Japanese Journal of Psychosomatic Medicine
Online ISSN : 2189-5996
Print ISSN : 0385-0307
ISSN-L : 0385-0307
Mechanisms of Onset in Psychosomatic Diseases : From the behavioral poit of view(Mechanisms of Onset in Psychosomatic Diseases)
Shin-ichi NozoeTetsuro MuranagaYasuyuki Koga
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1994 Volume 34 Issue 3 Pages 257-263

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Abstract
From the behavioral point of view, the continuation and aggravation of psychosomatic disorders are thought to be initiated by conditioned responses to aversive or noxious internal and/or external conditioned stimuli (CS). Anxieties and fears that accompany the conditioned response (CR) i. e, conditioned emotional response (CER), intensify the action of CS through a positive feedback loop such that, consequently, the CR is intensified. It is suggested that, after being evoked by the CS which are accompanied by some unconditioned stimuli, the CER can result from any of the following three processes or their interactions. A : Cognitive learning-Wrong cognitive learning or information provokes the patients' anxiety and this results in aggravation and continuation of symptoms. B : Operant learning-Operant behaviors, done by patients to reduce their anxiety or fear, results in aggravation and continuation of symptoms through the operant principle. C : Classical learning-An effect of the incubation phenomenon increases the patients' anxiety and fear and results in aggravation and continuation of symptoms. For the reasons mentiored above, psychosomatic disorders become worse through these three types of learning and become accelerated depending on their interactions. Cases in which the symptoms are continuous and deteriorating because of cognitive and operant learning (types A and B) are best treated by teaching the patient new ways of thinking, while those that are continuous and deteriorating through classical learning (type C) are best treated by teaching the patients how to control their anxiety.
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© 1994 Japanese Society of Psychosomatic Medicine
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