CP: Lecture 6 Dissociative disorders & somatic symptom related disorders

Question 1

history of dissociative disorders

Answer 1

 1900 BC – Egyptians: Hysteria - ‘Wandering Womb’
 Middle ages: satanic possession
 Paul Briquet (1796 –1881): somatisation
 Jean-Martin Charcot (1825 – 1893): hypnosis
 Pierre Janet (1859 – 1947): dissociation
 Sigmund Freud (1856 – 1939): repressed memories

Question 2

meest voorkomende somatic symptom

Answer 2

chest pain

Question 3

somatic symptom disorders main criteria=

Answer 3

excessive concerns about physical concerns or health

Question 4

illness anxiety =

Answer 4

unwarranted fears about a serious illness in the absence of any significant symptoms

Question 5

conversion disorder =functional neurological disorder =

Answer 5

neurological symptoms that cannot be explained by medical disease or culturally sanctioned behavior

Question 6

malingering

Answer 6

intentionally faking psychological or somatic symptoms to gain something

Question 7

factitious disorder

Answer 7

falsification of psychological or somatic symptoms without evidence of gains from those symptoms

vroeger Munchausen syndrome by proxy (Gyspy Rose)

Question 8

ocd cycle

Answer 8

obsession -> anxiety -> compulsion -> relief

Question 9

 In DSM-IV-TR: physical symptoms have no
known physical cause
◦ Nearly impossible to know actual cause
 In DSM 5: focus on positive symptoms:
◦ Somatic symptoms; medically explained or
unexplained
◦ Psychological and behavioural factors

Answer 9

oke

Question 10

somatic symptom disorder criteria in detail

Answer 10

at least one somatic symptom that is distressing

excessive thought, feeling, behaviours related to concerns via at least 1 of these:
health-related anxiety
disproportionate concerns about the medical seriousness of symptoms
excessive time and energy devoted to concerns

Question 11

hoelang moet somatic symptom disorder

Answer 11

at least 6 months

Question 12

specify if … bij somatic symptom disorder

Answer 12

predominant pain
persistent (langer dan 6 maanden)

Question 13

illness anxiety disorder criteria in detail

Answer 13

• Preoccupation with and high level of anxiety about having or acquiring a serious disease
• Excessive behaviors (e.g., checking for signs of illness, seeking reassurance)

or maladaptive avoidance (e.g., avoiding medical care)

• But: no more than mild somatic symptoms are present

Question 14

hoelang moet illness anxiety minimaal

Answer 14

6 maanden

Question 15

functional neurological symptom disorder basic

Answer 15

one or more symptoms:
sensory or motor function impaired but no known neurological cause. (vision, seizures, paralysis, aphonia, anosmia)

Question 16

factitious disorder=

Answer 16

fabrication or induction of physical or psychological symptoms/injury/disease.

deceptive behaviour without external rewards

imposed on self or imposed on others

Question 17

somatic symptom disorder model

Answer 17

pathogenesis -> symptoms <-> consequences/coping (focus on pain, attribute pain to disease)

= reinforcement of sickness behaviour

Question 18

somatic symptom disorder model: mechanisms

Answer 18

medical symptoms + psychiatric disorder/stress/trauma

leiden tot

physiological disturbance + emotional arousal

attention to body
symptoms are attributed to serious illness
health anxiety (gaat terug naar emotional arousal)

leidt tot

help seeking & communication of distress of avoidance & disability
social response (gaat terug naar avoidance + emotional arousal)

Question 19

cognitive behavioural factors of ssd

Answer 19

attention to bodily sensations + attributions of those sensations

->

sick role (limits health life style) and help seeking behaviours are reinforced by attention and sympathy

Question 20

pain model

Answer 20

injury -> painful experience

catastrophizing -> fear of movement/reinjury -> avoidance -> disability + disuse + depression

non-catastrophizing -> confrontation -> recovery

Question 21

dissocation definitie

Answer 21

“a disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior”

Question 22

2 mogelijke functies van dissociation

Answer 22

defense mechanisme
adaptive processes gone awry

Question 23

transdiagnostic symptoms of dissociation

Answer 23

high comorbidity with mood, Borderline Personality Disorder, Schizophrenia spectrum, Conversion, PTSD

Question 24

A criteria van depersonalization/derealisation disorder

Answer 24

presence of persistent or recurrent experiences of depersonalisation or derealisation

Question 25

depersonalisation =

Answer 25

experiences of unreality, detachment, or being an outside observer with respect to ones thoughts, feelings, sensations, body or actions

Question 26

derealisation =

Answer 26

experiences of unreality or detachmetn of surroundings

Question 27

during the depersonalisation or derealisation, what remains intact?

Answer 27

reality testing!

-> the ego recognizes the difference between the external and internal world.

Question 28

dissociative amnesia

Answer 28

inability to recall important autobiographical information, usually of traumatic or stressful nature that is inconsistent with normal forgetting.

vaak: localized/selective amnesia for a specific event, or generalised amnesia for identity and life history

Question 29

prevalence ocd and related disorders=

Answer 29

0-3%

Question 30

gender in ocd

Answer 30

women meer OCD en BDD
gelijk: hoarding disorder

Question 31

prevalence DID and depersonalisation/derealisation

Answer 31

0-3%

Question 32

prevalence PTSD and dissociative amnesia =

Answer 32

3-10%

Question 33

trauma prevalence

Answer 33

75-100%

Question 34

Restriction of the blood supply to a specific area resulting in a lack of oxygen in these brain areas.

Answer 34

ischaemia

Question 35

bleeding in the brain =

Answer 35

haemorrhage

Question 36

A collection of symptoms resulting from interruption of the blood supply to the brain.

Answer 36

stroke

Question 37

Necrosis in brain tissue due to obstruction of an artery.

Answer 37

infarct

Question 38

specification dissociative amnesia

Answer 38

with dissociative fugue: apparently purposeful travel or bewildered wandering that is associated with amnesia for identity

Question 39

dissociative identity disorder criteria A

Answer 39

disruption of identity characterized by two or more distinct personality states, whcih may be described in some cultures as possession.
disruption in identity involves marked discontinuity in sense of self and sense of agency + changes in affect, behaviour, consiousness, memory, perception, cognition, sensory-motor functioning.
may be observed by others or reported by the individual

Question 40

dissociative identity disorder criteria B

Answer 40

recurrent gaps in recall of everydaty events/personal info/traumatic events that are inconsistent with ordinary forgetting

Question 41

binding problem =

Answer 41

discontinuity of the time frame

Question 42

2 models for DID

Answer 42

1. post-traumatic stress disorder: DID is a defense mechanism, to take on a personality that did not go through the trauma
2. social-cognitive model: a creation of psycotherapy and the media

Question 43

more vulnerable to DID

Answer 43

childhood trauma
emotional dysregulation
sleep dysregulation
hyperassociativity
metacognition
alexithymia
fantasy proneness

Question 44

meta cognition =

Answer 44

Metacognition is an awareness of one’s thought processes and an understanding of the patterns behind them.

Question 45

alexithymia =

Answer 45

Mensen die hieraan lijden hebben te maken met moeilijkheden met het verwoorden en begrijpen van emoties en met het omgaan met hun emoties.