Psych - Pathology (Malingering, Factitious, Somatic, & Personality disorders) Flashcards
Pg. 510-512 in First Aid 2014 Sections include: -Malingering -Factitious disorders -Somatic symptom and related disorders -Personality -Cluster A personality disorders -Cluster B personality disorders -Cluster C personality disorders -Keeping "schizo-" straight
What defines Malingering? Emphasize key terms (in all caps) for the definition.
Patient CONSCIOUSLY fakes, profoundly exaggerates, or claims to have a disorder in order to attain a specific SECONDARY (EXTERNAL) GAIN (e.g., avoiding work, obtaining compensation).
What is important to known about Malingering patients in terms of clinical follow-up?
Poor compliance with treatment of follow-up of diagnostic tests.
What distinguishes Malingering from Factitious disorders?
Complaints cease after gain (vs. Factitious disorder).
Create a chart relating and distinguishing the following disorders: (1) Somatoform disorders (2) Factitious disorder (3) Malingering.
See p. 510 in First Aid 2014 for chart at top of page
What defines Factitious disorders?
Patient CONSCIOUSLY creates physical and/or psychological symptoms in order to assume “sick role” and to get medical attention (PRIMARY [INTERNAL] GAIN).
What are 2 types of Factitious disorders?
(1) Munchausen syndrome (2) Munchausen syndrome by proxy
What kind of disorder is Munchausen syndrome, and what kind of signs/symptoms predominate in it?
Chronic factitious disorder with predominantly physical signs and symptoms.
What characterizes Munchausen syndrome?
Characterized by a history of multiple hospital admissions and willingness to receive invasive procedures.
When does Munchausen syndrome by proxy occur? What is the motivation behind it?
When illness in a child or elderly patient is caused by the caregiver. Motivation is to assume a sick role by proxy.
Which type of factitious order is a form of child abuse? With what other kind of abuse is it associated?
Munchausen syndrome by proxy = Form of child/elder abuse
What defines/distinguishes Somatic symptom and related disorders?
Category of disorders characterized by physical symptoms with no identifiable physical cause. Both illness production and motivation are UNCONSCIOUS drives. Symptoms not intentionally produced or feigned.
In what gender are Somatic symptom and related disorders more common?
More common in women.
What are 3 types of Somatic symptom and related disorders?
(1) Somatic symptom disorder (2) Conversion disorder (3) Illness anxiety disorder (hypochondriasis)
What defines somatic symptom disorder?
Variety of complaints in one or more organ systems lasting for months to years.
With what occurrences are symptom disorders associated?
Associated with excessive, persistent thoughts and anxiety about symptoms.
With what condition may somatic symptom disorder co-occur?
May co-occur with medical illness.
What defines conversion disorder, and what often causes it?
Sudden loss of sensory or motor function (e.g., paralysis, blindness, mutism), often following an acute stressor
How may conversion disorder patients react to their symptoms?
Patient is aware of but sometimes indifferent towards symptoms (“la belle indifference”)
In what 3 patient populations is conversion disorder more common?
More common in females, adolescents, and young adults
What is another name for Illness anxiety disorder? What defines it?
Illness anxiety disorder (hypochondriasis); Preoccupation with and fear of having a serious illness despite medical evaluation and reassurance
What are 2 conditions related to personality?
(1) Personality trait (2) Personality disorder
What defines personality trait?
An enduring, repetitive pattern of perceiving, relating to, and thinking about the environment and onself
What defines personality disorder?
Inflexible, maladaptive, and rigidly pervasive pattern of behavior causing subjective distress and/or impaired functioning
How does a patient with personality disorder usually respond to their symptoms?
Person is usually not aware of problem.
By what age group does personality disorder usually present?
Usually presents by early adulthood
What are the personality disorder clusters? How should you distinguish/remember them, based on their symptoms?
Three clusters, A, B, and C; remember as “Weird, Wild, and Worried” based on symptoms.
What are 2 ways to describe a person with Cluster A personality disorders? What is the one word used distinguish Cluster A from other clusters? What are 3 examples of behavior illustrating this distinguishing word?
Odd or eccentric; “Weird” (Accusatory, Aloof, Awkward)
How do Cluster A personality disorders impact people’s social lives?
Inability to develop meaningful social relationships
Is their psychosis in Cluster A personality disorders? With what condition does they have a genetic association?
No psychosis; genetic association with schizophrenia
What are 3 types of Cluster A personality disorders?
(1) Paranoid (2) Schizoid (3) Schizotypal
In what Cluster of personality disorders is Paranoid? What defines it?
