Somatic Symptom/Dissociate Disorders

Question 1

Somatic Symptom Disorder Diagnostic Criteria

Answer 1

• 1+ distressing/disruptive somatic symptom
• One indicator of excessive thought/feelings/behaviors
  1. Excessive time/energy devoted
  2. High levels of anxiety
  3. Disproportionate thoughts about the seriousness of the symptom
• Persistent symptomatology (usually 6+ months)

Question 2

Illness Anxiety Disorder (IAD) Diagnostic Criteria

Answer 2

• Preoccupation with having/acquiring a serious illness
• Somatic symptoms are not present or MILD
• Patient performs excessive health-related behaviors-returning to ER for diagnostic tests repeatedly

Question 3

SSD & IAD Etiology

(4)

Answer 3

1. Genetic predisposition
2. Personality trait of negativity
3. Early life/family experiences (sexual, emotional abuse)
4. Delayed development of emotional intelligence

Question 4

Treatment of SSD & IAD

Answer 4

1. Address delayed development of emotional intelligence
2. CBT
3. Anti-anxiety/antidepressants in extreme cases to assist with CBT

Question 5

Conversion Disorder Diagnostic Criteria

Answer 5

Altered voluntary motor or sensory function
Examples: weakness or paralysis, difficulty swallowing etc
Incompatibility of the symptom with neurological disease
Psychological phenomenon

Question 6

Conversion Disorder Onset & Course

Answer 6

Typically sudden, after a major psychological stressor
Pt is often unconcerned with the symptoms (la belle indifference)
Usually short duration without recurrence

Question 7

Conversion Disorder Etiology

Answer 7

UNKNOWN

Question 8

Treatment of Conversion Disorder

Answer 8

1. Psychotherapy (CBT)
2. Hypnosis
   Medications are NOT approved for this

Question 9

Factitious Disorder Definition

Answer 9

Primary gain is attention and being in the sick role
Typically worked in healthcare
Munchausen Syndrome (imposed on oneself)
Munchausen Syndrome by proxy (imposed on another)

Question 10

Factitious Disorder Treatment

Answer 10

No specific treatment

Question 11

Malingering Definition

Answer 11

Individuals fake/induces physical or psychological symptoms for “external” rewards
* Classified under “other conditions that may be a focus of clinical attention”

Question 12

Dissociative Disorders Common features

Answer 12

1. Splitting off from conscious awareness an aspect of self (memory)
2. Unconscious coping strategy for stress

Question 13

Dissociative Amnesia Diagnostic Criteria

3 types

Answer 13

1. Localized: total loss of personal memory during a circumscribed period of time
2. Selective: Some limited recall of personal memories during circumscribed period of time
3. Generalized: loss of personal memory of entire life up to and including triggering event

Question 14

What is a fugue?

Answer 14

Purposeful travel or bewildered wandering associated with amnesia for identity or other autobiographical information

Question 15

Typical features of a fugue

Answer 15

1. Sudden onset
2. Brief (hours to days)
3. Unobstrusive lifestyle
4. Spontaneous termination of amnesea
5. Rarely recurs

Question 16

What is anterograde memory loss?

Answer 16

Difficulty learning new information in addition to past memory loss

Question 17

Retrograde memory

Answer 17

Patient learns new information well but has past memory loss

Question 18

Dissociative Identity Disorder Diagnostic Criteria

Answer 18

• Disruption of individual identity characterized by 2+ personality states (Primary, an alter)
• Inability to recall personal information
• Used as a coping mechanism d/t childhood psychological trauma etc.

Question 19

Treatment of Dissociative Identity Disorder

Answer 19

1. Psychotherapy
   No medications have been proven to be effective

Question 20

Depersonalization Diagnostic Criteria

Answer 20

Experiences of unreality, detachment or being an outside observer of one’s thoughts, feelings, sensations, body or actions