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Psychopathology > Chapter 6: Somatoform and Dissociative Disorders- Text > Flashcards

Chapter 6: Somatoform and Dissociative Disorders- Text Flashcards

1
Q

Somatoform disorders…give a general description of what they entail?

A
  • conditions that seem initially to be physical disorders but there actually is no identifiable medical conditioning causing the physical complaints.
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2
Q

Dissociative disorders…give a general description of what they entail….

A

-alterations or detachments in consciousness or identity
L> which are so extreme that one loses their identity entirely and assume a new one, or they lose their memory or sense of reality and are unable to function..

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3
Q

What is neurosis?

L> Is it still an accepted term?

A
  • disorders resulted from underlying unconscious conflicts, anxiety that resulted from those conflicts and implementations of ego defence mechanisms.
  • not accepted anymore…it’s too vague (1980)
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4
Q

What are the five basic somatoform disorders?

A
  • Hypochondrias
  • somatization disorder
  • conversion disorder
  • pain disorder
  • body dysmorphic disorder
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5
Q

Research indicates that hypochondriasis shares many with features with ___ and ___ disorders which are often in comorbid with hypochondriasis ; particularly ___ disorder.

A

anxiety, mood and panic disorders

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6
Q

Hypochondriasis is characterized by what?
Individuals are preoccupied with _____, misinterpreting them as indicative of illness or disease. Almost any _____ may become the basis of concern for individuals with hypochondriasis.

A
  • severe anxiety or fear focused on the possibility of having a serious disease.
  • bodily symptoms.
  • physical sensation
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7
Q

Does reassurance ease by professionals ease the mind of those with hypochondriasis ?

A
  • no if anything it only reduces fear and anxiety for a short term.
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8
Q

What is the difference between hypochondriasis and illness phobia?

A
  • illness phobic individuals are preoccupied with the fear of developing a disease; where as, hypochondriac patients are afraid that they already developed it.
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9
Q

What percentage of those with illness phobia were found to go on and develop hypochondriasis and panic disorder? (Benedetti et al. 1997)

A

60%

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10
Q

Is hypochondriasis more common in those with panic disorder or those with social phobia? Also for comparison those in a control group?

A
  • panic : 48%
  • social phobia: 17%
  • control: 17%
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11
Q

What is an important difference between panic disorder and hypochondriasis ?

A
  • individuals with hypochondriasis are concerned with long term process of illness and disease…ex: cancer..AID’s
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12
Q

Stats for Hypochondriasis?

  • medical patients that end up developing it?
  • sex ratio?
  • onset?
A
  • 1 to 14%
  • 50-50
  • peak ages are in adolescence, middle age ( 40 to 50) and after 60
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13
Q

Culture specific syndromes of Hypochondriasis?
Koro
Dhat
-Hot sensations in head, crawling in head ?
-sensation of burning in hands and feet ?
(last two what cultures do they belong to?)

A
  • genitals are retracting into the abdomen, Chinese males and some females.
  • losing semen, symptoms of dizziness, weakness and fatigue….India!
  • African
  • Pakistani or Indian patients.
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14
Q

Describe the process of determining the cause of hypochondriasis in a patient. (3)

A
  1. physician rules out a physical cause for somatic complaints.
  2. mental health professional determines the nature of the somatic complaints…..to figure out if they are related to a specific somatoform disorder or are they part of some other psychopathology.
  3. clinician must be aware of culture specific somatic symptoms
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15
Q

Most people agree that Hypochondriasis is a disorder of what?? (3)

A
  • cognition, perception and strong emotional roots.
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16
Q

Hypochondriacs tend to interpret what as threatening?

A
  • ambiguous stimuli

L> they take a “better safe than sorry approach”

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17
Q

Is there a genetic basis for hypochondriasis?

A

Yes it runs in families

modest genetic contribution !

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18
Q

Children with hypochondriacal concerns often report the same kinds of symptoms that other family members may have reported at some time therefore it is safe to assume what?

A
  • learned from family members to focus their anxiety on specific physical conditions and illness.
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19
Q

What two types of learning are connected to Hypochondriasis ?

A
  • instrumental and vicarious learning
    L> IL: rewarded by parents for bodily complaints…aka staying home form school
    L> VL: observing a parent or family member expressing anxiety about a bodily sensation..
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20
Q

What are the three factors that contribute to the etiological process of hypochondriasis?

A
  1. stressful life event
  2. disproportionate incidence of disease in their family as kids
  3. Sick role: when a sick person gets specially benefits for being sick…more attention
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21
Q

What is the best type of therapy for Hypochondriasis?

A
  • Cognitive Behavioural Therapy
    L>exposure to health and illness info
    L>learning to challenge misinterpretations of benign bodily sensations
    L>83% of those that undergo this no longer meet having Hypochondriasis
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22
Q

What pharmacology treatment is affective for people with Hypochondriasis?

A
  • antidepressants
    L> Selective serotonin re-uptake inhibitors
    ex: Fluoxetine
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23
Q

What is a huge difference between Hypochondriasis and Somatization disorder?

A
  • people with somatization disorder are not afraid of the direction the symptoms can talk but rather the symptoms themselves.
24
Q

Somatization Disorder …describe it go!
-Onset?
-What are the four criteria for symptoms that are required to be met for diagnosis.
give examples
2 -4 do not include symptoms related to just pain..

