Week 6 - Somatic symptoms and dissociative disorders Flashcards
Mental disorders that take the form of physical (or somatic) disease with medically unexplained symptoms are known as:
A) Somatic Symptom Disorders
B) Neurocognitive Disorders
C) Mood Disorders
D) Anxiety Disorders
A) Somatic Symptom Disorders
Which of the following are symptoms of Somatic Symptom Disorder?
A) Prominent somatic symptoms causing significant distress or impairment.
B) Preoccupation with symptoms and excessive worry about having a serious illness.
C) Excessive help-seeking behavior and frequent visits to healthcare providers.
D) Persistent thoughts or behaviors related to symptoms despite negative medical evaluations.
E) All of the above
E) All of the above
In DSM-III, somatic conditions were listed as ‘somatoform,’ while in DSM-5 they are referred to as:
A) Mood and Anxiety Disorders
B) Neurocognitive and Psychotic Disorders
C) Somatic Symptom and Related Disorders
D) Dissociative and Personality Disorders
C) Somatic Symptom and Related Disorders
What is the main difference between DSM-5 and DSM-IV for diagnosing somatic symptom disorders?
A) DSM-5 looks at how much distress or impairment the symptoms cause, while DSM-IV focused on whether the symptoms had a medical explanation.
B) DSM-5 needs a medical explanation for symptoms, while DSM-IV looks only at distress.
C) DSM-5 only considers psychological factors, while DSM-IV also considers medical factors.
D) DSM-5 and DSM-IV use the same criteria for diagnosis.
A) DSM-5 looks at how much distress or impairment the symptoms cause, while DSM-IV focused on whether the symptoms had a medical explanation.
New DSM-5 clarification may lead to overdiagnosis of the disorder given that only ______ somatic symptom is required to be present to meet the diagnostic criteria.
A) Two
B) Three
C) One
D) Five
C) One
Which of the following statements about the DSM-5 compared to the DSM-IV is accurate?
a. The DSM-5 provides a better prediction of psychological functioning because it focuses on psychological distress related to physical symptoms, whereas the DSM-IV emphasized medically unexplained symptoms.
b. The DSM-5 and DSM-IV provide equivalent predictions of psychological functioning.
c. The DSM-IV provides a better prediction of psychological functioning because it focused on psychological distress rather than medically unexplained symptoms.
d. The DSM-5 does not address psychological distress related to physical symptoms.
a. The DSM-5 provides a better prediction of psychological functioning because it focuses on psychological distress related to physical symptoms, whereas the DSM-IV emphasized medically unexplained symptoms.
Which of the following terms describes the process whereby different facets of an individual’s sense of self, memories, or consciousness become split off from one another?
a. Dissociation
b. Delirium
c. Hallucination
d. Psychosis
a. dissociation
Similar underlaying mechanism =
dissociation (or disconnection) occurring between mental awareness and another part of the normally
integrated mental system.
In the case of somatic symptom disorders (particularly conversion disorder), the part of the mental function that is split off involves the
sensory or motor system, rather than a ‘higher’ mental function such as memory or identity, as in the case of dissociative disorders. It is the same mechanism of dissociation in both situations: one entails mental function (dissociative disorders) and the other physical function (somatic symptom disorders). Some researchers even
refer to both phenomena as a type of dissociation, with one being
‘psychoform (i.e., psychological)
dissociation’ and the other ‘somatoform dissociation’ (e.g., conversion disorder among the somatic
symptom disorders)
Which of the following is an older term for conditions that are now classified as somatic symptom disorder or conversion disorder?
A) Psychosomatic Disorder
B) Hysteria
C) Neurotic Disorder
D) Dissociative Identity Disorder
B) hysteria
(the Greek word hysterikós meaning ‘suffering in the womb’, wondering womb)
The term coined by Sydenham, referring to intense anxiety about having a serious medical condition that one does not actually have, is:
A) Hypochondriasis
B) Conversion Disorder
C) Somatic Symptom Disorder
D) Factitious Disorder
A) Hypochondriasis
Which of the following disorders is characterized by a preoccupation with the fear of acquiring or having a serious medical illness, despite the absence of significant somatic symptoms?
A) Somatic Symptom Disorder
B) Conversion Disorder
C) Illness Anxiety Disorder
D) Factitious Disorder
C) illness anxiety
disorder
Which of the following is an example of illness anxiety disorder?
