Somatic Syptoms and Dissociative disorders Flashcards

1
Q

what is a hypocondriac

A

someone who exaggerates the slightest physical symptom which is normally harmless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are somatic symptom disorders overview

A

excessive or maladaptive response to physical symptoms or associated health concerns
accompanied by distress and impairment
medical explanations not necessary or important
typiclaly presents medically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

name the 7 DSM-5 classifications of somatic disorders

A
somatic symptom
illness anxiety
conversion
psychological factors affecting other medical condition
factitiuous
other specified
unspecified
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

somatic symptom disorder clinical description

A

somatic symotom that is distressing or significantly disrupts daily life
excessive thoughts, feelings or behaviours related to symptoms or concerns such as
-persistent thoughts about seriousness
-persistently high illness of sympptom anxiety
-excessive time and energy spent on helath or concern
persistent (6 months)
simple absence of medical diagnosis is not enough
missattribution of bodly sensations
repeated checking / seeking help - medical reassurance doesnt help

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

somatic symptom disorder statsq

A
prevalence around 5-7%
chronic
can occur at any age but usually adolescence
diagnosis in eldery = tricky
depression is common
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

risk factors for developing somatic symptom disordeR

A
negativity
depression
anxiety
low SES
low education
female
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

somatic symptom disorder causes

A

familial history of illness
stressful life events
sensitivity to physical sensations
secondary reinforcement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

treatment of somatic symptom disorder

A

CBT best
limit hospital visits through assigning gatekeeper physician
behavioural approaches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

illness anxiety disorder description

A

preoccupied with having or catching a serious illness
physical symptoms absent of very mild
disease conviction
repeated helth-related behaviours or avoidance
6 month duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

illness anxiety stats

A

most prior cases of hypocondriasis = somatic symotom dis, only 25% were illness anxiety
so prevalence = 1.3-10%
chronic and relapsing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

risk factors for developing illness anxiety disorder

A

exposure to major stressor or scare
history of child abuse
history of childhood illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is disease conviction

A

i have this specific diseasw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is illness conviction

A

disproportionate preoccupation with physical symptoms

belief i am sick, not what is causing it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

causes of illness anxiety

A

cognitive perceptual distrotions - unpredictable and uncontrollable world
overly attentive to physical sensations
misinterpretation of sensations
interpersonal influences - trigger event, family history of illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

illness anxiety treatment

A

change illness-related misinterpretations
substantial and sensitive reassurance
stress management and coping strategies
antidepressants (SSRIs) offer some help, but typically CBT = more lasting gains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

integrativemodel of causes of hypocondriasis

A

trigger leads to perceived threat
perceived threat is part of vicious circle
increased body focus, physiological arousal and checking behaviour
preoccupation with perceieved bodily state and sensations
misinterpretation od bodily sensations as indicating severe illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

clinical description of conversion disorder

A

1 or more symptoms altered voluntary motor or sensory function
findings incompatible with medical conditions
la belle indifference
retain most normal functions but unaware

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

stats of conversion disorders

A

rare
chronic intermittent course
2 to 3 times more liekly in women
onset at any time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

causes of converstion disorder

A

psychodynamic view
trauma, conversion and secondary gain
detatchment from the trauma and negative reinforcement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

treatment to conversion disorder

A

similar to somatic symptom
attend to the trauma
behavioural approaches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

citeria for psychological factors affecting other medical conditions

A

medical symptom or condition
psychological or behavioural influences - interpersonal coping, denial, no treatment
influence condition - course, treatment interference, increasing health risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

stats of psychological factors affecting other medical conditions

A

prevalence not known, less than somatic symptom

can occur at any time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

treatment of psych factors affecting other medical conditions

A

similar to somatic symptom disorder

CBT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

factitious disorder features

A

falsification of physica or psych symptoms
induction of injury or disease
deception
presents patient as ill, injured, impaired
no evidence of external rewards
patient my be self or another

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

statistics on factitiout disorder

A

prevalence unknown. perhaps 1% in hospital setting
intermittent course
onset in ealry adulthood

26
Q

treament of facticious disorder

A

not well identified

similar to somatic symptom

27
Q

what is conversion hysteria according to freud

A

unexplained physcial symptoms = conversion of unconscious emotional conflicts into a more acceptable form

28
Q

what is neurosis by psychoanalytic theory

A

specific but unproven cause - we dont use this anymore

29
Q

somatic disorder cognitive features

A

disorder of cognition or perception with strong emotional contributions
very act of forming attention to bodily sensations increases aruosal aand makes physical sensations more intense
stroop test - enhanced perceptual sensitivity to illness cues
ambigious stimuli as threatening
better safe than sorry
restrictive concept of health as symptom free
unspecified genetic personality tendencies

