Exam 3 Study Guide Flashcards
What does soma mean?
Body
What do all somatic symptom and related disorders involve?
Prominence of somatic symptoms associated with significant distress or impairment
What is it called when individuals have physical symptoms without a specific cause?
Somatic
What is hysterical neurosis?
because of anxiety the have physical symptoms (used to be conversion disorder)
What is the DSM-5 Criteria for Somatic disorders?
A.) One or more somatic symptoms that are distressing or result in significant disruption to daily life
B.) Excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated with health concerns as manifested by at least one of the following
-Disproportionate and persistent thoughts about the seriousness of one’s symptoms
-persistently high level of anxiety about health or symptoms
-Excessive time and energy devoted to these symptoms or health concerns
c.) Although any one somatic symptom may not be continuously present, the state of being symptomatic is persistent (at least 6 months)
What is somatic symptom disordeR?
usually experience multiple somatic symptoms that are distressing and/or disrupt their daily lives
Why do people with somatic symptoms usually receive this diagnosis?
because often times they have been to many clinics and have not gotten the diagnoses they wanted
What are the 3 disorders combined from the DSM-4?
1.) Hypochondriasis
2.) Somatization disorder
3.) Pain disorder
Which gender is more likely to develop somatic symptom disorder?
women
What is comorbidity for somatic disorders?
Anxiety and Substance abuse disorders, sometimes with depression
What did researchers find with the DSM-4 disorders?
Did not have good validity or reliability
What is illness anxiety disorder?
Individuals are preoccupied with either having or contracting a serious disease and experience high levels of anxiety about their health
What is the DSM-5 criteria for illness anxiety disorder?
A.) Preoccupation with having or acquiring a serious illness
B.) Somatic symptoms are not present or, if present, are only mild in intensity, if another medical condition is present or there is a high risk for developing a medical condition, the preoccupation is clearly excessive or disproportionate
C.) There is a high level of anxiety about health, and the individual is easily alarmed about personal health status
D.) the individual performs excessive health-related behaviors or exhibits maladaptive avoidance
-Ex; avoiding doctors appt.
E.) Illness preoccupation has been present for at least 6 months, but the specific illness that is feared may change over that period of time
F.) The illness-related preoccupation is not better explained by another mental disorder
What is conversion disorder (functional neurological symptom disorder)?
Symptoms or deficits in sensory or motor behavior that cannot be explained by known medical condition
What are the symptoms of Conversion disorder (functional neurological symptom disorder)?
Symptoms or deficits in sensory or motor behavior that cannot be explained by known medical condition
-Partial paralysis
-Blindness
-Deafness
-Pseudoseizures
What is the DSM-5 Criteria of conversion disorder (functional neurological symptom disorder)?
A.) One or more symptoms of altered voluntary motor or sensory function
B.) Clinical findings provide evidence of incompatibility between the symptom recognized neurological or medical conditions
C.) The symptom or deficit is not better explained by another medical condition or mental disorder
D.) The symptom or deficit causes clinically significant distress or impairment in social, occupational, or other important areas of functioning
In the DSM-4 criteria for conversion disorder there was a criteria included called “la belle indifference” what is this criteria?
patient appears to be unbothered by a serious medical condition or its symptoms
What are the categories of symptoms for conversion disorder?
1.) Sensory (loss of sight, smell, taste)
2.) Motor (paralyzed can’t speak)
3.) Seizure (pesudoseizure)
4.) Mixed
What are the risk factors of conversion disorder?
1.) Early abuse or trauma
2.) Lower SES (Socio economic status)
3.) Lower education
What is a pseudo seizure?
They wouldn’t drop like a normal seizure, it is not faking though they are not consciously aware of what is happening)
What is the cognitive explanation for somatic disorders?
1.) excessive attention on bodily symptoms
2.) misinterpretation of symptoms
3.) Overmagnification
What is the behavioral explanation for somatic disorders?
Modeling and/or reinforcement
What are treatments for somatic disorders?
1.) Symptom focused CBT (help the individual to deal with the symptoms where they will quit having to act in abnormal behaviors)
2.) Antidepressants (not first line of treatments–SSRI’s)
3.) 3 Prong approach for conversion disorder
What is the 3 prong approach for conversion disorder?
1.) Withdraw medication and social attention
2.) Physical/occupational therapy
3.) Psychotherapy to help with stress
What is malingering?
