chapter 8 Flashcards
They are a group of conditions that involve physical symptoms combined with abnormal
thoughts, feelings, and behaviors in response to those symptoms
somatic symptom disorder
it means “body”
soma
in this disorder the person intentionally produces psychological or physical symptoms (or both). Although
this may strike you as strange, the person’s goal is to obtain and
maintain the benefits that playing the “sick role” (even to the
extent of undergoing repeated hospitalizations) may provide,
factitious disorder
in this disorder the person is intentionally producing or grossly exaggerating
physical symptoms and is motivated by external incentives such as avoiding work or military service or evading criminal prosecution
malingering
Instead the focus
in DSM-5 is on there being at least one of the following three
features for somatic symptom disorder
disproportionate and persistent thoughts about the seriousness of one’s symptoms/ persistently high anxiety about one’s health or symptom/ excessive time and energy devoted to these symptoms or health concerns
Patients with this disorder
frequently engage in illness behavior that is dysfunctional, such
as seeking additional medical procedures or diagnostic tests
when the physician fails to find anything physically wrong with
them.
somatic symptom disorder
the person
is preoccupied either with fears of contracting a serious disease
or with the idea that of having that disease even though they
do not.
hypochondriasis
Major Characteristics of hypochondriasis: Individuals with hypochondriasis
tend to be highly preoccupied with _______(e.g., heart
beats or bowel movements), or with minor _______ (e.g., a small sore or an occasional cough), or with vague
and ambiguous _______
bodily functions/ physical abnormalities/ physical sensations
causal factor of somatic symptom disorder
misinterpretation of bodily sensations
this treatment approach focus on assessing the patient’s beliefs about illness and modifying misinterpretations of bodily
sensations.
cognitive behavioral therapy
is characterized by many different physical complaints.
To qualify for the diagnosis, these had to begin before age 30,
last for several years, and not be adequately explained by independent findings of physical illness or injury. They also had
to have led to medical treatment or to significant life impairment
somatization disorder
in dsm-iv-tr. how many symptoms out of 33 symptoms is required for the diagnosis of somatization disorder
8
treatment for somatization disorder
medical management (with cbt)
is characterized by persistent and severe pain in one or more
areas of the body that is not intentionally produced or feigned.
pain disorder
In this newly identified disorder, people have high
anxiety about having or developing a serious illness. This anxiety
is distressing and/or disruptive but there are very few (mild) somatic symptoms.
illness anxiety disorder
It involves a pattern in which symptoms or
deficits affecting the senses or motor behavior strongly suggest that the patient has a medical or neurological condition.
However, upon a thorough medical examination, it becomes
apparent that the pattern of symptoms or deficits cannot be
fully explained by any known medical condition.
conversion disorder (functional neurological symptom disorder)
This seeming lack of concern
in the way the patient describes what is wrong
was thought for a long time to be an important diagnostic criterion for conversion disorder.
la belle indifference
Freud used this term for these disorders (which were fairly common in his practice) because he
believed that the symptoms were an expression of repressed
sexual energy—that is, the unconscious conflict that a person felt about his or her repressed sexual desires. However,
in Freud’s view, the repressed anxiety threatens to become
conscious, so it is unconsciously converted into a bodily disturbance, thereby allowing the person to avoid having to deal
with the conflict.
conversion hysteria
for conversion symptoms this is the continued escape or avoidance of a stressful
situation.
primary gain
originally referred to advantages that the symptom(s) bestow
beyond the “primary gain” of neutralizing intrapsychic conflict,
has also been retained. Generally, it is used to refer to any “external” circumstance, such as attention from loved ones or financial
compensation, that would tend to reinforce the maintenance of
disability.
secondary gain
4 categories of conversion disorder symptoms
(1) sensory, (2) motor, (3) seizures, and (4) a mixed
presentation of the first three categories
the person loses her or his sense of feeling in a part of
the body.
anesthesias
the person cannot feel anything on the hand in the area where
gloves are worn, although the loss of sensation usually makes no
anatomical sense.
glove anesthesias
symptoms are most often in the visual system (especially blindness and
tunnel vision), in the auditory system (especially deafness), or
in the sensitivity to feeling
sensory symptoms or deficits
a person is able to talk
only in a whisper although he or she can usually cough in a
normal manner.
aphoniA
difficulty swallowing or
the sensation of a lump in the throat
globus hystericus
an example, of this is
conversion paralysis is usually confined to a single limb such
as an arm or a leg, and the loss of function is usually selective
for certain functions.
motor symptoms or deficit
resemble epileptic seizures in some ways but can usually be fairly
well differentiated via modern medical technology. do not show any EEG abnormalities and do
not show confusion and loss of memory afterward, as patients
with true epileptic seizures do.
pseudoseizures
sleeplike state induced by
drugs
narcosis
is diagnosed if the person is
intentionally producing or grossly exaggerating physical symptoms and is motivated by external incentives such as avoiding
work or obtaining financial compensation.
malingering
the person seeking medical help or consulting a mental health professional has intentionally produced
a medical or psychiatric illness (or appearance of an illness) in
another person who is under his or her care
factitious disorder imposed on another
severe and chronic form of factitious disorder. where the general idea was that the person had
some kind of “hospital addiction” or a “professional patient”
syndrome.
