Week 6 - Somatic symptoms and dissociative disorders Flashcards by Valentina Knezevic

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

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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

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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

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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.

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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

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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.

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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

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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)

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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)

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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

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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

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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.

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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

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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.

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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)

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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.

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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

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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

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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.

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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.

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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

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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).

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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

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The somatic symptom is more prevalent in ______ (younger/older) people?

Older

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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

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

What term describes feelings of uncertainty, puzzlement, or conflict regarding one’s identity? A) Depersonalization B) Derealization C) Identity Confusion D) Dissociative Amnesia

C) identity confusion

What term describes the experience of exhibiting behaviors or characteristics that reflect the presence of different identities or personality states? A) Dissociative Fugue B) Dissociative Amnesia C) Identity Alteration D) Depersonalization

C) Identity Alteration

What term describes the dissociative experience where a person undergoes a sudden, unexpected journey away from home, assumes a new identity, and has amnesia for their previous identity? A) Dissociative Amnesia B) Dissociative Identity Disorder (DID) C) Dissociative Fugue D) Depersonalization

C) Dissociative Fugue (The person may appear to function quite normally during the fugue state, except that gaps in memory may be noticed. Upon returning home from the journey, there may be no memory of the events that occurred during the fugue state)

Which dissociative disorder is characterized by repeated episodes of depersonalization and/or derealization? A) Dissociative Amnesia B) Dissociative Identity Disorder (DID) C) Depersonalization/Derealization Disorder D) Dissociative Fugue

C) depersonalisation/derealisation disorder (The diagnosis requires that these experiences are persistent or recurrent and causing significant distress and/or impairment in functioning, distress may be profound, with the person feeling as if s/he is the ‘walking dead)

Which dissociative disorder involves a loss of memory for important personal information, often related to stressful or traumatic events? A) Dissociative Identity Disorder (DID) B) Depersonalization/Derealization Disorder C) Dissociative Amnesia D) Dissociative Fugue

C) dissociative amnesia (consciousness may not appear affected at the time of the event, but afterwards there is complete or partial amnesia for the event)

Which dissociative disorder involves the development of more than one distinct identity or personality state, previously known as multiple personality disorder? A) Dissociative Amnesia B) Depersonalization/Derealization Disorder C) Dissociative Identity Disorder (DID) D) Dissociative Fugue

C) dissociative identity disorder (DID) (diagnosed by structured interview =questions that are standardised, written in advance and asked of every client).

According to the DSM-5, episodes of dissociative amnesia can be characterized as which of the following? A) Localized, Selective, Generalized, Systematized, Continuous B) Acute, Chronic, Episodic, Progressive C) Reactive, Permanent, Intermittent, Residual D) Transient, Persistent, Relapsing, Stable

A) Localized, Selective, Generalized, Systematized, Continuous

What type of dissociative amnesia involves forgetting events that occurred during a specific period while retaining memory of events before and after that period? A) Selective Amnesia B) Generalized Amnesia C) Systematized Amnesia D) Localized Amnesia

D) Localised amnesia

What type of dissociative amnesia involves recalling some but not all features of a specific event or circumstance? A) Localized Amnesia B) Generalized Amnesia C) Systematized Amnesia D) Selective Amnesia

D) selective dissociative amnesia

What type of dissociative amnesia involves the loss of all or most personal information, including one's name, personal history, and the identity of friends and family? A) Localized Amnesia B) Selective Amnesia C) Systematized Amnesia D) Generalized Amnesia

D) Generalised amnesia

What type of dissociative amnesia involves the inability to recall events that occurred after a specific point in time? A) Localized Amnesia B) Selective Amnesia C) Generalized Amnesia D) Continuous Amnesia

D) Continuous amnesia

What type of dissociative amnesia involves the inability to remember certain categories of experiences, such as memories related to a specific person or event? A) Localized Amnesia B) Selective Amnesia C) Generalized Amnesia D) Systematized Amnesia

D) Systematised amnesia (e.g. forgeting the details of car accident but remembering details of before and after, or no recollection of one relative (memories, events, interactions))

Brief episodes of depersonalisation/derealisation are common in general population, ___-___%, while disorder is found in ___-____%, and higher in adolescence (12-18yrs old), 12%.

