Chapter 7

Question 1

factitious disorder

Answer 1

1. 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

Question 2

conversion disorder

Answer 2

1. 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

Question 3

somatic symptom disorder

Answer 3

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

Question 4

somatization pattern

Answer 4

large and varied number of bodily symptoms

Question 5

predominant pain pattern

Answer 5

primary bodily problem is experience of pain

Question 6

Psychodynamic view of conversion

Answer 6

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

Question 7

primary gain

Answer 7

psychodynamic theory - gain achieved when somatic symptoms keep internal conflicts out of awareness

Question 8

secondary gain

Answer 8

psychodynamic theory - gain achieved when somatic symptoms elicit kindness from others or provide an excuse to avoid unpleasant activities

Question 9

Behavioural view of conversion

Answer 9

physical symptoms bring rewards; increased display of symptoms; more likely to mimic past illnesses or illnesses that are familiar; little support

Question 10

Multicultural view of conversion

Answer 10

In many cultures somaticization is viewed as normal/less stigmatizing

Question 11

placebo effect

Answer 11

belief/ expectation can trigger hormones/lymphocytes/endorphins - “wake up call for inner pharmacies”

Question 12

Conversion/somatic treatment

Answer 12

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

Question 13

Illness anxiety disorder

Answer 13

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)

Question 14

body dysmorphic disorder

Answer 14

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;

Question 15

dissociative disorders

Answer 15

when changes in memory/identity are significant and lack a clear physical cause

Question 16

dissociative amnesia

Answer 16

1. 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

Question 17

dissociative fugue

Answer 17

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

Question 18

subpersonality interaction

Answer 18

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

Question 19

Dissociative identity disorder

Answer 19

1. 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

Question 20

iatrogenic

Answer 20

unintentionally produced by practitioners

Question 21

Psychodynamic view - dissociative disorders

Answer 21

amnesia - single episode of repression; DID - lifetime of repression; most support drawn from case histories of child abuse

Question 22

behavioural view - dissociative disorders

Answer 22

learned through operant conditioning - mind drifts to other subjects = relief from thinking about traumatic events

Question 23

state dependent learning - dissociative disorders

Answer 23

different arousal levels produce different states

Question 24

self-hypnosis - dissociative disorder

Answer 24

self hypnotize into a state of forgetting

Question 25

dissociative amnesia treatment

Answer 25

psychodynamic therapy (guided search of unconsciousness for forgotten memory), hypnotic therapy (hypnotized and then guided to recall forgotten memories), drug therapy (barbiturates - calm people)

Question 26

depersonalization - derealization disorder

Answer 26

dissociative disorder without memory difficulty; persistent episodes of depersonalization, derealization or both; transient experience of these symptoms is fairly common