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Psyc 385 > Dissociative and Somatoform Disorders > Flashcards

Dissociative and Somatoform Disorders Flashcards

1
Q

What are the types of dissociative disorders?

A

Dissociative amnesia, dissociative fugue, depersonalization/derealization disorder, dissociative identity disorder

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2
Q

What are the types of Somatoform disorders?

A

Somatic symtpom disorder, including with “predominant pain”, illness anxiety disorder, factitious disorder (Munchausen Syndrome)

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3
Q

What is the underlying characteristic of these 2 disorders?

A

Anxiety

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4
Q

What is dissociation?

A

Persistent, maladaptive disruptions in the integration of memory, consciousness, and identity

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5
Q

When does dissociation become pathological?

A

When it is prolonged or persistent (has to be persistent) and interferes with a persons quality of life.

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6
Q

What is often followed by dissociation?

A

Trauma

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7
Q

What is a fugue?

A

Sudden unexpected flight from home, inability to remember one’s past or where one is. Rarely: forgotten identity

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8
Q

What is amnesia?

A

Inability to remember important, personal information

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9
Q

What is depersonalization?

A

The sensation that you are not in your own skin

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10
Q

What is derealization?

A

Sensation that one’s environment does not feel real

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11
Q

What did dissociative disorders act as a catalyst for?

A

Psychoanalysis

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12
Q

What is the primary symptom of dissociative amnesia?

A

Inability to remember personal information without evidence of organic impairment.

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13
Q

What is localized amnesia?

A

When you can’t recall information from a specific time period

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14
Q

What is selective amnesia?

A

When parts of an event (trauma) are remembered and others are forgotten

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15
Q

What is generalized amnesia?

A

When you forget all past personal information

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16
Q

What is continuous amnesia?

A

When you forget things from a certain date till present

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17
Q

What is systemized amnesia?

A

When you forget certain categories of information such as people or places

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18
Q

Which 2 types of amnesia are the most common?

A

Localized and selective

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19
Q

What is a dissociative fugue?

A

Rare and unusual form of amnesia. Loss of memory for past and personal information and also travel suddenly and unexpectedly. Usually happens in an overwhelmed and exhausted person and after disruptive, life defining events.

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20
Q

What is depersonalization/derealization disorder?

A

When there are persistent, recurrent episodes of depersonalization and derealization. Cognitive disruptions in perceptual and attentional processes

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21
Q

What is the third most commonly reported symptom in mental health?

A

Depersonalization

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22
Q

What causes depersonalization/derealization disorder?

A

Likely emotional trauma and reduced emotional reactivity to stressful or emotionally intense stimuli.

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23
Q

What is dissociative identity disorder?

A

When a patient presents with two or more distinct personality states that take control over the persons behaviour and emotions. Personalities represent disruption of identity and a discontinuity in the sense of self

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24
Q

When does “switching” occur in DID?

A

Under periods of stress

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25
Q

When is the average DID diagnosis made?

A

29-35

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26
Q

What are the three psychological factors that contribute to dissociative disorders?

A

Trauma, state-dependent learning, attachment theory

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27
Q

How can trauma result in a dissociative disorder?

A

Child learns to dissociate from traumatic situations. Uses imagination or characters to send self elsewhere or to take the abuse. Can practice this like a skill and transfer it to other stressful siuations

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28
Q

What is state-dependent learning?

A

When people learn certain emotional reactions under certain situations and react the same way to a non-threatening situation. Ex: if something has the same characteristic as trauma from childhood, will react with anger and violence.

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29
Q

How does attachment theory relate to dissociative disorders?

A

Problematic attachments in childhood lead to reactions later in life.

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30
Q

What are the two social factors that can contribute to dissociative disorders?

A

Disorganized attachment, Iatrogenic effects

31
Q

What is disorganized attachment?

A

What happens when parents are both loving and abusive (highly unpredictable). Can be confusing and scary

32
Q

How was disorganized attachment demonstrated in the 80s?

A

Child reacts to parent leaving the room- freezes and acts confused. When parent comes back, the kid approaches, then steps back, then does it again.

33
Q

What are Iatrogeic effects?

A

Theory that dissociative disorders arise because patients follow the lead of therapists. Induces idea of a disorder in someone who doesn’t have it.

34
Q

What is the main treatment focus for dissociative disorders?

A

On uncovering and expressing trauma

35
Q

What makes uncovering of trauma so difficult?

A

People tend to tell stories in bits and contradict themselves. The therapist has to put the story together and decide when story goes off the rails.

36
Q

How can hypnosis both help and hinder the treatment of dissociative disorders?

A

Help:Facilitate recollection and abreaction: expression of emotion as if event is happening
Hinder: Person could have been fed ideas by a therapist

37
Q

What is the main goal of treatment for DID?

A

Reintegrating personalities into a whole. Takes time.

38
Q

What is the main feature of somatic disorders?

A

Prominence of somatic symptoms associated with significant distress and impairment.

39
Q

What is diagnostic emphasis placed on with somatic disorders?

A

Anxiety, depression, reactions to trauma that cause excessive worry, distress, and impairment contributing to the severity of a somatic condition. Have to have bodily condition that becomes the focus of anxiety. May or may not have a diagnosable condition, but most important point is the level of distress.

