Somatic symptom disorder: Definition, causes, and symptoms

Somatic symptom disorder (SSD) is a condition in which a person has excessive thoughts and feelings relating to physical symptoms. SSD may cause anxiety and negative emotions.

Read on to learn more about SSD, including the causes, symptoms, diagnosis, and treatment. We also explain when to speak to a doctor.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), SSD is a type of mental illness that causes excessive feelings, thoughts, or behaviors that center around at least one somatic (physical) symptom. People may refer to SSD as hypochondria or illness anxiety disorder.

For a diagnosis of SSD, the negative thoughts and emotions must last for at least 6 months and cause one or more of the following symptoms:

  • exaggerated or persistent thoughts concerning the severity of symptoms
  • spending excessive time and energy on treating or handling symptoms or potential health concerns
  • persistently high anxiety concerning health or symptoms
  • physical symptoms that last for at least 6 months or more, significantly disrupt daily life, and cause distress
  • taking excessive actions to reduce the risk of perceived danger or harm

In the DSM-V, SSD replaced other mental health conditions, including:

  • somatization disorder
  • hypochondriasis
  • pain disorder
  • undifferentiated somatoform disorder

One key differentiation between SSD and the above former DSM-IV disorders is that people with SSD do not need to experience unexplainable symptoms.

Another difference from the former conditions is that SSD causes at least one chronic physical symptom. Additionally, it accompanies excessive, persistent negative feelings, thoughts, and emotions.

Currently, the cause of SSD is unknown. However, research suggests that people with SSD may have an intensified awareness of bodily symptoms and sensations. They may also perceive symptoms in a different way or describe feelings in a physical way.

In addition, these individuals may have the tendency to view these symptoms negatively or as a sign of medical illness.

In some cases, SSD is related to diagnosed medical conditions. However, to have the condition, someone must also develop associated persistent, pervasive negative emotions, thoughts, or actions.

In other cases, SSD is related to an undiagnosed medical condition, but this does not make it any less real.

No one knows why SSD really occurs, but research suggests that risk factors may include:

  • sexual, emotional, or physical abuse
  • childhood neglect
  • a chaotic lifestyle
  • a history of substance and alcohol abuse
  • having an axis II personality disorder, such as obsessive-compulsive disorder
  • psychosocial stressors, such as reduced occupational functioning and unemployment
  • genetic factors

People with SSD experience excessive anxiety and persistent negative emotions, feelings, and behaviors in relation to at least one chronic, disabling, or distressing physical symptom. Some common physical symptoms associated with SSD include:

  • increased heart rate
  • gastrointestinal problems
  • muscle tension, stiffness, and cramps
  • pain
  • trouble breathing or shortness of breath
  • weakness

To diagnose SSD, a doctor will ask the person about all of their symptoms, take their medical history, and perform a physical exam.

The doctor will typically then run a series of diagnostic blood, imaging, and other laboratory tests

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CDC changes definition of coronavirus ‘close contact’

The Centers for Disease Control has changed its definition of who is considered a “close contact” with someone who has coronvirus.

Previously, CDC defined close contact as being within 6 feet of an infected person for at least 15 minutes. That definition was used to determine when a person should be quarantined. Now, a “close contact” is defined as being within 6 feet of an infected person or persons for at least 15 minutes over a 24-hour period, indicating multiple brief encounters can contribute to spread of COVID-19.

While the CDC said data on the subject was limited, “15 cumulative minutes of exposure at a distance of 6 feet or less can be used as an operational definition (of a close contact) for contact investigation,” the guidance noted.

The change comes after a study looked at the spread of coronavirus at a Vermont prison when an employee contracted the virus after brief, close contact with infected incarcerated people that added up to more than 15 minutes over the course of an 8-hour shift.

Time of exposure does contribute to rate of transmission, however, CDC said.

“In general, the longer you are around a person with COVID-19 (even if they do not have symptoms), the more likely you are to get infected,” CDC said.

People who have come into close contact with a coronavirus-infected person are supposed to quarantine and be tested.

According to the CDC, the number of cases in the country are on an upswing with 70% of health districts experiencing an increase. The average daily case county in the past week was 13% higher than the previous 7 days, CDC said.