Intentionally producing or grossly exaggerating physical symptoms to gain external incentives
Clear benefit
What is factitious disorder?
intentionally faking psychological or physical symptoms (or both), but with no external incentives like with malingering
Unclear external benefit
What are the reasons people participate in factitious disorder?
Benefits of playing the sick role (internal)
Or the attention they receive from the sick role
What is Munchausen’s disorder?
Factitious disorder that is imposed on another (most of the time it is a parent or a child)
What is the DSM-5 Criteria for Munchausen’s (factitious)
A.) falsification of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception
B.) The individual presents himself or herself to others as ill, impaired or injured
C.) The deceptive behavior is evident even in the absence of obvious external rewards
D.) The behavior is not better explained by another mental disorder, such as delusional disorder or another psychotic disorder
What is dissociation?
Human minds ability to engage in mental activity cut off from conscious awareness
What is depersonalization?
individual has a feeling of detachment from themselves, experiences themselves as strange or foreign
What are the 5 dissociative experiences?
1.) Depersonalization
2.) Derealization
3.) Amnesia
4.) Identity confusion
5.) Identity alteration
What is derealization?
feeling of unfamiliarity or unreality to your environment
What is amnesia?
lose the ability to remember certain things that happened, almost always autobiographical
What is identity confusion?
Really unsure of their own values, beliefs
What is identity alteration?
individuals show overt behaviors that seem to indicate another identity
Can normal non-diagnosed people experience dissociate symptoms?
Yes, they could even be symptoms of other disorders
What happens when the symptoms of a dissociate become more prominent?
Then you might be looking at a dissociate disorder diagnoses
DSM-5 for Dissociate disorders?
characterized by disruption of and/or discontinuity in the normal integration of
(consciousness, memory, identity, emotion, perception, body representation, Moto control, and behavior)
What are the 3 distinct dissociate disorders in the DSM-5?
1.) Dissociate amnesia
2.)Depersonalization/derealization disorder
3.) Dissociative Identity Disorder
(most controversial in the DSM-5)
What is dissociative amnesia?
Sudden inability to remember personal information or events
-Usually preceded by some stress/trauma
-Generalized vs. Localized (selective)
-Deficits in explicit memory; not implicit
What is the DSM-5 criteria for dissociative amnesia?
No time limit associated
A.) Inability to recall important autobiographical information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting
Note: dissociative amnesia most often consists of localized or selective amnesia for a specific event or events; or generalized amnesia for identity and life history
B.) The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
C.) The disturbance is not attributable to the physiological effects of a substance or a neurological or other medical conditions
D.) The disturbance is better not explained by another mental disorder
What is dissociate fugue?
Individuals leave their locale travel somewhere else and then become amnesic for their original information
Apparently purposeful travel or bewildered wanderings that is associated with identity amnesia
Fugue= to leave
Specifier under dissociate amnesia
What is the DSM-5 criteria for depersonalization/derealization disorder?
A.) The presence of persistent or recurrent experiences of depersonalization, derealization or both:
1.) Depersonalization: experiences or unreality, detachment or being an outside observer with respect to one’s thoughts, feelings, sensations, body or action (e.g. perceptual alterations, distorted sense of time, unreal or absent self, emotional and/or physical numbing)
2.) Derealization: experiences of unreality or detachment with respect to surroundings (e.g. individuals or objects are experienced as unreal, dreamlike, foggy, lifeless or visually distorted)
B.) During the depersonalization or derealization experiences, reality testing remains intact
C.) The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
D.) The disturbance is not attributable to the physiological effects of a substance or another medical condition
E.) The disturbance is not better explained by another mental disorder
What is depersonalization/derealization disorder?
Individuals experience recurrent episodes of depersonalization and/or derealization which results in impairment to normal functioning
What is depersonalization?
experiences or unreality, detachment or being an outside observer with respect to one’s thoughts, feelings, sensations, body or action
What is derealization?
experiences of unreality or detachment with respect to surroundings
What is dissociative identity disorder?
Individual manifests at least 2 distinct personalities/identities that alternate in some way in taking control of behavior
1.) Host identity vs. alters
2.) Involves amnesia
What is the DSM-5 criteria for dissociative identity disorder?
