Dissociative, Somatic, And Sleep-wake Disorders Flashcards
Disturbance of, or alteration in, the usually integrated functions kd consciousness, memory, identity and perception
Dissociative disorders
Causative theories on dissociative disorder
Biological factors Genetic factors Psychosocial factors Psychodynamic theory Psychological trauma
Dissociative disorder: impaired ability to integrate memory
Dissociative amnesia
Dissociate disorder: inability to maintain one’s identity
Dissociative fugue or dissociative identity disorder
Dissociative disorder: persistent or recurrent disruption in perception… Detachment from the mind or body
Depersonalization
Dissociative disorder: unreality of surroundings
Derealization
Signs and symptoms of depersonalization
Dreamy
A sense of unreality
Slow movement of time
Sees self from a distance or detachment
Signs and symptoms of derealization
Unreal
Dreamlike
Distance or distorted experience in familiar surroundings
Dissociative amnesia: specific events during a specific period of time
Local
Dissociative amnesia: who they are, autobiographical data and general knowledge of the world
Generalized
dissociative identity disorder: insistence that alternate personalities inhabit separate bodies and are unaffected by the actions of one another
Cognitive distortion
dissociative identity disorder: unaware of the subpersonalities and is perplexed by lost time and unexplained events
Primary personality
dissociative identity disorder: often aware of the existence of each other to some degree
Subpersonalities
dissociative identity disorder: times of stress and may range from a dramatic to a barely noticeable event
Transition
dissociative identity disorder: lasting from minutes to months… Shorter periods are more common
Shift
Physical signs and symptoms with abnormal thoughts, feelings, and behaviors
Absence of physical findings or medical illness
Somatic disorders
Causative theories of somatic disorders
Genetic and familial factors
Learning and sociological factors
Psychological theory
Interpersonal model
Somatic disorder: deliberate fabrication of symptoms or slef-injury without obvious gains
Factitious disorder
Factitious disorder: deliberate fabrication of symptoms or injury is imposed upon another person often a child or another victim
Factitious disorder imposed on another
Factitious disorder: disorder by deception … Most severe and chronic form… “doctor shopping” in attempts to seek surgery and invasive diagnostic tests
Munchausen syndrome
Factitious disorder: manifested by a caregiver (usually a mother with a health care background)… Injuring a child to receive attention or sympathy
Munchausen syndrom by proxy
Factitious disorder: patient feigns sickness or disease through web forums
Munchausen by internet syndrome
Involves a conscious process of intentionally producing symptoms for an obvious benefit
Malingering
Symptoms of malingering
Highly subjective and difficult to prove or disprove
Symptoms of somatic disorder
Vague, dramatized, or exaggerated presentation
Excessive amount of time is spent on worrying a d concern about symptoms
Hypochondriasis
Unrealistic or inaccurate interpretation of physical symptoms or sensations, leading to preoccupation and fear of having a serious disease
Illness anxiety disorder
symptoms or deficits that affect voluntary motor or sensory functions and that suggest a medical condition
Conversion disorder
False belief that one is pregnant, while at the same time the woman’s body may mimic the signs and symptoms of pregnancy
Pseudocyesis
Sleep wake disorder: characterized by difficulty in initiating or maintaining sleep or by excessive sleepiness
Dyssomnias
Sleep wake disorder: occur during sleep but do not usually produce insomnia or excessive sleepiness
Parasomnias
Persistent difficulty in initiating or maintaining sleep
Insomnia
Insomnia: lifelong history of inability to obtain adequate sleep
Idiopathic insomnia
Insomnia: learned sleep-preventing associations and heightened physiologic response to stress
Psychophysiologic insomnia
Excessive daytime sleepiness
Narcolepsy
Narcolepsy: sudden loss of muscle tone at times of unexpected emotion
Cataplexy
Narcolepsy: hallucinatory experiences that occur at sleep onset or awakening
Hypnagogic hallucinations
Is characterized by cessation of breathing for 10 seconds or longer occuring at least 5 times per hour
Sleep apnea
Respiratory efforts of the diaphragm and intercostal muscles are apparent but ineffective against a collapsed or obstructed upper airway
Obstructive sleep apnea syndrome
Periodic episodes of repetitive, stereotypic leg movements that occur during sleep, causing partial arousals
Periodic limb movement disorder
Involves anything “crawling”, itching or tingling sensations of the leg while at rest and causes an almost irrwsistible urge to move
Restless leg syndrome
Persistent recurrent sleep disruption due to changes in ciecadian rhythm
Circadian rhythm sleep disorder
Circadian rhythm sleep disorder: non synchronous to the 24 hr environment
Time zone change syndrome
Circadian rhythm sleep disorder: insomnia during the major sleep period… Excessive sleepiness, inadvertent sleep during major wakefulness period due tk shift work schedule
Shift work sleep disorder
Arousal disorder: includes semi purposeful behavior. However the behavior may be lacking in coordination and appropriateness such as avoiding the closet
Sleepwalking or somnambulism
Arousal disorder: sudden arousals from slow wave sleep accompanied by screaming, tachycardia, diaphoresis, and othe manifestations
Sleep terrors
Sudden jerking movement of the legs that often occurs as a person is falling asleep
Sleep starts
May occur during times of stress
Sleep talking
Frightening dreams that arise in REM sleep and are often vividly recalled on awakening
Nightmares
May be an extension of the normal state of low muscle tone during REM sleep
Sleep paralysis
Grinding of the teeth during sleep
Sleep bruxism
Bed wetting
Sleep enuresis
Rhytmic in nature without episodes of apnea or hypoventilation
Primary snoring
Nursing jnterventions in somatic disorders
Offer meals at regular time Active meaningful activities during daytime Monitor frequency and duration of naps Individualized bedtime rituals Provide uninterrupted sleep
