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CU: Abnormal Psychology > Test 3: Somatic Symptom and Related Disorders & Dissociative Disorders > Flashcards

Test 3: Somatic Symptom and Related Disorders & Dissociative Disorders Flashcards

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1
Q

What are somatic symptom disorders?

A

Excessive or maladaptive response to physical symptoms or health concerns
- Preoccupation with health or symptoms
- Physical complaints
- Usually no identifiable medical condition

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2
Q

What disorder is characterized by
- Presence of one or more somatic symptoms: symptom is often medically unexplained
- Excessive thoughts, feelings, and behaviors related to the symptoms (excessive thoughts about seriousness of the symptom, frequent complaints and requests for help, health related anxiety, excessive research)
- Substantial impairment in social or occupational functioning

A

Somatic symptom disorder

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3
Q

What are the statistics of somatic symptom disorder?

A
  • relatively rare
  • onset: usually adolescence
  • more likely: unmarried, low socioeconomic status, women
  • chronic
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4
Q

What disorder is characterized by
- severe anxiety about the possibility of having or acquiring a serious disease
- actual symptoms are either very mild or absent
- strong disease conviction
- medical reassurance does not seem to help

A

Illness anxiety disorder

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5
Q

What are the statistics of illness anxiety disorder?

A
  • Effect: All ages equally
  • Comorbid: anxiety and mood disorders
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6
Q

What causes somatic symptom disorders?

A
  • Consistent overreaction to physical signs and sensations
  • Cause is unlikely to be found in isolated biological or psychological factors
  • Genetic component is present
  • May have learned from family to focus anxiety on physical sensations
  • Stressful life events
  • Illness in family during childhood
  • Benefits of illness (sympathy, attention)
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7
Q

What are the shared features of somatic symptom disorder and antisocial personality disorder?

A
  • Often begin early in life
  • Chronic and difficult to treat
  • More common in lower socioeconomic status
  • Linked to substance abuse and interpersonal problems
  • Disinhibition/impulsivity: seeking sympathy & other benefits
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8
Q

What are different features of somatic symptom disorders and antisocial personality disorder?

A

SSD:
- Dependence manifestation of impulsivity
- More common in females
ASPD:
- Aggression manifestation of impulsivity
- More common in males

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9
Q

What are treatments for somatic symptom disorders?

A
  • mild: detailed education and medical professional reassurance
  • CBT (effective)
  • Antidepressants (maybe helpful)
  • Gatekeeper physician to limit excessive use of medical services
  • Reduce supportive consequences of illness
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10
Q

Illness Anxiety Disorder vs. Somatic Symptom Disorder
***

A

IAD:
- Fear of disease
- Scientific in reporting data
- Limited complaints - often a fear of one disease
SSD:
- Fear of symptoms
- Describes symptoms vaguely
- Varied complaints - often fear of many symptoms

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11
Q

What disorder is characterized by
- psychological variable may be impacting a general medical issues

Examples:
- PT concentration affect taking medication
- PT in denial about diagnosis does not comply with medical advice

A

Psychological Factors Affecting Medical Condition

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12
Q

What disorder is characterized by
- Altered motor or sensory function inconsistent with neural/medical conditions and not better explained by another disorder
- ie lump in throat
- Suggestive of neurological problem but not detected
- Cause significant distress/impairment
- May display indifferent attitude toward symptoms (“la belle indifference”)
- Functioning may be mostly normal
- NOT deliberately faking

A

Conversion Disorder (Functional Neurological Symptom Disorder)

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13
Q

What is the deliberate faking of a condition?

A

Malingering

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14
Q

What are the statistics for conversion disorder?

A
  • Prevalence: Rare
  • Course: chronic, intermittent
  • Comorbid: Anxiety and mood disorders
  • Onset: usually adolescence
  • Primarily in females
  • Common in some cultural and/or religious groups
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15
Q

What causes conversion disorder?

A
  • Not well understood
  • Freudian psychodynamic view (common, unsubstantiated): past trauma/unconscious conflict “converted” into more acceptable manifestation (physical symptoms)
  • Primary gain: escape from conflict
  • Secondary gain: attention, sympathy, etc
  • Sociocultural factors: lower education/socioeconomic status, symptoms more familiar with
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16
Q

What is the treatment for conversion disorder?

A
  • Trauma: process and treat symptoms
  • remove sources of secondary gain
  • reduce supportive consequences of talk about physical symptoms
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17
Q

What disorder is characterized by
- purposely faking physical symptoms
- Induce physical symptoms or just pretend
- No obvious external gains (benefit of sick role)

A

Factitious disorder

  • NOT: malingering - faking to get concrete objective
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18
Q

What disorder is characterized by
- inducing symptoms in another person
- to receive attention or sympathy

A

Factitious Disorder imposed on another (Munchausen syndrome by proxy)
- typically a caregiver induces symptoms in a dependent (child)

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19
Q

How would you address a Christian with illness anxiety disorder or somatic symptom disorder?

A

Verses:
1 Peter 5: 7 - cast all your cares
Proverbs 3:5-6 - God is in control, trust Him not yourself
Isaiah 40:31 - Memorize and meditate on verses, run wing eagles
Philippians 4:8-9 - Set your mind on good things

  • Writing down examples of God’s faithfulness
  • Remember prayers and answers
  • Practice thankfulness
  • Verse meditation and memorization
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20
Q

What are dissociative disorders in general? What are the two types?

