Somatic Symptom Disorders Flashcards
DSM-5- Somatic Disorders trigger
anxiety
factitious disorder aka
manchausen
factitious disorder define, difficulty _____
false production of illness/injury
-hard to diagnose
what percent die from manchausen by proxy symptoms?
6-30% die
How many are disfigured or impaired by manchausen symptoms?
8%
define conversion disorder
physical symptoms are inconsistent with medical disorders
give example of conversion disorder
after a trauma, person experiences paralysis that is not related to physical cause
what disorder is glove anesthesia associated with?
conversion disorder
what are people with conversion disorder susceptible to?
hypnosis and suggestibility
how many patients display symptoms with no physical causes?
17%
what is the difference in gender in regards to conversion disorder?
2x more in women
when in lifespan does conversion disorder begin?
late childhood and young adulthood
what is conversion disorder in response to usually?
extreme stress that lasts weeks
How common is conversion disorder?
rare, 5/1000
Bartholomew considered mass hysteria to be a form of what disorder
conversion disorder
basic definition of somatic symptom disorder - 2- Excess ____ about _____ symptoms. Disrupts _____
- excessive anxiety about bodily symptoms
- disrupts life
what are the 2 kinds of somatic symptom disorder?
somatization pattern and predominant pain pattern
what is somatization pattern? 3
- no identifiable physical basis for symptoms.
- Exaggerated emotions and behaviors, their life is disrupted by these.
- Goes from Dr to Dr.
how common is somatization pattern?
4%
somatization pattern is aka?
Briquet’s syndrome
what gender experiences somatization pattern more?
women .2-2%
is somatization pattern genetic?
20% of close female relatives develop pattern
when does somatization pattern begin
adolescents and young adulthood
Define predominant pain pattern
patient experiences extreme pain, disruption caused by pain is disproportionate.
when does a predominant pain pattern usually occur?
after a serious accident or illness
what are conversion and somatic disorders in response to?
responses to severe stress, to escape stress
how are conversion and somatic disorders similar?
They can occur at the same time, they are treated in similar ways.
name 3 symptoms of somatic system disorder.
- at least one upsetting and repeated disruptive symptom
- unreasonable thoughts and behavior
- 6 months plus spend on excess energy towards disorder
unfortunately, many ‘hysterical disorders’ are often _____
poorly understood, misunderstood
Psychodynamic View, Freud, of conversion and somatic system disorder
needs of a girl in the phallic stage, Electra complex. dont learn how to handle anxiety.
Electra complex: define. What stage? age?
phallic stage, age 3-5, girls. Sexual attraction to father, compete with mother.
Psychodynamic/Freud: give an example of when someone would experience conversion disorder.
In fear of expressing anger, converts anger into physical paralysis in arm.
what is secondary gain?
sympathy from others
non-Freud, contemporary Psychodynamic’s view of conversion disorder
anxiety as physical pain
Explain cognitive-behavioral view of conversion and somatic disorders.
physical symptoms are rewarded via reinforcement.
give an example of a way conversion disorder is reinforced with rewards
physical pain creates distance from unpleasant relationships
true or false: cognitive-behavioral view of conversion/somatic disorders is supported by research.
False bitch
what is malingering?
intentionally feigning illness for some external gain, such as financial compensation.
Does factitious disorder seem to have an apparent goal?
no
malingering and factitious disorders both have ___ control of symptoms.
voluntary control
The cognitive view of conversion and somatic disorders propose that these disorders are forms of communication. What does that mean?
express emotions what would otherwise be difficult to display. Physical language is familiar and comfortable.
non-western culture: is it common to have somatic complaints?
yes, very common in non-western culture.
which USA ethnic group shows the most somatic symptoms?
Hispanic Americans.
What is western bias?
bias that sees somatic reactions as an inferior way of dealing with emotions.
People in Latin America seem to display the most ____ reactions.
somatic.
do people with conversion or somatic disorders seek therapy? 4
- Usually not
- they seek therapy only as a last resort.
- bounce from medical dr to medical dr.
- believe their symptoms are not mentally related
3 things therapists that focus on cause of disorder do:
- insight into causes
- exposure, overcoming trauma
- drug therapy, antidepressants
3 things that therapists that focus on the symptoms do:
- educate, explain disorder
- reinforcement- increase rewards for healthy behavior
- cognitive restructuring, focus on replacing unhealthy thoughts with accurate ones
what is cognitive restructuring?
replacing unhealthy thoughts with accurate ones.
what is the confrontational approach?
forwardly telling patient that their bodily symptoms are without medical basis.
describe illness anxiety disorder
convinced that they have or are developing a serious medical illness, despite the absence of somatic symptoms.
what is another term for hypochondriac?
illness anxiety disorder
name three characteristics of someone that has illness anxiety disorder.
- preoccupation and anxiety about getting illness
- no existing illness symptoms
- engage in health practices to prevent specific illnesses that they are anxious about
What is the percentage of all people who experience illness anxiety disorder?
1-5%
who is more likely to develop illness anxiety disorder? -2 item answer
equal amounts in men and women, most in early adulthood
what is main way to treat illness anxiety disorder?
medication, antidepressants. slows rumination. Is like OCD.
what is a popular term for psychological factors affecting other medical conditions?
psychophysiological
what is psychophysiological disorder? Mostly due to ____
psychological factors affect other medical conditions, stress mostly.
in psychophysiological disorders, psychological factors may cause:
significant medical symptoms, serious physical damage.
what are three main aspects of humanity that play a role in psychophysiological disorders?
biological, psychological, and social factors
what are the six main psychophysiological disorders?