26 - 74 0.8 - 2.4

Severity of dissociative amnesia is associated with severity of trauma. True/False

True (35% of those exposed to severe stress exhibited significant amnesia)

Prevalence of dissociative amnesia in general population is ___-___%

0.2 - 7.3 (much higher among individuals who have experienced trauma, approx 30% of individuals who report histories of child abuse also report periods of amnesia for it)

The Three Faces of Eve (1957), what was the claim made to Eve about her condition? A) She was the only person with Dissociative Amnesia in the world. B) She was the only person with Dissociative Fugue in the world. C) She was the only person with Dissociative Identity Disorder (DID) in the world. D) She was the only person with Depersonalization Disorder in the world.

C) She was the only person with Dissociative Identity Disorder (DID) in the world.

The prevalence of dissociative identity disorder in general population is 1.1–1.5% with estimates in clinical samples ranging from 0.4–6.0% and is similar to ____________.

schizophrenia

Which of the following biological mechanisms is associated with dissociative amnesia? A) Increased activity in the amygdala and decreased activity in the pre-frontal cortex B) Decreased activity in the amygdala and increased activity in the hippocampus C) Increased activity in the pre-frontal cortex and decreased activity in the hippocampus D) Decreased activity in the hippocampus and increased activity in the amygdala

C) Increased activity in the pre-frontal cortex and decreased activity in the hippocampus (hippocampus partially shuts down so spatiotemporal context of a memory is not attached to the emotional component (controlled more by the amygdala)

What term describes memory loss for events that occurred during hypnosis or for information designated by the hypnotist, occurring after the hypnotic state? A) Dissociative Amnesia B) Retrograde Amnesia C) Posthypnotic Amnesia D) Anterograde Amnesia

C) Post-hypnotic amnesia

Which of the following psychological explanations accounts for memory issues related to hypnosis, including memory loss for events that occurred during hypnosis and the impact of the hypnotic state on recall? A) State-Dependent Memory and Posthypnotic Amnesia B) Retroactive Interference and Dissociative Amnesia C) Anterograde Amnesia and Source Amnesia D) Repressed Memory and False Memory

A) State-Dependent Memory and Posthypnotic Amnesia

What is the dominant etiological theory for Dissociative Identity Disorder (DID)? A) Genetic predisposition and neurochemical imbalances B) Chronic physical illness and neurodegenerative disorders C) Severe trauma experienced during childhood D) Personality disorders and cognitive distortions

C) Severe trauma experienced during childhood (it is viewed as a form of childhood-onset PTSD but also as a variant of a developmental disorder)

What term describes the improvement in memory recall when the individual is in a psychological situation or state similar to the one in which the information was learned? A) Context-Dependent Memory B) State-Dependent Memory C) Retroactive Interference D) Proactive Interference

B) state-dependent memory (information is more easily recalled if the individual is in the same psychological or physiological state as when the memory was encoded, e.g. if someone learns information while feeling anxious, they are more likely to remember it later if they are in a similar anxious state. This principle extends to various states, including mood, emotional state, or even substance use)

Dissociative Identity Disorder (DID) is highly comorbid with which of the following conditions? A) Schizophrenia, Obsessive-Compulsive Disorder (OCD), and Attention-Deficit/Hyperactivity Disorder (ADHD) B) Post-Traumatic Stress Disorder (PTSD), Depression, Substance Abuse, Borderline Personality Disorder (BPD), and Phobias C) Bipolar Disorder, Eating Disorders, and Social Anxiety Disorder D) Autism Spectrum Disorder, Generalized Anxiety Disorder, and Somatic Symptom Disorder

