CP: Chapter 8 Dissociative disorders and somatic symptom-related disorders

Question 1

depersonalisation/derealisation disorder =

Answer 1

Experience of detachment from the self and reality/surroundings

Question 2

dissociative amnesia

Answer 2

Lack of conscious access to memory, typically of a
stressful experience. The fugue subtype involves
traveling or wandering coupled with loss of memory
of one’s identity or past

unable to recall imporant personal information

Question 3

dissociative identity disorder

Answer 3

at least 2 distinct personality states that act independently of each other. they usually do not know that the other exists

Question 4

depersonalisation =

Answer 4

being detached from one’s own mental processes or body (dus de self)

Question 5

derealisation =

Answer 5

being detached from ones surroundings (seem unreal)

Question 6

2 andere criteria van depersonalisation/derealisation disorder

Answer 6

symptoms are persistent or recurrent
not explained by psychosis/other conditions

Question 7

the symptoms of depersonalization and derealisation are usually caused by…

Answer 7

stress

Question 8

important to rule out these disorders…

Answer 8

ptsd
schizophrenia
borderline personality disorder

Question 9

dissociative amnesia kenmerken verder

Answer 9

usually about traumatic experience
holes in memory too extensive to be explained by normal forgetfullness
not permanently lost! but cannot be retrieved during the period of amnesia

Question 10

hoe lang last dissociative amnesia

Answer 10

several hours or several years

Question 11

fugue

Answer 11

more severe subtype of dissociative amnesia, more extensive memory loss. person typically dissappears from home, work, wander away, take on a new name etc.

Question 12

wanneer increased prevalence of DID

Answer 12

1970

Question 13

waardoor kwam die increase in DID

Answer 13

misscien meer mensen die de symptomen hadden, meer media attention to the diagnosis.

Question 14

ethiology of DID

Answer 14

• posttraumatic model
• sociocognitive model
• alters share implicit memories, even when they report amnesia about explicit memories

Question 15

posttraumatic model

Answer 15

waarschijnlijk:

childhood abuse -> dissociative symptoms -> more risk for other psychological disorders

Question 16

sociocognitive model

Answer 16

people who are abused seek explanations, or may want to get in another personality to avoid their trauma. also may be due to media attention

Question 17

treatment of DID

Answer 17

psychodynamic treatment: convince the person that splitting into different personalities is not the key to deal with trauma. overcome repressions, as dissociative identity disorder is believed to be due to blocking traumatic events from the conscious

Question 18

somatic symptom disorders key characteristic

Answer 18

excessive concerns about physical health or symptoms

Question 19

wat zijn 3 lastige punten aan somatic symptom disorder

Answer 19

• heel heterogeen
• heel subjectieve criteria, wat is de threshold for ‘too much concern’
• diagnosis is often stigmatized

Question 20

somatic symptom disorder (een)

Answer 20

excessive anxiety, energy or behaviour focused on somatic symptoms

Question 21

illness anxiety disorder

Answer 21

fears fo a severe disease in the absence of somatic symptoms

Question 22

functional neurologic disorder

Answer 22

vroeger conversion disorder!!

= sensory and motor dysfunctions that cannot be explained by medical tests.

Question 23

voorbeelden functional neurological disorder symptoms

Answer 23

paralysis of arms and legs
seizures
coordination disturbances
insensitivity to pain
anaesthesia
loss of sensations

Question 24

malingering =

Answer 24

person intentionally fakes a symptom to avoid a responsibility (work/military) or to achieve some goal/be rewarded.

Question 25

factitious disorder

Answer 25

people intentionally produce physical symptoms (sometimes psychological ones) to assume the role of a patient, without gains from those symptoms

Question 26

somatic symptom disorder heritability

Answer 26

the symptoms are not genetically determined

Question 27

which brain regions are different in ppll with ssd

Answer 27

brain regions involved in processing the unpleasantness of bodily sensations may be hyperactive

= anterior cingulate and anterior insula

Question 28

cognitive behavioural factors

Answer 28

some ppl are overly attentive to physical concerns and make negative interpretations about these symptoms

Question 29

wat voor treatment voor ssd cognitief

Answer 29

behavioural reinforcement, for maintaining the help seeking behaviour

Question 30

conversion disorder sackeim model

Answer 30

2 stage psychodynamic model:

people lack conscious awareness of perceptions
people are motivated to have these symptoms

Question 31

social and cultural factors in conversion disorder

Answer 31

social influences seem important, as groups of co workers can have the same factors.
the prevalence over time is unclear