40
Q

What is conversion disorder?

A

Disorder characterized by loss of functioning in part of the body. This is the most common somatic disorder. Loss of functioning often doesn’t follow nervous system patterns and can be inconsistent

41
Q

What has to be done before someone is diagnosed with conversion disorder?

A

Have to rule out any other medical explanations

42
Q

What is somatic symptom disorder?

A

The manifestation of 1 or more physical symptoms accompanied by excessive thoughts, feelings, and behaviours. Catastrophizing over symptoms. May or may not occur in conjunction with a medical disorder

43
Q

What kinds of symptoms can appear with conversion disorder?

A

Seizure-like behaviours, paralysis of limb, anesthesias, sensory loss.

44
Q

What does diagnosis focus on with somatic symptom disorder?

A

Positive symptoms like distress and abnormal thoughts, rather than a search for unexplained medical disorder.

45
Q

What is somatic symptom disorder with predominant pain?

A

Complaints of pain in one or more parts of the body. Emphasis is on stress, distress, and life issues.

46
Q

What must one have to be diagnosed with somatic symptom disorder with predominant pain?

A

Excessive pain, unrealistic thoughts, feelings, behaviours related to pain, exaggerated concerns of seriousness.

47
Q

Why are people who have somatic symptom disorder with predominant pain at risk for addiction?

A

Because they doctor shop for painkillers.

48
Q

What is Illness Anxiety disorder?

A

Disorder characterized by long standing fears, suspicions, or convictions of having a serious disease. Misinterpretations of bodily functions. Always a fear of a life threatening condition. Fear must cause serious impairments in life. Aren’t interested in alternative explanations.

49
Q

What is the difference between illness anxiety and somatic disorder?

A

In somatic symptom, they actually have symptoms (just unexplained). With illness anxiety, they don’t have an actual medical condition.

50
Q

What is the difference between illness anxiety and panic disorder?

A

Panic disorder fears they will die NOW. Illness fears they will die LATER.

51
Q

What is Factitious disorder (Munchausen Syndrome)

A

Deliberate faking of a medical condition to get medical attention. Conditions can be physical or psychiatric

52
Q

What is one of the key features in diagnosing Munchausen syndrome?

A

There can’t be any obvious external reward for faking sick (insurance money etc). Motivated by attention, sympathy, and sick role.

53
Q

What is one of the varients of Munchausen syndrome?

A

Munchausen by proxy- faking that a child is sick.

54
Q

Why is Munchausen’s so distressing?

A

Because it is difficult to detect and can result in people getting treatments or surgeries that could kill them.

55
Q

What is the biggest danger with somatic disorders?

A

Misdiagnosis. Diagnosis often goes by exclusion

56
Q

How could the APA axis be related to somatic disorders?

A

Alterations in the APA axis and immune system, possibly as a result of excessive stress and/or a demanding illness

57
Q

What is the two factor psychobiological theory proposed by Rief and Barsky?

A
  1. Increased bodily signals due to biological factors related to prolonged distress, lack of physical condition, chronically stimulated HPA-Axis
  2. A deficient filter system that amplifies body signals rather than inhibiting them or effectively selecting them
58
Q

What are some of the psychological factors relating to somatic disorders?

A

Childhood environment, unconscious expression of conflict/negative affect, secondary gain, positive and negative reinforcement, learned sick role, tendency to pay excessive attention to and amplify physical symptoms, misattribution, alexithymia.

59
Q

What is secondary gain?

A

A reward for being sick

60
Q

What is alexythimia?

A

Deficit in capacity to recognize and verbalize emotions-expressed in bodily symptoms.

61
Q

What are some disorders (somatic) that are currently rare in the general pop and may have been studied more during Freud’s time?

A

COnversion disorder and hysteria

62
Q

Which somatic disorders have been studied more closely and are more frequent?

A

Illness anxiety and somatic symptom disorder.

63
Q

What is the prevalence of SDD in the general population?

A

5-7%

64
Q

What is the prevalence of SDD in primary care?

A

17%

65
Q

How much more common is SDD in women than in men?

A

10:1

66
Q

What somatoform disorder occurs in Indian men?

A

Dhat

67
Q

Which groups have more somatic disorders?

A

Unemployed and people with impaired occupational functioning and who have experienced significant losses

68
Q

What are somatic disorders comorbid with?

A

Anxiety, substance abuse, depression

69
Q

What is the dirty triad?

A

Depression, fatigue, and pain

70
Q

What types of personality disorders is severe somatiziation associated with?

A

Avoidant, paranoid, and OCPD

71
Q

Which functional disorders has SDD also been associated with?

A

Fibromyalgia, IBS, chronic fatigue

72
Q

How is cognitive behavioural therapy used to treat somatic disorders?

A

Reinforcement of successful coping and life adaptation. Control over interpretation of bodily functions. Go back to normal activities.

73
Q

How can a consistent patient physician relationship help in the treatment of somatic disorders?

A

Frequent follow ups help to maintain trust and help with the monitoring of health problems.

74
Q

How should family members react when a person with a somatic disorder acts up?

A

Neutrally

Psyc 385 (12 decks)

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