Somatoform disorders

Question 1

factitious disorder

Answer 1

a disorder in which a person feigns of induces physical symptoms, typically for the purpose of assuming the role of a sick person. (Munchausen syndrome)

Question 2

conversion disorder

Answer 2

a disorder in which a person’s bodily symptoms affect his or her voluntary motor and sensory functions, but the symptoms are inconsistent with known medical diseases.

Question 3

somatic symptom disorder

Answer 3

people become excessively distressed, concerned, and anxious about bodily symptoms they are experiencing, and their lives are disproportionately disrupted by the symptoms.

Question 4

psychodynamic view of somatic/conversion disorders

Answer 4

Current psychodynamic theorists continue to believe the sufferers of these disorders have unconscious conflicts carried forth from childhood.

Question 5

primary gain

Answer 5

the gain people derive when their somatic symptoms keep their internal conflicts out of awareness.

Question 6

secondary gain

Answer 6

the gain people derive when their somatic symptoms elicit kindness from others or provide an excuse to avoid unpleasant activities.

Question 7

CBT view of somatic/conversion disorders

Answer 7

• rewards: physical symptoms yield rewards
• communication: conversion and somatic symptoms are forms of self-expression, providing a means for people to reveal emotions that would otherwise be difficult for them to convey.

Question 8

Multicultural view of somatic/conversion disorders

Answer 8

very high rates of stress-caused bodily symptoms in non-Western medical settings

Question 9

Illness anxiety disorder

Answer 9

people are chronically anxious about and preoccupied with the notion that they have or are developing a serious medical illness, despite the absence of somatic symptoms.

Question 10

CBT view of illness anxiety disorder

Answer 10

illness fears acquired through classical conditioning or modeling and people with the disorder so sensitive to bodily cues that they come to misinterpret them.

Question 11

Treatment for illness anxiety disorder

Answer 11

Treatment is similar to what is used in OCD. (antidepressants, exposure and response prevention)

Question 12

Psychophysiological disorders

Answer 12

biological, psychological and sociocultural factors interact to cause or worsen a physical illness.

• ulcers
• asthma
• insomnia
• muscle contraction or tension headaches
• migraine headaches
• hypertension
• coronary heart disease

Question 13

Biological factors that contribute to psychophysiological disorders

Answer 13

autonomic nervous system responds differently in different people, making some more likely to develop a psychophysiological disorder.

Question 14

Psychological factors that contribute to psychophysiological disorders

Answer 14

certain needs, attitudes, emotions or coping styles may cause people to overreact repeatedly to stressors, and increase their chance of developing these disorders.

Question 15

Type A v. Type B and psychophysiological effects

Answer 15

• Type A personality style: characterized by hostility, cynicism, drivenness, impatience, competitiveness, and ambition. (more likely to develop coronary heart disease)
• Type B personality style: more relaxed less aggressive, less concerned about time.

Question 16

Sociocultural factors and psychophysiological disorders

Answer 16

adverse social conditions like poverty, crime, unemployment can cause ongoing stress

Question 17

psychoneuroimmunology

Answer 17

the study of connections between stress, the body’s immune system, and illness.
* link between stress and weakened immune function

Question 18

biochemical activity from stress that will slow down immune system

Answer 18

sustained increase in cortisol and norepinephrine slows down immune system and leads to chronic inflammation

Question 19

how stress impacts behavioral changes that can impact immune system

Answer 19

stress can spark behavioral changes like bad sleep, poor eating, decreased exercise, smoking and drinking.

Question 20

how personality style can impact immune system

Answer 20

people who respond to life stress with optimism, constructive coping, and resilience experience better immune system functioning.

Question 21

how social support can affect immune system

Answer 21

people who are lonely and have few social supports have poorer immune functioning

Question 22

behavioral medicine

Answer 22

a field that combines psychological and physical interventions to treat or prevent medical problems.

Question 23

relaxation training

Answer 23

a treatment procedure that teaches clients to relax at will so they can calm themselves in stressful situations. Often used to treat high blood pressure.

Question 24

biofeedback

Answer 24

a technique in which a client is given information about physiological reactions as they occur and learns to control the reactions voluntarily.

Question 25

meditation

Answer 25

Mindfulness meditation used to treat people with severe pain.

Question 26

Features of somatoform disorders

Answer 26

• One or more distressing somatic symptom for at least 6 months
• Excessive thoughts, feelings, or behaviors related to somatic symptoms or health concerns
  
  • Disproportionate and persistent thoughts of seriousness
  • Persistent high level of anxiety about symptoms
  • Excessive time and energy devoted to symptoms

Question 27

Demographics of somatoform disorders

Answer 27

• Typical: low SES unmarried women; generally starts int teens or 20’s
• Anxiety, depression, and substance abuse frequently co-morbid
• Fairly uniform cross-culturally

Question 28

Psychological factors in somatoform disorders

Answer 28

• Impulsivity, poor delay of gratification
  
  • Short term gain from somatic problems yields long-term social isolation
• Manipulative behavior prominent
  
  • Sick role

Question 29

Psychological treatment components for somatoform disorders

Answer 29

• accept somatic complaints as valid
• stable level of contact regardless of symptom exacerbation
• goal of minimizing utilization of health care services (exams, tests, medications, procedures)

Question 30

Features of conversion disorders

Answer 30

• At least one symptom or deficit of sensory or voluntary motor function (usually paralysis, blindness, or loss of feeling)
• No medical evidence for symptoms
• Symptom presentation often associated with significant psychosocial stressor

Question 31

Demographics of conversion disorder

Answer 31

• relatively rare
• women>men
• onset between 10-30 years old
• Low SES, low education
• 10-30% of patients diagnosed with conversion disorder later found to have physical etiology for symptoms

Question 32

Psychological components of conversion disorder

Answer 32

• primary gain-
• secondary gain-
• inability to cope with emotional distress in initial etiology and subsequent manifestation
• modeling relatives
• personality disorders

Question 33

Psychological treatment components for conversion disorder

Answer 33

• emotional support for precipitating stressor
• expectation that symptoms will quickly wane
• reinforce improvements and symptom reduction
• removal of secondary gain

Question 34

Relationship/distinction between panic disorder and illness anxiety disorder

Answer 34

• misinterpretation of physical symptoms

* Panic has fear of immediate consequences, IAD has fear of long-term consequences

Question 35

Psychological components of illness anxiety disorder

Answer 35

• focused attention on physical sensations
• espousal of Western concept of health as being “free from symptoms”
• Possible learned component
  
  • Modeling from parents
  • benefits of sick role

Question 36

Contextual components of illness anxiety disorder

Answer 36

• onset during stressful life event
• high incidence of verifiable medical illness in family
• increasing prevalence with age related to fear of aging and dying

Question 37

Treatment for illness anxiety disorder

Answer 37

not well studied-

• psychotherapy
  
  • CBT
  • Reassurance/explanation
• pharmacological
  * antidepressants
  * anxiolytics