Cluster A personality disorders; Pervasive distrust and suspiciousness
What is the major defense mechanism for Paranoid patients?
Projection is the major defense mechanism
In what Cluster of personality disorders is Schizoid? What 3 characteristics define it?
Cluster A personality disorders; Voluntary social withdrawal, limited emotional expression, content with social isolation (vs. avoidant); Think: “schizoiD = Distant”
In what Cluster of personality disorders is Schizotypal? What 3 characteristics define it?
Cluster A personality disorders; Eccentric appearance, odd beliefs or magical thinking, interpersonal awkwardness; Think: “schizoTypal = magical Thinking”
What are 3 ways to describe a person with Cluster B personality disorders? What is the one word used distinguish Cluster B from other clusters? What phrase illustrates this distinguishing word?
Dramatic, emotional, or erratic; “Wild” (Bad to the Bone)
With what 2 conditions do Cluster B personality disorders have a genetic association?
Genetic association with mood disorders and substance abuse
What are 4 types of Cluster B personality disorders?
(1) Antisocial (2) Borderline (3) HIstrionic (4) Narcissitic
In what Cluster of personality disorders is Antisocial? What defines it?
Cluster B personality disorders; Disregard for and violation of rights of others, criminality, impulsivity
What gender has Antisocial personality disorder more?
males > females
What are the age and past medical history requirements for Antisocial personality disorder?
Must be > 18 years old and have a history of conduct disorder before age 15. Conduct disorder if < 18 years old
In what Cluster of personality disorders is Borderline? What are 6 characteristics that define it?
Cluster B personality disorders; (1) Unstable mood and (2) interpersonal relationships, (3) impulsiveness, (4) self-mutilation, (5) boredom, (6) sense of emptiness
What gender has Borderline personality disorder more?
Females > Males
What is the major defense mechanism used by patients with Borderline personality disorder?
Splitting is a major defense mechanism
In what Cluster of personality disorders is Histrionic? What are 4 characteristics that define it?
Cluster B personality disorders; (1) Excessive emotionality and excitability, (2) attention seeking, (3) sexually provocative, (4) overly concerned with appearance
In what Cluster of personality disorders is Narcissistic? What are 6 characteristics that define it?
Cluster B personality disorders; (1) Grandiosity, (2) sense of entitlement; (3) lacks empathy and (4) requires excessive admiration; (5) often demands the “best” and (6) reacts to criticism with rage
What are 2 ways to describe a person with Cluster C personality disorders? What is the one word used distinguish Cluster C from other clusters? What are 3 examples of behavior illustrating this distinguishing word?
Anxious or fearful; “Worried” (Cowardly, Compulsive, Clingy)
With what other kind of disorders do Cluster C personality disorders have a genetic association?
Genetic association with anxiety disorders
What are 3 types of Cluster C personality disorders?
(1) Avoidant (2) Obsessive-compulsive (3) Dependent
In what Cluster of personality disorders is Avoidant? What are 5 characteristics that define it?
Cluster C personality disorders; (1) Hypersensitive to rejection, (2) socially inhibited, (3) timid, (4) feelings of inadequacy, (5) desires relationships with others (vs. schizoid)
In what Cluster of personality disorders is Obsessive-compulsive? What are 2 major characteristics that define it?
Cluster C personality disorders; (1) Preoccupation with order, perfectionism, and control; (2) ego-syntonic: behavior consistent with one’s own beliefs and attitudes (vs. OCD)
In what Cluster of personality disorders is Dependent? What are 4 characteristics that define it?
Cluster C personality disorders: (1) Submissive and (2) clinging, (3) excessive need to be take care of, (4) low self-confidence.
With what other kind of disorders do Cluster C personality disorders have a genetic association?
Genetic association with anxiety disorders
What are 3 types of Cluster C personality disorders?
(1) Avoidant (2) Obsessive-compulsive (3) Dependent
In what Cluster of personality disorders is Avoidant? What are 5 characteristics that define it?
Cluster C personality disorders; (1) Hypersensitive to rejection, (2) socially inhibited, (3) timid, (4) feelings of inadequacy, (5) desires relationships with others (vs. schizoid)
In what Cluster of personality disorders is Obsessive-compulsive? What are 2 major characteristics that define it?
Cluster C personality disorders; (1) Preoccupation with order, perfectionism, and control; (2) ego-syntonic: behavior consistent with one’s own beliefs and attitudes (vs. OCD)
In what Cluster of personality disorders is Dependent? What are 4 characteristics that define it?
Cluster C personality disorders: (1) Submissive and (2) clinging, (3) excessive need to be take care of, (4) low self-confidence.
