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PSYC3102 > Lecture 6 'Somatic Symptoms' > Flashcards

Lecture 6 'Somatic Symptoms' Flashcards

1
Q

What are the two essential features of somatic symptoms and related disorders?

A

> physical symptoms suggest a physical disorder but there are no demonstratable organic findings or known physiological mechanisms
positive evidence or strong presumption that symptoms are linked with psychological factors/conflicts

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2
Q

Somatic symptoms and related disorders are a,one the most prevalent mental health problems in primary care; functional impairment is comparable with that seen in which other disorders?

A

Depressive and anxiety disorders

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3
Q

What are the five major somatic symptom disorders in the DSM5?

A
  1. Somatic symptom disorder
  2. Illness anxiety disorder
  3. Conversion disorder
  4. Factitious disorder
  5. Psychological factors affecting other medical conditions
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4
Q

For somatic symptoms and related disorders what are two exclusionary considerations?

A

Known physical causes must be ruled out

Has a physical cause been overlooked?

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5
Q

Males or females have higher prevalence rates of somatic symptom disorder?

A

females

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6
Q

What are the key characteristics of somatic symptom disorder?

A

> Somatic symptoms
Excessive thoughts/behaviours related to symptoms or health concerns
Pain + gastrointestinal complaints

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7
Q

What is the usual age of onset of somatic symptom disorder?

A

between 30-40 years

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8
Q

What is the difference between somatic symptom disorder and illness anxiety disorder?

A

Somatic > preoccupation with pain when there is no physical evidence to account for pain or its intensity

Illness anxiety > high level anxiety about having or acquiring a serious illness

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9
Q

Illness anxiety disorder can only be diagnosed when symptoms have been present for at least ________

A

six months

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10
Q

illness anxiety disorder was previously called?

A

hypochodriasis

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11
Q

males or females have higher prevalence rates in illness anxiety disorder?

A

both similar rates

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12
Q

John has been diagnosed with illness anxiety disorder. He complains of a stomach ache and decides it must be caused by a cancerous tumor. This is an example of?

A

somatosensory amplification

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13
Q

Illness anxiety disorder has high comorbidity rates with what two disorders?

A

anxiety and major depression

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14
Q

What is conversion disorder?

A

symptoms mimic neurological disorder or other medical condition (which may make no anatomical sense)

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15
Q

Anna complains of pain insensitivity limited to her hand and fingers, which makes no anatomical sense. Which disorder does she likely suffer from?

A

conversion disorder

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16
Q

What is the difference between factitious disorder and malingering?

A

Factitious > deliberately creating symptoms (e.g. MUNCHAUSEN syndrome - repetitive pattern of factitious disorder) which can be imposed on self or on another

Malingering > symptoms created for the purpose of compensation or to avoid a negative event.

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17
Q

Somatic symptom disorders (SSD) are frequently linked with which personality disorder?

How is this information helpful for understanding aetiology?

A

Antisocial personality disorder (APD)

Biological vulnerabilities:
> Male relatives of people with somatization disorder have higher rates of antisocial PD than controls
> APD more in males, SSD more in females = different manifestation?

18
Q

Somatic symptom disorders may be caused by neurological abnormalities in the __________

A

right hemisphere

19
Q

What are the biological vulnerabilities of somatic symptom disorders? HARD BONUS QUESTION

A

> > Anti-social PD

  • many similarities
  • just expressed differently?

> > Neurobiologically based disinhibition syndrome
- weak behavioural inhibition system

> > Neurological
- abnormalities in the right hemisphere

> > Somatosensory amplification
- greater physiological sensitivity

20
Q

What are three psychodynamic vulnerability theories for somatic symptom disorders?

A

> Negative feelings repressed and converted into physical symptoms

> Poor self awareness and ability to self regulate

> Less psychologically minded

21
Q

From the cognitive perspective, what are the two theories of somatic symptom disorder aetiology?

A

> > Somatoform symptoms = form of communication

Alexithymia (can’t read emotions) strongly correlated with psychosomatic symptoms

People use somatic symptoms e.g. “I have a headache” to explain that they’re not well - they avoid “I feel anxious”

> > Misinterpreted body sensations

More likely to view negative life events as unpredictable, threatening and uncontrollable (same way they interpret ambiguous stimuli)

22
Q

How may negative affectivity (NA) linked to somatic symptom disorders?

A

NA linked to: worry, pessimism, fear of uncertainty, poor self esteem, etc.