A.) Disruption of identity characterized by two or more distinct personality states, which may be described in some cultures as an experience of possession. The disruption in identity involves marked discontinuity in sense of self and sense of agency, accompanied by related alterations in affect, behavior, consciousness, memory, perception, cognition, and/or sensory motor functioning. These signs and symptoms may be observed by others or reported by the individual
B.) Recurrent gaps in the recall of everyday events, important personal information, and/or traumatic events that are inconsistent with ordinary forgetting
C.) The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
D.) The disturbance is not normal part of a broadly accepted cultural or religious practice
E.) The symptoms are not attributable to the physiological effects of a substance or another medical condition
What are the disk factors of dissociate identity disorder? (controversial)
1.) High suggestibility and hypnotizability
-Highly highly susceptible to hypnotization
2.) Abuse or childhood trauma
-Almost always there is childhood abuse
3.) Lack of social support
What are the controversies of dissociative identity disorder?
1.) Real-or fake
2.) Post-traumatic theory or sociocognitive theory
-use it as a way to cope with trauma and split it off (PTSD)
-Socio argues that it is not there or misdiagnosed in individuals
-The therapist could sometimes cause people to develop the disorder through susceptibility and leading questions (see it in the media too)
3.) Abuse as a cause/repressed memories
What are the challenges of dissociate identity disorder?
1.) Increase in number of cases over time
-1970 total # was 79, next time they counted it there was 6,000 (1986)
2.) No knowledge of alters prior to therapy
3.) Number of alters increases with therapy
-longer they are in therapy the more alters come out
4.) Few psychologists ever see Dissociative identity disorder
what is the minimum alters for DID?
2
What is the average number of alters for DID?
10
Can the different alters in DID have different physiological characteristics?
Yes (different glasses prescriptions and brain waves patterns)
What is the minimum length of time the individual has to have symptoms to get a diagnosis of schizoaffective disorder?
4 weeks
What is psychosis?
Severe mental condition characterized by loss of contact with reality
What are the schizophrenia spectrum and other psychotic disorders?
1.) Schizophrenia
2.) Schizoaffective disorder
3.) Schizophreniform disorder
4.) Delusional Disorder
5.) Brief psychotic disorder
what is schizoaffective disorder?
Hybrid of schizophrenia and a mood disorder, where mood symptoms must be present for more than 50% of the total illness
What is the DSM-5 criteria for schizoaffective disordeR?
A.) An uninterrupted period of illness during which there is a major mood episode (major depressive or manic) concurrent with Criteria A of schizophrenia
Note: the major depressive episode must include Criteria A 1: depressed mood
B.) Delusions or hallucinations for 2 or more weeks in the absence of a major mood episode (depressive or manic) during the lifetime duration of the illness
C.) symptoms that meet criteria for a major mood episode are present for the majority of the total duration of the active and residual portions of the illness
D.) The disturbance is not attributable to the effects of a substance (e.g. a drug of abuse, a medication) or another medical condition
What is schizophreniform disorder?
Shorter duration schizophrenia; must last at least a month but no more than 6 months
What is the DSM-5 criteria for schizophreniform disorder?
A.) Two (or more) of the following, each present for a significant portion of the time during a 1-month period (or less if successfully treated), at least one of these must be (1), (2) or (3)
1.) Delusions
2.) Hallucinations
3.) Disorganized speech
4.) Grossly disorganized or catatonic behavior
5.) Negative symptoms
B.) An episode of the disorder lasts at least 1 month but less than 6 months. When the diagnosis must be made without waiting for recovery, it should be qualified as provisional
C.) Schizoaffective disorder or depressive disorder or bipolar disorder with psychotic features have been ruled out because either 1.) no major depressive or manic episodes have occurred concurrently with the active-phase symptoms, or 2) if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness
D.) The disturbance is not attributable to the physiological effects of a substance (e.g. drug of abuse, a medication) or another medical condition
What is delusional disorder?
Delusions present, but otherwise fairly normal functioning
What are common delusions of those with delusional disorder?
1.) Erotomanic: delusions of a person being infatuated with them
2.) Grandiosity (im Jesus) –> usually for this disorder would not be as extreme
3.) Jealousy
4.) Persecution
5.) Somatic
What is the DSM-5 criteria for delusional disorder?
