Definition
According to the DSM IV , hypochondriasis is classified among the somatoform disorders as " concern related to the fear of having, or have the conviction of a serious illness, based on the erroneous interpretation of somatic symptoms on the part of the subject, the duration of alteration is at least 6 months.
Hypochondria has some aspects in common with anxiety disorders such as, for example, panic.
Both Hypochondriasis (anxiety about the state of health) in the attack of panic, he starts from the erroneous belief, caused by misinterpretation of physical signs or symptoms of having a serious illness or being to develop it, despite careful medical investigations have not found any disease. Patients with anxiety about the state of health does not expect the disaster is imminent, while patients with attacchi di panico vivono la catastrofe come imminente.
Modello cognitivo
Secondo il modello cognitivo (Salkovskis e Warwick, 1989,1990) il disturbo si manifesta quando avvenimenti critici attivano convinzioni disfunzionali relative a temi del benessere.
L’evento critico coincide con l’insorgenza di sintomi somatici non previsti, con la morte di un parente o con l’esposizione ad informazioni che riguardino patologie mediche. Una volta attivate convinzioni disfunzionali circa il benessere, si presentano false interpretazioni dei physical symptoms as markers of severe disease expressed in the form of negative automatic thoughts.
maintenance factors of concern:
factors that maintain the disorder are:
ü continuous control of your body
ü avoidance of anxiety-inducing situations
ü constantly looking for reassurance
Treatment
Cognitive therapy against anxiety connected to the state Health aims to shift attention from the patient's physical symptom behaviors and thoughts associated with it.
The work is based on verify the belief of the patient, when possible, through behavioral experiments. These experiments have order to undermine the initial forecasts and gather new evidence in favor of an alternative model, also induced opposed to those protective and avoidance.
It is useful that the patient identifies the errors of thought on the state of health (eg badly thought: "dramatization") and, together with the therapist, to take forward the minutes to produce a re-allocation is the most realistic alternative interpretations is evidence to support a psychological explanation of your problem (Wells, 1999).
Dr. Daphne Guandalini
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