week 9 Flashcards
Describe how somatoform disorders differ from physical conditions.
Contains no evidence of physical pathology
Disproportionate and persistent thoughts about the seriousness of one’s symptoms
Persistently high level of anxiety about health or symptoms
Excessive time and energy devoted to these symptoms or health concerns
What was hypochondriasis (DSM-IV)
75% of people with hypochondriasis will meet criteria for somatic symptom disorder
Preoccupation with fears of getting a serious disease or the idea that they already have one
Anxious preoccupation with having a disease based on a misinterpretation of bodily signs or symptoms
How is hypochondriasis treated?
Cognitive-behavioral therapy
SSRI
What was somatization disorder
Different complaints of physical aliments in four symptom categories several years
Four pain symptoms
Two gastrointestinal symptoms
One sexual symptom
One pseudoneurological symptom
Beginning before age 30
Not adequately explained by independent findings of physical illness or injury
Leading to medical treatment or to significant life impairment
What is important to do in treating somatization disorder?
Identification of one physician who integrates patient care and reduces medications and unnecessary testing
Medical management more effective if combined with cognitive-behavioral therapy focused on promoting appropriate behavior such as better coping and personal adjustment, and discouraging inappropriate behavior and preoccupation with physical symptoms
Reducing secondary gain is critical
What is pain disorder?
Experience of persistent and severe pain in one or more areas of body
Not intentionally produced or feigned
Has the pain symptoms in somatization but not the others
Although a medical condition can contribute to the pain, psychological condition must be judged to play an important role in the onset, severity, exacerbation or maintenance of the pain
Pain severe enough to cause life disruption
What is illness anxiety disorder?
Experience high anxiety about having or developing a serious illness
Preoccupation with having or acquiring a serious illness
Somatic symptoms are not present or are mild in intensity. If a medical condition is present, then the preoccupation is excessive
There is a high level of anxiety about health
Excessive health related behaviors (e.g. checking body for signs of illness) or exhibits maladaptive avoidance (ex, missing doctor’s appointments)
At least 6 months duration
Care seeking type (excessive doctor’s appointments)
Care-avoidant type
What percentage of individuals with hypochondriasis will meet illness anxiety disorder?
25%
Describe the symptoms of conversion disorder
Symptoms or deficits affecting sensory or voluntary motor functions
Leads one to think patient has medical condition but medical examination reveals no physical basis for the symptoms
Freud believed that the symptoms were an expression of repressed sexual energy
Example
Sensory: most often in the visual system (blindness or tunnel vision), in the auditory system (deafness), or in the sensitivity to feeling
Motor: loss of use of limb. Aphonia: talking only in a whisper
Pseudoseizers
Symptoms do not conform clearly to the particular disease or disorder simulated
Selective nature of the dysfunction
Hypnosis or narcosis (sleeplike state induced by drugs) can remove dysfunction
What are pseudoseizures? How would you distinguish this from a seizure
Pseudoseizures: no EEG abnormalities or confusion and loss of memory; excessive thrashing and writhing
What is primary gain?
Escape or avoidance of stress
What is secondary gain
Attention and financial compensation
What is malingering
Motivated by external incentive
Motivated by benefits of “sick role”
Different from somatic symptom disorders such as conversion disorder
Conscious intent can be a key distinction
What is munchausen’s syndrome
By proxy: a caregiver who derives a positive emotion experience when their child is sick, so they in turn make their child sick (gypsy rose)
When someone makes themselves sick with the intent to get concern and care because it feels good
What is derealization
Loss of one’s sense of the reality of the outside world