A) Persistent worry about having a serious illness despite normal tests.
B) Sudden memory loss without medical explanation.
C) Feigning illness to receive attention.
D) Fear of specific objects or situations.
A) Persistent worry about having a serious illness despite normal tests.
Somatic Symptom Disorder diagnostic criteria:
- One or more somatic symptoms that are distressing and disrupting to life
- Excessive thoughts, feelings, or behaviors related to the somatic symptoms or health concerns
- State of being symptomatic is persistent
- May specify:
- With predominant pain
Persistent (severe symptoms and impairment lasting longer than 6 months) - Mild, moderate, or severe—based on somatic symptoms and psychopathology
Which of the following describes the diagnostic criteria for Illness Anxiety Disorder?
A) Preoccupation with having a serious illness, minimal somatic symptoms, high health anxiety, excessive health-related behaviors, and illness preoccupation for at least 6 MONTHS.
B) Persistent distressing somatic symptoms with no health anxiety, focusing on predominant pain and severity levels.
C) Frequent delusions or hallucinations with a focus on physical symptoms and severe impairment.
D) Sudden onset of severe anxiety without health-related behaviors or illness preoccupation.
A) Preoccupation with having a serious illness, minimal somatic symptoms, high health anxiety, excessive health-related behaviors, and illness preoccupation for at least 6 MONTHS.
Which of the following best describes a disorder characterized by one or more symptoms of altered voluntary motor or sensory function that are incompatible with recognized neurological or medical conditions, causing significant distress or impairment?
A) Illness Anxiety Disorder
B) Somatic Symptom Disorder
C) Conversion Disorder (Functional Neurological Symptom Disorder)
D) Factitious Disorder
C) Conversion Disorder
(Functional Neurological Symptom Disorder)
Which of the following is an example of Conversion Disorder?
A) A person who suddenly loses the ability to speak or move a limb without any medical explanation, often following a stressful event.
B) A person who feigns paralysis to gain sympathy and attention.
C) A person who has preoccupation with having a serious illness but has no actual symptoms.
D) A person who fabricates symptoms to receive medical treatment.
A) A person who suddenly loses the ability to speak or move a limb without any medical explanation, often following a stressful event.
Which of the following best describes a disorder characterized by falsification of physical or psychological symptoms, or induction of injury or disease, in oneself or others, where the individual presents themselves or another as ill, impaired, or injured, without any apparent external reward?
A) Factitious Disorder
B) Somatic Symptom Disorder
C) Conversion Disorder
D) Malingering
A) Factitious Disorder
The disorder in which a person has a real medical condition that is negatively affected by psychological or behavioral factors is:
A) Somatic Symptom Disorder
B) Illness Anxiety Disorder
C) Psychological Factors Affecting Medical Condition
D) Conversion Disorder
C) Psychological factors affecting medical
condition
Which of the following is an example of Factitious Disorder?
A) A person who fabricates symptoms of a serious illness to receive medical attention and sympathy.
B) A person who has a real medical condition exacerbated by stress and anxiety.
C) A person who constantly worries about having a serious illness but has no actual symptoms.
D) A person who has frequent physical symptoms with no medical explanation and engages in excessive health-related behaviors.
A) A person who fabricates symptoms of a serious illness to receive medical attention and sympathy.
Which of the following is an example of Psychological Factors Affecting Medical Condition?
A) A person with diabetes who experiences worsening blood sugar levels and frequent complications due to high levels of stress and poor coping strategies.
B) A person who obsessively checks for signs of illness but has no actual medical condition.
C) A person who experiences physical symptoms without any identifiable medical cause.
D) A person who feigns illness to gain attention or special treatment.
A) A person with diabetes who experiences worsening blood sugar levels and frequent complications due to high levels of stress and poor coping strategies.
Which of the following DSM-5 diagnoses is characterized by one or more distressing or debilitating somatic symptoms accompanied by abnormal thoughts, feelings, and/or behaviors related to these symptoms?
A) Illness Anxiety Disorder
B) Conversion Disorder
C) Somatic Symptom Disorder
D) Body Dysmorphic Disorder
C) somatic symptom
disorder
Abnormal reactions to the ______ _______include:
1. disproportionate and persistent thoughts about the seriousness of one’s symptoms
2. persistently high levels of anxiety about one’s health or
symptoms
3. spending excessive time and energy devoted to these symptoms or health concerns (e.g., excessive
healthcare utilisation).
somatic symptom/s
(e.g. pain, gastro
intestinal symptoms (e.g., nausea, bloating, vomiting or food intolerance) and
neurological symptoms (e.g., paralysis, impaired coordination or loss of consciousness).
