Chapter 6 Somatic Symptom and Related Disorders and Dissociative Disorders Flashcards
Somatic symptom disorders
- Someone who exaggerates the slightest physical symptom
- Many people continually run to the doctor even though there is nothing really wrong with them.
- Preoccupation with their health or appearance becomes so great that it dominates their lives.
- An excessive or maladaptive response to physical symptoms or to associated health concerns
Dissociative disorders
- Lose their identity entirely and assume a new one or they lose their memory or sense of reality and are unable to function
- Disorder in which individuals feel detached from themselves or their surroundings, and reality, experience, and identity disintegrate.
Somatic symptom disorder
- Patients who came to see him with seemingly endless lists of somatic complaints for which he could find no medical basis
- Patients returned shortly with either the same complaints or new lists containing slight variations
Illness anxiety disorder
- “Hypochondriasis”
- Physical symptoms are either not experienced at the present time or are very mild, but severe anxiety is focused on the possibility of having or developing a serious disease.
- If one or more physical symptoms are relatively severe and are associated with anxiety and distress the diagnosis would be somatic symptom disorder
- The concern is primarily with the idea of being sick instead of the physical symptom itself.
- In any case the threat seems so real that reassurance from physicians does not seem to help.
Psychological factors affecting medical condition
- A related somatic symptom disorder
- The presence of a diagnosed medical condition such as asthma, diabetes, or severe pain clearly caused by a medical condition such as cancer that is adversely affected (increased in frequency or severity) by one or more psychological or behavioral factors.
- These behavioral or psychological factors would have a direct influence on the course or perhaps the treatment of the medical condition
Conversion disorders (Functional Neurological Symptom Disorder)
- Generally have to do with physical malfunctioning, such as paralysis, blindness, or difficulty speaking (aphonia), without any physical or organic pathology to account for the malfunction.
- Some suggest that some kind of neurological disease is affecting sensory-motor systems, although conversion symptoms can mimic the full range of physical malfunctioning
- May include total mutism and the loss of the sense of touch
- Some people have seizures- psychological in origin, because no significant electroencephalogram (EEG) changes can be documented
- These “seizures” are usually called psychogenic non-epileptic seizures
- Globus hystericus- the sensation of a lump in the throat that makes it difficult to swallow, eat, or sometimes talk.
Malingering
- Faking
2. Deliberate faking of a physical or psychological disorder motivated by gain.
Factitious disorders
- Fall somewhere between malingering and conversion disorders
- Under voluntary control, as with malingering, but there is no obvious reason for voluntarily producing the symptoms except, possibly, to assume the sick role and receive increased attention.
- May extend to other members of the family
Derealization
- Your sense of the reality of the external world is lost
- Things may seem to change shape or size
- People may seem dead or mechanical
- These sensations of unreality are characteristic of the dissociative disorders because, in a sense, they are a psychological mechanism whereby one “dissociates” from reality
- Depersonalization is often part of a serious set of conditions in which reality, experience, and even identity seem to disintegrate.
- Situation in which the individual loses his or her sense of the reality of the external world.
Depersonalization-derealization disorder
- When feelings of unreality are so severe and frightening that they dominate an individual’s life and prevent normal functioning
- When severe depersonalization and derealization are the primary problem
- Absence of the subjective experience of emotion
Dissociative amnesia
- Includes several patterns
- Dissociative disorder featuring the inability to recall personal information, usually of a stressful or traumatic nature.
- Forgetting is selective for traumatic events or memories rather than generalized.
Generalized amnesia
- Condition in which a person loses memory of all personal information, including his or her own identity.
- May be lifelong or may extend from a period in the more recent past, such as 6 months or a year previously
Localized or selective amnesia
- A failure to recall specific events, usually traumatic, that occur during a specific period.
- Memory loss limited to specific times and events, particularly traumatic events.
Dissociative fugue
- A subtype of dissociative amnesia
- Memory loss revolves around a specific incident- an unexpected trip
- Dissociative disorder featuring sudden, unexpected travel away from home, along with an inability to recall the past, sometimes with assumption of a new identity.
- Mostly, individuals just take off and later find themselves in a new place, unable to to remember why or how they got there.
- Usually they have left behind an intolerable situation.
- Fugue states usually end rather abruptly, and the individual returns home, recalling most, if not all, of what happened.
- The disintegrated experience is more than memory loss, involving at least some disintegration of identity, if not the complete adoption of a new one.
dissociative trance disorder (DTD)
Altered state of consciousness in which the person believes firmly that he or she is possessed by spirits; considered a disorder only where there is distress and dysfunction.
Dissociative identity disorder (DID)
Formerly known as multiple personality disorder, a disorder in which as many as one hundred personalities or fragments of personalities coexist within one body and mind.
Alters
Shorthand term for alter egos, the different personalities or identities in dissociative identity disorder.
body dysmorphic disorder (BDD)
Somatoform disorder featuring a disruptive preoccupation with some imagined defect in appearance (“imagined ugliness”).
Hypochondriasis
Somatoform disorder involving severe anxiety over the belief that the person has a disease process without any evident physical cause.
pain disorder
A somatoform disorder featuring true pain but for which psychological factors play an important role in onset, severity, or maintenance.
somatization disorder
Somatoform disorder involving extreme and long-lasting focus on multiple physical symptoms for which no medical cause is evident.
somatoform disorders
Pathological concern of individuals with the appearance or functioning of their bodies, usually in the absence of any identifiable medical condition.
pain disorder - acute
duration of less than 6 months
pain disorder - chronic
duration of 6 months or more
Emily constantly worries about her health. She has been to numerous doctors for her concerns about cancer and other serious diseases- even though she doesn’t report current notable physical symptoms- only to be reassured of her well-being. Emily’s anxiousness is exacerbated by each small ailment (for example, mild headaches or stomach pains) that she considers to be indications of a major illness. __________
Illness Anxiety Disorder
D.J. arrived at Dr. Blake’s office with a folder crammed full of medical records, symptom documentation, and lists of prescribed treatments and drugs. Several doctors are monitoring him for his complaints, ranging from marked chest pain to difficulty swallowing. D.J. recently lost his job for using too many sick days.
Somatic symptom disorder
Sixteen-year-old Chad suddenly lost the use of his arms with no medical cause. The complete paralysis slowly improved to the point that he could slightly raise them. However, Chad cannot drive, pick up objects, or perform most tasks necessary for day-to-day life.
Conversion disorder
Ann was found wandering the streets, unable to recall any important personal information. After searching her purse and finding an address, doctors were able to contact her mother. They learned that Ann had just been in a terrible accident and was the only survivor. Ann could not remember her mother or any details of the accident. She was distressed. ________
Generalized amnesia
Karl was brought to a clinic by his mother. She was concerned because at times his behavior was strange. His speech and his way of relating to people and situations would change dramatically, almost as if he were a different person. What bothered her and Karl most was that he could not recall anything he did during these periods. _________
Dissociative identity disorder
Terry complained about feeling out of control. She said she felt sometimes as if she were floating under the ceiling and just watching things happen to her. She also experienced tunnel vision and felt uninvolved in the things that went on in the room around her. This always caused her to panic and perspire. __________
Depersonalization-derealization disorder
Henry is 64 and recently arrived in town. He does not know where he is from or how he got here. His driver’s license proves his name, but he is unconvinced it is his. He is in good health and not taking any medication.
Dissociative fugue
Rosita cannot remember what happened last weekend. On Monday she was admitted to a hospital, suffering from cuts, bruises, and contusions. It also appeared that she had been sexually assaulted.
Localized amnesia