B) Post-Traumatic Stress Disorder (PTSD), Depression, Substance Abuse, Borderline Personality Disorder (BPD), and Phobias (prevalence as high as 98% in those with trauma experience)

Trauma is the only causing factor of dissociative identity disorder. True/False

False Kluft's additional factors: - capacity to dissociate (such as the ability to be hypnotised and enter trance-like states) - ability to cope using any mechanism other than dissociation - elaboration of the alternate identities of dissociative identity disorder with individualised characteristics such as names, ages and genders. - lack of soothing experiences after overwhelming events that leave the child to find ways of comforting him/herself that may include dissociating from the painful experience

What term describes the process by which an adverse effect is caused by treatment? A) Pathogenesis B) Iatrogenesis C) Etiology D) Nosogenesis

B) iatrogenesis (this theory lacks support) (according to this conceptualisation, therapists suggest the concept of dissociative identity disorder to their patients, teach them how to behave as a person with the condition, and reinforce the disordered behaviour with attention)

Which of the following treatments are used for managing dissociative amnesia? A) Imaginal Exposure, Barbiturate Derivatives or Benzodiazepines, Hypnosis B) Cognitive Behavioral Therapy (CBT), Antidepressants, Electroconvulsive Therapy (ECT) C) Exposure Therapy, Antipsychotics, Mindfulness-Based Stress Reduction D) Dialectical Behavior Therapy (DBT), Stimulants, Biofeedback

A) Imaginal Exposure, Barbiturate Derivatives or Benzodiazepines, Hypnosis

Which of the following are treatment options for Depersonalization/Derealization Disorder (DPDR)? A) Reassurance, SSRIs, Naltrexone, Lamotrigine, Repetitive Transcranial Magnetic Stimulation (rTMS), CBT B) Electroconvulsive Therapy (ECT), Antipsychotics, Stimulants, Art Therapy C) Dialectical Behavior Therapy (DBT), Mindfulness-Based Stress Reduction, Antihistamines, Cognitive Enhancement Therapy D) Psychoanalysis, Acupuncture, Benzodiazepines, Light Therapy

A) Reassurance, SSRIs, Naltrexone, Lamotrigine, Repetitive Transcranial Magnetic Stimulation (rTMS), CBT - Reassurance; alleviate guilt; provide hope; reassure prospective parents. - Meds: SSRIs such as fluoxetine, naltrexone, anti epilepsy drug lamotrigine, - repetitive transcranial magnetic stimulation (rTMS) - CBT (more research needed for all treatment options)

Which of the following best describes the recommended three-phase approach for treating Dissociative Identity Disorder (DID)? A) Establish safety, confront and work through traumatic memories, and integration and rehabilitation B) Cognitive Behavioral Therapy (CBT), pharmacotherapy, and family therapy C) Psychoanalysis, mindfulness-based stress reduction, and exposure therapy D) Electroconvulsive Therapy (ECT), hypnosis, and support groups

A) Establish safety, confront and work through traumatic memories, and integration and rehabilitation 1. establish safety, stabilise and reduce symptoms) 2. confronting and working through traumatic memories 3. integration and rehabilitation (limitations due to lack of control group)

Which of the following tools is used to assess dissociative symptoms and diagnose dissociative disorders? A) Dissociative Experiences Scale (DES) and Structured Interviews B) Beck Depression Inventory (BDI) and Hamilton Anxiety Rating Scale (HAM-A) C) Mini International Neuropsychiatric Interview (MINI) and State-Trait Anxiety Inventory (STAI) D) Wechsler Adult Intelligence Scale (WAIS) and Minnesota Multiphasic Personality Inventory (MMPI)

A) Dissociative Experiences Scale (DES) and Structured Interviews

Dissociation refers to _________ between the experiencing and observing self.

