Chapter 7 Flashcards
factitious disorder
- deceptive falisification/production/injury of physical or psychological symptoms even absence of external rewards; 2. presentation of onesself/another as ill/impaired/injured; (Munchausen syndrome/ by proxy); esp common in people who received extensive medical treatment as a child, carry a grudge against the medical profession, or have worked as a nurse, lab tech, or med aide; cause not understood, treatment not dependably effective
conversion disorder
- one or more symptoms/deficits that affect voluntary sensory function; 2. symptoms inconsistent/incompatible with known neurological or medical disease ex. glove anaesthesia, lack of atrophy; 3. significant distress/impairment
somatic symptom disorder
Briquet’s syndrome; incl somatization pattern and predominant pain parrern; 1. presence of 1 + somatic symptom (pain, GI, sexual, neuro) that is distressing/significantly disruptive to daily life; 2. excessive thoughts, feelings, and behaviours regarding health concerns incl. disproportionate/perisistent thoughts about seriousness of symptom(s), persistent/high anxiety about health/symptom(s); excessive time/energy devoted to symptoms or concerns; 3. persistent (not necessarily continuous) symptoms for 6 mos
somatization pattern
large and varied number of bodily symptoms
predominant pain pattern
primary bodily problem is experience of pain
Psychodynamic view of conversion
Freud - explained disorders on needs of girls during their phallic stage (3-5), develop electra complex (sexual feelings for father, competition w mother) and convert to physical symptoms; current view rejects some of this, proposes primary and secondary gain
primary gain
psychodynamic theory - gain achieved when somatic symptoms keep internal conflicts out of awareness
secondary gain
psychodynamic theory - gain achieved when somatic symptoms elicit kindness from others or provide an excuse to avoid unpleasant activities
Behavioural view of conversion
physical symptoms bring rewards; increased display of symptoms; more likely to mimic past illnesses or illnesses that are familiar; little support
Multicultural view of conversion
In many cultures somaticization is viewed as normal/less stigmatizing
placebo effect
belief/ expectation can trigger hormones/lymphocytes/endorphins - “wake up call for inner pharmacies”
Conversion/somatic treatment
therapy often a patient’s last resort as they do not believe they have a problem; psychodynamic - raising consciousness of underlying fears; behavioural - exposire treatment; biological - drugs; physical symptom treatment - suggesting that symptoms will resolve, reinforcement - remove rewards for symptoms, confrontational approach - straightforwardness
Illness anxiety disorder
formerly hypochondriasis; 1. preoccupation with having/acquiring a serious illness; 2. somatic symptoms are absent/mild; 3. anxiety/easily triggered alarm re: health; 4. performance of excessive health related behaviours, 4. chronic preoccupation lasting 6 mos (can be continuous or non-); treated similarly to OCD (antidepressant drugs, exposure therapy/response prevention)
body dysmorphic disorder
also: dysmorphobia; OCD related; 1. preoccupation with one + defects/flaws in physical appearance that are not observable/slight to others; 2. performance of repetitive behaviours/mental acts in response to concerns about appearance; 3. significant distress/impairment; 30% housebound, 22% attempt suicide; onset: adolescence, 5% of Americans afflicted; treated similarly to OCD;
dissociative disorders
when changes in memory/identity are significant and lack a clear physical cause
dissociative amnesia
- inability to recall important biographical info, usually traumatic; 2. significant distress/impairment; 3. symptoms are not attributable to a substance/medical condition; localized (amnestic episode of limited time, begins with trauma), selective (remember some but not all events), generalized (forgetting earlier events), continuous (forgetting continues into the present); in all cases memory of abstract/encyclopaedic information remains
dissociative fugue
form of dissociative amnesia in which a person travels to a new location and may assume a new identity, simultaneously forgetting his/her past (often outgoing people) 0.2 % pop
subpersonality interaction
mutually amnesic - no awareness; mutually cognizant - each is well aware of the rest; one-way amnesic - some personalities remember, some do not; co-conscious - “quiet observers”, watch actions and thoughts but do not interact; 15 avg/women, 8 avg/men
Dissociative identity disorder
- disruption of identity characterized by 2+ different personality states/experience of possession; 2. recurrent gaps in recall of everyday events, important personal info, traumatic events; 3. significant distress/impairment; 4. symptoms are not attributable to a substance/medical condition; 2+ sub/alternate personalities w unique memory/beh etc. +submissive personalities have less distinct memory; Primary/host personality most often; Women 3x: men, diagnosis in late adolescence/early adulthood; diagnosis increasing due to willingness to diagnose + more accurate procedure
iatrogenic
unintentionally produced by practitioners
Psychodynamic view - dissociative disorders
amnesia - single episode of repression; DID - lifetime of repression; most support drawn from case histories of child abuse
behavioural view - dissociative disorders
learned through operant conditioning - mind drifts to other subjects = relief from thinking about traumatic events
state dependent learning - dissociative disorders
different arousal levels produce different states
self-hypnosis - dissociative disorder
self hypnotize into a state of forgetting
dissociative amnesia treatment
psychodynamic therapy (guided search of unconsciousness for forgotten memory), hypnotic therapy (hypnotized and then guided to recall forgotten memories), drug therapy (barbiturates - calm people)
depersonalization - derealization disorder
dissociative disorder without memory difficulty; persistent episodes of depersonalization, derealization or both; transient experience of these symptoms is fairly common
