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8 - CBT for Somatic Symptom Disorder and Illness Anxiety Disorder

from Part One - Cognitive Behavioral Therapy for Anxiety Disorders

Published online by Cambridge University Press:  06 January 2022

By
Lillian Reuman  and
Jonathan S. Abramowitz
Edited by
Gillian Todd  and
Rhena Branch
Gillian Todd
Affiliation:
University of East Anglia
Rhena Branch
Affiliation:
University of East Anglia
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Summary

Somatic symptom disorder (SSD) entails a preoccupation with one or more physical symptoms that are attributed to a nonpsychiatric disease. Research on treatment for SSD supports the use of cognitive behavioral therapy (CBT) for reducing symptomatology and improving physical functioning and quality of life. This chapter summarizes the research base for CBT for SSD and provides a clinical guide to formulating, assessing, and implementing CBT for clients with SSD. Assessment requires ruling out organic medical conditions and assessing triggers of SSD, beliefs about body sensations, and associated safety behaviors. The use of a functional assessment and self-monitoring aids in developing an idiosyncratic case conceptualization. Treatment includes psychoeducation, cognitive restructuring to challenge beliefs about bodily sensations, a mix of interoceptive, in vivo, and imaginal exposure, and the elimination of all safety behaviors. The chapter concludes with a summary of recent advances in treatment of SSD, including mindfulness-based approaches.

Keywords

somatic symptom disorderillness anxietycognitive behavioral therapyfunctional assessmentexposure therapyresponse preventionsafety behaviors
Type
Chapter
Information
Evidence-Based Treatment for Anxiety Disorders and Depression
A Cognitive Behavioral Therapy Compendium
 , pp. 136 - 151
Publisher: Cambridge University Press
Print publication year: 2022

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References

Further Recommended Reading

Abramowitz, J. S., & Braddock, A. E. (2008). Psychological treatment of health anxiety and hypochondriasis. Hogrefe.Google Scholar
Deacon, B., & Abramowitz, J. S. (2008). Is hypochondriasis related to obsessive-compulsive disorder, panic disorder, or both? An empirical evaluation. Journal of Cognitive Psychotherapy, 22(2), 115–127.Google Scholar
Furer, P., Walker, J. R., & Stein, M. B. (2007). Treating health anxiety and fear of death: A practitioner’s guide. Springer.Google Scholar
Olatunji, B. O., Kauffman, B. Y., Meltzer, S., Davis, M. L., Smits, J. A., & Powers, M. B. (2014). Cognitive-behavioral therapy for hypochondriasis/health anxiety: A meta-analysis of treatment outcome and moderators. Behaviour Research and Therapy, 58, 65–74.CrossRefGoogle ScholarPubMed
Reuman, L., & Abramowitz, J. S. (2015). Illness anxiety disorder. In Phillips, K. A. & Stein, D. J. (Eds.), Handbook on obsessive-compulsive and related disorders (pp. 225–246). American Psychiatric Publishing.Google Scholar
Rief, W., Hiller, W., & Margraf, J. (1998). Cognitive aspects of hypochondriasis and the somatization syndrome. Journal of Abnormal Psychology, 107(4), 587.CrossRefGoogle ScholarPubMed
Salkovskis, P. M., Rimes, K. A., Warwick, H. M. C., & Clark, D. M. (2002). The Health Anxiety Inventory: Development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychological Medicine, 32(5), 843–853.Google Scholar
Taylor, S., & Asmundson, G. J. (2004). Treating health anxiety: A cognitive-behavioral approach. Guilford Press.Google Scholar

References

Abramowitz, J. S., & Braddock, A. E. (2008). Psychological treatment of health anxiety and hypochondriasis. Hogrefe.Google Scholar
Abramowitz, J. S., Deacon, B. J., & Valentiner, D. P. (2007). The Short Health Anxiety Inventory: Psychometric properties and construct validity in a non-clinical sample. Cognitive Therapy and Research, 31(6), 871–883.CrossRefGoogle Scholar
Abramowitz, J. S., Deacon, B. J., & Whiteside, S. P. (2012). Exposure therapy for anxiety: Principles and practice. Guilford Press.Google Scholar
American Psychiatric Association. (2013). Diagnostic and statistical manual of Mental Disorders (5th ed.). American Psychiatric Association.Google Scholar
Barlow, D. H. (Ed.) (2014). Clinical handbook of psychological disorders: A step-by-step treatment manual. Guilford Press.Google Scholar
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Furer, P., Walker, J. R., & Stein, M. B. (2007). Treating health anxiety and fear of death: A practitioner’s guide. Springer Science & Business Media.Google Scholar
Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischmann, R. L., Hill, C. L., … & Charney, D. S. (1989). Yale–Brown Obsessive Compulsive Scale (Y-BOCS). Archives of General Psychiatry, 46, 1006–1011.Google Scholar
Hedman, E., Andersson, G., Andersson, E., Ljótsson, B., Rück, C., Asmundson, G. J., & Lindefors, N. (2011). Internet-based cognitive-behavioural therapy for severe health anxiety: Randomised controlled trial. The British Journal of Psychiatry, 198(3), 230–236.Google Scholar
Hedman, E., Ljótsson, B., Andersson, E., Rück, C., Andersson, G., & Lindefors, N. (2010). Effectiveness and cost offset analysis of group CBT for hypochondriasis delivered in a psychiatric setting: An open trial. Cognitive Behaviour Therapy, 39(4), 239–250.CrossRefGoogle Scholar
Huppert, J. D., & Baker-Morissette, S. L. (2003). Beyond the manual: The insider’s guide to panic control treatment. Cognitive and Behavioral Practice, 10(1), 2–13.Google Scholar
Huppert, J. D., Roth Ledley, D., & Foa, E. B. (2006). The use of homework in behavior therapy for anxiety disorders. Journal of Psychotherapy Integration, 16(2), 128–139.CrossRefGoogle Scholar
Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. Dell Publishing.Google Scholar
Lovas, D. A., & Barsky, A. J. (2010). Mindfulness-based cognitive therapy for hypochondriasis, or severe health anxiety: A pilot study. Journal of Anxiety Disorders, 24(8), 931–935.Google Scholar
Salkovskis, P. M., Rimes, K. A., Warwick, H. M. C., & Clark, D. M. (2002). The Health Anxiety Inventory: Development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychological Medicine, 32(5), 843–853.Google Scholar
Segal, Z. V., Teasdale, J. D., Williams, J. M., & Gemar, M. C. (2002). The mindfulness‐based cognitive therapy adherence scale: Inter‐rater reliability, adherence to protocol and treatment distinctiveness. Clinical Psychology and Psychotherapy, 9(2), 131–138.Google Scholar
Taylor, S., & Asmundson, G. J. (2004). Treating health anxiety: A cognitive-behavioral approach. Guilford Press.Google Scholar
Tyrer, P., Cooper, S., Crawford, M., Dupont, S., Green, J., Murphy, D., et al. (2011). Prevalence of health anxiety problems in medical clinics. Journal of Psychosomatic Research, 71, 392–394.Google Scholar
Walker, J. R., & Furer, P. (2008). Interoceptive exposure in the treatment of health anxiety and hypochondriasis. Journal of Cognitive Psychotherapy, 22(4), 366–378.Google Scholar

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