Quiz #7: Somatic Disorders (Morrison Ch. 8) Flashcards
The common features of Somatic Disorders are the prominence of somatic symptoms associated with significant _______________.
distress and impairment
Most Somatic Disorders are commonly encountered in ________ before seeing a psychologist.
primary care and other medical settings
The distinctive feature of Somatic Disorders is not so much the somatic symptom, but how the symptom is __________ by the individual.
presented and interpreted
The category of Somatic Disorders emerged from earlier notions of ______.
Hysteria
Morrison says about Somatic Symptom Disorders:
“…these conditions are not bound together by common etiologies, family histories, treatments or other factors. This chapter is simply another convenient collection–in this case, of conditions that are concerned primarily with __________” (Morrison, p. 250)
physical symptoms
Which disorder experiences one or more somatic symptoms that are distressing or result in significant disruption of daily life?
Somatic Symptom Disorder (SSD)
For Somatic Symptom Disorder (SSD), how many symptoms must be present for diagnosis?
Only ONE symptom required
For Somatic Symptom Disorder (SSD), the symptom must either cause ______ or impair ________.
distress
functioning
At least ______ of people with Somatic Symptom Disorder (SSD) also report mood and/or anxiety symptoms.
half
Which disorder experiences excessive thoughts, feelings, or behaviors related to the symptoms of related health concerns, as seen in at least one of following:
- Disproportionate and persistent thoughts about seriousness of one’s symptoms
- Persistent high anxiety about health or symptoms
- Excessive time and energy devoted to these symptoms/health concerns
Somatic Symptom Disorder (SSD)
With Somatic Symptom Disorder (SSD), suffering is _______, and can also be _______ with other diagnosed health conditions.
authentic
comorbid
For Somatic Symptom Disorder (SSD), the focus is on the _________ caused by the symptoms.
distress
The most common somatic symptom in Somatic Symptom Disorder (SSD) is _________.
unexplained pain
Along with unexplained pain, the following are common symptoms of which disorder?
- fatigue, shortness of breath
- For children: recurrent abdominal pain, headache, fatigue, nausea
Somatic Symptom Disorder (SSD)
Morrison’s opinion on the DSM-5 SSD category is:
“I fear that we really may have truly come full circle, to the point where we are once again in danger of _________ people whose symptoms are perplexing, even mysterious, but which may well presage ultimate physical disease” He concludes, “Don’t use it!” You’ll do better with the DSM-IV criteria for _______.
misidentifying
Somatization Disorder
Which disorder experiences multiple somatic symptoms recurring over a period of several years, often beginning from an early age? The symptoms must begin before age 30 and result in seeking medical help or lead to significant impairment.
Somatization Disorder
The symptoms of Somatization Disorder must begin before age ___ and result in seeking medical help or lead to significant impairment.
30
Which disorder must have minimum of 8 of the following symptoms:
- Hx of pain related to at least 4 anatomical sites/functions
- Hx of at least 2 GI symptoms other than pain (bloating, constipation, diarrhea, nausea…)
- At least 1 sexual/reproductive symptom (erection difficulty, irregular menses)
- At least 1 pseudoneurological symptom not related to pain (blindness, deafness, double vision, difficulty swallowing)
- Not explained by other medical conditions.
Somatization Disorder
In the DSM-5, the Somatic Symptom Disorder (SSD) with predominant pain specifier replaced which disorder?
Pain Disorder
Which disorder experiences somatic symptoms predominantly involve pain.
- Typically chronic & severe
- Commonly located in lower back, head, pelvis or TMJ
- Often begins following an accident or illness
Somatic Symptom Disorder (SSD) with predominant pain specifier
Morrison notes about Somatic Symptom Disorder (SSD) with predominant pain specifier:
* Pain is __________, individuals experience it differently
* There is no gross ________ pathology
* __________ pain is hard
subjective
anatomical
measuring
Morrison notes about Somatic Symptom Disorder (SSD) with predominant pain specifier:
“So it’s hard to know that a patient who complains of ____________ pain, and …lacks adequate objective pathology, has a mental disorder at all” (p.257)
chronic or excruciating
Which disorder replaced the DSM-5 Hypochondriasis disorder?
