Somatic Symptom and Dissociative Disorders (Tut 502 & PB)

Question 1

What are disassociate disorders

Answer 1

Characterised by a disruption and or discontinuity in the normal integration of consciousness memory identity emotion perception body representation motor control and behaviour.

Question 2

What are somatic symptoms and related disorders

Answer 2

Are characterized by the prominence of somatic symptoms associated with significant distress and impairment.

Broad group of psychological disorders that involve physical symptoms or anxiety over illness including somatic symptom disorder illness anxiety disorders conversion disorder and factitious disorder

Question 3

Define somatic symptoms

Answer 3

Physical or bodily symptoms

Question 4

State what somatic symptom disorder is SSD

Answer 4

A condition involving a pattern of reporting distressing physical symptoms combined with extreme concern about health or fears of having an undiagnosed Medical condition.

Question 5

What is SSD with predominant pain

Answer 5

SSD involving severe or lingering pain that appears to have no physical basis.

Question 6

Define illness anxiety disorder

Answer 6

Persistent health anxiety and or concerns that one has an undetected Physical illness the person has few or no somatic complaints

Question 7

What tendencies do those with illness anxiety disorders have

Answer 7

Catastrophize and view ambiguous or mild somatic symptoms as indications of a severe or catastrophic illness

Overgeneralize by believing that serious illness and fatal conditions are prevalent.

Display all or nothing thinking such as believing they must be symptom free to be healthy

Show selective attention to medical info and focus on threatening info

Question 8

State what conversion disorder ( functional neurological symptom disorder)

Answer 8

Is a condition involving sensory or motor impairment suggestive of a neurological disorder but with no underlying medical cause

Question 9

Define psychogenic

Answer 9

Originating from psychological causes

Question 10

Define malingering

Answer 10

Freigning (faking) illness for an external purpose

Question 11

What is factitious disorder

Answer 11

Condition in which a person deliberately induces or simulates symptoms of physical or mental illness with no apparent incentive other than attention from medical personnel or others

Question 12

Distinguish between factitious disorder imposed on the self and others

Answer 12

Self imposed: symptoms of illness are deliberately induced simulated or exaggerated with no apparent external incentive

Imposed on another: a pattern of falsification or production of physical or psychological symptoms in another individual.

Question 13

What are the biological dimensions of SSD and related disorders

Answer 13

Lower pain threshold
Heightened sensitivity to pain
Greater sensitivity to somatic cues

Biological predisposition in CNS can cause hypervigilance or exaggerated focus on bodily sensation
Increased sensitivity to even mild bodily changes and a tendency to react to somatic sensations with alarm.

Repetitive activation of the SNS due to chronic exposure to stressors can lead to increased sensitivity of the nerves associated with pain and increase in pain sensation

Dysregulation connectivity in brain regions associated with symptoms.

Question 14

What are the psychological dimensions of SSD and related disorders

Answer 14

Psychodynamic perspective: Somatic symptoms defend against the awareness of unconscious emotional issues. Suggests that 2 mechanism produce and sustain somatic symptoms.

• 1st provide primary gain for the person by protecting him/her from anxiety associated with unacceptable desire the need for protection gives rise to physical symptoms.
• a secondary gain occurs when the person’s dependency needs are fulfilled through attention and sympathy

Cognitive behavioural perspective: reinforcement modelling cognition are important in developing SSD. People with SSD assume sick role as it reinforces and allows them to escape unpleasant circumstances or to avoid responsibility.

1. External triggers or internal trigger results in physiological arousal
2. The individual perceives bodily changes associated with triggers
3. Thoughts and worries about possible disease begin in response to physical sensation
4. Thoughts amplify bodily sensation causing further physical reactions and concern
5. Catastrophic thought increase response to magnified bodily sensation causing feedback pattern.

