title: Stress, distress, and bodytalk: co-constructing formulations with patients who present with somatic symptoms.
abstract: In the context of stress-internal or external events that threaten the individual's physical or psychological well-being-the human body signals distress along with disruptions in physiological regulation. When stress-related disruptions are extreme or are not limited in time, they may result in a broad range of somatic, behavioral, and cognitive symptoms. This article aims to (1) provide clinicians with a theoretical framework for understanding the body systems that mediate stress-induced somatic symptoms, and (2) illustrate how this framework can be applied clinically. The article begins with a brief overview of the key body systems involved in homeostasis, paying special attention to how those systems take on self-protective functions in the face of stress. Against that background, the focus then turns to a discussion of commonly occurring somatic symptoms and their probable neurophysiological underpinnings. Short vignettes illustrate typical presentations and how potential etiologies can be discussed with patients, be used to co-construct formulations, and be integrated into jointly determined treatment plans.
authors.affiliation: From the Disciplines of Psychiatry and of Paediatrics and Child Health, University of Sydney Medical School; The Children's Hospital at Westmead and the Brain Dynamics Centre, Westmead, New South Wales, Australia.
authors.forename: Kasia
authors.initials: K
authors.lastname: Kozlowska
mesh_terms: D003937:Diagnosis, Differential; D006706:Homeostasis / Q000502:physiology*; D006801:Humans; D013001:Somatoform Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D013312:Stress, Physiological / Q000502:physiology*; D013315:Stress, Psychological / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*