Somatic Symptom and Dissociative Disorders (Tut 502 & PB) Flashcards
What are disassociate disorders
Characterised by a disruption and or discontinuity in the normal integration of consciousness memory identity emotion perception body representation motor control and behaviour.
What are somatic symptoms and related disorders
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
Define somatic symptoms
Physical or bodily symptoms
State what somatic symptom disorder is SSD
A condition involving a pattern of reporting distressing physical symptoms combined with extreme concern about health or fears of having an undiagnosed Medical condition.
What is SSD with predominant pain
SSD involving severe or lingering pain that appears to have no physical basis.
Define illness anxiety disorder
Persistent health anxiety and or concerns that one has an undetected Physical illness the person has few or no somatic complaints
What tendencies do those with illness anxiety disorders have
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
State what conversion disorder ( functional neurological symptom disorder)
Is a condition involving sensory or motor impairment suggestive of a neurological disorder but with no underlying medical cause
Define psychogenic
Originating from psychological causes
Define malingering
Freigning (faking) illness for an external purpose
What is factitious disorder
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
Distinguish between factitious disorder imposed on the self and others
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.
What are the biological dimensions of SSD and related disorders
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.
What are the psychological dimensions of SSD and related disorders
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.
- External triggers or internal trigger results in physiological arousal
- The individual perceives bodily changes associated with triggers
- Thoughts and worries about possible disease begin in response to physical sensation
- Thoughts amplify bodily sensation causing further physical reactions and concern
- Catastrophic thought increase response to magnified bodily sensation causing feedback pattern.
What are the social dimensions possible explanation of SSD
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
What are the socio-cultural dimensions of SSD
Believed to only affect women.
Lower educational levels
Ethnicity
Immigrant status
What is the biological course of treatment for SSD and related disorders
Antidepressant medication SSRI
What is the psychological course of treatment for SSD and related disorder
CBT: interoceptive exposure
Mindfulness based cognitive therapy
What is the characteristic feature of dissociative disorder
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.
What’s a dissociative disorder
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.
Distinguish between dissociative and localised amnesia
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
What are systematized amnesia and selective amnesia
Systematized: loss of memory for certain category of info
Selective: an inability to remember certain details of an event.
What are repressed memories and complexity thereof
Memory of a traumatic event had been repressed and is unavailable for recall.
Comment on dissociative fugue
Episode involving complete loss of memory of one’s life and identity unexpectedly travel to a new location or assumption of a new identity.
Expand on depersonalization/derealization disorders
Dissociative condition characterized by feelings of unreality concerning the self and environment
What is dissociative identity disorder
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
Define Experience of possession
The replacement of a person’s sense of personal identity with a supernatural spirit or power
What is the biological dimensions of the aetiology of dissociative disorders
Atypical brain functioning in structures associated with memory encoding and retrieval.
Inhibited neural activity in hippocampus
Reduced metabolism in area of prefrontal cortex
What is the psychological dimensions of the aetiology of dissociative disorders
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
What is the social and socio-cultural dimensions of the aetiology of dissociative disorders
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
What is an iatrogenic disorder
A condition unintentionally produced by a therapists actions and treatment strategies
State the 5 types of amnesia and provide a description of each
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