Greater NA (esp. worry + pessimism) predicts increased severity of somatization

23
Q

If an individual has somatic symptom disorder and has a history of personal or family illness, why might this information be important in understanding the disorder’s aetiology?

A

The individual may notice that they/someone else always gets rewarded for being sick.

may be conscious/unconscious or deliberate/non-deliberate

24
Q

Describe Freud’s four basic processes of stress conversion and related gains in the development of conversion disorder?

A
  1. traumatic event
  2. conflict repressed, made unconscious
  3. anxiety increases / threatens to push into consciousness and is “converted” into physical symptoms
    PRIMARY GAIN = don’t have to deal with the conflict
  4. Increased attention and sympathy is received (SECONDARY GAIN)
25
Q

List the two points of supporting evidence for Freud’s four processes in stress-conversion theory.

A

> Association between somatization and childhood abuse

> Somatoform disorders more prevalent in cultures that discourage open discussion of psychological problems and that stigmatize mental disorders

26
Q

What are three challenges of getting people to reveal their somatoform disorder symptoms to professionals?

A
  1. Emphasis placed on physical symptoms
  2. Refusal to believe one has a psychological problem
  3. Psychological teatment often sought as last resort
27
Q

What has been established as the best treatment for somatic symptom disorders (excluding conversion and pain disorders)?

A

CBT

28
Q

What is the definition of a dissociative disorder?

A

Characterized by disruption in usually integrated functions of CONSCIOUSNESS, MEMORY, IDENTITY or PERCEPTION of environment

29
Q

What are the five dissociative experiences?

A
  1. Depersonalisation = feeling detached from body
  2. Derealisation = feeling unfamiliar about one’s physical or interpersonal environment
  3. Amnesia = inability to remember personal information
  4. Identity confusion = unclear/conflicted about personal identity
  5. Identity alteration = overt behaviour indicating one has assumed an alternate identity
30
Q

What are the characteristics of dissociative amnesia?

A

> sudden inability to recall important personal information (not due to organic mental disorder)

> Begins suddenly, ends abruptly

31
Q

What are the six types of disturbance in recall?

A
  1. localised amnesia (event/period of time)
  2. selective amnesia
  3. generalised amnesia
  4. retrograde amnesia (before)
  5. anterograde amnesia (transfer from short>long memory)
  6. posttraumatic amnesia
32
Q

What are four diferences between dissociative amnesia and organic amnesia?

A

Dissociative

  1. Loss of past both recent an remote
  2. Personal identity is lost, store of general knowledge intact
  3. Events that happen after the moment amnesia starts are remembered well
  4. Amnesia often reverses abruptly

Organic

  1. Distant past remembered well, but not recent past
  2. Both personal and general knowledge is lost
  3. Memory of events after amnesia starts are lost = primary symptom
  4. Memory gradually returns for retrograde, seldom returns for memories since brain damage; memory of trauma never revived
33
Q

What is dissociative fugue?

A

the specification of dissociative amnesia with a sudden, unexpected travel away from home environment and taking on a new identity with no memory of events before the fugue

34
Q

What is the essential feature of dissociative identity disorder?

A

A presence within a person of two or more distinct personality states, each with its own pattern of perceiving, relating to, and thinking about the environment and self

35
Q

What are the four differences between sub-personalities in dissociative identity disorder?

A
  1. Personality characteristics
  2. Demographic characteristics
  3. Abilities and preferences
  4. Physiological responses
36
Q

What is the essential feature of depersonalisation/derealisation disorder?

A

feelings of being detached from one’s body or mind ‘as if’ one is an external observer of ones own behaviour

37
Q

depersonalisation / derealisation disorder occurs most frequently in which age group?

A

adolescents

38
Q

According to the pschodynamic view, dissociation serves what purpose?

A

an escape / defence against painful events

39
Q

What are the three things psychodynamic and behavioural perspectives agree about dissociative disorder aetiology?

What are the differences between these perspectives?

A

> > DD’s are precipitated by traumatic experiences
DD’s represent ways of avoiding extreme anxiety
Patient’s unaware that disorder is protecting them from facing painful reality

– Different mechanisms at play (psychodynamic = unconscious; behavioural = reinforcement)

40
Q

Research suggests that fragmented _________ cycles helps explain dissociative symptoms

A

sleep-wake

41
Q

The manufacture of a disorder by its treatment is called?

A

Iatrogenesis

42
Q

Describe the dissociation-trauma model?

A

severe childhood trauma&raquo_space; child attempts psychological escape&raquo_space; dissociated experiences&raquo_space; adult stressors&raquo_space; alter personalities

PSYC3102 (13 decks)

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