separation/splitting

___________ terms were previously used to describe what we now refer to as somatic disorders.

Anatomical

Due to frequent uncertainty in the existence or otherwise of a medical basis for symptoms, the term __________has been replaced by somatic within the DSM-5.

somatoform

Clinicians who diagnose somatic disorders need to recognise the _________ of current medical technologies.

limitations

A diagnosis of somatic symptom disorder often includes which of the following specifiers? Multiple select question. severity persistence pain neuralgia

severity persistence pain

The primary way in which a psychosomatic disorder differs from a somatic disorder is: psychosomatic disorders involve a medically diagnosable condition, whereas somatic disorders do not dissociation occurs only within somatic disorders dissociation occurs only within psychosomatic disorders somatic disorders involve a medically diagnosable condition, whereas psychosomatic disorders do not

psychosomatic disorders involve a medically diagnosable condition, whereas somatic disorders do not

Somatic symptom disorder is one of the __________ (least/most) researched disorders within the somatic symptom and related disorders category.

least

One of the first psychological treatments for somatic disorders was _______, along with talking therapy.

hypnosis

Initially, what we now refer to as somatic disorders, were thought to affect only _____ (women/men).

women

Historically, somatic disorders have been referred to as: Multiple select question. hallucinations haloperidol hysteria hypochondriasis

hysteria hypochondriasis

Conversion disorder typically involves: excessive pain loss of function limited healthcare utilisation symptoms lasting more than 7 months

loss of function

Factors that help to differentiate medical from psychological symptoms include the: Multiple select question. nature of symptoms degree of worry about the symptoms level of help seeking from professionals intensity of symptoms

degree of worry about the symptoms level of help seeking from professionals

Early psychological approaches to somatic disorders primarily reflected the ____________ perspective.

psychodynamic

Ria kicked her toe last weekend. She thought it was broken, and so went to the doctor. It wasn't broken, and is no longer painful. However, Ria worries that the initial pain may have been from a malignant tumour bursting, and has sought multiple medical appointments to investigate this. Ria's behaviour is most consistent with: somatic symptom disorder illness anxiety disorder hypochondriasis conversion disorder

illness anxiety disorder (Hypochondriasis occurs in the presence of clear somatic symptoms—Ria is no longer experiencing pain)

Freud argued that somatic disorders originated from ______ trauma or fantasies.

sexual

One major difference between somatic symptom disorder and illness anxiety disorder is the _________ of somatic symptoms.

prominence/intensity

Arthur reports numbness, alternating with pain, between his elbow and wrist. His hand, fingers and upper arm are unaffected. The nature of his symptoms suggest that Arthur is experiencing: illness anxiety disorder somatic symptom disorder conversion disorder a neurological disorder

conversion disorder

Factitious disorder can be differentiated from malingering as factitious disorder: has a longer duration has no medical cause has no external incentive is intentional

has no external incentive

Unlike other somatoform and associated disorders, ________ disorder can focus on non-existent symptoms in others.

factitious

least to most prevalent:

factitious illness anxiety disorder conversion disorder somatic symptom dis

Continued preoccupation with having, or developing, a serious illness in the absence of marked somatic symptoms is diagnostic of _______ ________ disorder.

illness anxiety

HPA activity can be inferred from ________ levels.

cortisol

Damasio and Kozlowska argue that somatic symptom and related disorders likely emerge from inaccurate, temporary or otherwise false _____ ______.

body maps

Some researchers have argued that difficulties in identifying emotions stem from __________ of distress during childhood.

invalidation

Functional neurological symptom disorder is another name for _______ disorder.

conversion

Researchers have found that individuals with posttraumatic stress disorder have _______ (lower/higher) levels of somatic symptoms than those without the disorder.

higher

The hypothalamic-pituitary-adrenal axis is commonly referred to as the: fight or flight system homeostatic mechanism hormonal stress response system mind–body interaction mechanism

hormonal stress response system (This axis involves a complex set of interactions between the hypothalamus, pituitary gland, and adrenal glands, regulating the release of stress hormones like cortisol. It plays a crucial role in the body’s response to stress, helping to manage and adapt to stressful situations)

