Chapter 5 in class notes Flashcards
Somatic symptoms disorder A) Prevalence B) Onset C) Comorbid D) Prognosis
A) 1-5%
B) early adulthood diagnosis. Symptoms start at 10-13yrs
C) depression and anxiety
D) not good
Somatic symptoms disorder
A) preoccupation with ___
B) Less concerned with…
C) ___ thoughts, feelings and behaviors related to ___
D) How long for symptoms
E) example of distress or disruption in life
A) symptoms - headache, stomach B) underlying disease C) excessive, health concerns D) 6+ months E) doctors a lot, emergency room a lot. testing a lot.
[exam]
Somatic symptoms disorder (SSD)
vs
Illness anxiety disorder (IAD)
Somatic = symptoms
Illness = illness itself
Illness anxiety disorder
A) formerly known as
B) Prevalence
C) Onset
A) hypochondriasis
B) 6.7 - 16.6%
C) childhood worries/vague symptoms - caught in early adulthood
Illness anxiety disorder
A) Comorbid with
B) Prognosis
A) anxiety/depression
B) negative, difficult to treat
Illness anxiety disorder
A) __ conviction
B) Preoccupation with
C) Worrying about ___
A) disease conviction - doesn’t believe it’s a psychological disorder
B) the possibility of being sick or acquiring a disorder/illness
C) underlying disease
SSD and IAD
Causes of Somatic Symptom Disorder and Illness Anxiety Disorder
- Trigger - vulnerabilities
Perceived threat > Anxiety > Arousal (body focus, symptoms – this is where SSD happens) > Behavior checking > Preoccupation > Misinterpretation (Where Illness anxiety disorder happens) > Perceived threat
SSD and IAD treatment
A) ____ - not because effective
B) ____ and _____ strategies
C) Education between ___ and ____
A) CBT
B) stress management and coping strategies
C) education between body and mind relationship
Functional Neurological Symptom Disorder FNSD A) used to be called B) Prevalence rate C) Onset D) Female to male
A) conversion disorder
B) 3-15%
C) sporadic (from 20-55 years)
D) women primarily 2:1 - female to male. Women seek treatment more
Functional Neurological Symptom Disorder A) \_\_\_ malfunction w/out \_\_\_\_\_ B) Most are deficits in the \_\_\_\_\_ C) has symptoms of \_\_\_ but \_\_\_\_ D) Easily \_\_\_
A) physical malfunction without organic (physical) pathology
B) sensory-motor-system
C) neurological issues but there’s no apparent reason
D) Hypnotized - take suggestions easily
Functional Neurological Symptom Disorder
A) Malingering?
B) treatment
A) no
B) none that works. Decrease behavioral reinforcement - symptoms decrease
la belle indifference
FNSD - Functional Neurological Symptom Disorder
inappropriately complacent attitude towards their condition and physical symptoms, seen in patients with Functional Neurological Symptom Disorder (conversion) disorder.
Primary gains and secondary gains
Primary morbid gain produces positive internal motivations. For example, a patient might feel guilty about being unable to perform some task. If a medical condition justifying an inability is present, it may lead to decreased psychological stress. Primary gain can be a component of any disease, but is most typically demonstrated in Functional Neurological Symptom Disorder (conversion)– a psychiatric disorder in which stressors manifest themselves as physical symptoms without organic causes, such as a person who becomes blindly inactive after seeing a murder. The “gain” may not be particularly evident to an outside observer.
Secondary morbid gain can also be a component of any disease, but is an external motivator. If a patient’s disease allows him/her to miss work, avoid military duty, obtain financial compensation, obtain drugs, or avoid a jail sentence, these would be examples of a secondary gain. An example would be an individual having stomach cramps when household chores are completed by a family. In the context of a person with a significant mental or psychiatric disability, this effect is sometimes called secondary handicap.
Factitious Disorder
A) Formerly called
B) by proxy is called
A) Munchausen’s Syndrome
B) Factitious Disorder Imposed by Others (FDIO)
Factitious Disorder Imposed by Others FDIO
A) Falls between ___ and ____
B) Written about in ___ by ___
A) Conversion Disorder and Malingering
B) 1977 by Samuel Roy Meadows
Malingering
faking a disorder for $ or disability, drugs, get out of responsibilities
Factitious Disorder Imposed by Others FDIO
A) prevalence
B) victims death rate
C) Caregivers
A) unknown - hard to catch
B) 10% death rate for victims
C) the ones harming the victim. often seeking attention
Factitious Disorder Imposed by Others FDIO Methods of Illness Creation A) B) C)
A) Cause the illness
B) Prolong or exacerbate pre-existing condition
C) Fake results - putting blood in urine - protein in samples
FDIO - Characteristics of perpetrator A) Female to male (what % mom) B) Medical history C) Medical compliance D) Medical knowledge
A) 98% female - 75% mom
B) falsified
C) seem to comply
D) very knowledgeable
FDIO A) tests B) over\_\_\_\_ C) unconcerned about \_\_\_ D) mannerism/behaviors
A) more requested. they’ll suggest spinal tap (most invasive test and very painful)
B) attentive - very attentive and loving
C) prognosis - not concerned with future health. how long will they be in hospital. how many tests?
