Somatic 2

Question 1

Conversion Disorder

• ____ _____seizures
• Weakness and _____
• Movement disorders
• Speech disturbances (______)
• Globus sensation
• Sensory complaints
• Visual sxs
• Cognitive sxs (______)

Onset of sxs may be associated w/ ___ or _____.

Answer 1

• Psychogenic Non-epileptic
• Paralysis
• Slurred speech / foreign accent syndrome
• word finding difficulty, variability in speed of response

Stress or trauma

Question 2

Ex of Conversion Disorder

Answer 2

• Woman believes not acceptable to have violent feelings, may suddenly feel numbness in arms (symptom) after becoming angry (internal conflict)
• Instead of allowing herself to have violent thoughts about hitting someone, she experiences a physical symptom of numbness in arms

Question 3

Conversion Disorder

• Acute episode: present for less than ____
• Persistent: sxs occurring for more than _____

Answer 3

• 6 months
• 6 months

Question 4

2 things you need to specify w/ Conversion Disorder

Answer 4

• W/ psychological stressor (specify what the stressor is)
• W/o psychological stressor

Question 5

Comorbidities of Conversion Disorder

Answer 5

They commonly co-occur

• Anxiety disorders (esp panic disorder)
• Depressive disorders
• Substance use disorder
• Personality disorders (histrionic & dependent)

Question 6

4 tx steps for Conversion Disorder

Answer 6

• 1st line: pt education regarding disorder w/ UTD / Functional Neurological Disorder : a pts guide AND develop therapeutic alliance w/ pt
• 2nd line: CBT & PT for pts w/ motor sxs
• 3rd line: SSRIs (off label)
• If present, tx comorbidities

Question 7

Factitious Disorder was previously referred to as ____ ______.

Answer 7

Muchausen Syndrome

Question 8

Essential feature of Factitious Disorder

Answer 8

• falsification of medical or psych signs & sxs associated w/ identified deception (oneself or another)

Question 9

4 methods of falsification of Factitious Disorder

Answer 9

• Fabrication
• Exaggeration
• Simulation
• Induction

Question 10

2 ways in which a pt w/ Factitious Disorder causes others to view the individual (or another) as more ill or impaired

Answer 10

• Deceptive behavior
• Induction of injury

Question 11

Are people w/ Factitious Disorder seeking obvious external benefits

Answer 11

No

Question 12

What is the prevalence of Factitious Disorder?

Answer 12

Due to secretive nature of disorder, prevalence is unknown

Question 13

Factitious Disorder is more likely to occur in which 3 people?

Answer 13

• Females
• Unmarried individuals
• Healthcare workers

Question 14

Etiology of Factitious Disorder

Answer 14

Uknown

Theories:

• abnormal illness behavior begins in childhood to cope w/ stress
• Establishing identity, maintaining relationships w/ others, addressing unmet emotional needs –> receiving affection is motivator
• Pts may enjoy duping clinicians

Question 15

The individual presents another individual (victim) to others as ill, impaired, injured

• children
• adults
• pets

Answer 15

Factitious Disorder

Question 16

• Use of multiple healthcare facilities
• Evasiveness in providing hx
• Refusal to grant access to info from external sources (prior medical records)
• Eagerly accepted tests/procedures
• Course of illness is unusual

Answer 16

Factitious Disorder

Question 17

• Conscious attempt –> secondary gain —> ______
• Conscious attempt —> primary gain —> ______
• Unconscious attempt —> _____

Answer 17

• Malingering
• Factitious Disorder
• Somatic sx Disorder

Question 18

3 comorbidities of Factitious Disorder

Answer 18

• Depressive disorder
• Substance use disorders
• Personality disorders (especially borderline)

Question 19

1st line tx for Factitious Disorder

Answer 19

CBT

Question 20

Why is treating pts w/ Factitious Disorder challening?

Answer 20

Pts often deny the diagnosis and seek tx elsewhere

– should consult/collaborate w/ mental health providers

Question 21

What is considered a form of abuse

(appropriate action should be taken)

Answer 21

Factitious disorder imposed on another (child or adult)