The _________of somatic symptoms with both anxiety and depression discredits theories stating that somatic symptom disorders involve conversion of psychological into physiological distress.

comorbidity

The gate control theory explains the experience of ________ in the absence of external sensory input. physiological symptoms illness anxiety pain somatic symptoms

pain

According to cognitive-behavioural models of somatoform and related disorders, seeking medical attention can exacerbate symptoms by: increasing attributions of ill-health increasing perceptions of ill-health increasing illness anxiety increasing attention to physical symptoms

increasing illness anxiety

According to researchers, who of the following is most likely to demonstrate somatic symptom and related disorders? Richard, who recently fell while rock-climbing and broke his ankle Kelly, who was involved in a serious car accident as an infant Celia, who has a history of anxiety Eivan, who is in remission from bone cancer

Kelly, who was involved in a serious car accident as an infant

Alexithymia refers to the: reduced capacity to experience pleasure or positive affect reduced capacity to consciously experience or describe emotions reduced capacity to identify the emotions of others reduced capacity of the thyroid regulate metabolism

reduced capacity to consciously experience or describe emotions

The prevalence of healthcare resources and incidences of somatic symptom disorder are: positively correlated curvilinearly correlated negatively correlated uncorrelated

positively correlated

According to cognitive-behavioural models of somatic symptom and related disorders, individuals with such conditions experience ________ __________, whereby somatic sensations are increasingly intense and distressing.

somatosensory amplification

highest to lowest levels of alexithymia:

no identifiable disorder psychosis medical illness somatic symptom dis

From a sociocultural perspective, factors that may contribute to the development of somatoform disorders in Western societies include: Multiple select question. dominance of medical models of health ready access to health services dominance of biopsychosocial models of health ready access to healthcare rebates

dominance of medical models of health ready access to health services

When multiple health professionals are involved in treating an individual with somatic or related disorders, a consistent and _________ approach is vital.

coordinated

According to cognitive-behavioural models of somatic symptom and related disorders, what is the order of processes that occur to result in these conditions? illness behaviour, attribution, anxiety, perception perception, attribution, anxiety, illness behaviour anxiety, attribution, illness behaviour, perception anxiety, perception, attribution, illness behaviour

perception, attribution, anxiety, illness behaviour

__________ - based cognitive therapy may be helpful in reducing health anxiety.

Mindfulness

Researchers have demonstrated that family factors associated with the development of somatic symptom and related disorders include: Multiple select question. having a sick sibling increased attention from mothers when ill secondary gain parental modelling

increased attention from mothers when ill secondary gain parental modelling

When faced with a case of suspected acute somatisation, general practitioners should: Multiple select question. take a comprehensive health history explain the mind–body connection introduce the possibility of the role of psychological factors explain how the described symptoms are not due to physical or medical reasons

take a comprehensive health history explain the mind–body connection introduce the possibility of the role of psychological factors

People with chronic somatisation are ________ (willing/resistant) to have a referral to psychologist.

resistant

According to cognitive-behavioural models, the endpoint of the somatisation process is the: illness behaviour repetition of the cycle reinforcement of beliefs attention from others

illness behaviour

Which of the following is NOT one of the core overarching principles of treating somatic and related disorders? addressing reinforcers of the behaviours having only medical professionals involved in treatment proving the psychological basis of symptoms treating comorbidities

proving the psychological basis of symptoms (Reason: Treatment should recognise the full reality of the symptoms regardless of causation)

Acute forms of somatisation are generally characterised by: more intense symptoms weaker illness conviction stronger illness conviction less intense symptoms

weaker illness conviction (In acute somatisation, the focus is typically on the immediate and intense symptoms rather than a strong, long-term belief in illness. Chronic somatisation, on the other hand, often involves a stronger and more persistent illness conviction)

