Answer to Question 1
The two disorders do not typically occur in the same individual, but they often are found in different members of the same family. Since antisocial personality is far more common among men, while somatic symptom disorders have the opposite pattern, some have speculated that the two problems are flip sides of the same coin. Antisocial personality disorder may be the male expression of high negative emotion and the absence of inhibition, whereas somatic symptom disorder is the female expression of the same characteristics.
Answer to Question 2
The social learning perspective would suggest that somatic symptom disorders are caused by learning. There is a concept called learning the sick role in which behaving as if sick is acquired through observation of others, some of whom are actually ill. Once the patient is in a sick role, operant conditioning may take over. People take care of you, do things for you and reduce demands made of you, all of which can act as either positive or negative reinforcement and increase the behavior in question. Getting attention acts generally as positive reinforcement, while receiving reduced demands acts generally as negative reinforcement.
Maxine Williams was the founder and first president of the AAMA. Printed with permission of American
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