For a diagnosis of Somatic Symptom Disorder, the somatic symptoms should typically have been present for at least how many months?
A) 3 months
B) 6 months
C) 12 months
D) 18 months
B) 6 months
The somatic symptom is more prevalent in ______ (younger/older) people?
Older
Illness Anxiety Disorder is not classified with the anxiety disorders in DSM-5. In DSM-IV, it was considered a variant of a specific phobia. This means:
A) It is now categorized separately from anxiety disorders in DSM-5.
B) It remains classified as a variant of a specific phobia in DSM-5.
C) It is included under mood disorders in DSM-5.
D) It has been reclassified as a type of somatic symptom disorder in DSM-5.
D) It has been reclassified as a type of somatic symptom disorder in DSM-5.
In individuals with illness anxiety disorder symptoms are always present?
True/False
False
(not always present, individuals may have periods of illness preoccupation with few or no somatic symptoms)
Which of the following are causes or contributing factors for Illness Anxiety Disorder?
A) Disturbances in perception, affect, cognition, and behavior
B) Neurochemical imbalances, genetic predispositions, and environmental stressors
C) Trauma history, family dynamics, and substance abuse
D) Cognitive distortions, psychotic episodes, and relational issues
A) Disturbances in perception, affect, cognition, and behavior
Experience of feeling or emotion.
affect
Which of the following disorders is characterized by a sudden loss of functioning in a part of the body (such as blindness) without an identifiable medical cause?
A) Somatic Symptom Disorder
B) Illness Anxiety Disorder
C) Conversion Disorder (Functional Neurological Symptom Disorder)
D) Factitious Disorder
C) conversion disorder
( functional neurological symptom disorder as its alternative name in DSM-5)
What is the term for an occasional feature of Conversion Disorder where there is an unusual lack of concern about one’s loss of bodily function?
A) Dissociative Amnesia
B) La Belle Indifférence
C) Somatic Indifference
D) Factitious Detachment
B) La Belle Indifférence
(not distinct feature of conversion disorder)
Quite commonly, conversion disorder occurs in people who have, or have had, a ________ (physical/pyshocological) disease.
physical
(e.g. person with epilepsy having non-epileptic seizures, sometimes called ‘pseudo-seizures’. . Caution, of course, has to be maintained in making a diagnosis of conversion disorder, as it is
possible that a physical disease that accounts for the symptoms will later reveal itself)
Conversion disorder is acute and tends to resolve over time with no treatment. True/False
False
(readmission and chronicity are high)
What term describes the phenomenon where multiple people report similar symptoms, such as breathing difficulties, due to a shared belief in a non-existent threat, like a ‘chemical terrorist attack (e.g. 2005 Melbourne airport)’?
A) Somatic Symptom Disorder
B) Mass Psychogenic Illness (Masss hysteria)
C) Conversion Disorder
D) Illness Anxiety Disorder
B) Mass Psychogenic Illness (Masss hysteria)
Disorders characterised
by deliberately faking physical or mental illness in order to gain
medical attention.
factitious disorders
(involves fake accounts of both physical and mental illnesses)
What is a main criticism of including Factitious Disorder within the category of somatic symptom disorders?
A) It leads to more effective treatments for all somatic disorders
B) It may cause doctors to take somatic symptoms less seriously
C) It results in clearer diagnostic criteria for somatic symptom disorders
D) It enhances the understanding of organic medical conditions
B) It may cause doctors to take somatic symptoms less seriously
In Factitious Disorder, feigning symptoms is done deliberately and consciously, but what is NOT a motivation for this behavior?
A) Receiving compensation payments
B) Gaining attention or sympathy
C) Achieving psychological or emotional benefits
D) Assuming the sick role
A) Receiving compensation payments
The psychological profile for factitious disorder is believed to be of a disturbed, dependent or needy personality that seeks the security and comfort of medical care. True/False
True
Which variant of Factitious Disorder involves faking symptoms in another person, typically a child, to gain attention or sympathy?
