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PSYC 3604 B: Clinical Psychology > Chap 5: Somatic symptom and dissociative disorders > Flashcards

Chap 5: Somatic symptom and dissociative disorders Flashcards

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1
Q

Who introduced somatic symptom and related disorders? Give date and brief explanation of how it was identified

A

Introduced by Pierre Briquet (hysteria or Briquet syndrome) 1859 - somatic complaints with no physical cause, often also depressed/experienced large life event

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2
Q

Current definition of somatic symptom and related disorders? What are the 4 disorders under this umbrella?
What are the 3 key elements of this disorder? What is the prevalence?

A

Conditions in which physical symptoms or concerns about an illness cannot be explained by a medical or psychological disorder

Umbrella:

  1. Somatic symptom disorder
  2. Conversion disorder
  3. Illness anxiety disorder
  4. Factitious disorder

Key elements

  1. Physical symptoms suggestive of medical illness
  2. Significant psychological distress
  3. Functional impairment

Less than 1% in primary care settings

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3
Q

Define conversion disorder? What are the 3 groups of symptoms?
Define glove anesthesia and la belle indifference

A

Physically healthy people experience loss of functioning in part of the body with no neurological causes

Symptoms:

  1. Motor deficits
  2. Sensory deficits
  3. Seizures and convulsions

Glove: loss of sensitivity in the hand in the wrist, does not follow physical anatomy as nerves do not end at the wrist
La belle indifference: emotional indifference/undisturbed by severe physical symptoms

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4
Q

Define malingering? What makes it different from conversion disorder? Is it a mental illness?

A

A conditions in which physical symptoms are produced intentionally for material reward or external incentive - used to gain something (money) or avoid something (work) or seek attention in clinical/therapeutic settings

Differences: voluntary control, do not exhibit belle indifference, do not adhere to treatment plans well and stop showing symptoms when rewards stop

No, not according to DSM-5

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5
Q

Define illness anxiety disorder (Hypochondriasis)? What are the two types and the common behavioral symptoms?

A

Preoccupation with having or acquiring a serious illness

2 types:

  • Care seekers (desperate for care because afraid of illness)
  • Care avoiders (avoid care because afraid of illness)

Behavioral symptoms:

  • Reassurance seeking from medical professionals
  • Researching medical information
  • Voicing health concerns
  • Avoiding
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6
Q

What is factitious disorder (Munchausen)? What are the two types?
What are the facts around children and this disorder? What behaviors may cause a Dr. to suspect this disorder?

A

Physical or psychological signs of symptoms of illness are intentionally produced in what appears to be a desire to assume sick role

Two types:

  1. Imposed on the self
  2. Imposed on another

Suspect: patient is caught lying, has medical history that does not make sense, illness does not follow usual course, is hesitant to answer questions about illness

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7
Q

What are the facts around children and Munchausen?

A

Children

  • Child victims are most common
  • Have as many as 19 illnesses and an average of 3
  • 6-22% will die as a result of illness
  • Over 7% left with long -term/permanent injury
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8
Q

What is the onset, prevalence, risk factors, comorbidity and prognosis for somatic symptoms related disorders?

A

Onset: early to mid-adulthood
Prevalence: largely unknown, range from <1% to 10%
Risk factors:
- environment (stress, abuse, trauma, family problems)
- race/ethnicity/SES
- more common in women
- more common in adulthood
Comorbidity: other medical disorders, anxiety and depressive disorder
Prognosis: chronic with low rates of recovery

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9
Q

What are the biological explanations of the etiology of somatic symptom and related disorder?

A

Twin studies: moderate heritability of disorders
Bio vulnerability: sensitivity to pain
Structural or functional abnormalities
- Anatomical differences
- Right hemisphere functioning
- Neurological circuitry - stimulating numb hand/foot did not result in somatosensory region
Little support for genetic etiology

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10
Q

What are the psychological explanations of the etiology of somatic symptom and related disorder?

