Chapter 12 Pt 1

Question 1

what is malingering

Answer 1

CONSCIOUS feigning of symptoms in order to avoid, jail, court, or obtain housing or compensation
SECONDARY GAIN

Question 2

what is the criteria for somatic symptom disorder

Answer 2

ONE or MORE somatic symptoms (may be predominately pain) that are distressing or result in significant disruption

excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns

lasts at LEAST 6 MONTHS

Question 3

what are risk factors for somatic symptoms disorder

Answer 3

odler age
fewer years of education
lower socioeconomic status
unemployment
history of childhood sexual abuse

Question 4

what is treatment of somatic symptoms disorder

Answer 4

regularly scheduled casuists with a SINGLE primary care PROVIDER and MINIMIZE UNNECESSARY TESTS

ADDRESS PSYCHOLOGICAL ISSUES SLOWLY

Question 5

what is criteria for conversion disorder

Answer 5

at least one symptoms of altered voluntary motor or sensory function

incompatibility b/w the symptom and recognized neurological or medical conditions

Question 6

what are common symptoms of conversion disorder

Answer 6

paralysis
weakness
blindness
mutism
sensory complaints (paresthesias)
seizures
gobs sensation

Question 7

conversion like symptoms in elderly have higher likely hood of representing what

Answer 7

underlying NEUROLOGICAL deficit

Question 8

high incidence of cormorbid what in conversion disorder

Answer 8

neurological, depressive, and anxiety disorder

Question 9

what is tx for conversion disorder

Answer 9

EDCUATION ABOUT ILLNESS

CBT

Question 10

what is criteria for illness anxiety disorder

Answer 10

PREOCCUPATION with HAVING or ACQUIRING a serious illness

somatic symptoms ARE NOT PRESENT, or if present, mildly intense

high level of anxiety about health

performs excessive health-related behaviors or exhibits maladaptive behaviors

persists for at LEAST 6 MONTHS

Question 11

what is the ONLY somatic symptoms-related disorder that DOES NOT FAVOR WOMEN

Answer 11

illness anxiety disorders (men and women affected equally)

Question 12

what is treatment of illness anxiety disorder

Answer 12

REGULARLY SCHEDULED VISITS to ONE PRIMARY care physician

CBT

Question 13

what factors lead to better prognosis in illness anxiety diroser

Answer 13

fewer somatic symptoms
shorter duration of illness
abscess of childhood physical punishment

Question 14

what is meant by “Psychological Factors Affecting Other Medical Conditions”

Answer 14

pt with one or more psychological or behavioral factors (distress, coping styles, maladaptive health behaviors) adversely affecting a medical symptom or condition

anxiety worsening asthma

denial of need for treatment of acute chest pain

manipulating insulin to lose weight

Question 15

absence of external rewards is a prominent feature of what disorder

Answer 15

FACTICIOUS

Question 16

what is criteria for Factitious disorder

Answer 16

falsification of physical or psychological signs or symptoms, or indication of injury or disease, associated with identified deception

deceptive behavior evident even in absence of obvious external rewards

Question 17

what is muchhausen syndrome

Answer 17

older name for factitious disorder with predominately PHYSICAL COMPLAINS

Question 18

what is munchhausen syndrome by proxy

Answer 18

intentionally producing symptoms in someone else who is user one’s care

Question 19

what are commonly feigned symptoms in factitious isorder

Answer 19

psychiatric- hallucination, depression

medical- fever (heating thermometer), infection, hypoglycemia, abdominal pain, seizures, and hematuria

Question 20

factitious disorder is seen in higher incidence among what field of workers

Answer 20

hospital and healthcare

Question 21

many patinets with factitious disorder have a history of what

Answer 21

illness and hospitalization as well as childhood physical or sexual abuse

Question 22

what is treatment for factitious

Answer 22

collect collateral information from medical treaters and family

collaborate with PCP and treatment team to avoid unnecessary procedures

CONFRONTATION in a NONTHREATENING MANNER
-may leave AMA and seek hospitalization elsewhere

Question 23

what is malingering

Answer 23

INTENTIONAL reporting of physical or psychological symptoms in order to ACHIEVE PERSONAL GAIN

Question 24

what are common external motives for malingering

Answer 24

avoiding police
room and board
obtaining narcotics
receiving monetary compensation

Question 25

malingering is NOT considered what

Answer 25

a MENTAL ILLNESS

Question 26

patients with malingering usually present how

Answer 26

multiple VAGUE complaints that do not conform to a well known medical condition

long medical history with many hospital stays

Question 27

what are the distinguishing features of somatic symptom disorders

Answer 27

patients BELEIVE they are ill and do not internally produce or feign symptoms

Question 28

what are the distinguishing features of factitious disorder

Answer 28

patients intentionally produce symptoms of a psychological or physical illness because of a desire to assume the SICK ROLE, not for external rewards

Question 29

what are the distinguishing features of malingering

Answer 29

patients intentionally produce or feign symptoms for EXTERNAL REWARDS