A) Factitious Disorder Imposed on Self
B) Factitious Disorder Imposed on Another
C) Somatic Symptom Disorder
D) Conversion Disorder
B) Factitious Disorder Imposed on Another
(or ‘Munchausen’s by proxy’)
(form of child abuse, difficult to diagnose so video surveillance is used)
Which of the following behaviors is most commonly associated with Conversion Disorder according to one study?
A) Falsely reported disease/injury
B) Simulated disease/injury
C) Induced actual disease or injury
D) None of the above
C) Induced actual disease or injury
(59%).
Conversion disorder is difficult to study but one study shows it may be prevalent in females (two-thirds were female), and a large number had experience in health care (most common is nursing).
What term describes the act of feigning a symptom or disorder to gain a favorable situation, like financial compensation, or to avoid an unwanted situation, like military service?
A) Factitious Disorder
B) Conversion Disorder
C) Malingering
D) Somatic Symptom Disorder
C) malingering
(e.g. a worker who pretends to have a severe back injury to avoid going to work and to claim disability benefits or someone avoiding military service)
Factitious disorder is ______ (same/different) to malingering?
different
(malingering involves a reward and is not a disorder but deception more likely associated with ASPD)
Somatic symptoms in general are common and are the most frequent reason why people see doctors, one study showed:
- ______ reported at least one symptom leading to at least mild
impairment, and
- ______ reported at least one symptom leading to severe impairment.
81.6%
22.1%
It is estimated that close to ____% cent of
symptoms presented by patients to general practitioners remain unexplained from a medical perspective yet
persist over time.
30
(the most common
symptoms:
- 33% menstrual issues
- 30% headache
- 27% chest pain
- 19% fatigue
In Australia, ______% of population will have a diagnosis of illness anxiety at some point in their lifetime
6
Prevalence of somatic symptom is _______ (lower/higher) for females, while illness anxiety disorder is same for males and females.
higher
The number of unexplained symptoms decreases/increases in those with negative emotion (anxiety/depression).
Increases
(12% depression and 7% anxiety in individuals experiencing 2-3 unexplained somatic symptoms, and 44% depression and 30% anxiety for individuals experiencing 6-8 unexplained somatic symptoms.
Which of the following best describes a biological model (still not well understood) for the development of somatic symptoms?
A) Overactivity in the HPA axis, leading to heightened stress response
B) Underactivity in the HPA axis, interacting with environmental factors like physical activity
C) High levels of dopamine leading to excessive anxiety
D) Excessive production of endorphins that diminish pain perception
B) Underactivity in the HPA axis, interacting with environmental factors like physical activity
(This model suggests that reduced functioning of the HPA axis may impair the body’s ability to regulate stress responses, potentially leading to somatic symptoms)
In the context of somatic symptom disorders, what do “body maps” typically refer to?
A) The anatomical layout of the human body used in medical education
B) The mental representation and perception of bodily sensations and symptoms
C) The graphical representation of symptom frequencies across different body parts
D) The physical location of pain or discomfort in a medical diagnosis
B) The mental representation and perception of bodily sensations and symptoms
Which of the following best describes the concept of gate control theory?
A) Pain perception is solely determined by the intensity of the pain stimulus.
B) A “gate” in the spinal cord regulates the transmission of pain signals to the brain.
C) Pain is experienced only when there is physical damage to tissues.
D) Pain perception is independent of psychological factors.
B) A “gate” in the spinal cord regulates the transmission of pain signals to the brain.
(Gate control theory, proposed by Ronald Melzack and Patrick Wall, suggests that pain perception is controlled by a “gate” in the spinal cord. This gate can be influenced by various factors, including sensory input and emotional state. When the gate is open, pain signals are transmitted to the brain; when it’s closed, pain is lessened. The theory emphasizes the role of both physical and psychological factors in pain perception)
Regarding trauma, how is early trauma often represented in individuals, according to the model of somatic symptom disorders?
A) As clear and factual declarative memories
B) As emotions, actions, or body sensations rather than conscious thoughts
C) As detailed visual and auditory memories
D) As specific, documented medical conditions
B) As emotions, actions, or body sensations
How might adverse childhood events contribute to the development of somatic symptom disorder through personality characteristics?