A
  1. Four pain symptoms: ex: head, abdomen, back and joints.
  2. Two gastrointestinal symptoms: nausea, diarrhea, vomiting and bloating are examples.
  3. One sexual symptom: ex: erectile dysfunction, irregular menses, excessive menstrual bleeding, vomiting throughout pregnancy.
  4. One pseudoneurologic Symptom: conversion symptoms like blindness, double vision etc dissociative symptoms or loss of consciousness
25
Q

Is somatization disorder common?

A

no it’s very rare

26
Q

How many symptoms are required out of the listed 35 for diagnosis ?

A

8 symptoms

27
Q

What is Undifferentiated somatoform disorder?

A
  • when someone is diagnosed with less than 8 symptoms of the required 35 for the diagnosis of somatization disorder.
28
Q

What are the stats for somatoform disorder?

  • prevalence in large cities ?
  • prevalence in primary care settings?
A
  • 4.4% in a large city

- 16.6%

29
Q

Gender variations for somatization disorder?

A
  • tend to mostly be women (68% were female in Kirmayer’s study)
  • un married
  • lower SE groups
30
Q

In addition to physical symptom complaints those with somatization disorder can also have?
L>common?

A
  • psychological complaints

L> commonly mood or anxiety related

31
Q

What personality disorder is somatization disorder linked to in family and genetic studies?

A

Antisocial Personality Disorder (APD)

32
Q

aetiology of Somatization disorder?

mirrors APD

A
  • early life onset
  • chronic
  • +++ in low SE
  • difficult to treat
  • associated with marital discord, drug and ethanol abuse and suicide attempts.
33
Q

APD and Somatization disorder have what biological link? (theorized)

A

-Neurobiologically based disinhibition syndrome
L> short term gain with long term problems
L> continual development of new somatic symptoms gains immediate sympathy and attention but eventually social isolation occurs.

34
Q

So what causes the difference in Somatization disorder and APD???

A
  • Gender roles

L>

35
Q

Are people with somatization disorder quick to seek treatment?

A
  • no they are reluctant …very resistant to have psychological causes applied to their physical symptoms
36
Q

In treatment what is done to limit the amount of visits for people with somatization disorder?

A
  • gatekeeper physician screens all physical complaints

L> visits with specialists will be authorized by the gatekeeper.

37
Q

What type of therapy has shown to be the most effective when treating Somatization disorder?

A
  • Group Cognitive Behavioural Therapy

L> reducing health care costs and improving somatization disorder patients psychological well being.

38
Q

Describe Conversion Disorder?(General idea)

  • common ailments?
  • What new name is suggested for the DSM5 ?
A
  • generally have to do with paralysis, blindness or difficulty speaking ( aphonia) without any physical or organic pathology to account for the malfunction.
  • most seem to suggest neurological disease is affecting sensory motor systems.
  • Functional Neurological disorder
39
Q

What is astasia-abasia

Also what is it an example of?

A
  • weakness in legs, difficulty keeping balance but not actual paralysis
  • conversion symptom- conversion disorder
40
Q

What is globes hystericus?

What is it an example of/ symptom?

A
  • sensation of a lump in the throat that makes it difficult ti swallow, eat or sometimes talk.
  • conversion disorder
41
Q 
The follow are disorders very similar to Conversion Disorder that one must rule out first before diagnosis, explain them: 
- Malingering
L> La belle indifférence?
-Factitious disorders
L> example?
A

-faking……
L> hallmark of conversion symptoms.
- symptoms are under voluntary control…no obvious reason for faking them except possibly assuming the sick role…
EX: Munchausen syndrome by proxy (factitious disorder by proxy) - making a child sick for attention..

42
Q

What are two defining symptoms of conversion disorder? (2)

A

La belle indifference
conversion symptoms precipitating after a stressful event
**unaware either of this ability or sensory input

43
Q

The reduction in anxiety from conversion disorder is considered a ___ gain whereas the attention gained from assuming the sick role is considered a ___ gain.

A
  • primary, secondary
44
Q

Cognitive Behavioural Therapy involving Image exposure is used for treating?

A

conversion disorder

45
Q

Pain disorder?

A
  • may have had clear physical reasons for pain but psychological factors maintain it,
    Acute: less than six months
    Chronic: six +
46
Q

Body dysmorphic Disorder?

A
  • normal looking people imagine they are so ugly they are noble to interact with others or function normally via fear of mockery
47
Q

BDD
fixated on?(3)
Idea of reference?

A
  • skin>hair> mirrors

- everything going on in the world is related to them

48
Q

Treatment for BDD ?

A
  • SSRI
  • exposure and response prevention - behavioural therapy
  • cognitive behaviour therapy : exposure and response + restructuring
49
Q

Plastic Surgery and BDD?

A
  • it actually increases imagined ugliness causing them to return for touch ups or new areas of concern.
50
Q

Suggestibility and DID?

- autohypnotic model?

A
  • personality trait

- those who are very suggestible are able to use dissociation as a defence mech against trauma

51
Q

Biological link with DID?

A
  • seizure disorders, experience many of the same dissociative symptoms
52
Q

Individuals with what two dissociative disorders usually get better on their own?

A
  • amnesia and fugue
53
Q

Treatment of Dissociative disorders focus on?

difficult cases?

A
  • recalling what occurred in the dissociative state, confront it, integrate it into their conscious exp.
    L> Hypnosis and benz are used in difficult cases
54
Q

DID treatment?

A
  • reintegration of their identities through long term psychotherapy.
55
Q

Modern treatment of DID?

A
  • identify triggers that provoke memories of trauma or dissociation and neutralize them
  • confront and relive aspect of the trauma until it is simply a terrible memory instead of a current event.
    -hypnosis
    antidepressants in some cases

Psychopathology (19 decks)

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