Question 32

treatment of somatic symptoms and related disorders: obstacle

Answer 32

most people want medical care instead of mental health care

Question 33

dus wat voor treatments zijn er wel mogelijk

Answer 33

• interventions in primary care: make physicians address the symptoms nicely, and limiting medical tests
• cognitive behavioural treatment: adress the distress over somatic symptoms, try to reduce excessive attention to bodily cues, and adress overly negative interpretations of physical symptoms, reinforce behaviour that is not consistent with the sick role
• for pain: antidepressants may help

Question 34

somatic symptom disorder DSM

Answer 34

at least one somatic symptom that is distressing
excessive thought/distress/behaviour about symptoms, indicated by at least one of these:
1. health anxiety
2. disproportionate and persistent concerns aout the seriousness of symptoms
3. excessive time and energy devoted to health concerns

Question 35

hoelang moeten ssd symptoms bestaan voor diagnose

Answer 35

at least 6 months, maar hoeven niet continously present te zijn!!!
specificy if it is predominantly pain

Question 36

illness anxiety disorder dsm

Answer 36

• Preoccupation with and anxiety about having or acquiring a serious disease
• Excessive illness behavior (e.g., checking for signs of illness, seeking reassurance)
  or maladaptive avoidance (e.g., avoiding medical care)
• No more than mild somatic symptoms are present
• Preoccupation lasts at least 6 months, although need not be present continuously during that time

Question 37

functional neurological disorder dsm

Answer 37

• One or more symptoms affecting voluntary motor or sensory function
• The symptoms are incompatible with any recognized medical disorder
• Symptoms cause significant distress or functional impairment or warrant medical evaluation

Question 38

factitious disorder dsm

Answer 38

• Fabrication or induction of physical or psychological symptoms, injury, or disease
• Deceptive behavior is present in the absence of obvious
  external rewards
• In factitious disorder imposed on self, the person presents himself or herself to others as ill, impaired, or injured
• In factitious disorder imposed on another, the person fabricates or induces symptoms in another person and then presents that person to others as ill, impaired, or injured

Question 39

3 soorten dissociative disorders

Answer 39

depersonalization/derealization disorder, dissociative amnesia, and dissociative identity disorder

Question 40

ethiology of depersonalization/derealisation disorder is believed to be…

Answer 40

related to difficulties integrating somatic and sensory information.

Question 41

People with dissociative identity disorder (DID) often retrospectively report

Answer 41

severe physical or sexual abuse during childhood, but prospective research does not suggest that early adversity predicts the onset of DID.

Question 42

posttraumatic model says on did

Answer 42

extensive reliance on dissociation to fend off overwhelming feelings arising from abuse puts people at risk for developing dissociative identity disorder.

Question 43

sociocognitive model on did says

Answer 43

Proponents of the sociocognitive model point out that some therapists use strategies that suggest such symptoms to people and that most people do not recognize the presence of alternate personalities until
after they see a therapist.

Question 44

Although one of the defining features of
DID is the lack of shared memories among alternative personality states, evidence suggests that the alternate personalities may share more memories than they report. Also, symptoms of DID can be role-played effectively.

Answer 44

oke

Question 45

psychodynamic treatment en dissociative disorders?

Answer 45

Psychodynamic treatment is perhaps the most commonly used treatment for dissociative disorders, but some of the techniques involved, such as hypnosis and age regression, may make symptoms worse.

Question 46

health anxiety heritability

Answer 46

moderate

Question 47

Neurobiological models suggest that key brain regions involved in processing the unpleasantness of bodily sensations may be hyperactive among people with somatic symptom and related disorders. These regions include the anterior cingulate cortex and the rostral anterior insula. Cognitive variables are also important: Some people are overly attentive to physical concerns and make overly negative interpretations of symptoms and their implications. Avoidance may lead to health declines, and behavioral reinforcement may maintain help-seeking behavior. Safety behaviors may prolong and intensify health anxiety.

Answer 47

oke

Question 48

findings on conversion/functional neurological disorder

Answer 48

consistent with the psychodynamic idea that people with conversion disorder may not be conscious of their perceptions (in the case of blindness) or their control of
movements (in the case of movement symptoms). Sociocultural influences also appear important in conversion disorder.

Question 49

treatment for ssd en conversion disorder

Answer 49

When pain is a primary concern in somatic symptom disorder, CBT, hypnosis, ACT, and low doses of antidepressant medication may be helpful. Small trials indicate that CBT may also be helpful for conversion disorder.