A

Psychodynamic
Behavioral
Cognitive

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11
Q

What are the psychological - psychodynamic and behavioral explanations of the etiology of somatic symptom and related disorder?

A

Psychodynamic theories

  • Unconscious conflict and traumatic emotional experiences
  • Factitious disorders caused by
    • Attempt to gain control
    • Form of masochism
    • Deprived childhood
    • Attempt to deal with trauma

Behavioral theories
- Operant conditioning - Learning

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12
Q

What are the psychological - cognitive explanations of the etiology of somatic symptom and related disorder?

A

Inaccurate beliefs (faulty cognitive interpretations) about

  • prevalence of illness
  • meaning of symptoms
  • course and treatment of illness

Distorted cognitions
- somatic amplification

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13
Q

What is the cognitive model of health anxiety (four contributing factors)?

A
  1. Critical precipitating incidence
  2. Previous experience with illness and related medical factors
  3. Presence of inflexible or negative cognitive assumptions
    Severity of anxiety
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14
Q

What are the biological approaches to treatment for somatic symptom and related disorder?

A

Medications: antidepressants, antipsychotics (few trials conducted, but seem to be effective in short term)

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15
Q

What are the psychological approaches to treatment for somatic symptom and related disorder?

A

Cognitive behavioral therapy (CBT) - general focused on discouraging clients from seeking medical assurance/pointing out areas of physical focus
Symptom focused cognitive behavioral therapy (CBT) - basic education of mind body connection when it comes to symptoms, teaching patient to cope with symptoms (ex: diverting attention, coping strategies)
Exposure therapy
Short-term psychotherapy

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16
Q

What are dissociative disorders? what are the 3 conditions? what are the five types of dissociative experiences?

A

Disorders characterized by disruptions of consciousness, memory and identity

3 conditions

  1. Dissociative amnesia
  2. Depersonalization/derealization disorder
  3. Dissociative identity disorder

Types of dissociative experiences

  1. Depersonalization - feeling detached, experiencing the body as strange or unreal
  2. Amnesia - inability to remember
  3. Derealization - feeling like ur in a dream
  4. Identity confusion - conflict or lack of clarity about one’s identity
  5. Identity alteration
17
Q

What are the 3 types of dissociative amnesia?

A

Localized amnesia - piece of time
Generalized amnesia - all aspect of one’s life
Selective amnesia - some element of a traumatic even

18
Q

Define dissociative amnesia.
Define dissociative fugue
(include characteristics)

A

Amnesia
Amnesia occurs after a medical condition or event while dissociative amnesia follows a trauma/stressful event, not biologically or medically induced
Characteristics: procedural memory intact, autobiographical memory impaired

Fugue 
Apparently purposeful travel or bewildered wandering that is associated with amnesia for identity or other important auto-biographical information 
Characteristics:
Memory loss is more extensive 
Dissociation is more extensive
19
Q

Define depersonalization and derealization.

Define dissociative identity disorder.

A

Depersonalization
feeling detached from one’s body, mind, feelings, and/or sensations
Derealization
feeling detached from the surroundings (people, objects) which seem unreal
Characteristics: no memory disturbance, unusual sensory experiences

DID
Characteristics: primary vs. secondary alters, different traits, preference and skills, appear as voices

20
Q

What are the bio explanations for the etiology of dissociative disorders?
What are the psycho explanations for the etiology of dissociative disorders?

A

Biological explanations

  • Abnormal brain functioning
  • Structural abnormalities (changes in hippocampus/amygdala, but could be due to stress)
  • Neurochemical changes
  • Neurological conditions (epilepsy, head injury)
Psychological explanations 
Failure of normal personality integration 
Coping mechanism (e.g childhood sexual abuse)
Repressed, recovered and false memories 
Posttraumatic model (trauma model)
Iatrogenic model (fantasy model)
21
Q

What is the three stage treatment approach to dissociative disorders?

A

Psychoanalytic approach to treatment

  1. Symptom reduction
  2. Trauma recovery
  3. Integration of personalities

PSYC 3604 B: Clinical Psychology (5 decks)

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