Body-relatedness in somatic symptom disorder

Abstract

Chapter 2: Persons with somatic symptom disorder can have disturbed body awareness. Bodyoriented interventions such as psychomotor therapy can treat body awareness problems on the level of basic body signals, giving meaning in the here and now, or in the context of personal history. Such experience-based interventions offer a variety of learning opportunities that focus on the body with symptoms and seem to add to verbal interventions. The scientific base for these interventions, however, is still poor. Chapter 3: According to clients with somatic symptom disorders and their therapists, bodyrelatedness includes awareness of the body and self by understanding, accepting and adjusting to bodily signals, by respecting and regulating the body, by trusting and esteeming oneself and by being autonomous. This definition and structure of body-relatedness may help professionals to improve interdisciplinary communication, assessment, and treatment, and it may help clients to better understand their symptoms and treatment. Chapter 4: The mostly large differences in self-reports of body image between clients with somatic symptom disorder and a comparison sample from the general population as well as differences between diagnostic subgroups underline the importance of body image in clients with somatic symptom disorder. The results indicate the usefulness of assessing body image and treating negative body image in clients with somatic symptom disorder. Chapter 5: Own body drawings were studied as a form of assessment for body experience and several objective ratings were indicated to be reliable. Two internally consistent constructs, “details” and “basic elements”, summarized these objective ratings. Correlation of objective ratings with ratings of the drawings by experts as well as sensitivity to change indicated potential clinical significance and the absence of correlation with a self-report measure suggested that analyses of body drawings yield information other than body-related questionnaires. These findings indicate that analyses of body drawings may be a promising assessment tool in somatic symptom disorder. Chapter 6: The study of body drawings in a matched general population sample indicated that clients with somatic symptom disorder and people from the general population picture a similar mean number of details in drawings of their own body. Analysis in the general population sample tentatively suggested that the perspective of the drawer potentially influenced observation scores. Because both the factor structure and the association with self-report measures differed between the groups, scorings of body drawings appear to reflect a different meaning for the two groups. Assessments using the scoring template that was found in chapter five may be more useful in the context of somatic symptoms than in the general population. Chapter 7: In the initial analysis of a structured physical therapeutic observation for people with somatic symptom disorder modestly sound psychometric quality of observations of execution of instructions, muscle tension and behavioral adaptation were found, however not of clients’ ability to perceive the body adequately. This shows that these observations are feasible when restricted to observable behavior and it indicates the viability of further validation of the body-relatedness observation scale (BROS).