Munchausen’s syndrome
are a group of conditions involving
disruptions in a person’s normally integrated functions of consciousness, memory, identity, or perception. Included here are some of the more dramatic phenomena in the entire domain of psychopathology: people who
cannot recall who they are or where they may have come from,
and people who have two or more distinct identities or personality states that alternately take control of the individual’s behavior
dissociative disorders
refers to the human mind’s capacity
to engage in complex mental activity in channels split off from,
or independent of, conscious awareness
dissociation
occur when we daydream or lose track of what is
going on around us, when we drive miles beyond our destination
without realizing how we got there, or when we miss part of a
conversation we are engaged in.
mild dissociative symptoms
remembering things they cannot consciously recall
implicit memory
s demonstrated by any change in experience, thought, or action that is attributable to some event in the current stimulus field, even in the absence of conscious perception of that event.
implicit perception
one’s sense of the reality of the outside world is
temporarily lost,
derealization
one’s sense of one’s
own self and one’s own reality is temporarily lost.
depersonalization
In this disorder, people have persistent or recurrent experiences of feeling detached from (and like an outside observer of)
their own bodies and mental processes.
derealization/depersonalization disorder
is marked by difficulties forming
an accurate or coherent narrative sequence of events, which is
consistent with earlier research suggesting that time distortion is
a key element of the experience of depersonalization
memory fragmentation
is the partial or total inability to recall or
identify previously acquired information or past experiences;
retrograde amnesia
is the partial or total inability
to retain new information
anterograde amnesia
is usually limited to a failure to recall previously stored personal information
(retrograde amnesia) when that failure cannot be accounted for by ordinary forgetting.
dissociative amnesia
memories pertaining to events experienced)
episodic memory
memories pertaining to personal events experienced
autobiographical memory
memories pertaining to language and concepts)
semantic memory
memories pertaining on how to do things
procedural memory
an amnesic state —is a defense by actual flight—a person is not only
amnesic for some or all aspects of his or her past but also departs
from home surroundings.
dissociative fugue
formerly known as multiple personality disorder in
which a patient manifests two or more distinct identities that
alternate in some way in taking control of behavior
dissociative identity disorder
the one identity that is most frequently encountered and carries the person’s real name
host identity
other identities that may
differ in striking ways involving gender, age, handedness,
handwriting, sexual orientation, prescription for eyeglasses,
predominant affect, foreign languages spoken, and general
knowledge.
alter identities
According to this view, DID starts
from the child’s attempt to cope with an overwhelming sense of
hopelessness and powerlessness in the face of repeated traumatic
abuse. Lacking other resources or routes of escape, the child may
dissociate and escape into a fantasy, becoming someone else. This
escape may occur through a process like self-hypnosis (Butler
et al., 1996), and if it helps to alleviate some of the pain caused
by the abuse it will be reinforced and occur again in the future
posttraumatic theory
claims that DID develops when
a highly suggestible person learns to adopt and enact the roles
of multiple identities, mostly because clinicians have inadvertently suggested, legitimized, and reinforced them and because
these different identities are geared to the individual’s own
personal goals
sociocognitive theory
is said to occur when someone experiences
a temporary marked alteration in state of consciousness or
identity (but with no replacement by an alternative identity).
It is usually associated with either a narrowing of awareness
of the immediate surroundings, or stereotyped behaviors or
movements that are experienced as beyond one’s control.
trance
is said to occur when someone experiences
a temporary marked alteration in state of consciousness or
identity (but with no replacement by an alternative identity).
It is usually associated with either a narrowing of awareness
of the immediate surroundings, or stereotyped behaviors or
movements that are experienced as beyond one’s control.
trance
the alteration of consciousness or identity is replaced by a new identity that is
attributed to the influence of a spirit, deity, or other power.
possession trance
occurs when a dissociative episode leads to violent, aggressive, or homicidal behavior directed at other people and objects.
It occurs mostly in men and is often precipitated by a perceived
slight or insult. The person often has ideas of persecution, anger,
and amnesia, often followed by a period of exhaustion and
depression.
amok
One recent treatment showing some promise for the treatment
of dissociative disorders
rTMS (repetitive
transcranial magnetic stimulation)
One of the primary techniques used in most treatments of DID
hypnosis