Selective serotonin reuptake inhibitors have been shown to be effective in the management of which of the following disorders? somatic symptom disorder conversion disorder illness anxiety disorder factitious disorder

illness anxiety disorder

Rapport between psychologists and clients who experience somatising is best enhanced through: developing shared treatment goals accepting the role of biology in the person's condition developing a shared understanding of the problem origin having the psychologist liaise with other treating professionals

developing a shared understanding of the problem origin (having the psychologist liaise with other treating professionals may actually decrease rapport through a sense of the patient 'being ganged up on')

The primary differences between normal and pathological dissociation relate to: Multiple select question. duration awareness intensity frequency

duration awareness intensity

Magnus has a very high-pressure job. Recently, he went through a period of 24 hours in which it felt as though he had no control over his actions. Magnus would most likely be diagnosed with: dissociative disorder acute stress depersonalisation disorder derealisation disorder

acute stress (Depersonalisation disorder requires persistent or recurrent episodes occur)

Biological explanations for dissociative amnesia emphasise the role of the: amygdala and hippocampus amygdala and pre-frontal cortex hippocampus and cingulate gyrus pre-frontal cortex and temporal lobe

amygdala and hippocampus The amygdala and hippocampus are crucial for memory and emotional processing. The hippocampus is key for forming and retrieving memories, while the amygdala helps regulate emotions tied to those memories. Disruptions or malfunctions in these areas can lead to difficulties in recalling personal information, contributing to dissociative amnesia.

Unlike many other conditions, _________ symptoms and disorders are not assessed in the majority of psychological screening tools.

dissociative

________ refers to a separation between the observing and experiencing self.

Depersonalisation

The psychological treatment approach with the most research evidence for somatisation is: reattribution training reattribution cognitive behaviour therapy cognitive therapy

cognitive behaviour therapy (reattribution is a strategy, not a treatment approach)

Identifying effective interventions for dissociative disorders is impeded by the: Multiple select question. methodological limitations of existing research cultural variations in presentation low prevalence rates of dissociative disorders limited research interest

methodological limitations of existing research low prevalence rates of dissociative disorders

The forgetting of a personally significant traumatic event is a hallmark of _______ _______.

dissociative amnesia

Dissociation is: a very rare experience underreported a relatively common experience readily identifiable

a relatively common experience (dissociation disorder is not common)

The most effective treatment for dissociative disorders, other than dissociative identity disorder, is: psychological therapy a combination of pharmacotherapy and psychological therapy pharmacotherapy unknown

unknown (Pharmacotherapy has been shown to be somewhat effective for some people with specific dissociative disorders, but not universally)

The International Society for the Study of Trauma and Dissociation recommends a three-phase approach to treating dissociative identity disorder. Which of the following is the first phase of such treatment? integration of identities confronting and integrating traumatic memories stabilisation and symptom reduction recognition of trauma

stabilisation and symptom reduction

Iatrogenic theories of dissociative identity disorder emphasise the role of _______ in the development of the disorder.

suggestion

Forgetting where you left your car keys is an example of: amnesia dissociation derealisation forgetting

forgetting

The more physical symptoms an individual experiences, the more likely it is that: a. s/he will be depressed. b. s/he will be anxious. c. s/he will be both depressed and anxious. d. s/he will be neither depressed nor anxious. e. s/he will have psychosomatic complaints.

c. s/he will be both depressed and anxious.

The posttraumatic model of dissociative identity disorder argues that most individuals with this disorder show the following except: a. a reported history of childhood trauma and abuse. b. posttraumatic stress disorder. c. high trait anxiety. d. None of the given options is correct. e. All of the given options are correct.

c. high trait anxiety. (While individuals with DID may experience anxiety, high trait anxiety is not specifically highlighted as a defining feature of the posttraumatic model. The model focuses more on the history of trauma and the resultant dissociation)

Pathological dissociation may involve all of the following except: a. depersonalisation. b. derealisation. c. amnesia. d. identity confusion. e. excessive daydreaming.

e. excessive daydreaming.