D) perfectly put together. PTA soccer mom
FDIO - Clinical Presentation A) Age dependent B) Presence of \_\_\_ C) Symptomatology and presentation D) prognosis course of disease E) denial
A) young or old - nonverbal - perp can use more obvious means because they can. if they’re older they have to be discrete.
B) caregiver is constantly present. Mom stays home with kid, insists to stay with kid no matter what.
C) consistent. age of 6mo as long as they can until they’re verbal
D) chronic. They don’t usually switch methods. - go onto next kid. negative prognosis - they don’t think they’re wrong.
E) if the victim dies they don’t feel remorse - don’t feel they did it.
Dissociative Disorder
A) How common
B) Derealization - define
C) Depersonalization
A) Fleeting dissociation is common but this is 30 - 1hr
B) person feels like not part of reality. Foggy confused state. Could be dehydrated.
C) feel like separated from physical body. Body and mind separate.
[exam] Active versus Receptive parts of consciousness
Ernest Hilgard theory
Active - engaged
Receptive - passive.
Active and receptive usually in sync. with Dissociative Disorder they’re pulled apart.
Depersonalization - Derealization Disorder A) Prevalence B) Male and female C) diagnosed around \_\_\_ years D) Comorbid with
A) 4% (similar to PTSD)
B) Primarily in females. Experiences throughout childhood.
C) diagnosed around 20 years
D) anxiety, depression, PTSD
Depersonalization-Derealization Disorder
A) Frequent and severe episodes of ___
B) Before diagnosing need ___ testing
A) detachment from own mental processes or body (outside observer)
B) neuropsychiatric - could be oxygen cut off from brain
Dissociative Amnesia
A) Description
B) Prevalence
A) inability to recall important autobiographical info - personal info. Any or some.
B) 4-5%
Dissociative Amnesia
A) Types of amnesia
A) generalized
localized
Define:
A) Anterograde amnesia
B) Retrograde amnesia (dissociative specifically)
A) Struggles to encode - can’t learn new information
B) difficulty recalling past - personal past specifically
Dissociative Amnesia - what is affected more?
Retrograde affected more (which is strange) – they lose personal information but not general information.
Organic amnesia - caused by (A)
B) new information
C) old information
A) physical reason (brain damage, etc.)
B) new information is difficult to encode (anterograde) often affected
C) retrograde - if affected - they’ll lose personal AND general information
Before diagnosing Dissociative Amnesia need to rule out ___ and ____
organic amnesia and other psych disorders (alzheimers, etc.)
Dissociative Fuge
doesn’t have retrograde autobiographical information - sometimes they leave their past, lead a completely new life.
Dissociative Identity Disorder A) used to be called B) Prevalence C) Onset D) Gender stats E) common correlation
A) Multiple Personality Disorder B) 4-5% C) diagnosed 20-30 years old. Symptoms all the way back to childhood D) 9/10 in women E) trauma
Dissociative Identity Disorder
A) # of possible personalities/identities - average is _
B) Disruption of ___
C) Distinct ____ -
A) can be over 100. Average is 10
B) Identity - who we are tends to be fairly consistent
C) Identities - change in affect. Memory/sensory/cognitive functioning. Physiological/physical changes - fMRI measured changes
[exam] Clinical presentation of Dissociative Identity Disorder A) personalities B) A\_\_\_ C) [exam] comorbidity with... D) I\_\_\_ E) "Voices" from where?
A) has them
B) Amnesia - when other personalities are talking. core self is naive
C) anxiety, depression, PTSD and somatic illness anxiety disorder
D)
E) from inside their head - side conversations (the other personalities are talking to each other)
Issues with Diagnosis of Dissociative Identity Disorder
A) Unheard of prior to ___
B) famous serial killer who claimed it.
C) how was he caught?
A) 1980
B) Kenneth Bianchi - hillside strangler. Death Diploma - psychopaths speak.
C) personalities cannot be created on the fly - in hypnosis the Dr. said “it’s unusual to only have two personalities” – Bianchi created more.
