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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
Q

what might you dx a pt w. if they present solely w. health-related anxiety w. minimal somatic sx

A

illness anxiety

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26
Q

hypochondriasis w.o somatic sx

A

illness anxiety d.o

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27
Q

5 criteria for illness anxiety d.o

A

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

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28
Q

what is an example of excessive behavior related to illness anxiety d.o (2)

A

checking one’s body for signs of dz

repeatedly seeking info and reassurance from internet or other resources

29
Q

ddx for illness anxiety d.o

A

panic d.o

ssd

gad

ocd

30
Q

what is conversion d.o

A

physical symptoms suggesting neurological problem

31
Q

2 types of conversion d.o physical sx

A

sensory impairment → any modality

paresthesias/paralysis

32
Q

conversion d.o has __ onset, and

__ termination and reappearance

A

sudden

sudden

33
Q

__% of conversion d.o self resolve in 1 month

A

90%

34
Q

2 pt pops w. high incidence of conversion d.o

A

women

men in combat

35
Q

t/f: conversion d.o is commonly misdiagnosed and overpathologized

A

t!

15-50% go on to receive medical dx

36
Q

what is la belle indiference

A

“beautiful ignorance”

paradoxical absence of psychological distress despite having serious medical illness/sx related to health condition

37
Q

la belle indifference accounts for __ of conversion d.o

A

⅓

38
Q

ex of conversion d.o

A

blindness/paralysis that can not be explained by medical evaluation

39
Q

mainstay of tx for conversion d.o

A

strong/consistent provider-pt relationship

40
Q

recs for provider managing conversion d.o pt (3)

A

routine appointments

brief medical exams

consistent emotional support/reassurance

41
Q

what should be avoided in tx for conversion d.o

A

narcotics

invasive procedures

42
Q

is alexithymia typical of conversion d.o pt

A

yes

43
Q

why should referral to mental health provider be used cautiously w. conversion d.o pt (2)

A

risk of pt feeling belittled

referring often futile

44
Q

what is a factitious d.o

A

mental health d.o of deceiving others by appearing sick

45
Q

what are the 2 factitious disorderes

A

malingering

munchausen’s syndrome

46
Q

exaggerated physical or psychological sx motivated by external incentives

A

malingering

47
Q

ex of malingering (4)

A

avoiding work

obtaining drugs

obtaining financial compensation

avoiding prosecution

48
Q

intentional production of physical or psychological s/sx

A

factitious d.o/munchausen’s syndrome

49
Q

motivation of factitious d.o/munchausen’s syndrome

A

assume the sick role → attention of caregiver

50
Q

what is absent in munchausen’s syndrome

A

external incentives

ex money, time off work etc

51
Q

tx considerations for munchausen’s

A

one pcp

regular visits

treat comorbidities - ex dpn

educate staff

reinforce positive behaviors

52
Q

what is countertransferance

A

taking patient behavior personally

53
Q

what does CCLING stand for

A

confidence

common

legitimize

idiopathic

nonprogressive

gradual

54
Q

common

A

advise pt that symptoms are common

55
Q

nonprogressive

A

not typical catastrophic condition

56
Q

gradual

A

gradual remission expected

57
Q

in terms of watchful waiting on satisfaction and anxiety among patients seeking care for unexplained conditions…

A

patients were generally satisfied w. consultation

had moderately low anxiety

no difference btw immediate testing and 4 week watchful waiting groups

58
Q

many factors associated w. higher odds of pt satisfaction are related to

A

physician-patient communication

59
Q

factors associated w. higher odds of pt satisfaction (5)

A

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
Q

factors associated with higher odds of pt anxiety (3)

A

expecting testing/referral

not knowing seriousness of complaints after consult

provider not seeing cause for alarm

61
Q

anxiety about sx developing when not present

A

illness anxiety do

62
Q

inability to put emotions to words → emotions become physical sx

A

alexathymia

63
Q

psych do that focuses on neuro sx

A

conversion

64
Q

malingering is a __ process

A

conscious

65
Q

best tx for ssd

A

frequent office visits

build rapport

66
Q

major difference btw schizotypal and schizoid pd

A

schizotypal has:

cognitive/perceptual distortions

eccentricities of behavior

67
Q

pt feels empty all the time, abandoned, struggles w. pain

A

bpd

68
Q

munchausen’s by proxy

A

ex mom faking child’s sx for attention

69
Q

how to schedule apt’s for ssd

A

frequent office visits

goal to have pt question need for so many visits

Psychosocial Care (6 decks)

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