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Sharp decrease in reported COVID-19 exposures after NBISD changes ‘close contact’ definition

After changing its definition of a “close contact,” New Braunfels ISD reported a sharp decrease in the number of students and faculty exposed to COVID-19.

When NBISD began reopening, the school district northeast of San Antonio used the Centers for Disease Control and Prevention “close contact” guidelines.

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By that definition, anyone exposed to COVID-19 cases — through a cough or being within 6 feet of the person for 15 minutes — had to quarantine for 14 days, even if they were wearing a mask.


That policy led to 689 students and employees across multiple campuses having to quarantine. But administrators found that only five people out of that number contracted the virus from exposure at school.

Four of the five individuals had “close contact” in athletics, where masks were not being worn, NBISD Superintendent Randy Moczygemba wrote in a letter to parents on Oct. 13. The fifth person had “close contact” while at lunch without a mask.

“Our data indicates that when all students are wearing a mask, students have not contracted COVID-19 while at school,” Moczygemba wrote.

That data led school officials to change how they defined close contacts.

The new policy, which went into effect Monday, considers a person a “close contact” if they are coughed on or within 6 feet of an infected person for a total of at least 15 minutes. But if both individuals were properly masked, the exposed individual will not be considered a “close contact.”

Thus, they would not have to quarantine for 14 days. The district also barred neck gaiters as part of the adjustment.

“We feel confident about the change, but if the change results in students contracting COVID-19 while wearing a mask, we will come back and address that again,” Moczygemba told Community Impact Newspaper.

Since the beginning of the NBISD school year, 39 students and 13 staff members have tested positive for the virus.

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CDC Broadens Definition of ‘Close Contact’ in Tracing COVID Infections | Health News

By Robin Foster and E.J. Mundell
HealthDay Reporters

(HealthDay)

THURSDAY, Oct. 22, 2020 (HealthDay News) — In a move that widens the pool of people considered at risk for coronavirus infection, U.S. health officials released new guidance on Wednesday that redefines who’s considered a “close contact” of an infected individual.

The change, issued by the U.S. Centers of Disease Control and Prevention, will likely have the biggest impact in group settings where people are in repeated contact with others for brief periods over the course of a day, such as schools and workplaces, the Washington Post reported.

The CDC had previously defined a “close contact” as someone who spent at least 15 consecutive minutes within six feet of a confirmed coronavirus case. Now, a close contact will be defined as someone who was within six feet of an infected individual for a total of 15 minutes or more over a 24-hour period. State and local health departments rely on this definition to conduct contact tracing, the Post reported.

The new guidance arrives just as the country is “unfortunately seeing a distressing trend, with cases increasing in nearly 75 percent of the country,” Jay Butler, the CDC’s deputy director for infectious diseases, said during a rare media briefing Wednesday at CDC headquarters in Atlanta, the Post reported.

CDC scientists had been discussing the new guidance for several weeks, said an agency official who spoke on the condition of anonymity, the Post reported. Then came unsettling evidence in a government report published Wednesday: CDC and Vermont health officials had discovered the virus was contracted by a 20-year-old prison employee who in an eight-hour shift had 22 interactions — for a total of over 17 minutes — with individuals who later tested positive for the virus.

“Available data suggests that at least one of the asymptomatic [infectious detainees] transmitted” the virus during these brief encounters over the course of the employee’s workday, the report said.

Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security in Baltimore, called the updated guidance an important change.

“It’s easy to accumulate 15 minutes in small increments when you spend all day together — a few minutes at the water cooler, a few minutes in the elevator, and so on,” Rivers told the Post. “I expect this will result in many more people being identified as close contacts.”

At the same time, it’s not clear whether the multiple brief encounters were the only explanation for how the prison employee became infected, Rivers added. Other possibilities might have included airborne or surface transmission of the virus. She also noted that the new guidance “will be difficult for contact tracing programs to implement, and schools and businesses will have a difficult time operating under this guidance.”

Third COVID Surge Spreads Across the Country

Meanwhile, a third surge of coronavirus cases now has a firm grip on the United States, with an average of 59,000 new infections being reported across the country every day.

That tally is

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CDC broadens definition of who’s at risk of getting coronavirus

The CDC on Wednesday ramped up its criteria for who’s at risk of contracting the coronavirus, in a move with major implications for school and workplace reopenings.