Illness Anxiety Disorder
Which disorder fits the following description?
“Despite the absence of serious physical symptoms, the patient is inordinately concerned about being ill. High anxiety couples with a low threshold for alarm…” (Morrison, p. 261)
Illness Anxiety Disorder
Which disorder contains the following symptoms?
- If somatic symptoms present, excessive & disproportionate preoccupation with them
- High anxiety about health; easily alarmed
- Excessive health related behaviors (repeatedly checking for illness); or maladaptive avoidance of health care
Illness Anxiety Disorder
For Illness Anxiety Disorder, the patient must experience at least _______ of preoccupation with fears of having a serious disease based on misinterpretation of bodily symptoms.
6 months
For _______, the fear persists despite lack of medical confirmation.
- Care-seeking type/care-avoidant type
- Although no current illness, do report high level of childhood illness
Illness Anxiety Disorder
Caldwell’s hypothesis regarding Hypochondriasis (Illness Anxiety Disorder) is:
Adaptive response to a _________ to the client’s physical integrity.
“Staying in bed, worrying about deteriorating, and being preoccupied with the availability of medical help makes sense if one is terrified of bodily damage or death”
perceived overwhelming threat
Howard Hughes was _________ in his own germ-free environment, apparently terrified of physical illness.
imprisoned
If an individual has extensive worries about health but no or minimal somatic symptoms, more likely
____________. __________ is diagnosed when significant somatic symptoms are present.
Illness Anxiety Disorder
Somatic Symptom Disorder (SSD)
Which disorder experiences:
1) a change in how the body functions when
2) no causative physical… malfunctioning can be found” (Morrison)
Conversion Disorder (Functional Neurological Symptom Disorder)
Which disorder experiences:
- one or more symptoms of altered voluntary motor or sensory systems
- Evidence of incompatibility between the symptom & recognized neurological/medical conditions
Conversion Disorder (Functional Neurological Symptom Disorder)
The following was deleted from the DSM-5 from which disorder?
“Psychological factors are associated with symptom because they precede the onset or exacerbation of symptoms”
Conversion Disorder (Functional Neurological Symptom Disorder)
Morrison provides the following examples of ___________ within Conversation Disorder:
- Stocking anesthesia
- Blindness
- Deafness
- Double vision
- Hallucinations
Sensory Conversions
Morrison provides the following examples of ___________ within Conversation Disorder:
- Impaired balance or staggering
gait - Weak or paralyzed muscles
- Lump in throat
- Trouble swallowing
- Retention of urine
- Loss of voice
Motor Conversions
Which disorder has the following subtypes?
with weakness or paralysis (F44.4)
with abnormal movement (F44.4)
With swallowing symptoms (F44.4)
With speech symptom (F44.4)
With attacks or seizures (F44.5)
With anesthesia or sensory loss (F44.6)
With special sensory symptom (F44.6)
With mixed symptoms (F44.7)
Conversion Disorder
Morrison believes Psychological Factors Affecting Other Medical Conditions is ____ a medical condition, and should have been a Z-code (V code is a DSM-5-R)
NOT
Which disorder contains the following:
- A medical symptom/condition is present
- Psychological/behavioral factors adversely affect the medical condition in one of following ways:
- Affects the course of the condition
- Interferes with treatment of condition
- Creates additional health risks
- Influences underlying pathophysiology, either exacerbating symptoms or requiring medical attention
Psychological Factors Affecting
Other Medical Conditions
The following are examples of which disorder?
- Philip’s voices tell him not to go on kidney dialysis
- Alice’s depression prevents her from refilling a prescription to treat diabetes
- John’s hatred of authority figures causes him to reject doctor’s recommendation of heart surgery
- Tim, at 400 lbs., knows he should avoid sweetened drinks, but loves his Big Gulps
Psychological Factors Affecting
Other Medical Conditions
______ is the intentional production of physical or psychological signs or symptoms. This may include:
- fabrication of subjective complaints
- Falsification of objective signs
- Self-inflicted conditions
- Exaggeration of preexisting medical condition
Factitious Disorder
In Factitious Disorder, the motivation is to play the _________. There are NO external incentives for this behavior.