Question 15

What are the social dimensions possible explanation of SSD

Answer 15

Rejection or abuse by family members and feelings of being unloved
Sexual abuse or rape associated with chronic pelvic pain and gastrointestinal disorders
Linked to parental characteristics

Question 16

What are the socio-cultural dimensions of SSD

Answer 16

Believed to only affect women.
Lower educational levels
Ethnicity
Immigrant status

Question 17

What is the biological course of treatment for SSD and related disorders

Answer 17

Antidepressant medication SSRI

Question 18

What is the psychological course of treatment for SSD and related disorder

Answer 18

CBT: interoceptive exposure

Mindfulness based cognitive therapy

Question 19

What is the characteristic feature of dissociative disorder

Answer 19

Is a disruption of and/or discontinuity in the normal integration of consciousness memory identity emotion perception body representation motor control and behaviour functions which are usually intergrated.

Question 20

What’s a dissociative disorder

Answer 20

Are a group of disorders including dissociative amnesia dissociative identity disorder depersonalization disorder all which involves some form of dissociation or seperation of a part of the person’s consciousness memory or identity.

Question 21

Distinguish between dissociative and localised amnesia

Answer 21

Dissociative: sudden partial or total loss of important personal information or recall of events due to psychological factors

Localised: lack of memory for a specific event or events

Question 22

What are systematized amnesia and selective amnesia

Answer 22

Systematized: loss of memory for certain category of info

Selective: an inability to remember certain details of an event.

Question 23

What are repressed memories and complexity thereof

Answer 23

Memory of a traumatic event had been repressed and is unavailable for recall.

Question 24

Comment on dissociative fugue

Answer 24

Episode involving complete loss of memory of one’s life and identity unexpectedly travel to a new location or assumption of a new identity.

Question 25

Expand on depersonalization/derealization disorders

Answer 25

Dissociative condition characterized by feelings of unreality concerning the self and environment

Question 26

What is dissociative identity disorder

Answer 26

A condition in which 2 or more relatively independent personality states appear to exist in one individual including experience of possession known also as multiple personality disorder

Question 27

Define Experience of possession

Answer 27

The replacement of a person’s sense of personal identity with a supernatural spirit or power

Question 28

What is the biological dimensions of the aetiology of dissociative disorders

Answer 28

Atypical brain functioning in structures associated with memory encoding and retrieval.
Inhibited neural activity in hippocampus
Reduced metabolism in area of prefrontal cortex

Question 29

What is the psychological dimensions of the aetiology of dissociative disorders

Answer 29

Psychodynamic theory: suggests that dissociative disorders are caused by an individual’s use of repression to block unpleasant or traumatic event from consciousness which protects the individual from painful memories or conflicts.
Post traumatic model proposes that severe childhood abuse parental neglect or abandonment or early traumas. Factors necessary for DIDare
+Being exposed to overwhelming childhood stress like physical or sexual abuse
+ Genetic or biological predisposition psychiatric vulnerability life stressors and capacity to dissociate.
+ Encapsulating or walling off experience
+ Developing different memory systems

Question 30

What is the social and socio-cultural dimensions of the aetiology of dissociative disorders

Answer 30

Sociocogntive model conceptualises DID as display of multiple role enactment that created legitimized and maintained by social reinforcement.
The enactment is synthesized by drawing on variety of sources of information including media cues from therapist personal experience and observations of individual who enacted multiple identity

Question 31

What is an iatrogenic disorder

Answer 31

A condition unintentionally produced by a therapists actions and treatment strategies

Question 32

State the 5 types of amnesia and provide a description of each

Answer 32

Localised amnesia: the most common which is a failure to recall events that occur during a certain period of time which may be high stressful and emotional painful periods.

Selective amnesia: is an inability to remember certain details of an incident

Generalized amnesia: a rare type of amnesia is a total inability to recall any aspects of one’s past life

Systemised amnesia: involves loss of memory for a specific category of information.

Continuous amnesia: is where individual forgets each new event as it occurs