Somatoform Disorders

Question 1

Define Somatic

Answer 1

Of or relating to the body, especially as distinct from the mind

Question 2

Somatic Symptoms Disorder

Answer 2

One or more somatic symptoms that are distressing or result in significant disruption of daily life
Excessive thoughts, feelings, or behaviors related to the somatic symptoms or associated health concerns
The state of being symptomatic is persistent

Question 3

Somatoform Symptoms

Answer 3

Suggest physical disorder
Cannot adequately be explained physiologically
Often described in dramatic ways
Often co-exist with anxiety/mood/personality disorders

Question 4

Characteristics of Somatization Disorder

Answer 4

Reports of multiple physical symptoms with a medical basis
Runs in families
Rare
Onset usually in adolescents

Question 5

Treatment of Somatization Disorder

Answer 5

CBT

Therapy to broaden basis for relating to others

Question 6

Epidemiology of Somatization Disorder

Answer 6

Women > Men
5-7% general population
Older age of onset
Chronic course
Cultural influences affect gender ratios & body locations
Symptoms vary across cultures
Lower levels with higher education levels

Question 7

Somatization Disorder Pathophysiology

Answer 7

Patient needs to be sick

Question 8

Causes of Somatization Disorder

Answer 8

Family Hx of illness
Relation with antisocial personality disorder
Weak behavioral inhibition system

Question 9

Treatment for Somatization Disorder

Answer 9

Assign a PCP
Reduce supportive consequences of talk about symptoms
Frequent, short visits

Question 10

Define Conversion Disorder

Answer 10

Physical symptoms suggesting neurological problems

Question 11

Types of Neurological Problems in Conversion Disorder

Answer 11

Sensory impairment
Paresthesias
Blindness
Paralysis

Question 12

Epidemiology of Conversion Disorder

Answer 12

Suden onset, sudden termination, sudden reappearance
Women > Men except men in combat
Often misdiagnosed
Onset in late childhood
More common in rural areas, lower SES, & lower educational levels

Question 13

Conversion Disorder Criteria

Answer 13

One or more symptoms or deficits affecting voluntary motor or sensory function
Psychological factors are judged to be associated with symptoms or deficit because issue is preceded by conflicts or other stressors
Symptom or deficit in not intentionally feigned
Symptom or deficit cannot be fully explained by a general medical condition, substance use, or culturally sanctioned behavior or experience
Symptom/deficit causes significant distress or impairment in functioning
Symptom/deficit not limited to pain or sexual dysfunction

Question 14

Characteristics of Conversion Disorder

Answer 14

Severe physical dtysfunctioning without pathology
Affect people genuinely unaware that they can function normally
May coincide with other problems

Question 15

Treatment of Conversion Disorder

Answer 15

Assign PCP
Attend to trauma
Remove success of secondary gain
Reduce supportive consequences of talk about symptoms

Question 16

Causes of Conversion Disorder

Answer 16

Freudian psychodynamic view
Focus on past trauma & conversion
Address primary & secondary gain
Detachment from trauma

Question 17

Define Illness Anxiety Disorder

Answer 17

Severe anxiety of the possibility of having a disease

Preoccupied with normal sensations being serious disease

Question 18

Criteria for Illness Anxiety Disorder

Answer 18

Preoccupation with having or acquiring a serious illness
Somatic symptoms mild or not present
High level of anxiety about health; easily alarmed by personal health status
Individual performs excessive health related behaviors or exhibits maladaptive avoidance
Preoccupation present for at least 6 months; specific illness may change
Preoccupation not better explained by another mental disorder

Question 19

Epidemiology of Illness Anxiety Disorder

Answer 19

Male = Female
Any age at onset
Chronic course that waxes & wanes

Question 20

Associations with Illness Anxiety Disorder

Answer 20

Fears of aging and death
Doctor shopping
Poor relationships with providers
Past experience with disease
Family & work problems

Question 21

Causes of Illness Anxiety Disorder

Answer 21

Cognitive perceptual distortions

Family history of illness

Question 22

Treatment of Illness Anxiety Disorder

Answer 22

Challenge illness-related misinterpretations

Provide substantial & sensitive reassurance

Question 23

Biological Factors as Etiology of Illness Anxiety Disorder

Answer 23

Increased level of cortisol
No concordance for any somatoform disorder
Symptoms more likely on the left half of the body

Question 24

Other Specified Somatic Symptom & Related Disorder Criteria

Answer 24

Brief somatic symptom disorder (

Question 25

Psychoanalytic Theory of the Etiology of Somatoform Disorders

Answer 25

Controlling repressed sexual urges

Deny knowledge but use information

Question 26

Behavior Theory of the Etiology of Somatoform Disorders

Answer 26

Malingering
Social learning & reinforcement
Secondary gain

Question 27

Define Body Dysmorphic Disorder

Answer 27

Excessive concern with real or imagined defects in appearance

Question 28

Criteria for Body Dysmorphic Disorder

Answer 28

Preoccupation with an imagined defect in appearance
Preoccupation causes clinically significant distress or impairment in functioning
Preoccupation not better accounted for by another mental disorder

Question 29

Characteristics of Body Dysmorphic Disorder

Answer 29

Fixation with or avoidance of mirrors
Suicidal ideation
Suicidal behavior

Question 30

Facts about Body Dysmorphic Disorder

Answer 30

Men = Women
Onset in adolescence
Chronic course

Question 31

Associations with Body Dysmorphic Disorder

Answer 31

Excessive checking/grooming
Removal of mirrors
Social isolation
Surgical procedure
Suicide

Question 32

Causes of Body Dysmorphic Disorder

Answer 32

Genetic
Developmental
Psychosocial
Social
Cultural
Similarities with OCD

Question 33

Treatment for Body Dysmorphic Disorder

Answer 33

CBT
SSRIs
Plastic surgery NOT HELPFUL