“Sick Role”
Factitious Disorder contains the following subtypes:
- Factitious Disorder Imposed on ____
- Factitious Disorder Imposed on ______
Self
Other
_________ is the intentional production of false or grossly exaggerated physical or psychological symptoms motivated by external incentives. For example: avoiding military duty, avoiding work, evading prosecution, obtaining financial compensation
Malingering
The difference from Factitious Disorder is that Malingering requires an ______________.
external incentive
Symptoms are produced because of external motivation.
Malingering
Symptoms are not produced intentionally. There is no external
motivation present.
Somatic Symptom Disorders (SSD)
Symptoms are not produced by external motivation. Need to maintain the sick role.
Factitious Disorder
With Substance-Related and Addictive Disorders, there are ____ substances and ____ categories.
10 substances
3 categories
What are the 3 categories of Substance-Related and Addictive Disorders?
- Substance use disorders (dependence and abuse)
Substance-induced disorders:
2. Intoxication
3. Substance withdrawal
Caffeine Intoxication is a recent consumption of caffeine of ______.
250 mg +
For _______, there must be five symptoms from the following:
1. Restlessness
2. Nervousness
3. Excitement
4. Insomnia
5. Flushed face
6. Diuresis
7. GI disturbance
8. Muscle twitching
9. Rambling flow of thought and speech
10. Tachycardia or cardiac arrhythmia
11. Periods of inexhaustibility
Caffeine Intoxication
_________ is a prolonged daily use of caffeine.
Caffeine Withdrawal
For _______, there must be three or more symptoms from following:
A. Headache
B. Marked fatigue or drowsiness
C. Dysphoric mood, depressed mood, or irritability
D. Difficulty concentrating
E. Flu-like symptoms (nausea, vomiting, or muscle
pain/stiffness
Caffeine Withdrawal
Somatic Symptom Disorder used to be called _________.
Somatization Disorder
A chronic condition characterized by unexplained physical symptoms. Found almost exclusively in women.
Somatic Symptom Disorder (SSD)
The pain in question has no apparent physical or physiological basis, or it far exceeds the usual expectations, given the patient’s actual physical condition.
Somatic Symptom Disorder with predominant pain
These patients complain of isolated symptoms that seem to have no physical cause.
Conversion Disorder
This is a disorder in which physically healthy people have an unfounded fear of a serious, often life-threatening illness, such as cancer or heart disease–but little in the way of somatic symptoms.
Illness Anxiety Disorder
A patient’s mental or emotional issues influence the course of care of a medical disorder.
Psychological factors affecting other medical conditions
Patients who want to occupy the sick role (perhaps they enjoy the attention of being in a hospital) consciously fabricate symptoms to attract attention from health care professionals.
Factitious Disorder imposed on self
A person includes symptoms in someone else, often a child, possibly for the purpose of gaining attention
Factitious Disorder imposed on another
Psychological causes for symptoms should considered only after physical disorders have been eliminated.
Actual physical illness
Pain with no apparent physical cause is characteristic of some patients with major depressive disorder or bipolar I disorder, current or most recent depressed. Because they are treatable and potentially life-threatening, these possibilities must be investigated early.
Mood Disorders
In substance use, patients who use substances may complain of pain or other physical symptoms. These may result from the effects of substance __________ or __________.
intoxication or withdrawal
Some patients who are experiencing a reaction to environmental circumstances will complain of pain or other somatic symptoms.
Adjustment Disorder
These patients know their somatic (or psychological) symptoms are fabricated, and their motive is some form of material gains, such as avoiding punishment for work or obtaining money or drugs.
Malingering
It is called “Somatic symptom and related disorders” because their presentations resemble _________.
somatic (bodily) disease