- Ulcers
- asthma
- insomnia
- chronic headaches
- migraines
- hypertension
how many suffer from ulcers? how many die from?
25 million people per year suffer from and 6500 deaths
how many people suffer from asthma?
25 million
how many suffer from insomnia?
30% of population, 10% lasts months or years
how many people suffer from migraines?
25 million
what is a tension headache and how many people suffer from them?
when muscles around the skull tighten, narrowing blood vessels. 45 million per year.
what is hypertension? How many have?
chronic high blood pressure. 75 million people have it.
what is essential hypertension?
combo of psychological and physiological factors
how many cases of hypertension come from physiological factors alone?
ten percent
what is myocardial infarction?
heart attack
how many deaths from coronary heart disease each year?
7.3 million, 40% of all deaths. Leading cause of death for men and women.
what are three behaviors that people engage in to reduce stress?
80%- watch tv, read, music
68%- cellphone
50%- video games
what percentage of people engage in self harm to reduce effects of stress?
1%
what are two biological factors for psychophysiological disorders?
genetics- specific bio problems.
ANS autonomic nervous system
what are two psychological factors for psychophysiological disorders?
personality type and coping styles
men with repressive coping style tend to have particularly sharp rise in
blood pressure
describe type A personality
consistently angry, cynical, driven, impatient, competitive, ambitious, hostile, sense of urgency
describe type B personality
more relaxed, less aggressive, less concerned about time
which personality type produces continual stress and often leads to coronary heart disease?
Type A personalities
sociocultural factors for psychophysiological disorder
poverty, discrimination, dangerous environments, lack of adequate healthcare
what is the social readjustment rating scale?
what is name of measurement
assigns numerical values to stresses that most people experience. LCU- life change units
what is the most stressful event on the social readjustment rating scale?
death of a spouse
What is an LCU?
Life Change Units on the social adjustment rating scale
what is a 125 LCU considered?
a considerable amount of stress
what if a person had a 300 LCU?
likely to develop health problems.
_____ Americans experience greater stress than white Americans.
African Americans.
High amounts of stress is linked to
physical illness
what is psychoneuroimmunology? 3
links between psychosocial stress, the immune system, and health
characteristics of people that display fictitious disorders (4)
- no external rewards
- need for attention
- have fundamental medical knowledge
- extensive medical treatment as child
what are antigens?
foreign invaders: bacteria, virus, cancer
what are lymphocytes?
white blood cells, help body overcome invaders
what are helper T-cells?
identifies antigens, triggers immune cells
natural killer T-cells, what are?
seeks out and destroys body cells that have already been infected
what are B cells?
produces antibodies, protein molecules that recognize antigens and mark them for destruction.
How does stress interfere with lymphocytes?
slows them down and increases susceptibility to infection
what are macrophages?
big white blood cells in the immune system that attack the antigens
what is diagnostic overshadowing?
patients with serious mental illness receive worse medical care than “normal” people
what is described as the hidden human rights emergency?
diagnostic overshadowing.
How many year earlier to serious mentally ill people die when using public healthcare?
25 years earlier
What percentage of seriously mentally ill people die from treatable conditions?
60% die, number one killer is cardiovascular disease
excessive activity of what neurotransmitter slows down the immune system?
norepinephrine
if stress continues for an extended period of time, _____ travels to lymphocyte receptor and gives an ______ message, which slows immune functioning.
norepinephrine, inhibitory
what are corticosteroids? aka
cortisol, stress hormone
what is cortisol?
the stress hormone, contributes to poor immune system functioning
what are cytokines?
proteins that bind to receptors. cortisol triggers production of
why are extra cytokines bad?
lead to chronic inflammation, leads to heart disease
stress may slow down the ____ system.
immune system
what are the two stress pathways? what do they lead to?
ANS- Autonomic Nervous System
Hypothalamic pituitary adrenal pathway, leads to chronic inflammation
What are some bad behaviors that can result from stress?
sleep badly, eat poorly, exercise less, smoke and drink more, slow down the immune system
What personality style remains healthy after stressful events?
hardy or resilient
men with a general sense of hopelessness die at ____ average rates
above
women typically release more ____ hormones than men, so have poorer _____ system functiong
stress hormones, poorer immune system functioning.
Laughter decreases _____, a natural ____ cell activity
stress, killer cell
Spiritual people tend to be _____
healthier
people who have few ____ supports and feel ____ tend to have poorer_____ functioning in the face of stress
social supports, lonely, immune system
what is behavioral medicine?
combines psychological and physical approaches to treat medical problems.
What is biofeedback training aka?
EMG- electromyograph
what is biofeedback training?
machinery gives them readings about bodily activities, to track physical responses
what does EMG stand for
Electromyograph
What does cognitive interventions do for physical disorders?
teach new attitudes or cognitive responses.
what does self-instruction training do?
therapist teaches patient to identify and rid themselves of unpleasant thoughts, replace with coping self statements
give an example of coping self statement
when pain comes, just pause; keep focusing on what you have to do
discussion and writing down past and present emotions may help…
improve health and psychological function
What are combination approaches?
ex: relaxation and bio feedback training: equally helpful in high BP
combination interventions have also been helpful in changing __ _ personalities
type a personalities
today’s clinicians believe that ____ and ____ factors contribute to virtually physical ailments
psychological and sociocultural
game-playing was found to be more effective at _____ than anti-anxiety drugs., better ____ outcomes
relaxing, better surgical outcomes
