Trauma/Stressor-Related, Dissociative, and Somatic Symptom Disorders

Question 1

Q: What is a key diagnostic criterion for all Trauma- and Stressor-Related Disorders according to the DSM-5?

Answer 1

A: Exposure to a traumatic or stressful event.

Question 2

Q: What category do Trauma- and Stressor-Related Disorders fall under in the DSM-5?

Answer 2

A: They are a category of disorders that include exposure to a traumatic or stressful event as a diagnostic criterion.

Question 3

Q: What behaviors characterize Reactive Attachment Disorder?

Answer 3

A: A persistent pattern of inhibited and emotionally withdrawn behavior toward adult caregivers, including a lack of seeking or responding to comfort when distressed and social and emotional disturbances.

Question 4

Q: What social and emotional disturbances are associated with Reactive Attachment Disorder?

Answer 4

A: At least two of the following: minimal social and emotional responsiveness to others, limited positive affect, and unexplained irritability, sadness, or fearfulness when interacting with adult caregivers.

Question 5

Q: What history is required for a diagnosis of Reactive Attachment Disorder?

Answer 5

A: A history of extreme insufficient care that’s believed to be responsible for the person’s symptoms.

Question 6

Q: At what age must symptoms of Reactive Attachment Disorder begin, and what developmental age must the person have?

Answer 6

A: Symptoms must begin before age five, and the person must have a developmental age of at least nine months.

Question 7

Q: What behaviors characterize Disinhibited Social Engagement Disorder?

Answer 7

A: Inappropriate interactions with unfamiliar adults, including reduced or absent reticence in approaching or interacting with strangers, overly familiar behavior, and willingness to accompany strangers without hesitation.

Question 8

Q: What are the diagnostic criteria for Disinhibited Social Engagement Disorder?

Answer 8

A: At least two of the following symptoms: reduced or absent reticence in approaching or interacting with strangers, overly familiar behavior with strangers, diminished or absent checking with adult caregivers after separation, and willingness to accompany strangers without hesitation.

Question 9

Q: What history is required for a diagnosis of Disinhibited Social Engagement Disorder?

Answer 9

A: A history of extreme insufficient care believed to be responsible for the person’s symptoms.

Question 10

Q: At what developmental age must the person have symptoms of Disinhibited Social Engagement Disorder?

Answer 10

A: Symptoms must manifest with a developmental age of at least nine months.

Question 11

Q: What are the diagnostic criteria for PTSD?

Answer 11

A: Symptoms must last for more than one month, cause significant distress or impaired functioning, and be due to exposure to actual or threatened death, serious injury, or sexual violence. Symptoms include intrusion, avoidance, negative changes in mood or cognition, and alterations in arousal and reactivity.

Question 12

Q: What brain abnormalities are associated with PTSD?

Answer 12

A: PTSD has been linked to a hyperactive amygdala and anterior cingulate cortex, hypoactive ventromedial prefrontal cortex, and reduced hippocampal volume. Neurotransmitter abnormalities include increased dopamine, norepinephrine, and glutamate, and decreased serotonin and GABA.

Question 13

Q: What psychological treatments are recommended for PTSD?

Answer 13

A: Cognitive-behavior therapy, cognitive processing therapy, prolonged exposure, and eye movement desensitization and reprocessing (EMDR) are recommended. Brief eclectic psychotherapy and narrative exposure therapy are conditionally recommended.

Question 14

Q: What pharmacological treatments are conditionally recommended for PTSD in adults?

Answer 14

A: SSRIs (fluoxetine, paroxetine, sertraline) and SNRI (venlafaxine) are recommended. They help alleviate depression accompanying PTSD and may reduce core symptoms like re-experiencing, avoidance, and hyperarousal.

Question 16

Q: What are the diagnostic criteria for Acute Stress Disorder (ASD)?

Answer 16

A: ASD requires exposure to actual or threatened death, severe injury, or sexual violation, with at least nine symptoms from categories such as intrusion, negative mood, dissociative symptoms, avoidance, and arousal. Symptoms must persist for three days to one month and cause significant distress or impaired functioning.

Question 16

Q: How does the DSM-5 define Dissociative Disorders?

Answer 16

A: Dissociative Disorders involve “a disruption of and/or discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior” (DSM-5, p. 291).

Question 17

Q: What is Dissociative Amnesia according to the DSM-5?

Answer 17

A: Dissociative Amnesia involves an inability to recall important personal information that cannot be attributed to ordinary forgetfulness and causes significant distress or impaired functioning. It can manifest as localized (inability to recall all events during a specific period), selective (inability to recall some events), generalized (complete loss of memory for one’s entire life), systematized (loss of memory for specific categories), or continuous (inability to remember new events). Dissociative fugue, involving purposeful travel or wandering associated with memory loss, may also occur.

Question 17

Q: What are Somatic Symptom and Related Disorders characterized by?

Answer 17

A: Somatic Symptom and Related Disorders involve physical symptoms and/or health-related concerns that cause significant distress or impaired functioning. These disorders include Somatic Symptom Disorder, Illness Anxiety Disorder, Conversion Disorder (Functional Neurological Symptom Disorder), and Factitious Disorder.

Question 18

Q: What is Somatic Symptom Disorder characterized by?

Answer 18

A: Somatic Symptom Disorder involves one or more distressing somatic symptoms accompanied by excessive thoughts, emotions, or behaviors related to the symptoms. Criteria include disproportionate health concerns, persistent anxiety about symptoms, and significant time and energy spent on health worries. Specifiers include severity levels, predominant pain, and persistence for more than six months.

Question 19

Q: What is Illness Anxiety Disorder characterized by?

Answer 19

A: Illness Anxiety Disorder involves a preoccupation with having a serious illness despite minimal or no somatic symptoms. It includes excessive anxiety about health and may manifest as excessive health-related behaviors or avoidance of medical appointments. Symptoms must persist for at least six months, with fluctuations in the nature of symptoms over time.

Question 20

Q: What is Conversion Disorder (Functional Neurological Symptom Disorder)?

Answer 20

A: Conversion Disorder involves one or more symptoms that disrupt voluntary motor or sensory functions, such as paralysis or blindness. These symptoms cannot be explained by any known medical or neurological condition. Diagnosis requires that symptoms cause significant distress or impairment in functioning.

Question 21

Q: How is psychogenic non-epileptic seizures (PNES) related to Conversion Disorder?

Answer 21

A: PNES are seizure-like episodes that mimic epileptic seizures in behavior but do not show abnormal brain electrical activity on EEG. Video EEG monitoring is used to distinguish PNES from true epileptic seizures, helping in the diagnosis of Conversion Disorder.

Question 22

Q: What is Factitious Disorder?

Answer 22

A: Factitious Disorder involves falsifying or inducing physical or psychological symptoms without obvious external rewards. In Factitious Disorder imposed on self, individuals simulate illness or impairment in themselves, while in Factitious Disorder imposed on another, symptoms are induced in someone else, often a child by a caregiver.