Somatic Symtom Disorders Flashcards
What is the post traumatic model to somatic symptom disorder
Holds that somatic and dissociative issues are usually tied to stressful or traumatizing events
what are the 5 elements of dissociation
Depersonalization
derealization
Amnesia
Identity confusion (can’t recall identity)
Identity alteration ( establish new identity in lieu of old)
What is psychosomatic complaints
Prolonged stress exacerbates or contributes to real medical condition
What is somatization
experiencing psychological problems in physical expressions
What is dissociative fugue
Person experiencing dissociate amnesia, leaves home, travels to new loc
What is Dissociative identity disorder
2 or more distinct personalities with one being present at any given time
What is somatic symptom disorder
one or more somatic symptoms that the person thinks and worries about excessively but doesn’t require symtpms
called bodily distress disorder in icd11
Hypochondriasis/illness anxiety disorder
excessive worry about being physically ill
What is factitious disorder
for people who physically tamper with self or exaggerate/stimulate symptoms to produce signs of illness or convince others they are sick to obtain medical attention
(different from malingering)
Critics of disociative identity disorder
critics see it as a iatrogenic condition (Condition induced when mental health professionals subtly encourage pts they have it)
critics and support of somatic symptoms disorder in DSM 5
Critics- too broad, downplays physical symptoms
Support- good interrater, not as stigmatizing
What is hysteria and the wandering womb theory
early idea of somatization
womb breaks off and wind and wonders body
What is briquets syndrome
early somatization
-attribuited hysteria to brain dysfunction
what did charcot believe about hysteria
had biological origin but also trauma involved too n
la belle indeference- hyterical pts usually unconcerned w their symptoms
What are two major drugs used to tx dissociation
Glutamate and opiod antagonists (naltrexone)
what NT is sometimes lower in somatic disorders
somatic symptoms correlated w low serotonin levels–> antidepressants that’s increase serotonin will reduce somatic symptoms
What brain structures are changed in dissociation
- enhanced hippocampus and posterior parietal cortex activity
- Reduced parental lobe activity
- decreased hippocampus; and amyglada value
- HPA dysfunction
What is DID associated with in terms of brain (2)
- Decreased hippocampus and amygdala volume
- Decreased blood flow to orbitofrontal and sup frontal regions
What is somatic symptoms associated w brain bf
decreased blood flow to prefrontal cortical area-> greater difficulty handling intense pain
What brain area is conversion and malingering tied to
conversion- left dorsolateral prefrontal cortex
Malinegring- right ant prefrontal cortex
What does transcranial magnetic stem have promise in tx
psychogenic movement disorders
gene indicated in dissociation
5HTT (serotonin)
What is the evolutionary explanation for dissociation
may be designed to prevent people from being overwhelmed by emotions during traumatic events
What is the diathesis-stress model of psychosomatic illness
psychosomatic illness emerge from combo of
diathesis- predisposing organic/psychologcial weakness
Stress
What is primary and secondary gain in terms of persitent symptom disorders
primary- the reason for a symptom, the central conflict it is intended to adress
secondary- Other advantages a symptom provides beyond primary gain
What is the link between dissociation and splitting
coping w trauma by repressing it or disconnecting from their memories of it
(consistant w post traumatic model)
How does psycodynamic therapy help with splitting/disocciation
helps pts gain insight into unconscious conflicts and integrate dissociated parts of personality
–Until trauma is properly articulated, it is difficult for the pt to integrate into their lives.
eitology theories of DID
1- severely abused children
2- being very good at self hypnosis (being able to mentally go elsewhere)
how is dissociation learned thru classical and opperent conditioning
classical- Internal and external stem to evoke both physical and mental avoidance responses
Operant- Forgetting traumatic moms reinforced by providing emotional relief
What is state dependent learning
dissociated memories are only able to be recalled in certain emotional states
4 aspects of CBT for dissociation
- managing trigger events
- planned avoidence
- manage dissociate reaction by distracting oneself
- use cognitive restructerning
behavioural techniques for somatic symptoms (3)
relaxation training
exposure plus response prevention for hypochondria
biofeedback
cognitive techniques for somatic symptoms (2)
stress inoculation training- reduce negative thoughts that make pain hard to handle
Midfulness based stress reduction- facilitates awareness of thoughts without trying to influence or stop them