The updated guidance defines a “close contact” as anyone who spends at least 15 minutes within six feet of an infected individual over a 24-hour period. The agency previously applied that designation to people who spent 15 consecutive minutes within six feet of someone with Covid-19.

“Individuals who had a series of shorter contacts but over time added up to more than 15 minutes became infected,” CDC Director Robert Redfield said at a briefing, citing a study of multiple non-consecutive exposures. Redfield was joined by HHS Secretary Alex Azar and Jay Butler, the CDC’s deputy director for infectious diseases, who warned that the U.S. is showing a “distressing trend” with cases surging over 75 percent of the country.

The details: The guidance is based on a study out today showing brief exposures to infected individuals and resulted in virus spread. The study involved a Vermont correctional facility employee who tested positive after short interactions with multiple inmates who were infected.

The study said the correctional officer was never with the inmates for 15 consecutive minutes. The Vermont Department of Health said the officer wore a cloth mask, gown and goggles and had 22 interactions totaling about 17 minutes with six unmasked inmates who tested positive for the virus.

What’s next: The updated guidance could change how public health departments across the country conduct their contact tracing, by increasing the pool of potentially infected individuals. It also could upend plans to reopen schools and businesses that had been based around the earlier guidance, as President Donald Trump continues to call for a return to pre-pandemic conditions. The CDC in May released guidelines for reopening schools that Trump later disavowed, saying they were too burdensome.

The U.S. is reporting an average 60,000 cases per day with the Midwest seeing the largest increases in cases. Officials warned conditions could get worse as the cold weather sends people indoors, where the virus can spread more rapidly.

So far, there have been 8.3 million reported cases in the U.S. and more than 221,000 deaths.

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Definition, risk factors, and how to overcome

“Suicidal tendencies” is a term that people sometimes use to describe someone who may be “at risk of suicide.” However, it is not a correct term, as suicide is not a characteristic that a person would have a “tendency toward.”

Someone who is at risk of suicide may be experiencing suicidal thoughts. These can range from vague thoughts of not wanting to exist anymore to being intentional about planning a way to end one’s own life.

Keep reading to learn more about risk factors for suicide and how to overcome them. We also provide some tips on coping with stress and depression.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can call 800-799-4889.

Click here for more links and local resources.

A growing amount of scientific evidence suggests that there may be a genetic link associated with suicide.

A 2012 meta-analysis examined people with a psychiatric diagnosis and noted that those with a certain gene variation had a greater risk of suicidal behavior.

Family studies also suggest some genetic involvement. Researchers who reviewed studies that explored this link highlighted an array of evidence suggesting that relatives of people who have attempted or died by suicide may be at a greater risk of death by suicide than relatives of those who have not.

However, what places a person at risk of suicidal thoughts or behavior is multifaceted. It likely involves an interaction among genetic factors, learned behaviors, and personal circumstances.

That said, it is extremely important to note that if a person has a family member who dies by suicide, it absolutely does not mean that they will too. The data above are purely statistical, and mental health is a complex issue that reaches far beyond the limits of statistical data.

Aside from a family history of suicide, there are many other potential risk factors that may lead to suicidal behavior. Suicide is strongly linked to depression. However, it is important to note that there is rarely one single cause of suicide.

According to the American Foundation for Suicide Prevention, risk factors for suicide may include:

Health-related factors

A variety of health conditions can increase a person’s risk of suicidal thoughts and behavior. These include:

  • mental health conditions
    • aggressive behavior, mood swings, and difficulty maintaining relationships
    • anxiety disorders
    • bipolar disorder
    • contact disorder
    • depression
    • problems with substance use
  • severe physical health conditions, such as pain
  • traumatic brain injury

Environmental factors

External influences that can

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The True Definition of Conditioning in Sports and Fitness

Conditioning is a word that is used a lot in the fitness industry but what does it really mean to have conditioning? There are those that are ripped from strength conditioning, marathon runners have to go through a type of stamina conditioning and then there is the conditioning that is necessary for fighters and martial artists.

Conditioning can come off as this hard core concept of hard work and training to build your body up so it can perform or endure what the sport demands of it.

And it’s true.

