Page 33 - JCBP-3-4

Journal of Clinical and
Basic Psychosomatics Somatic symptom disorders and aging

with a diagnosed SSRD. It is recommended that clinicians have also highlighted some of the historical challenges
build a relationship with other members of the client’s and changes to the diagnostic category of the SSRDs
healthcare team to gain as much information about the client and noted how this category has been especially poorly
as possible. Doing so can help the client feel understood understood and confusing to medical and mental health
and can assist in the development of rapport. Rapport providers alike. The lack of elder-specific measures of
can also be improved by providing the client the space SSRD psychopathology is a major gap that hopefully will
to feel understood. Often times, clients with SSRDs want be addressed by further research. Likewise, large-scale
to find a physical cause for their symptoms to experience validity studies are critically needed to formally assess
a successful treatment. Introducing psychotherapy as a the psychometric properties of common assessment tools
second form of treatment to clients can help them not feel for SSRDs among diverse older adult populations. For
that their physical symptoms are not real, invalid, or only example, basic studies yielding evidence in support of
in their head. These recommendations are feasible ways to the internal consistency reliability, test-retest reliability,
better communicate with individuals with SSRDs, which convergent validity, and discriminant validity for
are transferrable skills that can also be used with older these measures are needed, including head-to-head
adults. There is also a limited knowledge of SSRDs in the comparisons between the key measures and evaluations of
general population. As such, public education campaigns the proposed factor structures of measures with subscales.
are needed. Indeed, such campaigns can be similar to those Studies are also needed to determine how these measures
devised for depression in later life, which have resulted in might be adapted for use with diverse older respondents,
increased awareness of depression and increased referrals including development of empirically-based cutoff scores
for appropriate treatment. 38 for the measures. Finally, treatment trials for older adults

3.4. Complex symptom presentation with SSRDs are necessary to establish sensitivity to change
for the key assessment tools.
A final barrier to adequate assessment of SSRDs among
older adults is that older adults with SSRDs often present We hope the information in this article provides a good
with a complex array of intertwined and reciprocal physical starting point for those interested in furthering their clinical
and psychological symptoms, requiring comprehensive and research work with older adults with SSRDs. Indeed,
assessment strategies. Chronic health conditions are we think that clinicians and researchers would benefit from
common in older adults, and while some individuals with a more nuanced understanding of these complex disorders
a health condition may have an SSRD, many do not, as in diverse clinical and research contexts. From a clinical
their distress and reaction to being ill are reasonable and perspective, practitioners would benefit from learning
appropriate to the context and situation. Unfortunately, more about SSRDs and assessing these types of symptoms
the rate of chronic conditions increases with age, and more routinely in their older patients. Likewise, the time is
psychogenic stress can also exacerbate those physical ripe for empirical research to accelerate and for our overall
health conditions, further complicating the assessment understanding of SSRDs in later life to improve.
process of older adult. Medical providers and mental
3,10
health clinicians must carefully investigate symptoms Acknowledgments
and health history to determine whether the individual None.
is experiencing an SSRD, an anxiety disorder, a mood
disorder, or is simply suffering from chronic and unpleasant Funding
medical conditions. This process takes a certain amount of None.
time and coordination between mental health clinicians
and medical providers, which is necessary for improved Conflict of interest
patient care, but unfortunately is frequently not allowable
for reimbursement from most insurance companies. As The authors declare no conflicts of interest.
such, full coordination is often an aspiration and not a Author contributions
clinical reality.
Conceptualization: Daniel L. Segal, Charlotte Howell
4. Conclusions and future directions Writing–original draft: Charlotte Howell, Daniel L. Segal

In this paper, we have attempted to elucidate some Writing–review & editing: All authors
of the nuances and challenges regarding the accurate Ethics approval and consent to participate
diagnosis and assessment of SSRDs among older adults,
who represent a growing and unique population. We Not applicable.

Volume 3 Issue 4 (2025) 27 doi: 10.36922/JCBP025080013