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Psychosocial Care > Test 3 - SSD > Flashcards

Test 3 - SSD Flashcards

1
Q

__% of pcp pt’s have a somatoform d.o

A

26%

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2
Q

somatic symptom d.o are higher incidence in (2)

A

single individuals

low social supports

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3
Q

incidence of somatic symptom d.o in gen pop

A

5-7%

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4
Q

somatization is linked to what 2 other d.o

A

dpn

anxiety

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5
Q

how are feelings expressed in early childhood

A

physical

ex alexithymia

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6
Q

somatothymia is same same

A

alexithymia

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7
Q

what is somatothymia/alexithymia

A

inability to express/describe one’s emotions

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8
Q

kids use __ language to express feelings

later, __ language is used to express thoughts and feelings

A

physical

verbal

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9
Q

somatic symptom and related d.o (6)

A

somatic symptom d.o

illness anxiety d.o

conversion d.o

psychological factors affecting other medical conditions

factitious d.o

other specified somatic sx

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10
Q

what are the other specified somatic symptoms

A

pseudocyesis

sx < 6 mo

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11
Q

what is pseudocyesis

A

thinking you’re pregnant

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12
Q

rf for childhood somatic sx d.o

A

inattentive parents

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13
Q

rf for somatic sx d.o (3)

A

not talking about feelings at home

early abuse

alcoholic parents

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14
Q

somatic sx disorder includes (4)

A

previous diagnoses of somatization d.o

undifferentiated somatoform d.o

hypochondriasis

some presentations of pain d.o

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15
Q

for dx, somatic sx d.o must

A

affect pt’s life in some way

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16
Q

criteria for somatic symptom d.o (3)

A
  1. somatic symptoms
  2. 2 out of 3 excessive thoughts, feelings. and behaviors related to the somatic symptoms or health concerns
  3. chronicity of 6 months
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17
Q

somatic symptom definition

A

excessive thoughts, feelings, and behaviors related to somatic symptoms or associated health concerns

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18
Q

how many thoughts, feelings, or behaviors must be present for dx of somatic symptom d.o

A

2 out of 3

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19
Q

what are the 3 thoughts, feelings, or behaviors that must be present for somatic symptom d.o dx

A

disproportionate and persistent concerns about the medical seriousness of one’s symptoms

high level of health-related anxiety

excessive time and energy devoted to these symptoms or health concerns

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20
Q

does a somatic symptom have to be continuously present for dx of somatic symptom d.o

A

no

but the state of being symptomatic must be chronic

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21
Q

how long must a pt be symptomatic for dx of somatic sx d.o

A

at least 6 months

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22
Q

optional specifiers for SSD

A

predominant somatic complaints (

predominant health anxiety

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23
Q

predominant somatic complaints is same-same

A

somatization d.o

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24
Q

predominant health anxiety is same same

A

hypochondriasis

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25
what might you dx a pt w. if they present solely w. health-related anxiety w. minimal somatic sx
illness anxiety
26
hypochondriasis w.o somatic sx
illness anxiety d.o
27
5 criteria for illness anxiety d.o
preoccupation w. having or acquiring a serious illness somatic sx are not present or mild high level of anxiety about health or having or acquiring serious illness related excessive behaviors illness related preoccupation is not better accounted for by sx of another mental d.o
28
what is an example of excessive behavior related to illness anxiety d.o (2)
checking one's body for signs of dz repeatedly seeking info and reassurance from internet or other resources
29
ddx for illness anxiety d.o
panic d.o ssd gad ocd
30
what is conversion d.o
physical symptoms suggesting neurological problem
31
2 types of conversion d.o physical sx
sensory impairment → any modality paresthesias/paralysis
32
conversion d.o has __ onset, and \_\_ termination and reappearance
sudden sudden
33
\_\_% of conversion d.o self resolve in 1 month
90%
34
2 pt pops w. high incidence of conversion d.o
women men in combat
35
t/f: conversion d.o is commonly misdiagnosed and overpathologized
t! *15-50% go on to receive medical dx*
36
what is la belle indiference
“beautiful ignorance” paradoxical absence of psychological distress despite having serious medical illness/sx related to health condition
37
la belle indifference accounts for __ of conversion d.o
⅓
38
ex of conversion d.o
blindness/paralysis that can not be explained by medical evaluation
39
mainstay of tx for conversion d.o
strong/consistent provider-pt relationship
40
recs for provider managing conversion d.o pt (3)
routine appointments brief medical exams consistent emotional support/reassurance
41
what should be avoided in tx for conversion d.o
narcotics invasive procedures
42
is alexithymia typical of conversion d.o pt
yes
43
why should referral to mental health provider be used cautiously w. conversion d.o pt (2)
risk of pt feeling belittled referring often futile
44
what is a factitious d.o
mental health d.o of deceiving others by appearing sick
45
what are the 2 factitious disorderes
malingering munchausen's syndrome
46
exaggerated physical or psychological sx motivated by external incentives
malingering
47
ex of malingering (4)
avoiding work obtaining drugs obtaining financial compensation avoiding prosecution
48
intentional production of physical or psychological s/sx
factitious d.o/munchausen's syndrome
49
motivation of factitious d.o/munchausen's syndrome
assume the sick role → attention of caregiver
50
what is absent in munchausen's syndrome
external incentives ex money, time off work etc
51
tx considerations for munchausen's
one pcp regular visits treat comorbidities - ex dpn educate staff reinforce positive behaviors
52
what is countertransferance
taking patient behavior personally
53
what does CCLING stand for
confidence common legitimize idiopathic nonprogressive gradual
54
common
advise pt that symptoms are common
55
nonprogressive
not typical catastrophic condition
56
gradual
gradual remission expected
57
in terms of watchful waiting on satisfaction and anxiety among patients seeking care for unexplained conditions…
patients were generally satisfied w. consultation had moderately low anxiety **no difference btw immediate testing and 4 week watchful waiting groups**
58
many factors associated w. higher odds of pt satisfaction are related to
physician-patient communication
59
factors associated w. higher odds of pt satisfaction (5)
general satisfaction w. physician feeling taken seriously knowing seriousness of complaint after consult provider discussing testing and not considering complaints unbearable older provider age
60
factors associated with higher odds of pt anxiety (3)
expecting testing/referral not knowing seriousness of complaints after consult provider not seeing cause for alarm
61
anxiety about sx developing when not present
illness anxiety do
62
inability to put emotions to words → emotions become physical sx
alexathymia
63
psych do that focuses on neuro sx
conversion
64
malingering is a __ process
conscious
65
best tx for ssd
frequent office visits build rapport
66
major difference btw schizotypal and schizoid pd
schizotypal has: cognitive/perceptual distortions eccentricities of behavior
67
pt feels empty all the time, abandoned, struggles w. pain
bpd
68
munchausen's by proxy
ex mom faking child's sx for attention
69
how to schedule apt's for ssd
frequent office visits goal to have pt question need for so many visits

Psychosocial Care (6 decks)

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