IX - Somatoform Disorders Flashcards

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1
Q

Somatoform vs Anxiety Disorders

A

Somatoform - primarily body. Anxiety - lots of things. If there is an individual preoccupied with disease but does not have somatic complaints, illness anxiety disorder. Somatoform - preoccupied with somatic symptoms; if person with anxiety has somatic symptoms, less intense. However, they can be comorbid.

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2
Q

Somatic Symptom vs Somatoform disorders

A

Same thing but Somatoform is DSM-IV and Somatic is DSM-V. Change in name because Somatic symptom disorders encapsulate several previously separate disorders. Conditions that involve physical symptoms as well as abnormal thoughts, feelings, behaviors in response. Medically unexplained symptoms key (though less emphasis in DSM-V). Not intentionally faking

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3
Q

Malingering

A

Producing or exaggerating physical symptoms for incentives like insurance money

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4
Q

Factitious Disorder

A

Person intentionally produces psychological or physical symptoms for benefits of “sick role”

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5
Q

DSM-IV Somatoform Disorders

A

5 patterns:

Hypochondriasis, somatization disorder, pain disorder, conversion disorder, body dysmorphic disorder

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6
Q

DSM-V Somatic Symptom Disorder changes from DSM-IV

A

Hypochondriasis, somatization disorder, pain disorder all eliminated. Less emphasis on medically unexplained part of IV - doctors like this (though such symptoms still key part of some disorders)

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7
Q

DSM-V Somatic Symptom and Related Disorders

A

Somatic symptom disorder, illness anxiety disorder, conversion disorder, factitious disorder, psychological factors affecting medical conditions, other specified and unspecified somatic symptoms and related disorders

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8
Q

Somatic symptom disorder

A

(A) 1+ somatic symptoms that are distressing or significantly disrupt daily life
(B) Excessive thoughts, feelings, behaviors related to symptoms/health concerns with disproportionate/persistent thoughts of seriousness, high anxiety, and/or excessive time and energy devoted to.
(C) Though a single symptom may not continuously present, the state of being symptomatic is persistent and usually lasts 6+ months.

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9
Q

DSM-V Illness Anxiety Disorder

A

(A) Preoccupation with having or acquiring serious illness
(B) Somatic symptoms not present or mild. If family history, worry is disproportionate
(C) High anxiety and alarm about health
(D) Excessive health-related behaviors or avoidance
(E) Preoccupation 6+ months (does not have to stay the same one)
(F) Not better explained by another disorder such as somatic symptom, panic, GAD, BDD, OCD.

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10
Q

DSM-V Factitious Disorder

A

(A) Falsification of physical/psychological symptoms, or induction of injury or disease
(B) Presents self as ill, impaired, or injured
(C) Deceptive behavior evident even in absence of obvious external incentives
(D) Not better explained by another disorder such as delusional or psychotic disorder.

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11
Q

DSM-V Conversion Disorder

A

(A) Altered voluntary movement or sensory function
(B) Clinical incompatibility between symptom and neurological/medical condition
(C) Not better explained by another medical or mental disorder
(D) Symptom causes clinically significant distress or impairment

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12
Q

DSM-IV Hypochondriasis

A

Preoccupied with getting serious disease or have idea they already have one. Preoccupied with bodily functions, physical abnormalities, misinterpretation of bodily functions. Not reassured by medical evaluation - “doctor shopping.” Chronic if untreated. Often comorbid w/ mood disorders, panic disorder, somatoform

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13
Q

Causes of DSM-IV Hypochondriasis

A

Closely related to anxiety disorders. Cog-beh: misinterpretation of bodily sensations, past experience with illness may lead to dysfunctional assumptions, which lead to excessive attention. Seek confirming evidence. See selves as weak. Secondary reinforcement includes sick role, which is developmentally acquired.

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14
Q

CBT for DSM-IV Hypochondriasis

A

Assess patient’s beliefs, selective focusing, response prevention

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15
Q

DSM-IV Somatization Disorder

A

Many different complaints of physical ailments lasting several years, not adequately explained by medical assessment. Characterized by combo of pain (4), gastrointestinal (2), sexual (1), pseudoneurological (1). This pissed doctors off b/c unnecessarily specific. Leading to treatment or significant life impairment. Symptoms not feigned.

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16
Q

Somatization Disorder vs Hypochondriasis

A

Many similarities but only people with hypochondriasis think they have organic disease. Usually only one or a few primary symptoms, while somatization with multiple.

17
Q

DSM-IV Somatization Causes

A

Specific etiology unclear. Perceptual amplification of bodily symptoms - catastrophize. Elevated stress hormones, lessened habituation to psychological stressors. Interaction of neurotic personality with cognitive and learning variables.

18
Q

DSM-IV Somatization Disorder Treatment

A

Very difficult to treat - combo of medical management and CBT may be helpful. Integration between physician and psychologist good here. Medical management also good for integration and avoiding unnecessary testing/meds

19
Q

DSM-IV Pain disorder

A

Persistent and severe pain in 1+ areas of body. Medical condition may contribute but psychological apparently plays important role. Similar to somatization but with only pain symptoms. More common in women. Often comorbid with anxiety or mood disorder

20
Q

DSM-IV Pain Disorder Subtypes

A

(1) Pain disorder associated with psychological factors

(2) “” with both psychological factors and general medical condition

21
Q

Conversion Disorder - DSM-IV

A

Symptoms or deficits affecting sensory or motor functions - paralysis, blindness, deafness, pseudoseizures. 4 categories: sensory symptoms/deficits, motor symptoms/deficits, seizures, mixed presentation Psychological factors must be judged to play important role - onset/exacerbation of symptoms correlate with emotional stressors. Freud believed repressed sexual energy -> symptoms. Diagnosis can be very difficult - symptoms often diff from organic, selectively dysfunctional, affected by hypnosis or abrupt awakening. Limited knowledge of treatment

22
Q

Comversion disorder - DSM-IV - primary and secondary gains

A

Primary gain - escape or avoidance of stressful situation

Secondary gain - external circumstances such as attention, financial comp