Munchausen’s by proxy refers to: a. a factitious disorder. b. a disorder whereby an individual, usually a parent, induces illness in a child. c. a type of child abuse. d. All of the given options are correct. e. None of the given options is correct.

d. All of the given options are correct.

Treatments for chronic somatic symptoms and related disorders include all of the following except: a. relaxation. b. exploring unconscious thoughts. c. graded exposure. d. distraction. e. challenging unhelpful thinking.

b. exploring unconscious thoughts.

There has been one addition in the DSM-5 to the criteria used in diagnosing dissociative identity disorder. What is it? a. Imaginary playmates are included. b. Religious beliefs are included. c. Pathological possession is included. d. Pathological daydreaming is included. e. Pathological fantasising is included.

c. Pathological possession is included. Pathological possession refers to instances where individuals feel controlled or overtaken by an external force or entity, which is a specific symptom included in the DSM-5 for diagnosing dissociative identity disorder.

People with somatic disorders have been found to have higher levels of: a. alexithymia. b. anhedonia. c. anxiety sensitivity. d. None of the given options is correct. e. All of the given options are correct.

c. anxiety sensitivity.

Cognitive-behavioural models of the somatisation process centre on: a. the hormonal stress-response system. b. the cycle of increasing somatosensory amplification. c. direct representations of traumatic events through bodily memory. d. personality characteristics that predispose the person to developing somatoform disorders. e. the interaction between interpersonal stressors and pain.

b. the cycle of increasing somatosensory amplification.

According to the iatrogenic theory, dissociative identity disorder is the product of: a. emotional abuse in childhood. b. physical abuse in childhood. c. lack of social contact. d. therapy or the popular media. e. None of the given options is correct.

d. therapy or the popular media.

According to Freud’s psychoanalytic theory, a man who develops paralysis in his arm after seeing his wife flirting with another man, would be displaying signs of: a. suppression of an unacceptable aggressive impulse. b. hysteria. c. dissociative fantasising. d. dissociative disorder. e. unacceptable sexual fantasies.

a. suppression of an unacceptable aggressive impulse.

The International Society for the Study of Trauma and Dissociation guidelines for the treatment of dissociative identity disorder emphasise all of the following treatment components except: a. hypnosis. b. confronting traumatic memories. c. establishment of a safe environment. d. integration. e. rehabilitation.

a. hypnosis.

Illness anxiety disorder is defined by the DSM-5 as: a. a fear of having (or belief that one has) a serious medical illness, for which clinical evidence is lacking. b. a motor or sensory neurological disturbance, with a sudden onset after an episode of psychological stress. c. a history of at least eight physical symptoms in at least four specified organ systems, not better explained by other physical or mental disorder(s). d. the deliberate feigning of illness, with symptoms either inaccurately reported or self-induced. e. fear of experiencing unexpected panic attacks.

a. a fear of having (or belief that one has) a serious medical illness, for which clinical evidence is lacking.

Most individuals with dissociative identity disorders also meet criteria for: a. schizophrenia. b. bipolar disorder. c. posttraumatic stress disorder (PTSD). d. All of the given options are correct. e. None of the given options is correct.

c. posttraumatic stress disorder (PTSD).

Explanations of the apparently increasing prevalence of dissociative disorders include which of the following? a. Many apparently new cases are incorrectly diagnosed. b. More cases are being detected by new and valid assessment tools. c. It is a culture-bound syndrome in North America, where most prevalence studies are conducted. d. All of the given options are correct. e. None of the given options is correct.

d. All of the given options are correct.

The most common precipitants of depersonalisation include all of the following except: a. amnesia. b. anxiety. c. substance abuse. d. stress. e. depression.

a. amnesia.