However, that is not the whole picture of what it means to be a conditioned athlete. Building your body and it’s performance potentials is only the outcome associated to having “great conditioning”.

The other half of the definition of conditioning is more about the discipline, the standard and the values that you adopt.

“Great conditioning” is the result of adopting and integrating habits, standards and values that slowly, over time changes and transforms the conditions of the body.

Conditioning isn’t so much about building yourself up but rather more about adopting a specific way of being that will serve you in the long run which is beneficial for the performance and execution of the skills in a given sport or physical activity.

So, how do you integrate a great conditioning ritual? One that will meet your athletic needs based on the sport or physical activity of your choice?

A good place to start is by looking at where your values are placed in your sport. By looking at the components that you already have a natural inclination to favour and value, then you have a platform where you can design for yourself a discipline that you are more than likely to commit to.

If for example you naturally favour cardio, then use that as a base to develop a discipline to condition, not only great cardio but also as a way to condition better form, more strength and greater endurance doing the activity that is the source of cardio. It’s also a great way to develop secondary attributes. If, for instance you typically rely on jogging for cardio but you would like to develop another physical skill or work on some upper body, than you might consider cardio boxing. Or you might want to develop better foot co-ordination and do some skip rope.

By focusing on what you already prefer, you are much more likely to build on it and develop a discipline and from a place of discipline is where conditioning can flow from the best.

Also, using discipline is a powerful way to predispose yourself to growth and improvement in a specific skill or attribute. Once you have established a discipline on a particular practice, then it’s only a matter of pushing yourself and upping the ante in order to improve and refine that conditioning.

Let me leave with one final thought, and that is, when thinking in terms of the type of conditioning you feel you may …

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Understanding the Definition of Health Related Fitness

Being a Health and Fitness Professional, it is my job to understand terms and definitions which are commonplace to this industry, as well to keep abreast of evolving trends. Through my experience, I have found that a number of terms deserve a little more clarification than that which they are granted.

Aside from clarifying the definition of Health Related Fitness, this article intends to shed some light on a few of the associated terms, and to show their respective distinctions.

Is it simply all in a name?

The fitness world seems to use the concept Health Related Fitness like a generic fitness principle – interchangeable with others like “Physical Fitness”, “Health and Fitness” or simply “Fitness.”

While all of these terms can be included under the broad term Health and Physical Fitness, they individually refer to different aspects – both generic and specific. Unfortunately, references to these and other fitness-related terms are often vague, while consistency in their intended use is meager at best; there is a kind of “generally accepted” use for them, but individuals often rely on own interpretation, and this can lead to confusion.

With that said, does Health Related Fitness simply infer fitness by means of good health? Not quite. That is why we need to understand a little more behind these words before digesting the definition.

How did the term Health Related Physical Fitness come about?

That is a good question. One could probably ask what is this concept all about – can we not simply use the terms “Fitness” or “Physical Fitness” instead?” Why Health “Related”?

The main reason stems from the fact that most health and fitness terms are used inconsistently and often refer to different concepts or notions. Subsequent to the 1996 report from the US Surgeon General (Physical Activity and Health; a report of the Surgeon General), there was a move to try and address the alarming rise in obesity levels among the general American public. Studies and initiatives required standardization among clinicians, health practitioners and fitness trainers to grapple with the task at hand. Enter “Health Related Physical Fitness”, a working term to address the general state of health among the public.

The definition of Health Related Fitness

According to the American College of Sports Medicine (ACSM), the main authority in this field, ineffective definitions with unclear and subjective wordings, as well as definitions containing terms which themselves require defining, have contributed to confusing the term “Physical Fitness.”

There exists no reliable guide for Health and Fitness Professionals to measure “Physical Fitness”, because the term has been so loosely and inconsistently defined. It is therefore that one should consider the concept of Health Related Fitness. The definition therefore centers on the 5 Components of Physical Fitness which relate to “good health.” These Components are:

  • Cardiorespiratory Fitness
  • Body Composition
  • Flexibility
  • Muscular Strength
  • Muscular Endurance

On the other hand, Skill Related Fitness Components are:

  • Balance
  • Reaction Time
  • Coordination
  • Agility
  • Speed
  • Power

According to the Centers for Disease Control and Prevention (CDC), …

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