A) By enhancing cognitive resilience and emotional expression
B) By increasing risk for personality traits that affect affect regulation and attachment
C) By promoting healthy emotional connections and social support
D) By improving the capacity to manage and express physical symptoms
B) By increasing risk for personality traits that affect affect regulation and attachment
What is a key characteristic of individuals with high neuroticism in relation to somatic symptom disorder?
A) They tend to experience positive affect and emotional stability
B) They tend to experience frequent negative affect
C) They have a high level of emotional intelligence and resilience
D) They exhibit consistent and stable mood regulation
B) They tend to experience frequent negative affect
How does alexithymia, or a diminished capacity to consciously express or describe emotions, relate to somatic symptom disorder?
A) It leads to an increased ability to link body sensations with emotions
B) It minimizes the expression of emotions and may cause misinterpretation of body sensations as signs of physical illness
C) It enhances the understanding and expression of emotional states
D) It improves the ability to communicate distress effectively
B) It minimizes the expression of emotions and may cause misinterpretation of body sensations as signs of physical illness
Family, social/cultural
1. Family
- Illness beh as learnt?
- Parent modelling
- Reinforcement of illness beh (learnt strategy for having needs met?)
- Secondary gain – attention, financial
2. Health system
- Inadvertently encourage phys symptoms
- Prevents integration of med and psych treatment
- Stigma of MH – it’s better to have a phys illness
3. Sociocultural
- Depends on culture
- Culture bound syndrome: only occurs in certain cultures
Compared with healthy controls, patients with somatic symptom disorders typically show what kind of performance in the Stroop test?
A) Faster performance, indicating a reduced focus on bodily sensations
B) Slower performance, suggesting a tendency to focus attention on bodily sensations
C) No significant difference in performance
D) Improved performance, reflecting better cognitive control
B) Slower performance, suggesting a tendency to focus attention on bodily sensations
What term describes the explanation a person forms about why an event occurred?
A) Diagnosis
B) Attribution
C) Attributional Style
D) Schema
B) attribution
Syndrome that occurs only in certain cultures
Culture-bound syndrome
Which of the following treatments for somatic symptom disorder aims to reduce physical symptoms, alleviate anxiety and depression, and improve daily functioning?
A) Grief Therapy
B) Group Therapy
C) Mindfulness
D) Cognitive Behavioral Therapy (CBT)
E) SSRIs
D) Cognitive Behavioral Therapy (CBT)
Which treatment for somatic symptom disorder focuses on the acceptance of what has happened and adjustment to altered circumstances, such as managing chronic pain?
A) Cognitive Behavioral Therapy (CBT)
B) Grief Therapy
C) Group Therapy
D) Mindfulness
E) SSRIs
B) Grief Therapy
Which treatment for somatic symptom disorder involves practicing nonjudgmental acceptance of physical pain or psychological distress to reduce rumination and catastrophizing?
A) Cognitive Behavioral Therapy (CBT)
B) Grief Therapy
C) Group Therapy
D) Mindfulness
E) SSRIs
D) Mindfulness
Which of the following treatments for somatic symptom disorder is effective in reducing hypochondriasis?
A) Cognitive Behavioral Therapy (CBT)
B) Grief Therapy
C) Group Therapy
D) Mindfulness
E) SSRIs
E) SSRIs
Treatment for somatic symptom disorder involve:
1. CBT (aims not to cure but to reduce physical symptoms, to reduce anxiety and depression and to increase daily functioning)
2. Grief therapy (acceptance of what has happened to them and adjustment to altered circumstances (e.g., managing chronic pain).
3. Group therapy (conducted with a group of individuals rather
than one-on-one)
4. Mindfulness (nonjudgmental acceptance of physical pain or psychological distress, reducing
the tendency to ruminate over and catastrophise these experiences)
5. SSRIs (effective in reducing hypochondriasis)
Pathological dissociation involves one of the five primary experiences:
Amnesia
Depersonalisation
Derealisation
Identity confusion
Identity alteration
What term describes the impairment in the ability to learn new information or to recall previously learned information or past events?
Amnesia
What term describes a change in an individual’s sense of their physical self, where the body feels unreal or unfamiliar?
A) Derealization
B) Depersonalization
C) Dissociative Amnesia
D) Dissociative Identity Disorder
B) depersonalisation
What term describes a change in an individual’s sense of the world, where the surroundings feel unfamiliar or distorted?
A) Depersonalization
B) Derealization
C) Dissociative Amnesia
D) Dissociative Identity Disorder
B) derealisation