A
  • Severe alterations or detachments from reality
  • Affect identity, memory, or consciousness
    1) Depersonalization: distortion in perception of one’s body or experience
    2) Derealization: losing a sense of the external world
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21
Q

What disorder is described as:
- Recurrent episodes in which a person has sensations of unreality of one’s own body or surroundings
- Feelings dominate and interfere with life funcitoning
- Only diagnosed if primary problem involves depersonalization and derealization
– Similar symptoms may occur in the context of other disorders, including panic disorder and PTSD

A

Depersonalization/Derealization Disorder

22
Q

What are some features of depersonalization/derealization disorder?

A
  • Cognitive deficits in attention, short-term memory, spatial reasoning
  • Easily distractible
  • Difficulty absorbing new information
  • Reduced emotional responding
  • May have dysregulation of HPA axis in brain
23
Q

What ae facts a statistics of depersonalization/derealization disorder?

A
  • High comorbidity with anxiety and mood disorders
  • Onset: typically adolescents
  • Couse: usually chronic
  • Risk factor;: history of trauma
  • (1-3% population)
24
Q

What is the treatment of depersonalization/derealization disorder?

A
  • Research scarce
  • No systematic research on psychological treatments
  • Trial of antidepressant (Prozac) showed no effect above placebo
25
Q

What disorder is characterized by
several forms of psychogenic memory?

Two types?

A

Dissociative Amnesia
- Generalized type: inability to recall anything, including their identity
- Localized or selective type: failure to recall specific (usually traumatic) events

26
Q

What are the five patterns of dissociative Amnesia?
***

A
  • Localized
  • Selective
  • Generalized
  • Continuous
  • Systematized
27
Q

What is the definition of localized pattern of dissociative amnesia?
***

A

All events from a certain time period are blocked out

28
Q

What is the definition of selective pattern of dissociative amnesia?
***

A

“spot erasures,” forgetting certain aspects/events during a specific time period

29
Q

What is the definition of generalized pattern of dissociative amnesia?
***

A

Forgetting one’s entire past life

30
Q

What is the definition of continuous pattern of dissociative amnesia?
***

A

Forgets events after a certain time period up to the present, including events occurring after onset of amnesia

31
Q

What is the definition of systematized pattern of dissociative amnesia?
***

A

Forgets only certain categories of information, while other memories remain intact

32
Q

What are the types of memory that relate to amnesia?
***

A
  • Episodic memory
  • Semantic memory
  • Procedural memory
  • Explicit memory
  • Implicit memory
33
Q

How is episodic memory affected by amnesia?
***

A

(memory of personal experience) is lost

34
Q

How is semantic memory affected by amnesia?
***

A

(general knowledge) is spared

35
Q

How is procedural memory affected by amnesia?
***

A

(skills) is intact

36
Q

How is explicit memory affected by amnesia?
***

A

(intentional recollection of information) may be lost

37
Q

How is implicit memory affected by amnesia?
***

A

(memories not consciously aware of) affects behavior

38
Q

Read diagnoses of each disorder

A

In the textbook

39
Q

What disorder is characterized by
- During the amnestic episode, person travels or wanders, sometimes assuming a new identity in a different place
- Unable to remember how or why one has ended up in a new place

A

Dissociative fugue

40
Q

What are the statistics of dissociative amnesia and fugue?

A

Onset: adulthood (rare in childhood)
Course: rapid onset and dissipation

41
Q

What are the causes of dissociative amnesia and fugue?

A
  • Little is known
  • Trauma and stress can serve as triggers
  • Most recover/remember without treatment
42
Q

What disorder is characterized by
- Replacement of the customary sense of personal identity by a new identity, attributed to the influence of a spirit, power, deity and is associated with stereotypes involuntary movements of amnesia
- Dissociative symptoms and sudden changes in personality
- Change may be attributed to possession by a spirit
- Only considered a disorder if leads to distress or impairment

A

Dissociative trance

Nigeria: vinvusa
Thailand: phii pob

43
Q

What disorder is characterized by
- Formerly known as MPD
- Dissociation of personality
- Adoption of several new identities (ave 15, up to 100) that display unique behaviors, voice, and postures

A

Dissociative Identity Disorder (DID)

44
Q

What are the unique aspects of DID?

A
  • Alters: different identities or personalities
  • Host: the identity that keeps other identities
  • Switch: Quick transition (instantaneously) from one personality to another, the person may exhibit physical transformations
45
Q

Can DID be faked?

A
  • some are faking: may “produce” an alter when suggested by therapist
  • some are not: seen in physiological and brain functioning changes
46
Q

What are the statistics of dissociative identity disorder?

A
  • Prevalence not well known (1-2%)
  • More common in females
  • Onset: typically childhood/adolescence, due to abuse
  • Comorbidity: other psychological disorders
  • Dissociation
  • Course: chronic
47
Q

How can DID malingering be detected?

A
  • Brainwaves
  • Pain sensitivity
  • Skin conductance
  • Personality test
  • Handedness
  • Eyeglasses Rx
    (malingering eager to demonstrate their symptoms)
48
Q

What causes dissociative identity disorder?

A
  • Typically: severe, chronic trauma - often childhood abuse (risk increases without support)
  • Mechanisms: dissociation offers escape
  • Closely related to PTSD
  • Biological vulnerability possible but not well understood, almost all risk is environmental
49
Q

How is dissociative identity disorder treated?

A
  • Focus on identity reintegration
  • Identify and neutralize cues/triggers
  • Relive/confront trauma (hypnosis)
50
Q

What is the problem, consequence, and conclusion of false memories?

A
  • Problem: possible to create false memories of abuse by power of suggestion
  • Consequence: some pts think they have repressed memories of abuse later shown to be false, can be damaging to pt & families
  • Conclusion: therapists need to be well trained in memory function and be careful not to suggest an untrue history by mistake

CU: Abnormal Psychology (7 decks)

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