Do Not Panic

This guide Don't Panic has tips and additional information on what you should do when you are experiencing an anxiety or panic attack. With so much going on in the world today with taking care of your family, working full time, dealing with office politics and other things, you could experience a serious meltdown. All of these things could at one point cause you to stress out and snap.

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