What is somatization? Somatization is a psychological phenomenon where emotional distress is expressed through physical symptoms. People who somatize often have multiple unexplained physical complaints that may lead to frequent medical visits. In the Assessment and Diagnosis of the ASWB exam outline, you'll find this: the indicators of somatization. Let's take a look at some:

  • Chronic, Unexplained Physical Symptoms: Clients who somatize frequently report physical symptoms, such as headaches, fatigue, stomachaches, and pain, that cannot be attributed to any underlying medical condition.

  • Multiple Complaints: They often present with a multitude of complaints, and these complaints can vary across different body systems.

  • Migrating Complaints: When somatizing, once one physical symptom fades, another often pops up soon after.
  • Long History of Medical Visits: Somatizing individuals may have a long history of seeking medical attention and consulting multiple healthcare professionals for their physical symptoms.

  • No Medical Explanation: Despite undergoing numerous medical tests and evaluations, there is typically no clear medical explanation for their symptoms.

  • Psychological Distress: Somatization is often associated with underlying psychological distress, such as anxiety, depression, or stress. These emotional issues can be the driving force behind the physical symptoms.

  • Health Anxiety: People who somatize may also exhibit health anxiety, fearing that their physical symptoms are indicative of a severe or life-threatening illness.

  • Social and Occupational Impairment: Somatization can lead to significant social and occupational impairment due to the frequent medical visits and the impact of the physical symptoms on their daily life.

  • Exaggeration of Symptoms: The symptoms they report are often described in exaggerated terms, and sufferers may have a heightened perception of pain and discomfort.

  • Resistance to Psychological Explanations: Somatizing individuals may resist accepting that their symptoms have a psychological basis, often seeking further medical tests and treatments.

It's important to note that somatization can be complex, and it's often associated with other mental health conditions. Working in concert with MDs who can rule out medical sources of symptoms is key. Treatment may include psychotherapy, cognitive-behavioral therapy, and, in some cases, medication.

Somatic Symptom Disorder

Somatization Disorder was a diagnosis included in previous editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), such as DSM-IV. However, it has been replaced by a different diagnosis in the latest edition, the DSM-5, which was published in 2013. In the DSM-5, the diagnosis of "Somatization Disorder" has been replaced by Somatic Symptom Disorder.

The criteria for Somatic Symptom Disorder:

A. One or more somatic symptoms: The individual must have one or more distressing somatic symptoms. These symptoms can be related to a single or multiple organ systems.

B. Excessive thoughts, feelings, or behaviors related to the somatic symptoms: The person's thoughts, feelings, or behaviors must be significantly disproportionate to the seriousness of the somatic symptoms. In other words, they are excessively concerned about their health and the symptoms they are experiencing.

C. Persistently high level of anxiety about health or symptoms: The individual experiences a high level of anxiety, concern, or fear related to their health or the somatic symptoms. This anxiety is often described as excessive and may lead to frequent health-related behaviors, such as checking for medical problems or seeking repeated medical evaluations.

D. Duration: These symptoms and behaviors must be present for at least 6 months. The 6-month duration helps distinguish this disorder from temporary or transient concerns about health.

E. Distress or impairment: The somatic symptoms and related thoughts, feelings, or behaviors must cause significant distress or impairment in social, occupational, or other important areas of functioning.

Social Work Exam Prep

Some possible stems for questions about somatization and somatic symptom disorder:

  • When working with individuals from culturally diverse backgrounds, what is an important consideration in addressing somatization?
  • A client reports multiple physical symptoms, but upon further assessment, it becomes evident that the client is intentionally producing these symptoms for attention and care. What might be a possible diagnosis in this case?
  • What is the best approach for treating somatization in social work practice?

You get the idea.

For questions like these--with answers and explanations!--try Social Work Test Prep's full-length practice tests and boosters. They've helped thousands of social workers pass the ASWB exam. Hopefully, you're next.

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October 31, 2023
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