30
Q

koro

A

belief / fear genitals are retracting into abdomen
chinese male
central imporatnce of sexual functioning
typical sufferes = guilty about excessive masturbation, unsatisfactory sex, promiscuity

31
Q

pa-leng

A

chinese
fear about cold wind in ones body
context ying and yang

32
Q

dhat

A

indian
losing semen
disiness, weakness and fatigue

33
Q

kyol gocu

A

cambodia
wind overload
closely resembles
panic disorder

34
Q

shinkeishitsu

A

japan
resembles western anxiety
headaches, blushing
worry about symptoms hurting others

35
Q

what does functioning

A

symptom without an organic course

36
Q

malingering

A

deliberate faking of a physical pr psych disorder motivated by gain
- so how can we tell the difference

37
Q

freud’s 4 basic processes in development of conversion disorders

A

traumatic event = unacceptable unconscious conflict
conflict repressed as unacceptable
anxiety increases and threatens to emerge into consciousness so person “converts” into physical symptoms = presence of dealing with conflict relieved. this is primary gain or reinforcing event that maintains the symptom
attention and sympathy = secondary gain

38
Q

overview of dissociative disorders

A
severe alterations or discontinuities in identity, memory or consciousness
fragmentations of identity
depersonlizations
derealization
amnesia
reality testing intact
variations of normal
to be a disorder = experiences are distressing or interferences with life functioning
39
Q

what is depersonalization

A

distortion in perception of one’s mind, self or body

40
Q

derealization

A

detachment from one’s surroundings

41
Q

depersonalization disorder facts and stats

A

prevalence 2%
comorbidity with anxiety and mood disorders is extremely high
onset is typically around age 16, rare after 40
usually runs lifelong course

42
Q

causes of depersonalization disorder

A

childhood trauma
severe stress
show cognitive deficits in attention, short term memory and spatial reasoning
cognitive deficits correspond with reports of tunnel vision and mind emptiness

43
Q

treatment of depersonalization disorder

A

attend to the trauma

integrate the personalities

44
Q

key features of dissociative amnesia

A

psychogenic memory loss
generalized = inability to recall anything including their identitiy
localized or selective = failure to recall specific (usually traumatic) events

45
Q

define dissociative fugue

A

purposeful travel or wondering associated with amnesa

such presons may assume a new identity

46
Q

stats on dissociative amnesia

A
sudden onset
progressive
prevalence - 1.8%
more common in women
all ages, kids more difficult
typically rapid onset and dissipation
47
Q

causes of dissociative amnesia

A

violent/ abusive childhood trauma

dissociation in general may have genetic diathesis

48
Q

DID clinical description

A

adoption of 2 or more identities
identities display unique behaviours voice and posture
gaps in memory
dissociation of certain aspects of personality

49
Q

three unique things of DID explained

A

alters - different identities
host - identitiy that seeks treatment and tries to keep fragile elements together
switch - often instantaneous from one personality to another

50
Q

prevalence od DID

A

3-6%
average number of identities around 15
female : male 9:1but DSM says almost equal
onset is almost always in childhood
high comorbidity rates with a lifelong course
70% attempt suicide

51
Q

DID causes

A

child abuse
PTSD relation
most are highly sugestible - genetic

52
Q

treamtnet of DID

A

reintegration of genetics

identify and neutralize cues/ triggers

53
Q

false memories and therapists

A

can be very easy to suggest during therapy

therapist must be aware of this

54
Q

depersonalization - derealization disorder

A

individuals lose sense of reality to both their external world and their own body
intense panic attacks - 50% of people will experience feelings of unreality
chronic course
DDD = distinct cognitive profile with deficits in attention, information processing, short term memory, spatial reasoninig
= easily distracted and slow to process new info
deficits in perception, emotion and HPA axis

55
Q

amok

A

transitive state often brutally attack/ assault sometimes killing humans and animals
if alive at the end of state dont remeber

56
Q

dissociative trance disorder

A

altered state of consciousness in which people fimly believe they are possessed by spirits; considered a disorder only where there is distress and dysfunction

57
Q

how to test faking of DID

A

transient microstrabismus that are not observed in other personalities difficult to fake for exmaple
physiological responses different to emotionally laden words - eg sweat glands and eeg
fMRI = change at the switch
malingerers tend to be eager to demonstrate their symptoms and do so in a fluid fashion

58
Q

autohypnotic model

A

people who are suggestible may use dissociation as a defense against extreme trauma

59
Q

bio contribution to dissociatoin

A

definite link

heritable traits - tension, responsiveness, like PTSD

60
Q

genital exam in 3yo girsl example

A

girls given medical, half = genital exam, other half no
children were inaccurate in reporting where doctro touched them
60% of those touched in the genitals refused to indicate this
60% in control indicated genital insurtions where none had occured