A.) The presence of one (or more) delusions with a duration of 1 month or longer
B.) Criteria A for schizophrenia has never been met
Note: Hallucinations if present, are not prominent and are related to the delusional theme (e.g. the sensation of being infested with insects associated with delusions of infestation)
C.) A part from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired, and behavior is not obviously bizarre or odd
D.) If manic or depressive episodes have occurred, these have been brief relative to the duration of the delusional periods
E.) The disturbance is not attributable to the physiological effects of a substance or another medical condition and is not better explained by another mental disorder, such as body dysmorphic disorder or OCD
What is the DSM-5 criteria of brief psychotic disordeR?
A.) Presence of one (or more) of the following symptoms, at least one of these must be (1), (2) or (3)
1.) Delusions
2.) Hallucinations
3.) Disorganized speech
4.) Grossly disorganized or catatonic behavior
Note: do not include a symptom if it is a culturally sanctioned response
B.) Duration of an episode of the disturbance is at least 1 day but less than 1 month, with eventual full return to premorbid level of functioning
C.) the disturbance is not better explained by major depressive disorder or bipolar disorder with psychotic features or another psychotic disorder such as schizophrenia or catatonia, and is not attributable to the physiological effects of a substance (e.g. a drug of abuse, a medication) or another medical condition
What are the genetic risk factors of schizophrenia?
Family studies
Twin studies
Adoption studies
What is the main reason for schizophrenia?
biological
What are the neurochemistry
Dopamine Hypothesis
Glutamate hypothesis
What is the dopamine theory of schizophrenia?
Cause of schizophrenia Is a functional excess of the neurotransmitter dopamine
What is the dopamine hypothesis?
oversensitivity and overabundance of dopamine
What are the dopamine pathways?
1.) Mesolimbic
2.) Nigrostriatal
3.) Mesocortical
What is the mesolimbic?
Hallucinations, delusions
What is the nigostriatal?
side effects comparable to Parkinsons
What is mesocortical?
deficits, stop expressing emotion/talking
What are the elements of the neurodevelopment hypothesis?
Maternal viral infection
Rh incompatibility (protein and red blood cells)
pregnancy and birth complications (oxygen deprivation = high risk for developing schizophrenia)
What is the diathesis stress model?
structural and/or genetic diathesis
+
dysfunctional family environment
high communication deviance
What is expressed emotion?
Measure of family environment
-Criticism
-Hostility
-emotional over-involvement
What are treatments?
Drug therapy
-Antipsychotics (1st generation)
-Thorazine, mellaril, haldol
-side effects?
What is tardive dyskinesia?
causes involuntary, repetitive movements in the body or face
What are side effects of antipsychotics?
Movement issues, weight gain, dizziness, agitation, `
What are atypical antipsychotics? (2nd generation)O
Clozapine, risperidone, zyprexa,
What is agranulocytosis?
body has very low levels of granulocytes, a type of white blood cell that helps fight infection
What are the psychosocial approaches?
family therapy
social skills training
cognitive remediation
what is cognitive remediation?
helps people improve their cognitive skills, such as attention, memory, and communication
How is expressed emotion related to relapse?
risk factor for poor treatment outcomes and relapse, high probability for relapse.
What is the psychodynamic explanation of somatic symptom disordeR?
unconscious emotional conflicts that are “converted” into physical symptoms
How would a learning theorist explain somatic symptom disorders?
learned behavior, where individuals have developed a pattern of interpreting and responding to bodily sensations as signs of serious illness due to past experiences, environmental factors, and reinforcement of these beliefs,
Why is depersonalization disorder described as an “as if” disorder?
people experiencing it frequently describe their symptoms using phrases like “as if I’m watching myself from outside” or “as if I’m in a dream,” meaning they feel detached from their own body and reality, but they still recognize that this perception isn’t actually true; they are aware that the experience is not real, just feeling “as if” it were happening to them`
What are the treatments for different dissociative disorders?
psychotherapies and medications
What influences could lead to structural abnormalities with schizophrenia?
genetic factors, prenatal and perinatal complications, environmental stressors, and potential disruptions in brain development during critical periods
What is the supporting evidence of the dopamine hypothesis with schizophrenia?
antipsychotic medications, which block dopamine receptors, effectively reduce positive symptoms like hallucinations and delusions, along with findings from brain imaging studies showing increased dopamine activity in the mesolimbic pathway of individuals with schizophrenia,
What is the supporting evidence for the glutamate hypothesis in schizophrenia?
neuroimaging, brain tissue studies, genetic studies, animal studies, glutamate levels
Describe the effectiveness and limitations to drug therapies with schizophrenia?
